Tobacco and Health

Extract

[...] Other forms of tobacco use include pipes and cigars (used by of men and of women) and smokeless tobacco ( of men and of women). Smokeless tobacco use in the United States is primarily oral snuff and chewing tobacco, whereas nasal snuff is used to a greater extent in the United Kingdom. Oral snuff (snus) is widely used by men in Sweden. Harmful Constituents of Tobacco Tobacco smoke is an aerosol of droplets (particulates) containing water, nicotine and other alkaloids, and tar. [...]

[...] Risks are increased for coronary heart disease, sudden death, cerebrovascular disease, and peripheral vascular disease, including aortic aneurysm. Cigarette smoking accelerates atherosclerosis and promotes acute ischemic events. CARDIOVASCULAR DISEASE The mechanisms of the effects of smoking are not fully elucidated but are believed to include hemodynamic stress (nicotine increases the heart rate and transiently increases blood pressure; endothelial injury and dysfunction (nitric oxide release and resultant vasodilation are impaired), CARDIOVASCULAR DISEASE development of an atherogenic lipid profile (smokers have on average higher low-density lipoprotein, more oxidized low-density lipoprotein, and lower high-density lipoprotein cholesterol than nonsmokers do; enhanced coagulability, arrhythmogenesis, and relative hypoxemia because of the effects of carbon monoxide. [...]

[...] Smoking reduces the secretion of thyroid hormone in women with subclinical hypothyroidism and increases the severity of clinical symptoms of hypothyroidism in women with subclinical or overt hypothyroidism, the latter effect reflecting antagonism of thyroid hormone action. OTHER COMPLICATIONS Cigarette smoking also potentially interacts with a variety of drugs by accelerating drug metabolism or by the antagonistic pharmacologic actions that nicotine and/or other constituents of tobacco have with other drugs. Health Hazards of Smokeless Tobacco Smokeless tobacco refers to snuff and chewing tobacco. Oral snuff is placed (as a "pinch") between the lip and gum or under the tongue; chewing tobacco is actively chewed and generates saliva that is spit out ("spit tobacco"). [...]

[...] Patches are applied in the morning and removed either the next morning or at bedtime, depending on the patch. Treatment of Nicotine Addiction Full-dose patches are recommended for most smokers for the first 1 to 3 months, followed by one to two tapering doses for 2 to 4 weeks each. Nicotine nasal spray, one spray into each nostril, delivers about 0.5 mg of nicotine systemically and can be used every 30 to 60 minutes. Local irritation of the nose commonly produces burning, sneezing, and watery eyes during initial treatment, but tolerance develops to these effects in 1 to 2 days. [...]

[...] Public Health Service consists of 5 As: ask about smoking at every opportunity, advise all smokers to stop, assess willingness to make a quit attempt, Treatment of Nicotine Addiction assist the patient in stopping and maintaining abstinence, and arrange follow-up to reinforce nonsmoking. Assistance in quitting should include providing self-help material or quit kits, which are widely available from governmental health agencies; professional societies; and local organizations, such as cancer, heart, and lung associations. Treatment of Nicotine Addiction The physician may offer additional education and counseling through the office (most efficiently provided by office staff and by teaching aids such as videotapes) or through referral to community smoking cessation programs. [...]