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 INTRODUCTION TO SMOKING

When your parents were young, people could buy cigarettes and smoke pretty much anywhere — even in hospitals! Ads for cigarettes were all over the place. Today we're more aware about how bad smoking is for our health. Smoking is restricted or banned in almost all public places and cigarette companies are no longer allowed to advertise on TV, radio, and in many magazines.
Almost everyone knows that smoking causes cancer, emphysema, and heart disease; that it can shorten your life by 10 years or more; and that the habit can cost a smoker thousands of dollars a year. So how come people are still lighting up? The answer, in a word, is addiction.
You may have started smoking because all your friends do or because you grew up in a house where lots of people smoked. Some people try smoking because they are curious or bored. No matter why you started, if you're thinking about quitting, it would probably help your asthma.
Smoking can undo the effect of any controller medicine you're taking. It also can force you to use your rescue  medicine   more often. It can also disturb your sleep by making you cough more at night and can affect how well you perform in sports or other physical activities. Worst of all, it can send you to the emergency department with a severe asthma flare-up.
If you decide to quit smoking, you don't have to go it alone. Seek the support of others who are also trying to quit. You also might ask your doctor about medication or different strategies that can help you crave cigarettes less.

Once You Start, It's Hard to Stop

Smoking is a hard habit to break because tobacco contains nicotine, which is highly addictive. Like heroin or other addictive drugs, the body and mind quickly become so used to the nicotine in cigarettes that a person needs to have it just to feel normal.


People start smoking for a variety of different reasons. Some think it looks cool. Others start because their family members or friends smoke. Statistics show that about 9 out of 10 tobacco users start before they're 18 years old. Most adults who started smoking in their teens never expected to become addicted. That's why people say it's just so much easier to not start smoking at all.

DEFINITION: 

Smoking refers to the inhalation and exhalation of fumes from burning tobacco in cigars, cigarettes and pipes. Historically, smoking as a practice, was followed by natives of the Western Hemisphere, in religious rituals and for medicinal purposes. It has a history starting from the late 1500s. We would try to answer the question as to what is smoking later in the article.
Explorers of the New World saw it fit to introduce tobacco into Europe, in-spite of the opposition from the then rulers. But the novelty and thrill factor won over many a new user. Towards the end of the nineteenth century,cigarettes were higher in demand than the cigars and pipes, which had been popular amongst smokers until then.

Health Effects of Smoking

Tobacco smoke contains nicotine – a poisonous alkaloid – and other harmful substances like carbon monoxide, acrolein, ammonia, prussic acid and a number of aldehydes and tars. Health reports giving definitive proof that cigarette smoking is a serious health hazard have been submitted from time to time by the Surgeon General’s Advisory Committee on Health, appointed by the U.S. Public Health Service. Findings include that a smoker has a significantly greater chance of contracting lung cancer than a nonsmoker, depending on factors such as number ofcigarettes smoked daily, number of years the subject smoked and the time in the person’s life when he or she began smoking.
Additionally, the report also gave proof of smoking being a primary cause of chronic obstructive pulmonary disease, emphysema, heart disease, stroke and other cardiovascular diseases.
Smoking has proved to pose a threat to male potency. Pipe and cigar smokers are a comparatively fortunate lot as compared to cigarette smokers, if they do not inhale. They are not as prone to lung cancer as cigarette smokers. On the downside, the former set is just as likely to develop cancers of the mouth, larynx and esophagus. Groups of people indulging in snuff or chewing tobacco-a.k.a smokeless tobacco – also run a greater risk of developing cancer of the mouth.

Smoking Affects those Associated with Smokers too

Health groups are increasingly targeting smokers who inhale tobacco smoke for increasing the risk of heart disease and respiratory problems for them. These have resulted in dedicated movements for smokeless environments in public spaces such as government buildings, office buildings and restaurants.

Regulation of Smoking:
Due to mounting facts of health risks, television advertisements for cigarettes are increasingly being banned and governments world over are advising for stronger warning labels on all print advertising. It is now the responsibility of The Framework Convention on Tobacco Control, a treaty adopted by World Health Organization members in 2003, to establish international standards for anti smoking measures once it is ratified. This convention creates precincts on the marketing/sales of tobacco products.

What happens when you quit smoking? 
What to expect when i stop smoking?
Short term effects when you quit smoking are:

• Your blood pressure will become normal within only 20 minutes if you quit smoking right now.
• The oxygen levels of your blood will return to normal within 8 hours.
• Your sense of smell will return to normal within 2 days.
• Your chances of having heart attack will also reduce in the same amount of time.
• Nicotine level from blood will decrease remarkably in the same period.
• Within 2 to 8 weeks circulation in the body will increase.

Long term effects when you quit smoking:

• Within 9 months your lung capacity will improve by 10% due to which breathing related problems will dissipate.
• The risk of heart attack due to smoking will reduce to half within 1 year.
• The risk of heart stroke which might have been caused due to your smoking habit will reduce to none within 5 years.
• The risk of lung cancer will become like a person who has never smoked within 10 years.
• The risk of heart attack which might have been induced by your smoking habit will become nil within 15 years.

Above all quitting smoking will give a big boost to your morale and feeling of achievement. YES, I thought, I tried and I achieved what millions have tried and failed.

What are the side effects when you quit smoking?
Once you decide and suddenly quit smoking, the body is in kind of a state of loss. Your body is confused and doesn’t know how to work normally as it was unable to work normally since long. The common side effects when you quit smoking are:

• Blood sugar might go down
• headache
• insomnia
• irritation
• drowsiness
• cough
• weight gain
• ubiquitous sweet tooth

There is no need to worry about the above problems since they are temporary and should vanish within 3-5 days.

How Smoking Affects Health

As mentioned above, smoking affects health in many ways. Smokers develop yellow teeth and wrinkles. They also suffer loss of bone density, making them prone to osteoporosis, which increases the risk of fractures. Smokers’ athletic performance is also affected as their lung capacity is diminished.

Smoking Affects Fertility
Smoking affects the sexual performance of men and women, and causes fertility problems. Women smokers who use hormone-based birth control methods such as ring, patch or pills, face increased risk of suffering health issues like heart attack.

Bad Skin
Smoking narrows blood vessels, which prevents adequate supply of nutrients and oxygen to the skin. This is the reason why chain smokers look unhealthy and pale. Smoking also increases the risk of getting psoriasis, which is a skin rash.

Bad Breath
Regular smokers cannot avoid halitosis or chronic bad breath.

Evil-Smelling Hair and Clothes
Stale cigarette smoke lingers on furniture, hair, clothes and inside cars. As a result, smokers smell bad, which drastically reduces their attractiveness.

Smoking Affects Athletic Performance
Regular smokers become laggards at sports as smoking impacts their athletic performance. This is because smoking causes shortness of breath, decreased circulation and increased heartbeat. Smokers also face greater chances of injury due to brittle bones. Their ability to heal is also affected.

Less Immunity
Research reveals that smokers suffer more bouts of pneumonia, bronchitis, flu and colds. Certain conditions such as asthma become much worse with smoking. Smokers also tend to eat less, which means they do not get enough nutrients to maintain good health.

Symptoms of smoking and smoking-related diseases

Symptoms of smoking and related diseases, disorders and conditions include:

• Bad breath and yellowing of the teeth
  
• Cold hands and feet
  
• Frequent or recurrent lung infections and other diseases, such as influenza, common colds, bronchitis, and pneumonia
  
• Hypertension  (high blood pressure) and rapid heart rate
  
• Loss of taste and smell
  
• Low oxygen levels in the blood
  
• Low tolerance for exercise and fatigue
  
• Nicotine-stained fingers and teeth
  
• Premature aging and wrinkling of the skin
  
• Shortness of breath and difficulty breathing
  
• Smoker's cough (an ongoing loose cough that produces phlegm) and hoarse voice
  
• Smoky-smelling clothes and hair
  

Symptoms of smoking cessation

If you are a smoker who attempts to quit smoking, you may experience symptoms of nicotine withdrawal. Symptoms of nicotine withdrawal decrease over time and will eventually go away. Symptoms of nicotine addiction and nicotine withdrawal include:

• Constipation
  
• Cravings for tobacco
  
• Difficulty concentrating
  
• Dizziness
  
• Headache
  
• Hunger
  
• Irritability
  
• Mood swings
  
• Sleep disturbances
  
• Tremors
  

Serious symptoms that might indicate a life-threatening condition

Long-term smoking can result in serious and life-threatening diseases and conditions, such as oral cancer, lung cancer, heart disease chronic obstructive pulmonary disease (COPD), and pneumonia. Seek prompt medical care if you have sores or ulcers in your mouth that do not heal, which could be a symptom of oral cancer, or a cough that does not go away, which is a possible symptom of lungs cancer,
Seek immediate medical care (call 911) if you, or someone you are with, have any of these potentially symptoms:

• Chest pain, chest tightness, chest pressure, or palpitations
  
• High fever (higher than 101 degrees Fahrenheit)
  
• Persistent, wet cough that produces thick greenish, yellow, brown, or blood-tinged phlegm
  
• Shortness of breath or difficulty breathing
  

Smoking and cancer

Smoking causes many cancers and the vast majority of cases of lung cancer. Cancers caused by smoking include:

• Bladder cancer
  
• Cancer of the pharynx and larynx (voice box)
  
• Esophagus cancer
  
• Kidney cancer
  
• Leukemia
• Lung cancer
  
• Oral cancers
  
• Pancreas cancer
  
• Stomach cancer
  
• Throat cancer
  
• Uterine cancer
  

Smoking and lung, heart, and vascular disease

Smoking causes life-threatening lung and cardiovascular diseases, such as:

• Abdominal aortic aneurysm
  
• Chronic obstructive pulmonary disease  includes emphysema and chronic bronchitis)
  
• Coronary heart disease
  

Smoking also exposes you to carbon monoxide, a gas that lowers the level of oxygen in the blood. This is further complicated by the fact that smoking constricts blood vessels, decreasing blood flow to vital organs, such as the brain and heart and large arteries of the arms and legs, which can lead to peripheral vascular disease. Smoking also thickens the blood and increases the risk of developing life-threatening blood clots and complications of blood clots including:

• Buerger’s disease (acute inflammation and clotting of arteries and veins)
  
• Deep vein thrombosis (blood clots in the leg)
  
• heart attack
  
• Higher risk of serious blood clots in women who take contraceptives containing hormones
  
• Pulmonary embolism (blood clot in the lung)
  
• stroke
  

Smoking and pregnancy

Smoking causes or increases the risk of serious complications with pregnancy and infections in infants including:

• Increased risk of ear infection in infants and toddlers exposed to secondhand smoke
  
•   Infertility
  
• Low birth weight babies
  
• Premature delivery
  
• Stillbirth
  
• Sudden infant death syndrome (SIDS)
  
  
  

What causes smoking?

The Centers for Disease Control and Prevention estimates that 46 million people in the United States (18 years of age and older) smoke cigarettes. Smoking is more common in men than women and appears to be prevalent across a variety of different ethnic groups. The highest percentage of smokers is in the 25 to 44-year old age group. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
Despite the prevalence of smoking, the factors that lead a person to start smoking are difficult to understand. In many cases, smoking is started at a young age due to peer pressure, tobacco advertising, or a concept that smoking is an acceptable behavior. Many people who start smoking have a family member or close friend who smokes.
Once started, cigarette smoking and chewing tobacco are difficult to stop. It is a well-known fact that smoking and chewing tobacco are behaviors that can become addictions due to the presence of nicotine and other chemicals generated from smoking. Like many other addictive substances, these chemicals trigger a series of biochemical reactions and pleasant sensations to which you can quickly become accustomed. Regular tobacco users eventually develop a need to experience these sensations in order to feel normal, which makes quitting a difficult challenge.

What are the risk factors for smoking?

Although there does not appear to be a specific trigger that causes a person to start smoking or chewing tobacco, there are several risk factors associated with smoking. Risk factors include:

• Behavioral problems such as aggression
  
• Family member who smokes
  
• Lack of education past high school
  
• Low self-esteem
  
• Poor financial or social status
  
• Poor school or academic performance
  

Hookahs and Electronic Cigarettes
There are rumors going around that hookahs and electronic cigarettes are safer than regular cigarettes. This is not true. Hookahs do not have filters. Hence they cannot filter out the harmful chemicals in tobacco. Besides, hookahs are commonly shared, which increases the risk of spreading germs among users.Electronic cigarettes contain toxins and carcinogens and do not have FDA approval. Basically, all nicotine products are harmful, so stay away from all of them.

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How Smoking Affects Your Health

There are no physical reasons to start smoking. The body doesn't need tobacco the way it needs food, water, sleep, and exercise. And many of the chemicals in cigarettes, like nicotine and cyanide, are actually poisons that can kill in high enough doses.
The body is smart. It goes on the defense when it's being poisoned. First-time smokers often feel pain or burning in the throat and lungs, and some people feel sick or even throw up the first few times they try tobacco.

The consequences of this poisoning happen gradually. Over the long term, smoking leads people to develop health problems like heart disease, stroke, emphysema (breakdown of lung tissue), and many types of cancer — including lung, throat, stomach, and bladder cancer. People who smoke also have an increased risk of infections like bronchitis and pneumonia.
These diseases limit a person's ability to be normally active, and they can be fatal. In the United States, smoking is responsible for about 1 out of 5 deaths.

Smokers not only develop wrinkles and yellow teeth, they also lose bone density, which increases their risk of osteoporosis (pronounced: ahs-tee-o-puh-row-sus), a condition that causes older people to become bent over and their bones to break more easily. Smokers also tend to be less active than nonsmokers because smoking affects lung power.
Smoking can also cause fertility problems and can impact sexual health in both men and women. Girls who are on the pill or other hormone-based methods of birth control (like the patch or the ring) increase their risk of serious health problems, such as heart attacks, if they smoke.
The consequences of smoking may seem very far off, but long-term health problems aren't the only hazard of smoking. Nicotine and the other toxins in cigarettes, cigars, and pipes can affect a person's body quickly, which means that teen smokers experience many of these problems:

• Bad skin. Because smoking restricts blood vessels, it can prevent oxygen and nutrients from getting to the skin — which is why smokers often appear pale and unhealthy. Studies have also linked smoking to an increased risk of getting a type of skin rash called psoriasis.
• Bad breath. Cigarettes leave smokers with a condition called halitosis, or persistent bad breath.
• Bad-smelling clothes and hair. The smell of stale smoke tends to linger — not just on people's clothing, but on their hair, furniture, and cars. And it's often hard to get the smell of smoke out.
• Reduced athletic performance. People who smoke usually can't compete with nonsmoking peers because the physical effects of smoking (like rapid heartbeat, decreased circulation, and shortness of breath) impair sports performance.
• Greater risk of injury and slower healing time. Smoking affects the body's ability to produce collagen, so common sports injuries, such as damage to tendons and ligaments, will heal more slowly in smokers than nonsmokers.
• Increased risk of illness. Studies show that smokers get more colds, flu, bronchitis, and pneumonia than nonsmokers. And people with certain health conditions, like asthma, become more sick if they smoke (and often if they're just around people who smoke). Because teens who smoke as a way to manage weight often light up instead of eating, their bodies also lack the nutrients they need to grow, develop, and fight off illness properly.

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Hookahs and E-Cigarettes

It's not only cigarettes that get people dependent on tobacco. Hookahs, staples of Middle Eastern café society, are water pipes used to smoke tobacco through a hose with a tapered mouthpiece. There's a myth going around that hookahs are safer because the smoke is cooled when it passes through the water.
But take a look at the black, resinous gunk that builds up in a hookah hose. Some of that gets into users' mouths and lungs. Indeed, experts say hookahs are no safer than cigarettes — and since they don't have filters and people often use them for long periods, the health risks might be even greater. Hookahs are usually shared, so there's the additional risk from germs being passed around along with the pipe.
Also beware of electronic cigarettes (e-cigarettes), which contain cancer-causing chemicals and other toxins, including a compound used in antifreeze. These battery-operated devices use cartridges filled with nicotine, flavorings, and other chemicals and convert them into a vapor that's inhaled by the user.
E-cigarettes haven't been evaluated or approved by the U.S. Food and Drug Administration (FDA), so they don't have to post the health warnings that nicotine replacement products or conventional cigarettes do. But there's no such thing as a safe nicotine product.

Kicking Butts and Staying Smoke Free

All forms of tobacco — cigarettes, pipes, cigars, hookahs, and smokeless tobacco — are hazardous. It doesn't help to substitute products that seem like they're better for you than regular cigarettes, such as e-cigarettes or filtered or low-tar cigarettes.
The only thing that really helps a person avoid the problems associated with smoking is staying smoke free. This isn't always easy, especially if everyone around you is smoking and offering you cigarettes. It may help to have your reasons for not smoking ready for times you may feel the pressure, such as "I just don't like it" or "I want to stay in shape for soccer" (or football, basketball, or other sport).
The good news for people who don't smoke or who want to quit is that studies show that the number of teens who smoke has dropped dramatically. Today, about 20% of high school students smoke — which means 4 out of 5 don't.
If you do smoke and want to quit, you have lots of information and support available. Different approaches to quitting work for different people. For some, quitting cold turkey is best. Others find that a slower approach is the way to go. Some people find that it helps to go to a support group especially for teens. These are sometimes sponsored by local hospitals or organizations like the American Cancer Society. The Internet offers a number of good resources to help people quit smoking.
When quitting, it can be helpful to realize that the first few days are the hardest. So don't give up. Some people find they have a few relapses before they manage to quit for good.
Staying smoke free will give you a whole lot more of everything — more energy, better performance, better looks, more money in your pocket, and, in the long run, more life to live!
Reviewed by: Larissa Hirsch, MD
Date reviewed: March 2010

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