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Smoking rate dropping; still killing too many
Health advice
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Once socially accepted, smoking is now known to be the leading preventable cause of death and disability in the United States. During the first decades of the last century, lung cancer was rare, but as cigarette smoking became more popular, the incidence became more and more common.
This year, women comprise about 20 percent of the world’s more than 1 billion smokers. The epidemic of tobacco use among women, however, is increasing in some countries. Women are a major target of opportunity for the tobacco industry, which is seeking to recruit new users to replace smokers who will die prematurely from tobacco-related diseases. This is believed to be approximately one half of all current tobacco users.
Particularly troubling is the rising prevalence of tobacco use among girls. A new World Health Organization report on women and health points to evidence that tobacco advertising increasingly targets girls.
Reacting to that statement, public health initiated preventive health and education programs to reduce tobacco use. Since then the incidence of smoking-related cancers (including cancers of the lung, oral cavity, and pharynx) has declined along with the decline in smoking. The exception is for lung cancer among women. In addition, age-adjusted death rates for heart disease have decreased and it is estimated that approximately 1.6 million deaths that would have been caused by smoking were prevented.
Research has defined the following diseases and conditions that are caused by tobacco use: heart disease, atherosclerotic peripheral vascular disease, laryngeal cancer, oral cancer, esophageal cancer, chronic obstructive pulmonary disease, intrauterine growth retardation, and low birth weight. The harmful effects of smoking do not end with the smoker. Even brief exposure can be dangerous because nonsmokers inhale many of the same carcinogens and toxins in cigarette smoke as smokers. Even smokeless tobacco, cigars, and pipes also have deadly consequences, including lung, larynx, esophageal, and oral cancer.
Despite the research and epidemiological achievements of the 20th century, approximately 48 million U.S. adults still smoke cigarettes. Tobacco use is currently responsible for approximately 430,000 deaths each year, one of every five deaths.
While we see the effects of tobacco in our country, developing countries are facing the brunt of the epidemic. Tobacco use has declined in many high-income countries but there has been a sharp increase in tobacco use, especially among men, in low and middle-income countries in recent years. This, by itself, justifies investments in tobacco control programs. It is important to note that tobacco use and its relationship to disease, tends to follow a gradient pattern. In other words, poorer individuals tend to use tobacco products more than their wealthier counterparts and similar patterns exist with respect to education and socioeconomic status.
More attention needs to be given to the ways in which tobacco increases poverty. This should include the damage done when scarce family resources are spent on tobacco products rather than food and other essential needs. For example, if two-thirds of the money spent on cigarettes in Bangladesh were spent on food instead, it could save more than 10 million people from malnutrition.
Research suggests that by the year 2020, tobacco will become the leading cause of death and disability in the world - killing more than 10 million annually - thus causing more deaths than HIV, tuberculosis, maternal mortality, motor vehicle accidents, suicide and homicide combined.
The WHO has selected “Gender and tobacco with an emphasis on marketing to women” as the theme for the next World No Tobacco Day, May 31. If someone you love smokes, take this opportunity to encourage them to stop and set an example should  this be  a habit you have.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.
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