Cigarette Smoking

Overview
Cigarette smoking is the single largest preventable cause of death and disease in
Australia. It is a major risk factor for cardiovascular disease, as well as a range of cancers
and other disabling conditions. More than 19,000 Australians die each year from diseases
caused by smoking
[1]
. This means that almost 50 Australians per day die because they
smoked. Approximately half of all people who smoke regularly will eventually be killed by
their smoking habit, with many of these deaths occurring in middle age
[2]
. As well as
causing premature death, consumption of tobacco greatly diminishes quality of life
[3]
, and
this affects family, friends and colleagues, as well as smokers themselves.
There is no safe level of tobacco use and smoking is highly addictive. The majority of
adult smokers wish that they had never started to smoke and most want to quit
[4]
.
Cigarette smoking harms not only smokers, but also the health of non-smokers exposed
to other peoples tobacco smoke.
Whats in a cigarette?
Tobacco smoke contains thousands of chemicals, many of which are poisonous. The
following components of tobacco smoke contribute to disease:
Nicotine: an addictive drug found in tobacco smoke. Nicotine increases blood
pressure, which makes the heart work harder and also affects brain and muscle
activity.
Carbon monoxide: makes the heart beat faster and takes the place of oxygen in
the blood.
Tar: coats the lungs like soot in a chimney making it harder to breathe. Tar in
tobacco contains dozens of chemicals that cause cancer.
Some other poisons in tobacco smoke that are inhaled by both smokers and
passive smokers include nitrogen oxides, hydrogen cyanide, arsenic (white ant
poison), ammonia (floor cleaner), phenol (paints), naphthalene (mothballs),
cadmium (car batteries), urethane acetone (paint stripper), carbon monoxide (car
exhaust), DDT (insecticide) and butane (lighter fuel).
Health effects of tobacco smoking
Smoking has both short and long term effects on the body. Smoking just one cigarette
can have immediate health effects
[5]
, including:
temporary increases in blood pressure and heart rate;
constriction of blood vessels, which slows down blood flow around the body; and
binding of carbon monoxide to haemoglobin in the bloodstream. This reduces the
amount of oxygen delivered to the tissues.
Cigarette smoking can also cause:
bad breath;
smelly hair, clothes and hands;
stained teeth and fingers; and
facial wrinkles, especially around the mouth and eyes.
Tobacco smoking is a major risk factor for a range of diseases and disabling conditions.
These include heart, stroke and blood vessel diseases and many cancers, including
cancers of the lung, throat, cervix, bladder and tongue
[6]
. Smoking increases the risk of
For more information contact Heartline 1300 362 787
or www.heartfoundation.com.au
Information from the
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male impotence
[7]
, and women who smoke can suffer reduced fertility and/or menstrual
problems
[6]
. Smoking during pregnancy increases risks of miscarriage, premature labour,
stillbirth, complications during labour and low-birth weight babies
[6]
. Recent research has
found that there is a link between smoking and diabetes
[8, 9]
and macular degeneration (that
can cause blindness)
[10]
.
Tobacco smoke also affects the health of non-smokers. Passive smoking (environmental
tobacco smoke) can cause heart, stroke and blood vessel diseases, lung cancer and
respiratory tract irritation; an increased risk of bronchitis, pneumonia, asthma onset in
children, sudden infant death syndrome; and increased frequency and severity of asthma
symptoms
[6]
.
Smoking and heart, stroke and blood vessel diseases
Cigarette smoking is a major cause of heart attack, stroke, peripheral arterial disease and
abdominal aortic aneurysms, all of which are forms of cardiovascular disease. Both
mainstream (directly inhaled) tobacco smoke and sidestream (environmental or passively
inhaled) tobacco smoke have been shown to negatively affect cardiovascular health
[11]
.
Cardiovascular disease is the leading cause of death in Australia, and around 13% of deaths
from cardiovascular disease are caused by tobacco smoking
[12]
. In 1998, this represented
over 6600 deaths from cardiovascular disease
[12]
. Nearly 40% of all the people who die from
smoking die from heart, stroke and blood vessel (cardiovascular) disease
[13]
and tobacco use
is responsible for a large proportion of heart attacks among younger cigarette smokers, who
are otherwise at low risk of coronary heart disease
[14, 15]
.
Smoking adds to the artery-clogging process (atherosclerosis) that can lead to heart attack,
stroke and peripheral arterial disease
[11]
. It also makes the heart work much harder, reduces
its oxygen supply, makes clots more likely to form in blood vessels, and increases the risk of
potentially fatal changes in the heart beat
[11]
.
Public awareness of the health consequences of smoking has increased. However, a 1998
Victorian survey of more than 2000 people found that while 94% of people could name at
least one illness caused by smoking; only 26% readily recalled heart disease or heart attack;
7% stroke or vascular disease and 6% circulatory problems; compared to 53% recall for lung
cancer
[16]
.
Risks associated with smoking
Smoking is a major factor in both the development and rate of progression of cardiovascular
disease
[17]
. Overall, smokers have a 70% greater risk of death from coronary heart disease
than non-smokers
[14]
. Even smoking one to four cigarettes per day can double or triple the
risk of coronary disease
[11,18]
. The risk increases with the number of years of smoking and
number of cigarettes smoked
[11, 19]
.
Specifically, research indicates that cigarette smoking:
increases the risk of heart attack two to six times
[18, 20]
;
increases the risk of heart disease among women using the oral contraceptive pill
[14, 21]
;
increases the risk of stroke three-fold
[22, 23]
;
increases the risk of peripheral arterial disease (which can lead to gangrene and limb
amputation) by more than five times
[24]
; and
increases the likelihood of an abdominal aortic aneurysm (swelling of the bodys main
artery in the abdomen which may rupture) by six to seven times (for current
smokers)
[25]
.
Risks associated with passive smoking
Passive smoking is associated with:
a 25% increase in the risk of coronary heart disease among non-smokers
[26]
; and
an increase in the risk of stroke
[23]
.
Even brief exposure to passive smoking (e.g. for as little as 30 minutes) can affect the
cardiovascular system of non-smokers
[27, 28]
.
Non-smokers living with smokers have about a 25% increase in risk of death from heart
attack and are also more likely to suffer a stroke
[29, 30]
.
How do smokers begin smoking?
80% of new smokers are children or adolescents, most starting during their secondary
school years
[6]
.
There is a complex interplay of factors that directly and indirectly affect an individuals
choice to use tobacco. These include lower academic achievement, poor self-
esteem/self-image, a belief about the positive values of smoking, the perceived
acceptability of smoking in school, home and community settings, peer and parental
smoking and the availability of cigarettes in the community
[31, 32]
.
Some of the factors that discourage young people from continuing to smoke include: the
influence of friends, cost of cigarettes, parental reaction against smoking, dislike of taste,
acceptance of the health risk and good refusal skills
[32, 33]
.
Smoking in Australia
Smoking among school students
In 1999, around 269,000 boys and girls at school aged 12 to 17 years were current
smokers
[34]
. If all of these students were to continue smoking, it is estimated that about
134, 000 would die prematurely from their smoking habit
[34]
.
The proportion of smokers among students increases with age. By 17 years of age, 30%
of girls and 33% of boys are current smokers
[34]
.
From age 13 onwards, smoking tends to be more prevalent among girls than boys;
however boys are more likely to be heavier smokers than girls
[34]
.
Across the 12 to 17 year old age group, 31% of boys and 18% of girls indicate that they
have had at least a few puffs of a cigar, with 15% of boys and 6% of girls smoking at
least one cigar
[34]
.
Comparisons of secondary student surveys conducted in 1996 and 1999 indicate an
encouraging decrease in the prevalence of smoking among 12 to 15 year old students
over this period
[34]
.
Despite laws against sales to minors, 38% of boys who smoke and 26% of girls who smoke
bought their last cigarette, most often from a milk bar, delicatessen or petrol station
[34]
. For
both boys and girls, friends are the single most common source of cigarettes
[34]
.
It is estimated that the government revenue in 1998 from taxes on cigarettes smoked by
children in Australia was $64 million
[35]
.
Smoking among adults
In 1998, 23% (approximately 3.5 million) of Australians aged 18 years and over were
regular smokers, and a further 3.5% (approximately 555, 000) people were occasional
smokers
[36]
.
Six million people in Australia report to be ex-smokers
[36]
.
Overall, the prevalence of smoking is higher among males than females (25% and 20%
respectively)
[36]
.
The prevalence of smoking peaks between the ages of 20 and 29 for both men and
women
[36]
, after which smoking generally decreases.
Surveys indicate that more than 75% of smokers in Australia do want to quit
[4, 37]
.
Among current smokers, about 40% have tried to stop smoking in the last 12 months,
and about the same proportion of smokers will intend to quit smoking in the next three
months
[4]
.
Smoking among Indigenous Australians
Aboriginal and Torres Strait Islander people are almost twice as likely to smoke as non-
Indigenous Australians
[38]
.
The prevalence of smoking among Indigenous people varies with age and between
communities, but overall is about 50% for males and 30% for females
[38]
.
Smoking among Australian residents born overseas
Research indicates that the prevalence of smoking in some communities (for example
among males of Vietnamese and Greek backgrounds) are significantly higher than in the
general population
[39]
.
The cost of smoking to the community
Tobacco smoking places a huge financial drain on the community. In 1992 for example,
health economists estimated that the direct and indirect costs of smoking to Australia
were $12.7 billion
[40]
. This makes it societys most costly drug.
The benefits of quitting smoking
There is a rapid decline in the risk of coronary heart disease within one year of quitting
smoking
[41-45]
.
Within 2 6 years, the risk of developing coronary heart disease can return to a similar
level as that of a non-smoker
[42, 44, 45]
.
The risk of suffering a stroke begins to fall
[23, 41]
soon after quitting smoking, with most of
the benefit of quitting occurring within 2-5 years
[23, 46]
.
It is never too late for smokers to quit, even if they already have some form of
cardiovascular disease
[47]
. Quitting smoking can reduce the likelihood of a repeat heart
attack and the chances of developing other forms of cardiovascular disease
[48]
.
Reducing the prevalence of smoking in the community can result in considerable short-
term savings in medical costs associated with heart attacks and strokes that are
prevented
[47]
.
Further Information
For further information any heart health issue please call Heartline, the Heart Foundations
national telephone information service, on 1300 36 27 87 (cost of local call).
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