Cigarette Smoking

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                           (This sheet is summary of links to the above website as of July 2004)

Cigarette Smoking .. see also passive smoking

Smoking and heart and blood vessel disease
Cigarette smoking is a major cause of heart attack, stroke and peripheral vascular disease. Smoking kills just over 18,000 Australians a year.1 This means that almost 50 Australians a day die from smoking.

Nearly 40% of all the people who die from smoking die from heart and blood vessel disease.1 In 1992 there were 7,265 deaths due to smoking related cardiovascular disease. This represents 13% of deaths from cardiovascular disease (54,912 deaths).1

Tobacco use is accountable for a large proportion of heart attacks among younger cigarette smokers, both male and female, who are otherwise at low risk of coronary heart disease.2,3

Although public awareness of the health consequences of smoking has increased, only 34% of people freely recall that heart disease is related to smoking, 7% recall that stroke/vascular disease is related to smoking, compared to 62% recall for lung cancer.4

Tobacco smoke and heart and blood vessel disease mechanisms

  • Tobacco smoke contains more than 4,000 chemicals, many of them known poisons.
  • Nicotine and carbon monoxide play a role in the process leading to heart and blood vessel disease. Tar in tobacco contains dozens of chemicals that cause cancer.
  • Smoking adds to the artery-clogging process that can lead to heart attack, stroke and peripheral vascular disease. It also overworks the heart and reduces its oxygen supply, makes clots more likely to form in blood vessels, and increases the risk of potentially fatal changes in the heart beat.

Risks
Smokers have a 70% greater risk of death from coronary heart disease than non smokers.2

Cigarette smoking:

  • doubles the risk of heart attack;
  • doubles the risk again if you have high blood pressure or high cholesterol;
  • increases the risk of heart attack 10 times in women using the contraceptive pill;
  • doubles the risk of stroke; and
  • increases the risk of gangrene by more than five times.

Smoking and child health

Passive smoking is especially risky for children and babies. It can cause the following5, 6:

  • low birth weight babies
  • sudden infant death syndrome (SIDS)
  • bronchitis and pneumonia
  • middle ear infections

Exposure to passive smoking at home

  • In 1995 38% of persons under 18 years of age were exposed to tobacco smoke in the home; this represents approximately 1.7 million children and adolescents.7
  • In 1995 over 40% of under 5 year olds lived with at least one smoker 8
  • Non-smokers living with smokers have about a 25% increase in risk of death from heart attack and are also more likely to suffer a stroke.6,9

Starting smoking

  • 80% of new smokers are children or adolescents, most starting during their secondary school years.10
  • There is a complex interplay of factors that directly and indirectly affect an individuals choice to use tobacco. These include lower academic achievement, poor self-esteem/self-image, a belief about the positive values of smoking, the perceived acceptability of smoking in school, home and community settings, peer and parental smoking and the availability of cigarettes in the community 11,12
  • The reasons why young people do not continue with smoking are because of friends, cost of cigarettes, parental reaction against smoking, dislike of taste, health risk acceptance and good refusal skills12.

Smoking among school students

  • In a single year more than 336,000 Australian school children spend $100 million on more than 370 million cigarettes.13
  • The proportion of smokers among students increases with age: by 17 years, 32% of girls and 31% of boys are current smokers.14
  • From age 13 onwards, smoking is more prevalent among girls than boys; however boys tend to be heavier smokers than girls.14
  • Despite laws against sales to minors, 52% of girls who smoke and 48% of boys who smoke bought their last cigarette, most often from a milk bar or delicatessen.14
  • It is estimated that the government revenue in 1998 from taxes on cigarettes smoked by children in Australia was $64 million.13

Smoking among adults

  • In 1995 27% of men and 23% of women were smokers. The prevalence of smoking peaks between the ages of 25 and 29 for both men and women (35%), after which age smoking generally decreases.15
  • Among current smokers, 75% have attempted some form of tobacco reduction in the last 12 months by cutting back the number of cigarettes, trying to quit or changing to lower tar or nicotine.16

Smoking among Indigenous Australians

  • More than half (54%) of urban Aboriginal and Torres Strait Islander peoples are current or regular smokers.17 This is much higher than among non-Aboriginal people.

Smoking among Australian residents born overseas

  • In 1993 males born in Scotland and Ireland, Southern Europe, and the Middle East were more likely to smoke than Australian born males.18 Females from Scotland and Ireland, and Western Europe were more likely to smoke than Australian born females.18

Cost

  • In 1992, the social cost to Australia of tobacco use (excluding passive smoking), was estimated at $12.7 billion.19 This makes it society's most costly drug.

Quitting Smoking

  • A smokers excess risk of heart disease is reduced by 50% after only one year of smoking abstinence20
  • Fifteen years after stopping smoking the risk of heart disease is about the same as if you had never smoked20
  • There are short term economic and health benefits of smoking cessation both in terms of dollars saved on medical costs and CVD events avoided21

March 1999 - References

  1. English DR, Holman CDJ, Milne E, Winter MG, Hulse GK, Codde JP, Bower CI, Corti B, de Klerk N, Knuiman MW, Kurinczuk JJ, Lewin GF, Ryan GA. The quantification of drug caused morbidity and mortality in Australia, 1995 edition. Commonwealth Department of Human Services and Health, Canberra, 1995.
  2. U.S. Department of Health and Human Services. The health consequences of smoking: cardiovascular disease. A report of the Surgeon General 1983. Rockville, Maryland: Public Health Service, Office on Smoking and Health.
  3. Parish S, Collins R, Peto R et al for the International Studies of Infarc Survival (ISIS) Collaborators 1995. Cigarette smoking, tar yields, and non-fatal myocardial infarction: 14000 cases and 32000 controls in the United Kingdom. Br Med J 311:471-477.
  4. Mullins R, Morand M, Borland R. Key findings of the 1994 and 1995 Household Survey. In: Victorian Smoking and Health Program. Quit Evaluation Studies No.8, 1994-1995. Melbourne: Victorian Smoking and Health Program, 1996: 1 -23.
  5. California Environmental Protection Agency, Office of Environmental Health Hazard Assessment. Health effects of exposure to environmental tobacco smoke. Sacramento: California Environmental Protection Agency, 1997. (http://www.calepa.cahwnet.gov/oehha/docs/finalets.htm)
  6. National Health and Medical Research Council. The health effects of passive smoking. A Scientific Information Paper. Commonwealth of Australia. November 1997.
  7. Williams P. Progress of the National Drug Strategy: Key National Indicators. Evaluation of the National Drug Strategy 1993-97 Statistical Supplement. Department of Health and Family Services, Commonwealth of Australia, AGPS, 1997.
  8. Moon L, Rahman N, Bhatia K. Australia's Children 1998. Their Health and Wellbeing. AIHW Cat. No. PHE-7, Canberra. AIHW. www.aihw.gov.au/publications
  9. Law M, Morris J, Wald N. 1997. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ 1997; 315:973-80
  10. Winstanley M, Woodward S, Walker N. Tobacco In Australia. Facts and Issues. Victorian Smoking and Health Program. 1995
  11. US Department of Health and Human Services. Preventing Tobacco Use Among Young People. A Report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health promotion, Office on Smoking and Health, 1994. http://www.cdc.gov/tobacco/
  12. Smoking and the Young. A report of a working party of the Royal College of Physicians. Royal College of Physicians of London, 1992.
  13. Scollo M. The 64 million dollar Question. Unpublished report. Prepared for the Heart and Cancer Offensive, September 1998
  14. Hill D, White V, Segan C. Prevalence of cigarette smoking among Australian secondary school students in 1993. Aust J Public Health 1995; 19(5):445-9
  15. Hill DJ, White VM, Scollo MM. Smoking behaviours of Australian adults in 1995:trends and concerns. MJA 1998; 168: 209-213
  16. National Drug Strategy. Household Survey. Survey Report 1995. Commonwealth Department of Health and Family Services. Commonwealth of Australia 1996.
  17. National Drug Strategy. Household Survey. Urban Aboriginal and Torres Strait Islander Peoples Supplement. Commonwealth Department of Human Services and Health. AGPS 1994
  18. Bennett SA. Inequalities in risk factors and cardiovascular mortality among Australia's immigrants. Aust J Public Health 1993; 17:251-261
  19. Collins DJ, Lapsley HM. The social cost of drug abuse in Australia in 1988 and 1992. National Drug Strategy. Monograph Series No. 30. Canberra:AGPS, 1996.
  20. The Health Benefits of Smoking Cessation. A Report of the Surgeon General, 1990. Alanta, GA: Centers for Disease Control, Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1990. US Dept of Health and Human Services.
  21. Lightwood and Glantz. 1997. Short term economic and health benefits of smoking cessation. Myocardial Infarction and Stroke. Circulation 96(4): 1089-1096.

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