Hazardous to your health
What are the risks of smoking?
ATLANTA (CNN) -- Before Dr. Luther L. Terry, then the Surgeon
General of the United States, issued his office's first
"Report on Smoking and Health" more than 30 years ago,
thousands of articles had already been written on the effects
of tobacco use on the human body.
Tobacco companies had countered the reports -- which
purported to show links between smoking and cancer and other
serious diseases -- with denials and competing studies.
So in 1964, Terry and his Advisory Committee on Smoking and
Health knew they were stepping into a major pit of
controversy when they announced "cigarette smoking is a
health hazard of sufficient importance in the United States
to warrant appropriate remedial action."
It was America's first widely publicized acknowledgment that
smoking cigarettes is a cause of serious diseases.
But the issue wasn't settled in 1964, nor is it settled in
1997, despite literally thousands more studies -- and
litigation that has forced at least one tobacco company to
admit what some activists say they knew all along: cigarette
smoke is hazardous to your health.
More than 30 years -- and more than 20 Surgeon General
reports -- later, the issue appears headed for settlement in
the courtroom rather than the laboratory.
So what are the risks? Here's what tobacco's critics say:
The Centers for Disease Control and Prevention says cigarette smoking is responsible for 151,322 cancer deaths annually in the United States. Most of those -- 116,920 -- are from lung cancer. The CDC says men who smoke are 22 times more likely to die from lung cancer than non-smokers. Women who smoke are 12 times more likely to die from the disease.
Statistical studies have long shown that people who don't
smoke live longer than people who do, and scientists have
seen statistically the correlation between smoking and
incidences of lung cancer since the 1950s.
But a study earlier this year by Gerd Pfeifer of the Beckman
Research Institute pinpointed specific carcinogens in
cigarette smoke that target parts of a gene already known to
be prominent in some cancers.
Pfeifer wrote in Science that cigarette smoke causes changes
in the gene p53, which protects against cancer when normal
but promotes cancer growth when mutated.
Another study, published by the American Cancer Society, said
that low-tar cigarettes offered no relief from the potential
of cancer, and in fact were responsible for a type of cancer
that reaches deeper into lung tissue.
Other cancers are also affected by cigarette smoke. An
American Cancer Society researcher reported earlier this year
that smoking increased men's risk of dying of prostate
cancer, while other studies have linked tobacco use to
increased risk of other cancers, including throat, breast and
Smoking also has been linked time and again to cardiovascular diseases. Among these, the biggest killer is heart disease: according to the CDC, smoking triples the risk of dying from heart disease among middle-aged men and women.
Studies also show an increased risk of death from stroke, aneurysms, high blood pressure, and other cardiovascular illnesses.
Smoking is cited as a risk for dying of pneumonia, chronic bronchitis, or emphysema. The CDC says people who smoke increase their risk of death from bronchitis and emphysema by nearly 10 times.
A report recently published in the American Journal of
Epidemiology suggested that smoking increased the risk of
developing non-insulin-dependent diabetes mellitus (NIDDM) by
more than three times.
Studies have pointed to smoking as a risk in vision loss among older people, mental impairment later in life, Alzheimer's disease and other forms of dementia.
Pregnant women who smoke can pass nicotine and carbon monoxide to their baby through the placenta. Research indicates this can prevent the baby from getting the oxygen and nutrients it needs to grow -- potentially leading to fetal injury, premature birth, or low birth weight. According to the American Lung Association, smoking during pregnancy accounts for an estimated 20 to 30 percent of low birthweight babies, up to 14 percent of premature deliveries, and about 10 percent of all infant deaths.
A mother who smokes can also pass nicotine to her baby through her breast milk.
The studies didn't just point to the ill effects of smoking
on those who smoke -- non-smokers, too, are apparently
affected by the smoke from their friends, family members and
strangers who light up in their presence.
A steady stream of reports documented the statistical
risks of contracting cancer or suffering from heart disease,
even if you've never put a cigarette to your lips.
The American Heart Association last fall released a
seven-year study showing that never-smoking spouses of
smokers have more than a 20 percent greater chance of death
from coronary heart disease than those who have never smoked
who live with non-smokers. That study gave more impetus to
the drive to make workplaces and other public areas
The effects of smoking are hard on the children of smokers as
well, the studies say. Dr. Claude Hanet of the St. Luc
University Hospital in Brussels, Belgium, said earlier this
year that a baby born to a smoking mother "should be
considered an ex-smoker."
Hanet's study cautioned that cigarette smoke was more
detrimental with decreasing age.
And a University of Birmingham, England, study, published in
the British Journal of Cancer showed a possible link between
fathers who smoked and an increased incidence of cancers in
their children, while studies in the U.S. showed a possible
link between smoking and DNA damage.
Of all the diseases associated with smoking, addiction is
perhaps the one that receives the least attention. But
President Clinton declared nicotine an addictive drug last
August. In March, the Liggett Group, makers of
Chesterfield and Lark brand cigarettes, admitted that
cigarettes were addictive and cause cancer and agreed to pay about $750 million total to 22 states that had filed suit to force tobacco companies to pay for Medicaid for smoking-related illnesses.
Scott Harshbarger, the Massachusetts attorney general and
president of the National Association of Attorneys General,
told reporters that the Liggett deal "will produce
information that indicates major tobacco companies were
fully aware that the product they were selling is addictive,
that the product they were selling had great impact on public
Other tobacco companies are clearly none too keen on the
Liggett deal. For them, nicotine remains what they call a
harmless flavor enhancement.
Despite the weight of the data about the ills of tobacco
smoke, research also shows some occasional benefit from
smoking. Researchers at the Brookhaven National Laboratory in
Upton, New York, reported that something in cigarette smoke
lowers the levels of an enzyme known as MAO B.
This coincides with an increase in dopamine, known for years
to be the brain chemical responsible for part of nicotine's
Smokers, say the researchers, may have a lower risk of
Parkinson's disease, because the nerve disease is aggravated
by shortages of dopamine.
And while smoking may be a cause of dementia, it also could
be sharpening the mind. University of California-San Diego
researchers presented a study to the Society for Neuroscience
earlier this year showing that smoking cigarettes sharpens
short-term learning and memory among young people.
Researchers in the study, however, cautioned that such
benefits don't outweigh the risks of more serious ailments.
ASHES TO ASHES
According to the CDC, 400,000 Americans die each year because they smoke cigarettes, making it the single most preventable cause of premature death in the United States.
Quitting doesn't necessarily help, according to another
University of Birmingham study -- at least not if the smoker
waits too long. Stroke risk is high for up to 20 years after
a smoker quits, according to that study, published in the
Journal of Epidemiology and Community Health.
The CDC says that on average, if you smoke, you will die seven years earlier than if you don't.