Tobacco-Related Health Problems & This site is
intended to provide information on and access to materials concerning
tobacco-related health problems affecting people of all ages, but
particularly as these health problems affect older persons. Since the
health problems causally related to tobacco are so numerous and so
serious, this site will group articles/materials under a number of
categories, including the following: Cancers other than lung cancer; COPD
(Chronic Obstructive Pulmonary Diseases), including asthma, emphysema, and
chronic lung diseases; Dementia; Eye/vision Diseases; Heart diseases; Lung
cancer; Stroke; etc. Also included is an Overview Articles section. Since this portion of this site was created after August, 2000, we
will largely be including materials and articles below which were published
after this date; for references to materials on this subject published
prior to this date, go to the section of this site titled Bibliography of
Tobacco & Older Persons Articles by clicking here. Related information can be found on the following sections of this web site:
Smoking Cessation, Quality of Life & Older Persons; Tobacco & the Elderly
Notes newsletters; and the Smoke-Free Environments Law Project site,
particularly the ETS & Health Effects portion of that site. The following are materials/articles related to this topic (simply click on
the underlined headings to access the full articles/materials): Overview of Tobacco-related Health
The Center for Social Gerontology
2307 Shelby Avenue, Ann Arbor, MI 48103 tel: 734 665-1126 fax: 734 665-2071
This site is intended to provide information on and access to materials concerning tobacco-related health problems affecting people of all ages, but particularly as these health problems affect older persons. Since the health problems causally related to tobacco are so numerous and so serious, this site will group articles/materials under a number of categories, including the following: Cancers other than lung cancer; COPD (Chronic Obstructive Pulmonary Diseases), including asthma, emphysema, and chronic lung diseases; Dementia; Eye/vision Diseases; Heart diseases; Lung cancer; Stroke; etc. Also included is an Overview Articles section.
Since this portion of this site was created after August, 2000, we will largely be including materials and articles below which were published after this date; for references to materials on this subject published prior to this date, go to the section of this site titled Bibliography of Tobacco & Older Persons Articles by clicking here.
Related information can be found on the following sections of this web site: Smoking Cessation, Quality of Life & Older Persons; Tobacco & the Elderly Notes newsletters; and the Smoke-Free Environments Law Project site, particularly the ETS & Health Effects portion of that site.
The following are materials/articles related to this topic (simply click on the underlined headings to access the full articles/materials):
Overview of Tobacco-related Health Problems
Centers for Disease Control web site on Tobacco-related Health Issues
The CDC site has a wealth of information on tobacco-related health issues, including access to reports of the Surgeon General on tobacco topics, as well as fact sheets and recent news.
SURGEON GENERAL RELEASES NEW REPORT ON THE HEALTH CONSEQUENCES OF SMOKING; New Report Expands List of Diseases Caused by Smoking
On May 27, 2004, the Surgeon General released a report titled The Health Consequences of Smoking. A press release stated: U.S. Surgeon General Richard H. Carmona today released a new comprehensive report on smoking and health, revealing for the first time that smoking causes diseases in nearly every organ of the body. Published 40 years after the surgeon general's first report on smoking -- which concluded that smoking was a definite cause of three serious diseases -- this newest report finds that cigarette smoking is conclusively linked to diseases such as leukemia, cataracts, pneumonia and cancers of the cervix, kidney, pancreas and stomach. According to the report, smoking kills an estimated 440,000 Americans each year. On average, men who smoke cut their lives short by 13.2 years, and female smokers lose 14.5 years. The economic toll exceeds $157 billion each year in the United States -- $75 billion in direct medical costs and $82 billion in lost productivity. In 1964, the Surgeon General's report announced medical research showing that smoking was a definite cause of cancers of the lung and larynx (voice box) in men and chronic bronchitis in both men and women. Later reports concluded that smoking causes a number of other diseases such as cancers of the bladder, esophagus, mouth and throat; cardiovascular diseases; and reproductive effects. Today's new report, The Health Consequences of Smoking: A Report of the Surgeon General, expands the list of illness and conditions linked to smoking. The new illnesses and diseases are cataracts, pneumonia, acute myeloid leukemia, abdominal aortic aneurysm, stomach cancer, pancreatic cancer, cervical cancer, kidney cancer, and periodontitis. Statistics indicate that more than 12 million Americans have died from smoking since the 1964 report of the surgeon general, and another 25 million Americans alive today will most likely die of a smoking-related illness. The report concludes that smoking reduces the overall health of smokers, contributing to such conditions as hip fractures, complications from diabetes, increased wound infections following surgery, and a wide range of reproductive complications. For every premature death caused each year by smoking, there are at least 20 smokers living with a serious smoking-related illness. Dr. Carmona said it is never too late to stop smoking. Quitting smoking at age 65 or older reduces by nearly 50 percent a person's risk of dying of a smoking-related disease. In addition to the 960-page printed report, The Health Consequences of Smoking, the U.S. Department of Health and Human Services released a new interactive scientific database of more than 1,600 key articles cited in the report, available through the Internet (www.surgeongeneral.gov). The database can be used to find detailed information on the specific health effects of smoking as well as to develop customized analyses, tables and figures. To access the report, press release, database and related information, click above.
Editorial: New Insights from the British Doctors Study -- Risks for persistent smoking are substantially larger than previously suspected
An editorial in the June 22, 2004 issue of the British Medical Journal by Meir Stampfer, chair of the Department of Epidemiology of the Harvard School of Public Health states: The cause of the sharp increase in lung cancer rates that began early in the last century was not well established until Richard Doll and colleagues presented the initial findings from the British doctors study exactly 50 years ago. That paper and the updates that followed provided irrefutable evidence showing the extraordinarily adverse health consequences of cigarette smoking. The current report represents far more than a celebratory milestone in public health. With the extended follow up of the British doctors cohort, this new report provides critical new information and convincingly shows that the risks for persistent cigarette smoking are actually substantially larger than had previously been suspected. Indeed, this study shows that about half to two thirds of all persistent cigarette smokers will eventually be killed by their habit. This study shows that with successive age cohorts, reflecting earlier ages at initiation, the death rates among persistent smokers climb dramatically. The probability for a 70 year old lifelong non-smoker to reach age 90 increased from 12% in the first decade of the study (to 1961), to 33% in the most recent decade. In contrast, the corresponding likelihood among cigarette smokers actually declined, from 10% in the first decade to 7%. Thus all of the benefits for increased longevity over the past half century are completely abrogated among smokers. The authors estimate that during the 50 year follow up, about 6 million British citizens were killed by tobacco use. For the full editorial, click above. To access the study by Sir Richard Doll and colleagues, see note immediately below.
Cigarettes Cut About 10 Years Off Life, 50-Year Study Shows; British Survey of Smoking Doctors Details Long-Term Risks
A June 23, 2004 Washington Post article states: Fifty years after British researchers published the first study firmly linking cigarette smoking to lung cancer, the same scientist following the same group of subjects has reported the most detailed and long-term results ever of the health effects of smoking. His stark conclusion: A life of cigarette smoking will be, on average, 10 years shorter than a life without it. While the lethal effects of cigarette smoking have long been known, the new study, published on June 22, 2004 in the British Medical Journal, is the first to quantify the damage over the lifetime of a generation. The effects, the researchers reported, were "much larger than had previously been suspected." In the 50-year study of a group of almost 35,000 British doctors who smoked, the pioneering epidemiologist Richard Doll, who is now 91, and his colleagues found that almost half of all persistent cigarette smokers were killed by their habit, and a quarter died before age 70. The study also found, however, that kicking the cigarette habit has equally dramatic effects. He found, for instance, that someone who stops smoking by age 30 has the same average life expectancy as a nonsmoker, and that someone who stops at 50 will lose four, rather than 10, years of life. "What we now know is that consistent cigarette smoking doubles mortality rates in both middle age and old age," said Richard Peto, Doll's 30-year associate in the ongoing study. "But we also know that stopping smoking will significantly limit the harm." The consequence of the tobacco "epidemic" has been to undercut great strides in public health that would otherwise have kept millions more people alive, the researchers said. "Over the past few decades, prevention and better treatment of disease have halved nonsmoker death rates in Britain," said Doll, lead author on both the 1954 and current tobacco studies. "But these improvements have been completely nullified by the rapidly increasing hazards of tobacco for those who continue to smoke cigarettes." Doll began studying smoking among British doctors in 1951, and the research has continued every decade since, with the final study begun in 2001. At that time, almost 6,000 of the doctors first studied in 1951 were still alive. The effects of smoking show up especially starkly after age 60. At 70, the study found, 88 percent of nonsmokers were still alive, compared with 71 percent of smokers. And at age 80, 65 percent of nonsmokers were alive but only 32 percent of smokers were. To look at the data another way, a 70-year-old who never smoked has a 33 percent probability of living to 90. For a 70-year old smoker, the probability of living 20 more years is only 7 percent. For the full news report, click above. To access the full text of the study, click here.
Cigarette Smoking Among Adults -- United States, 2002
This report on smoking rates among adults was released on May 28, 2004 in the Morbidity & Mortality Weekly Report and states: One of the national health objectives for 2010 is to reduce the prevalence of cigarette smoking among adults to <12%. To assess progress toward this objective, CDC analyzed self-reported data from the 2002 National Health Interview Survey (NHIS) sample adult core questionnaire. This report summarizes the results of that analysis, which indicated that, in 2002, approximately 22.5% of adults were current smokers. Although this prevalence is slightly lower than the 22.8% prevalence among U.S. adults in 2001 and substantially lower than the 24.1% prevalence in 1998, the rate of decline has not been at a sufficient pace to achieve the 2010 national health objective. During 1983 to 2002, adults with household incomes below the poverty level and those with less than some college education consistently had higher smoking prevalence.
Cigarette Smoking-Attributable Morbidity by State
National estimates of cigarette smoking-attributable morbidity were published in the September 5, 2003 Morbidity and Mortality Weekly Report (see note immediately below to access the MMWR report). Researchers at the Roswell Park Cancer Institute, who led that publication, are now also releasing preliminary state-specific estimates of cigarette smoking-attributable morbidity. To assess smoking-attributable morbidity, data were analyzed from three data sources: Behavioral Risk Factor Surveillance System (BRFSS), National Health and Nutrition Examination Survey III (NHANES), and the U.S. Census. In 2000 in the United States, an estimated 8.6 million persons had an estimated 12.7 million smoking-attributable diseases. State-specific estimates are also presented in the Table. Data on the distribution of disease type overall and for current and former smokers is presented elsewhere1. The findings indicate that more persons are harmed by tobacco use than is indicated by mortality estimates. For every tobacco-attributable death that occurs, there are approximately 20 people alive who are suffering from a serious, chronic disease that is attributable to cigarette smoking. For the full Roswell Park Cancer Center report, with state tables, click above. To access the MMWR article, click here.
Cigarette Smoking-Attributable Morbidity -- United States, 2000
This report in the Morbibity & Mortality Weekly Report of September 5, 2003 provides the first national estimates of the number of persons with serious chronic illnesses caused by smoking and the total number of their smoking-attributable conditions. The findings indicate that more persons are harmed by tobacco use than is indicated by mortality estimates. Examining trends in tobacco-attributable morbidity provides another way to monitor the progress of tobacco-control efforts. Each year in the United States, approximately 440,000 persons die of a cigarette smoking-attributable illness, resulting in 5.6 million years of potential life lost, $75 billion in direct medical costs, and $82 billion in lost productivity. To assess smoking-attributable morbidity, the Roswell Park Cancer Institute, Research Triangle Institute, and CDC analyzed data from three sources: the Behavioral Risk Factor Surveillance System (BRFSS), the National Health and Nutrition Examination Survey III (NHANES III), and the U.S. Census. This report summarizes the results of that analysis, which indicate that an estimated 8.6 million persons in the United States have serious illnesses attributed to smoking; chronic bronchitis and emphysema account for 59% of all smoking-attributable diseases. These findings underscore the need to expand surveillance of the disease burden caused by smoking and to establish comprehensive tobacco-use prevention and cessation efforts to reduce the adverse health impact of smoking. Data on the number of persons by sex, age group (18-34 years, 35-49 years, 50-64 years, and >65 years), and race (white or other race) for each state and the District of Columbia were obtained from the 2000 U.S. Census. National estimates of the prevalence of current, former, and never smokers were derived from the combined data from the 1999, 2000, and 2001 BRFSS surveys. Click above to access the full report.
Study gives Medicare a better prognosis; Living longer will not necessarily translate into steeper health-care costs, research found
According to a Sept., 2003 news report: More "golden years" do not cost the health-care system more, federal researchers say, calculating that medical costs are about the same for people who are healthy at age 70 and live independently for many more years and those who are sickly and die sooner. The findings have big implications for taxpayers, because they suggest that the outlook for the Medicare program as America's baby boomers grow old might not be as dire as some policymakers feared. Given projections saying the baby-boom generation will bankrupt the Medicare trust fund in about 25 years, politicians and economists have wondered whether the increasing longevity of healthier senior citizens would increase or reduce Medicare spending. Neither, say National Center for Health Statistics researchers. They found medical expenses from age 70 until death averaged $140,700, with little difference between active, long-lived senior citizens and disabled ones, except for those already in a nursing home. "Improving health should be the overall goal of our health-care policy, but it's not going to save the Medicare system," said Jim Lubitz, acting chief of the Aging Studies Branch in the statistics center's Office of Analysis, Epidemiology and Health Promotion. Sandra Decker, a researcher at the International Longevity Center-USA, said Medicare costs would rise because of the sheer number of beneficiaries, not their longer life span. "It means, yes, we'll spend more on Medicare, but maybe not as much more as we thought," she said. Uwe Reinhardt, a professor and health economist at Princeton University, said 70-year-olds today had far fewer disabilities than their counterparts a couple of decades ago, when economist Victor R. Fuchs first reported that longevity did not affect health-care spending much. Reinhardt said the new study provided updated numbers on those costs. The study is reported in the September 11, 2003 New England Journal of Medicine. Click above to access the full text of the study. You will need to be a registered user or an activated subscriber to NEJM. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Costs of Smoking to the Medicare Program in 1993, Updated to 1997
This study -- published in the Summer 1999 issue of Health Care Financing Review -- provides state-specific data on smoking-caused Medicare expenditures for 1993, as well as national totals, and updates its national totals to 1997 (based on nationwide changes in total Medicare, Medicaid, and personal healthcare expenditures). The study finds that total smoking-caused health expenditures were $89.17 billion in 1997 (up from $72.73 billion in 1993), with Medicare expenditures totaling $20.48 (up from $14.18 billion) and Medicaid totaling $16.95 billion (up from $12.89 billion). [The Campaign for Tobacco-Free Kids suggests that the study's 1993 estimates for smoking-caused expenditures in each state could be roughly but reasonably updated to 1997 by multiplying the 1993 numbers by the increase found in the study for the nationwide increase in smoking-caused Medicare expenditures from 1993 to 1997: 44% (i.e., multiply the 1993 estimate by 1.44 to get a 1997 estimate). If you want to update the 1997 estimates to today, you could multiply them by the increase in the Consumer Price Index for Medical Care from December 1997 to February 2004, which is 30.4% (i.e., multiply your 1997 estimate by 1.3). For the CPI data, click here. Using this formula suggests that smoking-caused Medicare costs currently amount to about $26 billion per year.] To access the study, in pdf format, click above.
Statistics Canada report finds Smokers not only die sooner, they suffer chronic disabilities longer than non-smokers
A report released on June 22, 2001 by Statistics Canada provides excellent data on the effects of smoking on both death rates and rates of chronic disability. The report provides data showing the dramatic differences in both life span and years without chronic disability for non-smokers versus smokers. Click above for "The Daily," the Statistics Canada's official bulletin on this report. Click here for a news article on the report.
CDC: Series of Reports Monitoring Health of Older Americans
This CDC site has a series of reports to focus attention on some of the most important health issues facing today's generation of older Americans. Aging Trends, produced with support from the National institute on Aging, uses data from a variety of sources to help monitor the health and well-being of older persons. The first four reports in this series include: Trends in Causes of Death Among the Elderly; Trends in Vision and Hearing Among Older Americans; The Oral Health of Older Americans; and The Changing Profile of Nursing Home Residents: 1985-1997. Additional reports will be added to this series over time. Click the main link above to access the "Healthy Aging" section of the CDC website.
Nicotine Addiction in Britain: A Report of the Tobacco Advisory Group of the Royal College of Physicians
This comprehensive and important report addresses the fundamental role of nicotine addiction in smoking and provides a wealth of information about health issues related to smoking. It is now recognized that nicotine addiction is one of the major reasons why people continue to smoke cigarettes, and that cigarettes are in reality extremely effective and closely controlled nicotine delivery devices. Recognition of this central role of nicotine addiction is important because it has major implications for the way that smoking is managed by doctors and other health professionals, and for the way in which harmful nicotine delivery products such as cigarettes should be regulated and controlled in society. At a time when smoking still causes one in every five deaths in Britain, measures designed to achieve further reductions in smoking are clearly important and, if successful, will realize substantial public health benefits.
Smoking & Health: A Statement on Physician Responsibility
This 1995 statement by the Joint Committee on Smoking & Health representing various medical society organizations from throughout the world was intended to set forth the physician's responsibilities to patients and the community with regard to smoking and health. The statement includes data, as of 1995, on a number of smoking and health topics. The statement was published in CHEST Journal , volume 108, pages 1118-21 in 1995.To access the statment in pdf format, please click the main title link above.
Link to TCSG's Tobacco & the Elderly Notes newsletters
The Tobacco & the Elderly Notes newsletters contain a wide variety of easy-to-read articles on the effects of tobacco and secondhand smoke on older persons. Many of these articles are also footnoted to the journal articles and other sources on which they are based. Further, the Fall/Winter, 1998 issue contains fact sheets on tobacco and older persons and minorities.
Health Hazards of Secondhand Smoke in the Workplace
This August 9, 2000 study in the Journal of the American Medical Association (JAMA) titled "Environmental Tobacco Smoke Exposure Among Police Officers in Hong Kong" provides strong new evidence of the dangers of secondhand smoke to workers on their job. The study surveyed almost 4,500 male and over 700 female police officers in Hong Kong who were never smokers; it found that 80% were exposed to secondhand smoke in the workplace, and that significant associations existed between this exposure and respiratory problems in both men and women. The study states that the findings demonstrate a clear need for bans on smoking in the workplace. To access the full text of the study, click the main link above.You will need to be a registered user or an activated subscriber to JAMA. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Health Effects of Exposure to Secondhand Smoke
This is the final report by the California Environmental Protection Agency, adopted on June 19, 1997, titled "Health Effects of Exposure to ETS." This report, is one of the most comprehensive reports yet compiled and identifies the many health dangers of secondhand smoke. The full 430 page report is available online by clicking above.
Secondhand Smoke & Health: Link to Smoke-Free Environments Law Project siteArthritis
Arthritis Strongly Associated with Heavy Smoking
According to a study in the March, 2001 issue of the Annals of the Rheumatic Diseases , heavy cigarette smoking is strongly associated with rheumatoid arthritis, although the association was less strong for lighter smokers and those who had smoked at some time in the past. An increasing association between pack years smoked and rheumatoid arthritis was found. The association between heavy smoking and rheumatoid arthritis was markedly more prevalent in patients without a family history of rheumatoid arthritis, according to this study. To access the full text of the study, click the main link above.You will need to be a registered user or an activated subscriber to ARD Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Cancers other than lung cancer
Cancer Statistics 2006
Click the main title link above to access the 2006 American Cancer Society U.S. Cancer Statistics. The statistics include updated information by age, sex, race and ethnicity, environmental factors, etc. There is also a "Tobacco Use" section on p. 36 that describes the health consequences of smoking, annual number of deaths to cancer due to tobacco use, trends in smoking, smoking cessation, second-hand smoke exposure, and more. Click here to access the report from the American Cancer Society.
American Cancer Society site
This link to the site of the American Cancer Society provides information specifically about cancer and its relationship to tobacco use. The site provides fact sheets and links to a wide variety of information about various cancer diseases caused by tobacco use.
Cancer Statistics, 2000
This document provides the year 2000 annual compilation of estimated cancer incidence, mortality, and survival data for the U.S., based on the Surveillance Research Program of the American Cancer Society's Department of Epidemiology and Surveillance Research reports. Click the main like above to access the pdf version of the report originally published in the CA: A Cancer Journal for Clinicians , Vol 50, Issue 1, p. 7-33.
Cancer Statistics by Race and Ethnicity
This document provides detailed information about cancer incidence, mortality and survival based on race and ethnicity. The article provides brief synopses and links to extensive tables and charts. Smoking, among other risk factors for cancer, is addressed.Click the main like above to access the pdf version of the report originally published in the CA: A Cancer Journal for Clinicians, Vol 48, Issue 1 31-48.
COPD (Chronic Obstructive Pulmonary Diseases), including asthma, emphysema, and chronic lung diseases
Asthma and Tobacco Smoke: The Relationship
This link to the Action on Smoking & Health (ASH) of Great Britain site provides an analysis of the complex inter-relationship of tobacco smoke to asthma. The information was compiled in November, 2001 and includes data on asthma in persons of all ages. ASH concludes that, while the relationship of asthma and tobacco smoke is complex, the evidence that asthma in non-smokers is aggravated or can be caused by tobacco smoke, particularly in children, shows that exposure to tobacco smoke remains a major risk factor.
Article in Chest concludes that adults exposed to secondhand smoke in their workplace have higher rates of chronic bronchitis and asthma
This document originally published in Chest Journal , Vol. 122, p. 1086-1090 in September, 2002 states the following: The effects of passive smoke exposure on respiratory health are still under debate. Therefore, we examined the risk of respiratory symptoms related to passive smoke exposure among German adults within the European Community Respiratory Health Survey. The questionnaire data of the population-based sample in which 1,800 persons were analyzed. The relative odds for chronic bronchitis were significantly higher in subjects reporting involuntary tobacco smoke exposure in the workplace. Conclusion: The control of passive smoke exposure in the workplace might reduce the risk of respiratory symptoms independently of exposure to other airborne contaminants. Click above to access a pdf copy of the study.
Asthmatics at higher risk of lung cancer
This link to a January 2, 2002 BBC News report titled "Asthmatics at higher risk of lung cancer," discusses a Swedish study which looked at over 100,000 patients over a 30 year period. The research followed persons after they had been diagnosed with asthma. The researchers found that asthmatics were affected by lung cancer more frequently than the general population; the cancers registered over the course of the study exceeded the anticipated level by 58%, with women at even higher risk. The excess risk of cancer in women with asthma was 78%, and in men it was 51%. Scientists say smoking could be a factor in the link between asthma and lung cancer. The results of the study were published in the European Respiratory Journal. Click above for the BBC News report.
Obstructive Lung Disease & Low Lung Function in U.S. Adults
This June 12, 2000 article in the Archives of Internal Medicine uses data from the 1988-94 National Health & Nutrition Examinations Survey and states that OLDs diseases are the fourth most common cause of death in the U.S. and accounted for more than 109,000 deaths in 1997; it also says that OLDs is the only major disease among the top five causes of death that is rising in prevalence and mortality. An estimated 16 million people in the U.S. have chronic bronchitis and emphysema or COPD. The study showed that when persons with mild to moderate OLDs quit smoking, their lung function declined only slightly over the next five years; in contrast, similar patients who continued to smoke had rapid rates of decline in ling function. To access the full text of the study, click the main link above. You will need to be a registered user or an activated subscriber to Archives of Internal Medicine. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Smoking & Lung Function in Elderly Men & Women
The June 23, 1993 issue of the Journal of the American Medical Association (JAMA) has an article titled Smoking and Lung Function in Elderly Men and Women, by Higgins, et al, which concludes by stating that "cigarette smoking is associated with reduced pulmonary function in elderly men and women. However, smokers who quit, even after age 60 years, have better pulmonary function than continuing smokers." The article also states that reduced lung function was directly related to pack-years of cigarette use, with the greater the number of pack-years, the greater reduction in lung function. This article is not available online, but is an excellent reference source.
COPD: Clearing the Air
This link is to a special supplement to the CHEST Journal issue of February 1, 2000 titled "COPD: Clearing the Air," which provides access to abstracts of a number of articles devoted to COPD.
What is Emphysema and What is its relationship to Tobacco?
This site, prepared by Dr. Frederic Grannis, Jr., provides a brief description of emphysema and points out that at least 75% of all emphysema cases occur in cigarette smokers.
American Lung Association site
This link to the web site of the American Lung Association provides information on asthma, including its relationship to tobacco. The site includes fact sheets and a wide variety of information about asthma, including about asthma and older persons.
Assessment of Asthma in the Workplace
This article, titled Assessment of Asthma in the Workplace, appeared in the October CHEST Journal in 1995, Vol. 108, p. 1084-1117 and provided a state-of-the-art approach to the assessment and management of asthma in the workplace. While it does not focus extensively on secondhand smoke issues related to asthma in the workplace, it does have value for persons dealing with smoking, asthma and the workplace. Click above to access the pdf document.Cystic Fibrosis
Smoking and Cystic Fibrosis
This article published in the Journal of the Royal Society of Medicine in Supplement No. 40, Vol. 94 in 2001 discusses the literature about active and passive smoking and how it relates to cystic fibrosis. The paper also includes a survey about smoking prevelence in CF patients and their families. To access a pdf copy of the study, click the above link.Dementia, including Alzheimer's Disease
Cardiovascular Health Study and the effects of secondhand smoke on dementia
Click the main title link above to access the abstract from the American Academy of Neurology's Cardiovascular Health Study. The study, presented at the AAN's 59th annual meeting in April and May of 2007, attempted to determine if there is a link between secondhand smoke exposure and early-onset dementia. It found conclusively that exposure to SHS does increase this risk. To view the press release dated May 1, 2007 from the American Academy of Neurology about the conclusions of the study, please click here. To access a news article by News-Medical.net on the study, click here.
Smoking linked to accelerated cognitive decline in the elderly
Contrary to early case-control studies that suggested smoking protects against Alzheimer disease (AD), recent prospective studies have shown that elderly who smoke may be at increased risk for dementia. Smoking speeds up cognitive decline in the elderly, according to a large, multi-center study published in the March 23, 2004 issue of Neurology, the scientific journal of the American Academy of Neurology. The rate of decline was found to be an average of five times higher per year in current smokers than those who never smoked. Researchers in several European countries studied smoking habits and the change in cognitive function in a group of 9,209 non-demented men and women aged 65 and older over an average of 2.3 years. Cognitive function was screened with a series of questions and tests called the Mini-Mental State Examination (MMSE). Among those who never smoked (41 percent), the MMSE score declined .03 points per year. The score for current smokers (22 percent) declined .16 points per year, about five times more. Former smokers (37 percent) dropped .06 points per year. "On the individual level, a small difference in MMSE score has little meaning," said study author Alewijn Ott, MD, of Erasmus Medical Center in Rotterdam, the Netherlands. "On the group level, rates of change are more informative and show that smoking has an impact on cognitive function in the elderly." Greater cognitive decline occurred with higher cigarette pack-year exposure, a calculation involving the number of years someone has smoked and the reported average daily number of cigarettes. This was significant mainly for the former smokers and not the current smokers, perhaps due to lower numbers of current smokers in the study and greater measurement error in this group, Ott noted. To access a press release on the study, click here. To access the abstract to the study, click above.
Smoking and Dementia in Male British Doctors: Prospective Study
This article, in the August 5, 2000 British Journal of Medicine (BMJ) assessed the possible association between smoking and all types of dementia, including Alzheimer's. As the article states, there have been a few small studies which had indicated that it was possible that smoking might be associated with a decreased likelihood of dementia occurring; this finding would be one of the very rare cases in which smokers would seem to benefit from smoking, at least in terms of not getting some form of dementia (the studies had pointed out that, even if the person avoided dementia, they would still be more likely to suffer from other tobacco-related diseases than non-smokers or persons who quit smoking). This very comprehensive study, of over 34,000 male British doctors followed up on since 1951, found, contrary to the earlier, less reliable studies, that smoking does not substantially reduce the onset of Alzheimer's or of dementia in general; if anything, the authors reported, smoking might increase the rate of dementia onset. Thus, the findings of this study suggest that the onset of dementia is not forestalled if one is a smoker.Diabetes
Diabetes and Smoking
This section of the American Diabetes Association (ADA) website provides an overview of the linkages between diabetes and smoking. Once at this portion of the ADA site, you may wish to access much more information about diabetes generally.
Tobacco and diabetes
This section of the World Health Organization (WHO) website discusses the different kinds of diabetes and how tobacco usage exacerbates the diabetes symptoms. Once at this portion of the WHO site, you may access information about their diabetes program.
Smoking as a Modifiable Risk Factor for Type 2 Diabetes in Middle-Aged Men
This 2001 study published by Diabetes Care , Vol. 24, p. 1590-1595 by S. Goya Wannamethee, Ph.D, et. al found that cigarette-smoking significantly increases the risk of diabetes, even after adjusting for age. To access the study in pdf version, please click the main title link above.
Smoking and Age Related Macular Degeneration
Click the main title link above in order to access the abstract by the British Journal of Ophthalmology from January, 2006, Vol. 90, p. 78-80. The study focused on the link previously established between age related macular degeneration (AMD) and smoking, and it attempted to further the evidence. They found a strong association between years of cigarette smoking and the development of GA (geographic atrophy) and CNV (choroidal neovascularisation), both factors in AMD. The findings led the researchers to conclude a causal relationship between the two. To access the full text of the study, click here. You will need to be a registered user or an activated subscriber to BJO Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Smokers' Blindness Risk 'Doubled'
This article from the BBC on September 6, 2005 states that according to recent research, smokers are twice as likely to develop blindness in later life than non-smokers. It is estimated that there were 54,000 people living in the U.K. with smoking-related macular degeneration. To access the article, click the main title link above.
Editorial: Smoking and blindness -- Strong evidence for the link, but public awareness lags
The following is from an editorial in the March, 2004 British Medical Journal: While most people and many patients attending eye clinics recognise many adverse health hazards of tobacco smoking, they remain largely unaware of its link with blindness. Although smoking is associated with several eye diseases, including nuclear cataract and thyroid eye disease, the most common cause of smoking related blindness is age related macular degeneration, which results in severe irreversible loss of central vision. Current treatment options are of only partial benefit to selected patients. Identifying modifiable risk factors to inform efforts for prevention is a priority. A risk factor is generally judged to be a cause of disease if certain causality criteria are fulfilled. Applying commonly used criteria to available evidence provides strong evidence of a causal link between tobacco smoking and age related macular degeneration. ... Tobacco smoking is the prime modifiable risk factor for age related macular degeneration. Evidence indicates that more than a quarter of all cases of age related macular degeneration with blindness or visual impairment are attributable to current or past exposure to smoking. For the full editorial, with citations, click above.
Ten-Year Incidence of Age-related Maculopathy and Smoking and Drinking: The Beaver Dam Eye Study
This abstract from an article in the October 1, 2002 issue of the American Journal of Epidemiology by Ronald Klein, Barbara E. K. Klein, Sandra C. Tomany and Scot E. Moss of the Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, examined associations between smoking and alcohol consumption and the long-term incidence of age-related maculopathy (ARM) in people in the Beaver Dam Eye Study who were aged 43-86 years in 1988-1990 and examined over a 10-year period. After controlling for age, sex, and other factors, the authors found that people who had smoked more were more likely to develop large soft drusen per 10 pack-years smoked and pigmentary and to have progression of early ARM than people who had smoked less. Smoking was not associated with the incidence of late ARM. People who reported being heavy drinkers at baseline were more likely to develop late ARM than people who reported never having been heavy drinkers. Smoking appears to have a modest, positive association with early but not late signs of ARM, and heavy drinking appears to be related to an increased risk of late ARM, although the exposure and outcome were infrequent, and the effect is based on few exposed cases. Click above to access the abstract and click here for the full text of the study. You will need to be a registered user or an activated subscriber to AJE Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Risk Factors for Age-Related Maculopathy
This abstract describes research from the Archives of Ophthalmology in October, 2001, volume 119, pages 1455 to 1462. Age-related macular degeneration is a progressive disease that affects the central part of the retina, resulting in a gradual loss of clear central vision including that needed to perform many daily tasks such as driving. The condition is the most common cause of vision loss among older people in most developed nations of the world. Current treatment for the disease involves laser surgery and is only partially successful and then only in patients with an early stage of the disease. Researchers are therefore looking for ways to prevent the condition from developing in the first place. This study involved more than 4,000 people ages 40 and over. Researchers looked at a wide range of possible risk factors. Results showed a significant link between the eye disease and three factors: Age, smoking for longer than 40 years, and having ever taken cholesterol-lowering medications. The investigators concluded that the only good way for people to reduce their risk of developing age-related macular degeneration is to stop smoking or never start. Click above to access the abstract and click here for the full text of the study. You will need to be a registered user or an activated subscriber to AO Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Risk factors associated with age-related macular degeneration: Smoking a significant risk factor
This abstract for an article titled "Risk factors associated with age-related macular degeneration" in the Journal of the American Academy of Ophthalmology in 2000, volume107 at pages 2224 to 2232 sought to investigate possible risk factors for age-related macular degeneration (AMD). The authors concluded that "our findings for smoking and hypertension, which have been noted in previous studies, suggest that two important public health recommendations, the avoidance of smoking and the prevention of hypertension, may reduce the risk of developing AMD." Click above to access the abstract and click here for the full text of the study. You will need to be a registered user or an activated subscriber to JAAO Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Smoking Cessation and Risk of Age-Related Cataract in Men
This abstract to an article in the August 9, 2000 issue of the Journal of the American Medical Association (JAMA) states that smoking has been shown to be a risk factor for the development of age-related cataract and concludes that, while some smoking-related damage to the eye lens may be reversible, smoking cessation reduces the risk of cataract primarily by limiting the total dose-related damage to the lens. The study found that men who had quit smoking had a 23% reduced risk of cataract diagnosis and a 28% reduced risk for cataract extraction (a surgical treatment) compared to men who currently smoked. The authors found that even the most heavily exposed men benefited from smoking cessation, at any age. Click above to access the abstract and click here for the full text of the study. You will need to be a registered user or an activated subscriber to JAMA Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
Cigarette Smoking and Cardiovascular Diseases
This is a link to the American Heart Association's website page regarding cigarette smoking and how it is related to cardiovascular disease. The information on the page includes how smoking affects coronary heart disease, how smoking is related to stroke and peripheral arterial disease, risk factors of passive and secondhand smoke, and much more. Click the main title link above to access the AHA site.
Fact Sheet: Tobacco, Heart Disease and Stroke
This document prepared by the World Heart Federation discusses tobacco use and the risk factors for heart disease and stroke. It includes information about the prevelence of smokers with cardiovascular disease, the dangers of passive smoke, and more. Click the main title link above to access the pdf document. To access the World Heart Federation website, please click here.
Environmental Tobacco Smoke Exposure and Ischaemic Heart Disease
This study from the British Medical Journal (BMJ) on October 18, 1997 discusses the link between tobacco smoke exposure and the development of ischaemic heart disease. The study concludes that "[B]reathing other people’s smoke is an important and avoidable cause of ischaemic heart disease, increasing a person’s risk by a quarter." To access the full text of the study, please click the main title link above.
Tobacco Use and Heart Disease Fact Sheet
This is a fact sheet prepared by the American Dental Hygienists' Association about tobacco use and heart disease. It includes "key heart disease and heart disease statistics" as well as links to related sites and information. Click the above link to access the ADHA fact sheet.
More Women, Elderly Falling Prey to Heart Attacks; Smoking Key Cause
This is a link to a March 8, 2002 news story concerning a new Mayo Clinic study, published in the Annals of Internal Medicine the week of March 8th, which found that: "Prevention programs targeted at middle-aged men have succeeded in cutting the number of heart attacks among men. However, such programs are now needed for women and the elderly, who are suffering increased rates of heart attacks." The study looked at people in Olmsted County, Minn., who'd been hospitalized for 1,820 heart attacks between 1979 and 1994. It found that heart-attack rates for men in the county dropped by 8 percent during that time, but heart attacks for women increased by 36 percent. Further underscoring the gender/age divide, heart attacks among 40-year-old-men declined 31 percent, but were up 49 percent among 80-year-old women. Authors of the study say it suggests that different factors may be contributing to the higher rate of heart attacks among women and older people. One is the increase in the number of women who smoke cigarettes. An estimated 22 percent of U.S. women are smokers, according to the American Lung Association. Also, as more women enter the workforce, they have less time to devote to exercise and other healthy lifestyle choices. Click above to access the abstract and click here for the full text of the study.
Effects of Smoking on Heart Disease
This link is to an abstract of a September, 2000 article titled "Coronary Heart Disease in Smokers," by Kaufmann, et al, published in Circulation, the journal of the American Heart Association. This is the first study to demonstrate that the harmful effects of smoking extend beyond the heartÕs large arteries into the network of tiny blood vessels that supply blood to most of the heart muscle.
Heart Disease and Secondhand Smoke
This is a link to the abstract for a seminal, 1991 article by Glantz and Parmley titled Passive Smoking and Heart Disease - Epidemiology, Physiology and Biochemistry. In this study, the authors estimated, based on a review of ten epidemiological studies, that there are ten times as many deaths due to secondhand smoke-induced heart disease as lung cancer deaths due to seondhand smoke-induced diseases, and that these deaths contribute to the estimated 53,000 death annually in the U.S. due to secondhand smoke.
Cancer Statistics 2006
Click the main title link above to access the 2006 American Cancer Society U.S. Cancer Statistics. The statistics include updated information by age, sex, race and ethnicity, environmental factors, etc. There is also a breakdown by cancer type with specific information regarding Lung Cancer. The report also includes a "Tobacco Use" section on p. 36 that describes the health consequences of smoking, annual number of deaths to cancer due to tobacco use, trends in smoking, smoking cessation, second-hand smoke exposure, and more. Click here to access the report from the American Cancer Society.
Tobacco News: Lung Cancer
This is the link to the Lung Cancer news section of the Tobacco.org, Tobacco News and Information website. The page is updated almost daily with information relating to lung cancer from newspapers, blogs, magazines, scientific journals, and more. There is also a "search" feature to enable the viewer to find specific articles or topics more easily. To access this site, click the main title link above.
Lung Cancer Affects Sexes Differently
The New York Times on April 14, 2004 reported as follows: Women with lung cancer survive slightly longer than men with the disease, respond differently to at least one cancer drug and show higher levels of tobacco-induced genetic damage in their lungs, researchers are reporting today. Some differences may stem from the effects of estrogen, whether naturally occurring or taken as a drug, and the scientists said more women should be included in studies of lung cancer to find out whether particular methods of treatment, prevention and detection are best suited to them. The researchers also said that clarifying differences in the disease between men and women might yield information that would ultimately help both sexes. "It may help us unlock some secret about how lung cancer behaves," said Dr. Peter B. Bach, a pulmonologist and an epidemiologist at the Memorial Sloan-Kettering Cancer Center in Manhattan who is an author of the report. The other authors are Dr. Mark G. Kris, also of Sloan-Kettering, and Dr. Jyoti D. Patel of Northwestern University. Their report reflects a growing medical interest in understanding differences in the way major diseases affect men and women. Researchers have recognized, for instance, that women who have heart attacks may not suffer the crushing pain that men experience and that women are more prone than men to autoimmune diseases like lupus and multiple sclerosis. The article by Dr. Bach and his colleagues, published in the April 14, 2004 issue of The Journal of the American Medical Association, calls lung cancer "a contemporary epidemic" in women. Most cases, up to 80 percent in women, are from smoking. Last year, 80,100 new cases were diagnosed in American women, and 68,800 women died from the disease. The report notes that although women's death rates from lung cancer have stabilized in the last five years, they may start increasing again as groups of women with the highest rates of smoking reach the age when cancers begin to develop. Lung cancer is among the deadliest cancers, because it often starts spreading before being detected. Among cases diagnosed from 1992 to 1999, only 12 percent of patients over all survived five years, 10 percent of the men and 14 percent of the women. "It's dismal, and it hasn't improved much," Dr. Bach said. The disease kills more women in the United States than any other cancer, as many as breast cancer and all gynecological cancers combined. Lung cancer passed breast cancer in 1987 as the leading cause of cancer deaths in women. From 1930 to 1997, as more and more women took up smoking, their death rate from lung cancer rose 600 percent. Although smoking has been known for decades to cause most lung cancers, a quarter of adult women in the United States smoke. In 2000, 30 percent of high school girls surveyed said they had smoked in the last 30 days. Since the 1960's, smoking rates for American men have decreased nearly 50 percent. For women, the decrease is 25 percent. Click above for the study abstract. To access the full text of the study, click here. You will need to be a registered user or an activated subscriber of JAMA Online. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.
American Lung Association site
This link to the web site of the American Lung Association provides information specifically on the relationship of tobacco to lung cancer and other tobacco-related respiratory diseases. The site includes fact sheets and a wide variety of information documenting that about 90% of lung cancer cases are tobacco-caused.Oral Diseases
The American Academy of Periodontology: Tobacco Use and Periodontal Disease
The American Academy of Periodontoloogy has a page on their website relating to tobacco use and the development of periodontal disease. The page includes topics such as understanding the danger of tobacco, saving your smile, and other information. Click the main title link above to access this page. The website also explains periodontal disease in depth on another page, and it includes tobacco as a risk factor. There are links to several press releases and studies about tobacco use and the development of periodontal disease. Click here to access the page.
WHO: Tobacco & Oral Disease
The World Health Orgainzation (WHO) has in conjunction with the WHO Collaborating Centre of Malmö University, Sweden, created an educational website relating to tobacco and the development of oral disease. The page includes a variety of information including basic disease information, statistics for tobacco use by country, a pdf document from the Global Framework Convention on Tobacco Control, and a pdf document on "Global Facts on Tobacco or Oral Health." Some information comes from the EU Working Group on Tobacco and Oral Health Meeting Report. To access the page, please click the main title link above.
The Impact of Tobacco Use on Oral Diseases
Action on Smoking & Health (ASH) of Great Britain has produced an overview of the health impact of tobacco use on oral diseases. This is a very useful site, but be warned, the site includes some fairly gruesome pictures of oral diseases caused by tobacco use.
Tobacco and Oral Disease
This article in the August 26, 2000 issue of the British Dental Journal, Vol. 189, No. 4, p. 200-206, was produced by the European Union Working Group on tobacco and Oral Health. The report provides a brief, but thorough, review of the many and various harmful effects of tobacco on oral health. The report states that there is overwhelming evidence that tobacco usage is harmful and increases risks of oral cancer, periodontal diseases and other deleterious oral conditions, and it adversely affects the outcome of oral care. The report also has a very useful list of footnotes of related journal articles.To access a copy of the abstract, please click the main title link above. To access the full text of the study including a table of contents, please click here.
Smokers & Drinkers Awareness of Oral Cancer
This study in the December 25, 1999, Vol. 187 issue of the British Dental Journal provides the results of a focus group study which examined the perceptions and understanding of oral cancer among older (over 44 years of age) male smokers and drinkers in England. The study noted that, in spite of the link between oral cancer and smoking, there is a very low perception of these risks, including among those persons with direct contact with the disease. The study underscores the need for increased preventive health activities by dentists regarding smoking by their patients. To access the full text of the study, please click the main title link above.
Sexual Health & Function
Smoking and Male Sexual Problems
This page is part of the Action on Smoking and Health (ASH) website. The page specifically relates to tobacco use and the onset of a variety of sexual problems. The article gives information about the mechanisms of Penile Erectile Dysfunction, evidence of the relationship, views of speicalists, and what can be done to treat the problem. To access the page, please click the mian title link above.
Impotence in Older Men due to Smoking &/or Secondhand Smoke
A study released on October 28, 2000 by statistician Henry Feldman of the New England Research Institutes in Watertown, Massachusetts reported on impotence among men who were studied when they were 40 to 70 years old and who are now 50 to 80 years old. The researchers said that long-term studies of aging have found an estimated 10% of men between 40 and 70 are completely impotent, and aging is still the biggest single cause of impotence. However, the researchers found that, of the 513 men followed for 10 years, moderate or complete impotence was found in 26% of nonsmokers who were exposed to secondhand smoke both at home and in the workplace. Nonsmokers who reported no exposure to secondhand smoke had an impotence rate of 14%. For cigarette smokers, the rate of impotence was 24%, and cigar smoker had a 30% impotence rate. The highest rate of impotence, at 33%, was among smokers who were exposed to secondhand both at home and in the workplace. There seems to be a message here for old and young men.
Cigarette Smoking & Sexual Health
This article from the American Council on Science and Health concisely discusses the varied health consequences of smoking on sexual health and function. It points out that this aspect of the effects of smoking are often unknown to most people, but that smoking has potential effects on both reproductive processes and human sexual behavior. The article discusses the relation of smoking to: fertility in women; miscarriages/spontaneous abortion; fertility in men; erectile dysfunction; and, frequency of sex and sexual satisfaction.
Fact Sheet: Tobacco, Heart Disease and Stroke
This document prepared by the World Heart Federation discusses tobacco use and the risk factors for heart disease and stroke. It includes information about the prevelence of smokers with cardiovascular disease, the dangers of passive smoke, and more. Click the main title link above to access the pdf document. To access the World Heart Federation website, please click here.
Primary Prevention of Stroke: American Heart Asso. Scientific Statement
This AHA Scientific Statement, published in January, 2001 in the journal Circulation, provides a concise overview of the evidence regarding various established and potential stroke risk factors. Among the "established and well documented" risk factors for stroke is smoking. This scientific statement delineates the risks of stroke faced by smokers versus former and nonsmokers; it also discusses the reduction of stroke risk for smokers who quit, showing that the risk is reduced by 50% within 1 year of quitting, and that the effects of smoking are virtually eliminated after 5 years of not smoking. This document also discusses other health risk factors associated with stroke.