Tobacco-Related Diseases: Overview

Tobacco-related diseases, including lung disease, heart disease, stroke * , and cancer * , are illnesses caused by tobacco use. Tobacco use is responsible for nearly one in every five deaths in the United States.

Tobacco use is linked to a host of undesirable effects on the human body. It can cause shortness of breath, a loss of stamina, stained teeth and yellowed fingers, and wrinkled skin. But of greatest concern are the serious health conditions that tobacco use can lead to. Hundreds of studies have found that cigarette smoking can cause lung disease, heart disease, stroke, cancer, and many other diseases. Smoking as few as one to four cigarettes per day is enough to cause significant health problems. Tobacco-related diseases cost the United States around $170 billion each year in direct medical care and another $156 billion in lost productivity due to the premature deaths of tobacco users and illnesses contracted by nonsmokers due to secondhand smoke.

Tobacco use eventually leads to death or disability for around half of all regular users. In fact, it is the leading cause of preventable death in the United States. It kills more people than AIDS, * alcohol, drug abuse, car crashes, murders, suicides, and fires combined.

The following are some of the diseases and health conditions that are linked to tobacco use.

Bronchitis (brong-KY-tis) refers to a long or frequently recurring inflammation * of the bronchial (BRONG-kee-al) tubes, the airways that connect the windpipe to the lungs. This condition leads to a cough that brings up lots of thick, sticky mucus * . About 9 million Americans have chronic bronchitis, with smoking being the most common cause.

Emphysema (em-fe-ZEE-ma) is a chronic lung disease in which the air sacs of the lungs are overly large. This condition makes the lungs work less efficiently and leads to shortness of breath. About 3.5 million Americans have emphysema, and most of these cases are caused by smoking.

Heart disease refers to a range of conditions involving the heart, including those caused by narrow or blocked blood vessels, such as heart attacks and angina (chest pain). Smoking increases blood pressure and increases the tendency of blood to clot, which can lead to heart disease. Approximately 610,000 people die of heart disease in the United States every year. Smokers are twice as likely as nonsmokers to have a heart attack and two to four times as likely to die suddenly of heart problems.

A stroke occurs when a blood vessel to the brain is blocked or bursts, which can damage the brain. Strokes are the leading cause of serious, long-term disability in the United States and kill around 130,000 people per year. Smoking raises the risk of having a stroke.

Smoking by pregnant women is linked to miscarriage * , stillbirth * , premature birth * , low birth weight * , and infant death. Women who smoke are also more likely to have trouble getting pregnant.

Lung cancer kills more people than any other kind of cancer. Each year, more than 210,000 people are diagnosed with lung cancer in the United States, and about 158,000 people die from it. Smoking is the direct cause of almost 80 percent of all lung cancers.

Cigarette smoke contains more than 7,000 different chemicals, and at least 69 of these have been shown to cause cancer in humans and animals. Smokers are more likely to get several kinds of cancer, including that of the mouth, larynx * , esophagus * , bladder * , cervix * , pancreas * , and kidney * .

Use of smokeless tobacco can lead to gum problems and tooth loss.

Smoking has also been linked to a variety of other health problems, including asthma * , gum disease * , cataracts * , bone thinning, pneumonia * , peripheral artery disease (disease of the blood vessels outside the heart, such as those of the legs, hips, and kidneys), and peptic ulcers * .

No form of tobacco use is safe. In addition to smoking cigarettes, using smokeless tobacco (also called oral, spitting, or chewing tobacco, and snuff) can have deadly results. It can cause bleeding gums, tooth loss, and sores of the mouth that never heal. Eventually, smokeless tobacco can cause cancer of the mouth, larynx, and esophagus. Young people who use smokeless tobacco are also more likely to start using cigarettes.

Pipe and cigar smokers, like cigarette smokers, have higher death rates from heart disease than nonsmokers. They are more likely to get cancer of the mouth, larynx, and esophagus, too. The use of any tobacco product, even ones that are labeled “low tar,” “naturally grown,” or “additive free,” as well as hand-rolled cigarettes and smoking using a hookah (water pipe), can cause addiction and health problems.

In addition to harming the health of the smoker, smoking also affects nonsmokers. Secondhand smoke, also called environmental tobacco smoke or passive smoke, is when smoke is inhaled passively or involuntarily by someone who is not smoking. Secondhand smoke in adults can lead to heart disease and stroke. In children it can cause infections of the lower airways and lungs and worsen asthma symptoms. It can also lead to ear infections, bronchitis, and pneumonia. Babies born of mothers exposed to secondhand smoke may have low birth weight and be more likely to die of sudden infant death syndrome (SIDS) * .

Disagreement exists over whether or not secondhand smoke causes lung cancer. According to the Centers for Disease Control and Prevention (CDC), secondhand smoke causes 7,300 nonsmokers to die from lung cancer yearly. However, a study published in the Journal of the National Cancer Institute in 2013 found no strong link between secondhand smoke and lung cancer in almost all of the participants, although the scientists couldn't completely rule it out as a risk factor.

The nicotine in tobacco is the chemical that causes people who smoke to become addicted (hooked). Nicotine is absorbed easily from tobacco smoke in the lungs. Within seconds, nicotine travels through the bloodstream to the brain. There, it signals the brain to release chemicals that make people want to smoke more. The effect is very powerful. If smokers become addicted to nicotine, they can become dependent on it physically and suffer unpleasant symptoms when it is taken away. The ability of nicotine to cause addiction is as strong as that of heroin or cocaine. Users of smokeless tobacco can also become addicted because nicotine is absorbed through the inner lining of the mouth.

One hallmark of any addiction is tolerance, which means that over time people start to need more and more of a substance to feel its effects. When people first start smoking, one cigarette may make them queasy and dizzy; some first-time smokers even vomit with their first inhalation. Soon these individuals can smoke several cigarettes without any problem, and most smokers are up to a pack or more each day by age 25.

Another sign of addiction is withdrawal symptoms, which means that people have physical symptoms and feel sick if they stop using the substance to which they are addicted. When people are forced to stop smoking even for a short time, they may have unpleasant symptoms. Many rush to light up as soon as they leave a place where smoking is not allowed.

In 2014 around 40 million adults (16.8 percent) in the United States were smokers. Non-Hispanic American Indians/Alaska Natives made up the largest group of smokers, at 29.2 percent; Asians were the smallest group, at 9.5 percent. With regard to gender, 18.8 percent of men and 14.8 percent of women were smokers in 2014.

Tobacco use during the teenage years is of special concern because nicotine is highly addictive at this age. Nealy nine out of ten adults who smoke began smoking by age 18. Young people who stay smoke-free through high school have a good chance of never lighting up. In 2014 nearly 25 percent of high school students and almost 8 percent of middle school students reported being tobacco users. In addition to cigarettes, numbers of students also reported smoking cigars, electronic cigarettes, and hookahs. Student athletes were more likely to use smokeless tobacco products.

Young people who start smoking are more likely to get lower grades in school than nonsmokers. These students often have low self-esteem, and they may turn to smoking because they think it will make them more attractive or popular. Because such teenagers lack self-confidence, they may have trouble saying no to tobacco.

Most smokers say they do not plan to be smoking in five years. But in fact, more than 70 percent of smokers continue to smoke. The main reason it is so tough to quit is the discomfort of withdrawal. When smokers suddenly stop or sharply cut back on their tobacco use, a host of distressing symptoms quickly set in. People are tempted to start smoking again to relieve the distress. Common symptoms of tobacco withdrawal include the following:

Three strategies have been shown to best help people quit smoking: using medications, getting support and encouragement, and learning to handle the urge to smoke.

Personal counseling or a quit-smoking program can help someone learn how to live life as a nonsmoker. Studies have shown that the more counseling people have, the greater their chances of success. A quit-smoking program that offers at least four to seven sessions over a period of at least two weeks and devotes a satisfactory amount of time and attention to the problem has proven to be the most successful. Friends and family members can also give support. In addition, self-help books and telephone hotlines may be helpful.

People benefit from becoming aware of the situations or problems that make them want to smoke. For example, many people like to smoke when they are around other smokers or are feeling sad or frustrated. It is a good idea to avoid these situations as much as possible when trying to quit. Engaging in enjoyable and healthy physical activities, such as going for a walk or bike ride, can reduce stress. People who want to quit need to keep their minds busy, too, to help control thoughts of smoking.

Choosing not to smoke goes a long way toward preventing tobacco-related diseases, but secondhand smoke is also harmful and should be avoided whenever possible. Children should not be regularly exposed to secondhand smoke, and smokers should be encouraged to quit for their health and the health of others. Advocating for smoke-free restaurants and stores, workplaces, and residential buildings is also important. Several states have enacted laws that ban smoking in certain areas and establishments.

See also Addiction • Asthma • Bronchiolitis and Infectious Bronchitis • Cancer: Overview • Cataracts • Emphysema • Environmental Diseases: Overview • Heart Attack (Myocardial Infarction) • Heart Disease: Overview • Hypertension • Kidney Cancer • Lung Cancer • Oral Cancer • Pancreatic Cancer • Peripheral Vascular Disease • Pregnancy • Stroke • Substance Abuse • Sudden Infant Death Syndrome (SIDS) • Uterine Cancer

* stroke is a brain-damaging event usually caused by interference with blood flow to the brain. A stroke may occur when a blood vessel supplying the brain becomes clogged or bursts, depriving brain tissue of oxygen. As a result, nerve cells in the affected area of the brain, and the specific body parts they control, do not properly function.

* cancer is a condition characterized by abnormal overgrowth of certain cells, which may be fatal.

* AIDS, or acquired immunodeficiency (ih-myoo-no-dih-FIH-shen-see) syndrome, is an infection that severely weakens the immune system; it is caused by the human immunodeficiency virus (HIV).

* immune system (im-YOON SIStem) is the system of the body composed of specialized cells and the substances they produce that helps protect the body against disease-causing germs.

* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.

* mucus (MYOO-kus) is a thick, slippery substance that lines the insides of many body parts.

* miscarriage (MIS-kare-ij) is the end of a pregnancy through the death of the embryo or fetus before birth.

* stillbirth is the birth of a dead fetus.

* premature birth (pre-ma-CHUR) means born too early. In humans, it means being born after a pregnancy term lasting less than 37 weeks.

* low birth weight means born weighing less than normal. In humans, it refers to a full-term (pregnancy lasting 37 weeks or longer) baby weighing less than 5 pounds.

* larynx (LAIR-inks) is the voice box (which contains the vocal cords) and is located between the base of the tongue and the top of the windpipe.

* esophagus (eh-SAH-fuh-gus) is the soft tube that, with swallowing, carries food from the throat to the stomach.

* bladder (BLAD-er) is the sac that stores urine produced by the kidneys prior to discharge from the body.

* cervix (SIR-viks) is the lower, narrow end of the uterus that opens into the vagina.

* pancreas (PAN-kree-us) is a large gland located behind the stomach that secretes various hormones and enzymes necessary for digestion and metabolism (me-TAB-o-liz-um).

* kidney is one of the pair of organs that filter blood and remove waste products and excess water from the body in the form of urine.

* asthma (AZ-mah) is a condition in which the airways of the lungs repeatedly become narrowed and inflamed, causing breathing difficulty.

* gum disease is an infection caused by bacteria that affect the tissues surrounding and supporting the teeth.

* cataracts (KAH-tuh-rakts) are areas of cloudiness of the lens of the eye that can interfere with vision.

* pneumonia (nu-MO-nyah) is inflammation of the lungs.

* ulcer is an open sore on the skin or the lining of a hollow body organ, such as the stomach or intestine.

* sudden infant death syndrome (SIDS) is the sudden, unexplained, unexpected death of a child in the first year of life.