Cigarettes deaths

Chronic obstructive pulmonary disease (COPD) affects over 5% of the adult population, is the fourth leading cause of death worldwide and is the only major cause of mortality that is increasing worldwide. It is an inflammatory disorder of the lungs, caused mainly, but not exclusively, by cigarette smoking. 15-20% of smokers develop COPD. 

The a-tocopherol, P-carotene (ATBC) Cancer Prevention study was a randomised-controlled trial that tested the effects of daily doses of either 50 mg (50 lU) vitamin E (all-racemic a-tocopherol acetate), or 20 mg of P-carotene, or both with that of a placebo, in a population of more than 29,000 male smokers for 5-8 years. No reduction in lung cancer or major coronary events was observed with any of the treatments. What was more startling was the unexpected increases in risk of death from lung cancer and ischemic heart disease with P-carotene supplementation (ATBC Cancer Prevention Study Group, 1994). Increases in the risk of both lung cancer and cardiovascular disease mortality were also observed in the P-carotene and Retinol Efficacy Trial (CARET), which tested the effects of combined treatment with 30 mg/d P-carotene and retinyl pahnitate (25,000 lU/d) in 18,000 men and women with a history of cigarette smoking or occupational exposure to asbestos (Hennekens et al, 1996). 

In adults, a study of 75 autopsies of persons who had resided in a soft-water, leached soil region of North Carolina found a positive correlation between lead level in the aorta and death from heart-related disease (Voors et al. 1982). The association persisted after adjustment for the effect of age. A similar correlation was found between cadmium levels in the liver and death from heart-related disease. (Aortic lead and liver cadmium levels were considered to be suitable indices of exposure.) The effects of the two metals appeared to be additive. Potential confounding variables other than age were not included in the analysis. The investigators stated that fatty liver (indicative of alcohol consumption) and cigarette smoking did not account for the correlations between lead, cadmium and heart-disease death. 

Haglund B, Cnattingius S. 1990. Cigarette smoking as a risk factor for sudden infant death syndrome A population-based study. Am J Public Health 80 29-32. 

The World Heath Organisation has stated that cigarette smoking is the single most preventable cause of death in the world. Explain why breathing in tobacco smoke is so lethal. 

Figure 1. The age-specific incidence of lung cancer deaths in male cigarette smokers and nonsmokers (Kahn, 1966, Appendix Table A). The lifetime incidence for nonsmokers includes lung cancers attributable to passive smoking, asbestos inhalation, and other occupational exposures.

Women >55 years or premature menopause without estrogen-replacement therapy Family history of premature CHD (definite myocardial infarction or sudden death before 55 years of age in father or other male first-degree relative or before 65 years of age in mother or other female first-degree relative) Cigarette smoking... 

Compared to the general population, Adventists have an exceptionally low risk of fatal lung cancer and other diseases which are strongly related to cigarette or alcohol use. They also appear to have a marked reduction in risk of death from large bowel cancer, coronary disease, stroke, diabetes, and nontraffic accidents. 

While gender roles and norms in some parts of the world have discouraged women from smoking, smokeless tobacco is more acceptable in some regions (e.g., Africa, India), and waterpipes in others (Middle East). Smokeless tobacco is responsible for four million deaths per year worldwide half of these are among women this is predicted to increase to 10 million deaths per year by 2030 (Christotides 2003). In contrast to India, women in the United States are much more likely to smoke cigarettes than to use smokeless tobacco. 

Smoking tobacco causes damage to endothelial cells due to free radicals present in tobacco smoke. It is estimated that each puff of a cigarette produces lO " free radicals. In addition, the resultant lack of oxygen causes damage or death to neurones, and nicotine and carbon monoxide, both present in tobacco smoke, cause an increase in blood pressure. 

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