Smoking and Quitting Smoking (cont.)
What is in the future for smoking?
Health care workers have become extremely active in publicizing the negative
effects of smoking. In fact, health care workers have been instrumental in passing various legislation to limit smoking in public; as a result, the
proportion of people in the US who smoke has dropped from 40.4% in 1965 to 22.5%
in 2002 (data from the US Department of Health).
This reduction in the percent
of people who smoke, however, has been significantly less in women than in men.
That is, from 1965 to 2002, smoking among men dropped from 50.2% to 25.2% while
during the same period, smoking among women dropped from 31.9% to 20.0%. So, in
the future, efforts need to be made to understand and eliminate this difference
between the genders. Moreover, with the passage of even stricter legislation,
the percent of people who smoke should (hopefully) fall to single digits by the
year 2010.
One interesting area of the current research on smoking
is the study of the population distribution of the genes for smoking (genetic
epidemiology).
(Genes determine an individual's inherited characteristics.) Only a small
fraction of individuals who start smoking as an adolescent will actually become
nicotine dependent. So, what determines which individuals will become
nicotine-dependent? Investigators have found that smoking initiation (the
obligatory first step) and the development of nicotine dependence are both
influenced by genetic factors. The genetic factors appear to play a larger role
in nicotine dependence than in smoking initiation. The next step will be to
identify these genes and learn how they work in order to facilitate the
development of effective prevention and treatment strategies for tobacco
addiction.
Teen smoking rates remain of concern; in 2003, approximately 22% of
high school students were smokers. According to the American Cancer Society, the
majority of cigarette use begins before a person reaches 18 years of age. Those
who do not begin smoking by age 18 generally do not start to smoke later in
life. Education of the at-risk teen population is therefore critical for
prevention of tobacco use. Various celebrities and activist groups actively
promote campaigns aimed at a teen audience that educate about the consequences
of smoking and offer advice on smoking cessation and prevention. While teen
smoking rates increased during the 1990s (36% of teens smoked in 1997),
prevention and education campaigns have brought about a decrease in teen smoking
in recent years.
- Although smoking is an addiction, people can quit
smoking.
- Secondhand smoke is harmful to the health of
children, family members, and coworkers
- Quitting smoking cuts the risk of lung cancer, heart
disease, stroke, and respiratory diseases The steps in quitting, each of which
requires special attention and efforts by the smoker, are getting ready to
quit, quitting, and staying quit
- A number of techniques are available to assist people
who want to quit, including nicotine replacement therapy (NRT), behavioral
modification, and self-help literature
- In nicotine replacement therapy, which is the
cornerstone of most smoking cessation programs, another source of nicotine is
substituted while the cigarettes are stopped (The idea of nicotine replacement
therapy is to eliminate
both the smoking habit - although the addiction remains - and the symptoms of
withdrawal. Then, the replacement nicotine is gradually stopped.)
- Currently, three forms of nicotine replacement therapy are available over the
counter: nicotine patches, nicotine gum, and nicotine lozenges, while two
forms are available by prescription, an inhaler and a nasal spray
- Nicotine replacement therapy has about a 25% success rate, which increases to
35 or 40% when nicotine replacement therapy is combined with intensive behavioral counseling
- Nicotine-containing substances have side effects,
interactions with other medications, effects on other medical conditions, and
limitations in their use
- A prescription drug called bupropion (Zyban,
Wellbutrin) has been found to be effective in helping people to stop smoking
For
more information about quitting, call:
The National Cancer Institute: 1-800-422-6237; or look in your local phone directory for smoking cessation resources
that may be available in your area, such as local chapters of the American
Cancer Society, American Lung Association, American Heart Association, or state
and local health departments.
Reference: U.S.
National Institutes of Health.
Previous contributing authors and editors: Medical Author: Zab Mohsenifar, MD
and Medical Editor: Leslie J. Schoenfield, MD, PhD
Last Editorial Review: 6/15/2007
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