Why is Smoking Dangerous?
|Prevention and Early Detection|
The 1982 Surgeon General's Report stated that "Cigarette smoking is the major single cause of cancer mortality in the United States." This statement is as true today as it was in 1982. Because cigarette smoking and tobacco use are acquired behaviors, ones that individuals choose to do, smoking is the most preventable cause of premature death in our society.
The purpose of this document is to provide a brief overview of cigarette smoking: who smokes, how it affects health, and what some of the many benefits of quitting are. For more information about quitting smoking, see the American Cancer Society document, "Guide to Quitting Smoking."
According to the Centers for Disease Control and Prevention (CDC), 44.5 million US adults were current smokers in 2004 (the most recent year for which numbers are available). This is 20.9% of all adults (23.4% of men, 18.5% of women) – more than 1 out of 5 people.
When broken down by race/ethnicity, the numbers were as follows:
The numbers were higher in younger age groups. Almost 24% of those 18 to 44 years old were current smokers, compared to less than 9% in those aged 65 or older.
Nationwide, 22.3% of high school students and 8.1% of middle school students were current smokers in 2004. White and Hispanic students were among the highest in terms of cigarette use. (For more information, see the American Cancer Society document, "Child and Teen Tobacco Use.")
Health Effects of Smoking
About half of all Americans who continue to smoke will die because of the habit. Each year, about 438,000 people die in the US from tobacco use. Nearly 1 of every 5 deaths is related to smoking. Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined.
Cigarette smoking accounts for at least 30% of all cancer deaths. It is a major cause of cancers of the lung, larynx (voice box), oral cavity, pharynx (throat), and esophagus, and is a contributing cause in the development of cancers of the bladder, pancreas, cervix, kidney, stomach, and some leukemias.
About 87% of lung cancer deaths are caused by smoking. Lung cancer is the leading cause of cancer death among both men and women, and is one of the most difficult cancers to treat. Fortunately, lung cancer is largely a preventable disease. Groups that promote nonsmoking as part of their religion, such as Mormons and Seventh-day Adventists, have much lower rates of lung cancer and other smoking-related cancers.
Other Health Problems
Cancers account for only about half of the deaths related to smoking. Smoking is also a major cause of heart disease, aneurysms, bronchitis, emphysema, and stroke, and it contributes to the severity of pneumonia and asthma.
Tobacco has damaging effects on women's reproductive health. It is associated with reduced fertility and a higher risk of miscarriage, early delivery (prematurity), stillbirth, infant death, and is a cause of low birth weight in infants. It has also been linked to sudden infant death syndrome (SIDS).
Smoking has also been linked to a variety of other health problems, including cataracts, bone thinning, hip fractures, and peptic ulcers.
Effects on Quantity and Quality of Life
Based on data collected from 1995 to 1999, the CDC estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking.
But not all of the health problems related to smoking result in deaths. In the year 2000, about 8.6 million people were suffering from at least one chronic disease due to current or former smoking, according to the CDC. Many of these people were suffering from more than one smoking-related condition. The diseases occurring most often were chronic bronchitis, emphysema, heart attacks, strokes, and cancer.
Ingredients in Tobacco
Cigarettes, cigars, and smokeless and pipe tobacco consist of dried tobacco leaves, as well as ingredients added for flavor and other properties. More than 4,000 individual compounds have been identified in tobacco and tobacco smoke. Among these are more than 60 compounds that are known carcinogens (cancer-causing agents).
There are hundreds of substances added by manufacturers to cigarettes to enhance the flavor or to make the smoking experience more pleasant. Some of the compounds found in tobacco smoke include ammonia, tar, and carbon monoxide. Exactly what effects these substances have on the cigarette consumerÂ’s health is unknown, but there is no evidence that lowering the tar content of a cigarette improves the health risk. Manufacturers do not provide the public with information about the precise amount of additives used in cigarettes, so it is hard to accurately gauge the public health risk.
Addiction is characterized by the repeated, compulsive seeking or use of a substance despite harmful consequences. Addiction is often accompanied by physical and psychological dependence on the substance. Nicotine is the addictive drug in tobacco. Regular use of tobacco products leads to addiction in a high proportion of users.
In 1988, the US Surgeon General concluded the following:
Nicotine is found in substantial amounts in all forms of tobacco. It is absorbed readily from tobacco smoke in the lungs and from smokeless tobacco in the mouth or nose and rapidly spreads throughout the body.
Tobacco companies are required by law to report nicotine levels in cigarettes to the Federal Trade Commission (FTC) but in most states are not required to show the amount of nicotine on the cigarette brand labeling. The actual amount of nicotine available to the smoker in a given brand of cigarettes may be different from the level reported to the FTC. In one regular cigarette, the amount of nicotine ranges between about 1 mg and 2 mg.
Although 70% of smokers want to quit and 35% attempt to quit each year, fewer than 5% succeed. The low rate of successful quitting and the high rate of relapse are due to the effects of nicotine addiction.
Benefits of Quitting Smoking
In September 1990, the US Surgeon General outlined the benefits of smoking cessation:
The risk of having lung cancer and other smoking-related cancers is related to total lifetime exposure to cigarette smoke, as measured by the number of cigarettes smoked each day, the age at which smoking began, and the number of years a person has smoked.
The risk of having lung cancer and other cancers can be reduced by quitting smoking. The risk of lung cancer is less in people who quit smoking than in people who continue to smoke the same number of cigarettes per day, and the risk decreases as the number of years since quitting increases.
People who stop smoking at younger ages experience the greatest health benefits from quitting. Those who quit in their 30s may avoid most of the risk due to tobacco use. However, even smokers who quit after age 50 substantially reduce their risk of dying early. The argument that it is too late to quit smoking because the damage is already done is not true.
For more information, see the American Cancer Society document, "Guide to Quitting Smoking."
More Information from Your American Cancer Society
The following information may also be helpful to you. These materials may be ordered from our toll-free number, 1-800-ACS-2345 (1-800-227-2345).
National Organizations and Web Sites
In addition to the American Cancer Society, other sources of information and support include*:
American Heart Association & American Stroke Association
American Lung Association
Centers for Disease Control and Prevention
National Cancer Institute
*Inclusion on this list does not imply endorsement by the American Cancer Society.
The American Cancer Society is happy to address almost any cancer-related topic. If you have any more questions, please call us at 1-800-ACS-2345 any time, 24 hours a day.
American Cancer Society. Cancer Facts & Figures 2006. Atlanta, Ga: American Cancer Society; 2006.
Centers for Disease Control and Prevention (CDC). Annual smoking-attributable mortality, years of potential life lost, and economic costs - United States, 1995-1999. MMWR. 2002;51:300-303. Available at: www.cdc.gov/mmwr//preview/mmwrhtml/mm5114a2.htm. Accessed October 10, 2005.
Centers for Disease Control and Prevention (CDC). Annual smoking-attributable mortality, years of potential life lost, and productivity losses - United States, 1997-2001. MMWR. 2005;54(25):625-628. Available at: www.cdc.gov/mmwr//preview/mmwrhtml/mm5425a1.htm. Accessed October 7, 2005.
Centers for Disease Control and Prevention (CDC). Cigarette smoking among adults - United States, 2004. MMWR. 2005;54:1121-1124. Available at: www.cdc.gov/mmwr//preview/mmwrhtml/mm5444a2.htm. Accessed November 11, 2005.
Centers for Disease Control and Prevention (CDC). Cigarette smoking-attributable morbidity - United States, 2000. MMWR. 2003;52(35):842-844. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5235a4.htm. Accessed October 12, 2005.
Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion. Toxic chemicals in tobacco products. Available at: www.cdc.gov/tobacco/research_data/product/objective21-20.htm. Accessed October 12, 2005.
Centers for Disease Control and Prevention (CDC). Tobacco Use, Access, and Exposure to Tobacco in Media Among Middle and High School Students -- United States, 2004. MMWR. 2005;54:297-301. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5412a1.htm. Accessed October 7, 2005.
Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328:1519-1528.
Office of the US Surgeon General. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. 1990. Available at: http://profiles.nlm.nih.gov/NN/B/B/C/T. Accessed October 12, 2005.
Office of the US Surgeon General. The Health Consequences of Smoking: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. 2004. Available at: www.surgeongeneral.gov/library/smokingconsequences/. Accessed October 12, 2005.
Office of the US Surgeon General. The Health Consequences of Smoking: Cancer: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. 1982. Available at: http://profiles.nlm.nih.gov/NN/B/C/D/W/. Accessed October 12, 2005.
Office of the US Surgeon General. The Health Consequences of Smoking: Nicotine Addiction: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. 1988. Available at: www.cdc.gov/tobacco/sgr/sgr_1988/index.htm. Accessed October 12, 2005.
Office of the US Surgeon General. Reducing Tobacco Use: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. 2000. Available at: www.cdc.gov/tobacco/sgr/sgr_2000/index.htm. Accessed October 12, 2005.
Peto R, Darby S, Deo H, Silcocks P, Whitley E, Doll R. Smoking, smoking cessation, and lung cancer in the UK since 1950: Combination of national statistics with two case-control studies. BMJ. 2000;321:323-329.