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I believe the most important thing an individual can do for his or her health is to not smoke. Smoking has been identified as the most important preventable cause of disease and premature death by the U.S. Surgeon General. There are over 350,000 deaths each year that are directly related to smoking. This is more than the total number of American lives lost in World War I, Korea and Vietnam combined. Twenty-three percent of the adult population smoke.
Smoking mainly causes death through heart attacks, cancer, and lung disease. Five and one-half minutes of life are lost for each cigarette smoked. This reduces the overall life expectancy by 5-8 years. The lifetime medical costs for smokers, despite their shorter lives, are higher than those for nonsmokers by approximately one third. What these figures do not reflect is the quality of life. These people are miserable in their later years. I have patients who are actually short of breath while sitting still. They cannot do anything physical and just seem to exist. The direct health-care costs associated with smoking are in excess of 16 billion dollars. Nonsmokers contribute one hundred dollars per year to take care of smoking induced illnesses. We pay this primarily through taxes and insurance premiums. Smoking directly causes thirty to forty percent of the 565,000 deaths from heart disease each year. Women who smoke and take birth control pills have a ten times greater risk of dying from a heart attack than nonsmokers. Your chance of developing lung cancer is increased 11 times if you smoke. The nonsmoking spouse of a smoker has double the chance of developing lung cancer just from being exposed to his or her spouse's smoke.
Lung cancer causes over one-fourth of all cancer deaths making it the most common cause of death from cancer. Lung cancer can't be detected early and we are not even close to a cure. The last "big break through" was in treating oat cell lung cancer. Instead of dying 3-6 months after the diagnosis, you can now live up to 18 months. Again, these figures do not reflect the quality of life. The chemotherapy alone causes extreme nausea and vomiting. Smoking also causes cancer of the larynx, mouth, esophagus (which is the feeding tube) and the bladder.
Smoking increases the risk of developing chronic lung disease by 30 times. Children of smokers get more colds and have a 70% greater chance of being hospitalized for respiratory conditions than children of nonsmokers. Smoking during pregnancy results in smaller infants and there is an increase in early fetal and neonatal deaths. Smoking is a type of immune deficiency. The body has difficulty fighting off diseases. This is why smokers seem to get more infections than nonsmokers. After you quit smoking it takes about 10-15 years before your chance of getting cancer is about the same as nonsmokers. Nicorette chewing gum helps improve the quitting rate by about 50 percent. The nicotine containing patches are helpful also. There are some medications that also help one stop smoking, but there must be a strong desire to quit.


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2. Fielding JE. Smoking: health effects and control (1). N Engl J Med 1985 Aug 22;313(8):491-97
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The information provided above is offered as a community service about health-care issues and is not a substitute for individual consultation. Advice on individual problems should be obtained from your personal physician. This information is based on research by the author and represents his interpretation of the literature.

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