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 has been created in August, 2000, we
will largely be including materials and articles below which are 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. This site is just being created, so
the materials/articles initially will be limited in number, but we will be
adding materials will on a very regular basis. 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): 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. 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. 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. 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. 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
site
Older
Persons
The Center
for Social Gerontology
2307 Shelby Avenue, Ann Arbor, MI 48103 tel: 734
665-1126 fax: 734 665-2071
tcsg@tcsg.org
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. Click above for an abstract of the study.
Cancers other than lung cancer
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.
COPD (Chronic Obstructive Pulmonary Diseases), including asthma, emphysema, and chronic lung diseases
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.
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.
This link is to a special supplement to the CHEST issue of February 1, 2000 titled "COPD: Clearing the Air," which provides access to abstracts of a number of articles devoted to COPD.
Smoking & Pulmonary Diseases, including Asthma, Emphysema and COPD
This link is to a listing of abstracts of articles on smoking and asthma, emphysema and COPD which appeared in CHEST in 1999 through May, 2000.
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 CHEST journal in 1995 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.
Dementia, including Alzheimer's DiseaseSmoking 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.
DiabetesDiabetes and Smoking: Fact Sheet
This Fact Sheet from the American Diabetes Association (ADA) web site provides an overview of the linkages between diabetes and smoking. Once at this portion of the ADA site, you may access much more information about diabetes generally.
The Role of Diabetes in Smoking Cessation among Middle-aged & Older Persons
This June 12, 2000 news release describes a study by Dr. Linda Wray which found that even among long time smokers, a diagnosis of diabetes prompted more than twice as many smokers to quit as smokers who were not faced with the disease. These findings suggest that a health crisis such as diagnosis of diabetes can be a significant catalyst for quitting smoking if health professionals inform the smoker of the linkages between diabetes and smoking.
Eye/Vision Diseases
Smoking Cessation and Risk of Age-Related Cataract in Men
This article in the August 9, 2000 issue of the Journal of the American Medical Association 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.
Heart Diseases
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.
This link to the web site of the American Heart Association provides access to a wide variety of information about heart diseases. Click on their Heart & Stroke A-Z Guide for an easy to use reference guide.
Lung CancerAmerican 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 DiseasesThis article in the August 26, 2000 issue of the British Dental Journal 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.
Smokers & Drinkers Awareness of Oral Cancer
This article in the December 25, 1999 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.
Sexual Health & Function
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.
Stroke
This link to the web site of the American Heart Association (AHA) provides access to a wide variety of information about strokes. Click on their Heart & Stroke A-Z Guide for an easy to use reference guide. There is also a link to the AHA's American Stroke Association site.
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.