According to the National Institute on Drug Abuse, there are many species of tobacco plants; the tabacum species is the major source of tobacco products today. Tobacco products include cigarettes, cigars, pipes, and smokeless tobacco. According to the 1999 National Household Survey on Drug Abuse, 57 million Americans are current smokers and 7.6 million use smokeless tobacco. The use of cigars, pipes, and smokeless tobacco among women is low, but cigar smoking may be increasing. In 1999, almost 10% of high school girls under age 18 had past-month cigar use. Forms of smokeless tobacco include chewing tobacco and snuff. Chewing tobacco is leaf tobacco that is chewed and sucked in after it is placed between the cheek and the teeth. Snuff is finely ground tobacco that is placed between the cheek and gum or between the lower lip and gum.
HEALTH CONSEQUENCES OF TOBACCO USE
All tobacco products cause lung diseases (lung cancer, emphysema, and chronic bronchitis) and cancers of the mouth, throat, and larynx. In the United States, deaths from tobacco-related cancers contribute to over 30% of cancer mortality. Globally, lung cancer is one of the most deadly of the tobacco-related diseases; these rates are expected to increase because of increased cases in developing countries. Data from a 1998 study indicate that U.S. women have the highest death rate from lung cancer in the world.
Women smokers also seem to have an increased risk for conception delay, infertility, ectopic pregnancy, spontaneous abortion, and preterm delivery. Other disorders that may be associated with cigarette smoking in women include menstrual dysfunction, early menopause, estrogen deficiency disorders, and osteoporosis.
ENVIRONMENTAL TOBACCO SMOKE (ETS)
Environmental tobacco smoke is classified as a Group A carcinogen (known to cause cancer in humans). According to the National Center for Chronic Disease Prevention and Health Promotion, Environmental tobacco smoke causes about 3,000 lung cancer deaths per year among adult nonsmokers and causes serious respiratory problems in children (such as asthma and upper respiratory infections). A major problem with Environmental tobacco smoke is that most persons affected by it have no control over Environmental tobacco smoke. Many schools, work sites, and public gathering places are now enforcing smoke-free environments to protect nonsmokers from Environmental tobacco smoke.
In 1996, the Agency for Health Care Policy Research (AHCPR) produced guidelines for smoking cessation, which supported the involvement of all health professionals in tobacco control efforts. Societal efforts to reduce tobacco use and to reduce exposure to Environmental tobacco smoke have increased over the last 10 years. Societal strategies include counteradvertising, increasing tobacco taxes, laws that prohibit minors’ access to tobacco products, and banning smoking in workplaces and in public places.
INTERVENTIONS FOR TOBACCO USE
In 2000, the U.S. Department of Health and Human Services published clinical practice guidelines for treating tobacco use and dependence. Many states have demonstrated programs called “best-evidence”-based programs, which show a successful reduction of smoking rates among women and girls. Also, the American Lung Association (ALA) supports research and other programs to help people to quit using tobacco. Because it is so difficult to stop smoking, many public health efforts are now focusing on prevention of tobacco use, particularly in young people. Most adult smokers start their tobacco use as teenagers.
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- United States Department of Health and Human Services. (1996). Smoking cessation. Clinical Practice Guideline No. 18. Rockville, MD. (AHCPR Publication No. 96-0692, April).
- United States Department of Health and Human Services. (2000, June). Clinical practice guidelines: Treating tobacco use and dependence.