Smoking prevalence has been declining in countries such as the United States, Australia, Canada, and the United Kingdom, but these declines are matched by increasing rates in most other countries. The Healthy People 2010 goal in the United States is to decrease prevalence from 24 percent to 12 percent by the year 2010. This goal can only be achieved by helping current smokers to quit. Increasing the incidence of quitting is achieved through medications, counseling strategies, and public health approaches.
IMPACT OF SMOKING
In the United States smoking became increasingly popular from the early 1900s through the mid-1960s, but it then declined substantially. During the 1950s, the link between smoking and respiratory diseases and cancer became known. In 1964, the first Surgeon General's Report on smoking noted the substantial health hazards associated with smoking. Cigarette smoke contains more than 4,000 chemicals, of which forty-three are known to cause cancer. Among the more toxic chemicals in tobacco are ammonia, arsenic, carbon monoxide, and benzene. Cigarette smoking is now known to cause chronic obstructive pulmonary disease (COPD), heart disease, stroke, multiple cancers (including lung cancer), and adverse reproductive outcomes. Smoking causes about 21 percent of all deaths from heart disease, 86 percent of deaths from lung cancer, and 81 percent of all deaths from chronic lung disease.
Nicotine is highly addictive and causes persistent and compulsive smoking behavior. Most users make four to six quit attempts before they are able to remain nicotine-free. Smoking cessation produces major and immediate health benefits by reducing mortality and morbidity from heart disease, stroke, cancer, and various lung diseases.
CORINNE G. HUSTEN, ABBY C. ROSENTHAL, MICAH H. MILTON, The Gale Group Inc., Macmillan Reference USA, New York,