As a major health issue, tobacco use affects a majority part of the American population and other citizens worldwide. Tobacco-related deaths are the result of life-threatening sicknesses, and victims rarely survive to narrate their experiences. The number of tobacco-related deaths in America alone constitutes about 15% of the total population, whereby about 8,000 Americans lose their lives from the direct effects of smoking weekly. Tobacco-related deaths actually outstrip the number of deaths from a combination of such other factors as suicide, AIDS, fires, murder, alcoholism, illicit drugs, and motor vehicle (Ropeik & Gray, 2007, p.140). The social effects of smoking are tremendous, while the monetary value and human life cost are staggering. It is therefore ironic to note how the American society continues to worry about food additives, West Nile Virus, pesticides, and unsafe drinking water while a large part of the population is going down to the graves as a result of tobacco-related illnesses (Rabinoff et al., 2007, p.11, 14).
The human race has used tobacco products for a period stretching extending over four centuries. Common methods of combusted tobacco inhalation have been smoking filtered and non-filtered cigarettes and cigars, smoking water filtered or non-filtered pipes, and to a lesser extent, consumption of smokeless tobacco (Bayram et al., 2005, p. 2). But tobacco is dangerous to human health and has led to vast losses of human lives through tobacco-related sicknesses. In America, for example, the annual number of tobacco-related deaths stands at 400,000, while secondhand smoke leads to about 50,000 deaths. Records from the World Health Organization (WHO) estimate that the number of Americans who lost their lives to smoking for the period between 1950 and 2000 is about 16 million. Cigarette smoking has led to more citizen deaths than the number of American soldiers killed in World War II, Vietnam. Korea and other conflicts put together. But Americans are yet to mobilize in the same manner they have mobilized against such wars, and ironically, the American society continues to behave in a very indifferent manner towards the detrimental effects that smoking continues to have in this society (Rabinoff, 2007, p. 11).
But this problem is not restricted to America alone. WHO projections estimated smoking-related deaths to stand at about 1.3 billion in 2003 and 1.7 billion by 2025, reflecting a 31% increase in the number of active cigarette smokers worldwide. The same projections reflected a staggering 5 million smoking-related deaths worldwide in one year. Studies conducted by the United States Environmental Protection Agency (USEPA) have confirmed that cigarette smoke is the number one cancer-causing agent and that secondhand smoke causes more dangers to human health than most people are aware of. In China, which is a major cigarette manufacturer, there are over 320 million active smokers, out of which 67 percent are males. As a result, predictions indicate that about a third of all males living in China’s cities are exposed to smoking-related deaths (Rabinoff, 2007, p.12, 41, 43).
There are a number of recreational drugs that are widely used in most societies, but cigarette smoking remains one of the most addictive and one that has also proved very difficult to discontinue once a user gets accustomed to smoking. Despite widespread public education about the risks that tobacco use has on the general health of a human being, there are still about 20% of American adults addicted to tobacco consumption, with 30% new recruits coming from among fresh college students. These new recruits gradually turn into long-term smokers. As the smoking habit gets out of hand and becomes uncontrollable, smokers and non-smokers alike continue to fall victim to tobacco-related health complications. Cigarette smoking is a virtually avoidable habit, but the rate of success in quitting the habit that leads to permanent withdrawal is barely more than 10% among active smokers depicting a serious determination to quit. A considerable number of non-smokers fall victim to certain events that trigger them back into the habit even after a long period of quitting (Bayram et al., 2005, p. 4).
Inhalation of combusted tobacco produces tax phase and gas phase toxins which affect both mainstream and side-stream (environmental) smokers by leading to severe health complications. It is alarming to note the large number of chemicals that get released through this combustion, a number that has been estimated to stand at about 4000. Examples of such toxic chemicals are nicotine, peroxyl, alkoxyl, quinine/hydroquinone, butadiene, bacterial endotoxin, aldehydes, carbon monoxide, and large amounts of nitric oxide (NO), to name but a few (Ropeik & Gray, 2007, p.141). Cigarette smoking has been identified with most of the common diseases that affect the human race, including various types of cancer, thyroid disease, renal impairments, heart disorders, myocardial infarction, osteoporosis, peptic ulcer, immune dysfunction, periodontal disease, diabetes mellitus, pancreatic disorder, erectile dysfunction, respiratory complications, rheumatic arthritis, and ovarian cysts among others. Tobacco use has been blamed for reducing the life expectancy of the users by about 15 years as well as being the cause of thousands of human deaths. Environmental smokers have not been lucky either, and secondhand smoke released by smokers has widely been blamed for leading to atherosclerosis disease among non-smokers (Byram et al., 2005, p.2).
Oftentimes, cigarette smoking has been singled out as the most common preventable cause of several tobacco-related cancers. The use of tobacco has for a long time been on the lead among the causes of tobacco-related deaths resulting from cancer. In the U.S. alone, about 90% of lung cancer-related deaths among American males, and 75-80% among females, are a direct result of cigarette smoking. Tobacco smoking has become very widespread throughout developing nations, a trend that could soon lead to increased numbers of tobacco-related deaths in these countries. Among the types of cancers associated with cigarette smoking are cancers of the kidney, lung cancers, pancreatic, bladder, and larynx cancers, as well as cancer of the pharynx and oral cavity cancer. Studies have also established an association between rectum and colon cancer, and cancer also small intestine cancers. Indications have also been brought forward linking tobacco consumption and gastric cancer. Myriad leukemia and cell sinonasal cancer have also been associated with smoking (Bayram et al., 2005, p. 62-63).
Cigarette smoke contains carcinogens which, in the course of prolonged tobacco use, get deposited in the smoker’s lungs leading to various types of lung cancer or primary carcinomas. Different types of lung cancers include large cell carcinoma, squamous cell carcinoma, Aden carcinoma, and small cell carcinoma, among others. These types of cancer are, however, a leading cause of death among smokers than non-smokers. Another type of cancer common with smokers is laryngeal cancer, affecting the smoker’s vocal cords and evident through hoarseness of the voice as well as the coughing of blood. There are other types of cancer that affect the throat and mouth and which are prevalent among smokers. Esophageal cancers affecting the esophagus and pancreatic cancer are also very common causes of death among smokers as the survival rate for the same is very poor. Smokers are also prone to death from urinary bladder cancers and kidney cancer (Slovic, 2001, p. 21-24). Women who smoke during pregnancy have suffered adverse effects on their reproduction. Apart from reducing the unborn child’s birth weight, there is enough evidence linking smoking to other problems like placenta Olivia, spontaneous abortion, perinatal mortality, and to some extent, Sudden Infant Death Syndrome (SIDS) (Slovic, 2001, p.17). In the U.S. alone, about 1000 infants lose their lives from complications acquired during their mothers’ pregnancies. Children also constitute the largest part of the population worst affected by secondhand smoke, and though this may not lead to immediate deaths on their part, they are in the long run exposed to dangers of developing lung cancer and contracting respiratory tract and ear infections. (Rabinoff, 2007, p.13).
During smoking, burning of the tobacco produces both mainstream and side-stream types of smoke. While the quantities of Arsenic, Cadmium, and Nickel present in this smoke may not have any significant contribution to lung cancer and other types of smoke-related cancers, they have been co-factors towards the occurrence of these sicknesses. After long-term accumulation in the body of a smoker, these metals could, together with carcinogens, act as possible promoters. Side-stream smoke contains more chemicals than mainstream smoke, and even though this smoke is largely filtered by the environment, it has widely been linked to radon-related cases of lung cancer among non-smokers (Bayram et al., 2005, p. 64-65, 106). Every year, about 400,000 American smokers die from heart disease, emphysema, and lung cancer. The number of deaths gets even larger considering that second smoke leads to another 3,400 lung cancer deaths and 46,000 heart illnesses related deaths or complications. A study conducted by the U.S. government early in the 1990s found that out of 800 Americans above the age of 4 years that were tested, 800 had cotinine in their blood as a result of exposure to environmental smoke (Rabinoff, 2007, p. 40).
Also linked to cigarette smoking are cardiac arrests, aortic aneurysms, sudden death, peripheral vascular sickness, and cardiovascular disease. Cigarette smoking is a major cause of cardiovascular diseases such as atherosclerosis, Coronary Heart Disease (CHD), and stroke, also referred to as Cerebral Vascular Disease. CHD is a major cause of heart attacks (myocardial infarction) and sudden cardiac deaths. In all of these conditions, there is a common narrowing of coronary arteries, a condition that affects the rate at which blood is carried back to the heart. When there is reduced oxygen in the blood, a condition referred to as atherosclerosis occurs. The muscles serving the arteries get weak from the lack of oxygen, and this can lead to complete blockage of the artery. When the aorta, which is the main artery in the blood circulation, gets affected, a condition known as aortic aneurysm occurs, and this could lead to rupture of the aorta and subsequent death of the victim. Epidemiological evidence linking smoking and cardiovascular disease indicates that the risk of death from this disease among smokers increases with daily increased and prolonged use of tobacco (Slovic, 2001, p.18).
Tobacco use also leads to low lung function or chronic obstructive pulmonary disease (COPD), a major cause of respiratory deaths among smokers. Another term for this kind of condition is emphysema, although COPD is more commonly applied today. This kind of sickness progressively develops in a small number of smokers and will normally accelerate after lengthy use of tobacco to result in reduced lung capacity. Unchecked inflammation of the lungs that goes untreated for a long time will develop into COPD and subsequent death of the victim. Respiratory infections such as fatal pneumonia, bronchitis, and laryngitis are also very common, especially in smokers exhibiting both COPD and CHD. These infections are a leading cause of death in smoking with these conditions as compare to non-smokers. Many cigarette smoke components, through excessive irritation of the respiratory system, lead to excess secretion of bronchial mucus, causing chronic mucociliary and pulmonary dysfunction (Slovic, 2001, p.18-19).
Genetically, have the tendency to fight or run away from danger, and socially, they are conditioned to respond to immediate threats or perceived dangers. While some reactions get overboard in relation to the actual problem, other dangers are dismissed as normal situations and receive little or no reaction at all. Cigarette smoking is one such danger that receives little kind of reaction in comparison to the dangers that tobacco users are exposed to. This has mainly been attributed to the expensive, concerted, and conscious advertising and media coverage that tobacco manufacturing companies have continued to carry out when marketing their products. These companies mainly direct their advertisements towards young adults because most addictions take place before the 21 year age mark. Through these advertisements, tobacco-producing companies entice teenagers into the habit through such attractive ideals as glamour, sophistication, athletic prowess, being grown-up, and being sexy (Rabinoff, 2007, p. 57, 80).
The war against cigarette smoking is a tough one for governments and anti-tobacco crusaders. For every dollar spent by state governments in campaigns to prevent the use of tobacco, tobacco companies spend over 20 dollars in the marketing of the same. They are said to spend more capital in tobacco marketing in a period running for three weeks than what states spend in anti-tobacco campaigns every year. And although cigarette smoking continues to lose status as an acceptable social norm in the U.S. and other countries, it seems like this problem has already reached pandemic or plague levels. The majority of smokers get hooked to the habit before they get to the age of 18 years either for the fun of it or out of peer pressure, and unless there is a serious intervention into the situation, addiction to tobacco will continue to take an upward trend as tobacco companies continue to replace the millions of people they have escorted to their deaths through smoking ((Rabinoff, 2007, p.12, 59).
Cigarette smoking is so addictive that the majority of the smokers are well aware of how much they hurt themselves as well as their families but are nevertheless unable to quit the habit. Most tobacco-related deaths are normally lengthy; painful experiences wrapped up in a very expensive package, money-wise. This comes in the form of direct Medicare costs, neonatal care, and lost productivity, which affects both the smokers and their families. Tobacco producing companies are known to keep a low profile in advertising of such remedial products as Nicorette gum and nicotine patches. But every smoker affected by a tobacco related illness is more than willing to quit the habit, and as such, it is important that they are helped in achieving this good course (Rabinoff, 2007, p.14-15, 39).
Since smoking related health complications occur much later in the lives of smokers, the best way to control tobacco related mortality is by helping children to completely keep off from the habit. In such way, the world can be sure that smoking will not be a cause of death for another 50 years. Smokers who quit the habit before they get to middle age also reduce the likelihood of premature death from smoking related illnesses. After middle age, there is a higher risk of illness, but the risk of death is substantially reduced. This makes quitting the only practical way of reducing tobacco related deaths. A 50 per cent reduction of smokers would tremendously help to avoid roughly 200 million related deaths in a century. Any achievements through such a move would make quitting the best method of intervention into the tobacco pandemic; better than any other health care method (Jones, 2004, p.391). Increasing federal and state tax on tobacco products has also achieved positive results towards the reduction of tobacco related illnesses. Increasing the price of cigarettes helps to decrease the number of regular smokers, especially among the teenagers and young adults (Ropeik & Gray, 2002, p.145).
Quitting as a solution to reducing tobacco related deaths is a process that requires a very strong will on the part of the affected persons. But a strong will certainly give birth to positive results considering the advantages associated with a smoke free life. Several products are now available in the market, which help smokers to quit smoking. These products supply the smoker’s nicotine needs while eliminating the effect of other harmful ingredients of tobacco smoke. Examples of these products include nicotine substitutes such as sprays, gums, inhalers and patches. Although these are meant to help with the gradual withdrawal of the smoker from nicotine, the users remain exposed to the dangers of nicotine use. Better results from such products can only be realized in combination of support from close relatives and colleagues as well as cessation programs (Ropeik & Gray, 2002, p.147). Clinical facilities in support of the war against tobacco use should be increased and properly staffed to help nicotine addicted persons through the recovery process. Psychological treatments such as counseling should go along drug treatment as a means of sustaining the motivation to quit smoking. This gives better results if applied at the individual level. (Jones, 2004, p.391).
But the tobacco problem requires a long term solution rather than medical attention. Approaching the problem from a more social perspective would produce better results, and the best available channels for such action are fiscal policies, bans on cigarette advertising, retailer restraints and restriction of cigarette smoking within all public places. These policies have achieved some positive results in developed and also in some of the developing countries, though they have only helped to reduce smoking among the already engaged population. A better solution to the problem is the implementation of social policies that will be geared towards improving the living standards of the less privileged in society (Jones, 2004, p. 391).
Jones.R. (2004). Oxford Textbook of Primary Medical Care. New York: Oxford University Press.
Bayram.N., Owing. J.H., Cheetah.A., and D’lppolito.R. (2005). Smoking and health: New Research. New York: Nova Publishers.
Rabinoff.M. (2007). Ending the Tobacco Holocaust: How the Tobacco Industry Affects Our Health Pocketbook, and Political Freedom and what We Can Do about it. Santa Rosa: Elite Books.
Ropeik.D. and Gray.G. (2002). Risk: A Practical Guide for Deciding what’s really Safe and what’s Dangerous in the World Around You. Boston: Houghton Mifflin Books.
Slovic.P. (2001). Smoking: Risk, Perception & Policy. Seminole: Sage Publishers.