bar Title: Smoke Signals | New Bad News from Nicotineland
Author: Lisa Turney
Publisher: Do It Now Foundation
Publication Date: October 2009
Catalog Number: 117

..Going, Going...

Smoking has always been a dying habit.

That isn't news. What is news is that the industry that grew up around smoking is finally getting a taste of its own medicine, and things are starting to look terminal.

Let's consider some recent symptoms. Just don't get too close to the patient; he's coughing up blood already:

  • In July, 2000, a Florida jury stunned the tobacco industry with the most-costly judgment in U.S. legal history -- a punitive-damages bill totalling $144.8 billion -- for knowingly selling a deadly, defective product to the American public and lying about it for decades.
  • In 1998, the tobacco industry voluntarily agreed to the biggest civil settlement in U.S. history, promising to pay $206 billion over 25 years for the health costs of smokers. This came in the wake of a $40 billion deal with four other states, conceding liability in the deaths and illness of millions of smokers.
  • Topping off that deal, the industry even agreed to spend $1.7 billion for anti-smoking ads and to stop youth-oriented marketing, including the use of cartoon characters. (Rest in peace, Joe Camel.)

Still, while the prognosis is bleak for the tobacco industry, long-term, in the short-term, the patient is still alive and kicking -- everyone who gets in the way:

  • 45.3 million American adults still smoke.
  • 4 of 5 smokers say they want to quit -- but when they try, 80 percent light up again within a year.
  • At least 1,100 U.S. deaths a day are caused by smoking -- and the rate's still climbing.

That's why we're inviting you to take a little time now to look closely at smoking.

We think if you really understand what happens when you smoke, you won't find it that hard to stop.

And if you're not already a smoker, you'll find it a lot easier to stay that way.

..Tobacco Talk

When you talk tobacco, two words -- tar and nicotine -- are unavoidable. That's because tar and nicotine are the best-known (and best-studied) chemicals in Nicotiana tabacum.

A main reason why is that there's simply so much of them in there.

Cigarette smoke contains .06-2.5 mg of nicotine and .5-35 mg of tar. Cigars contain even more -- up to 120 mg of nicotine (enough to kill you, if you choked it all down at once) -- while smokeless tobacco weighs in at around 6.9-14.4 mg.

But that's not all that's there. Tobacco also contains hundreds of other chemicals, and releases as many as 4,000 when it burns.

That might seem like enough weird simultaneous chemistry experiments to satisfy most people, but cigarette companies add more -- including menthol and other flavorings to enhance taste and "smokeability."

[That's even starting to change, though, with one manufacturer now touting their flagship brand as a "naked" additive-free cigarette. (As if that makes it healthy somehow).]

Naked or not, the tar, nicotine, and other gunk in a cigarette race to the lungs within nanoseconds of a smoker's first drag. There, the gunk does what gunk does, but the nicotine and other tobacco byproducts (like carbon monoxide and formaldehyde) mix with oxygen, move into the bloodstream, and head straight for the brain. And that's when things get really interesting.


In the brain, a cigarette's main drug effects kick in. And all of them center on nicotine, tobacco's main mood-altering chemical.

Like caffeine, nicotine is a stimulant that speeds up the flow of chemical signals in the brain. It also acts on the heart and other body systems, raising blood pressure and heart rate, reducing pain response and stress levels, and cutting appetite.

Nicotine also raises metabolism -- the rate at which the body burns off energy. That's one reason smokers tend to weigh less than non-smokers. It's also a reason why their skin wrinkles so quickly.

But that's not all that nicotine does. Probably what it does best is to create a need for itself in the body (and mind) of a smoker.

Mark Twain probably put it best when he said that quitting smoking is easy: He'd done it hundreds of times.

He wasn't alone. Most smokers do try to quit -- usually more than once.

One reason so many fail is that smoking is a learned behavior. And external "cues" -- drinking a cup of coffee, for example, or racing to meet a deadline -- can trigger associations that kick off a craving for cigarettes.

But the thing that turns the craving into a compulsion is nicotine, a drug that the U.S. Surgeon General has described as addictive as heroin or cocaine.

Like those drugs, nicotine boosts mood by altering the balance of neurotransmitters in the brain that regulate attention and arousal.

And just like its heavy-hitting chemical cousins, nicotine triggers a full-scale withdrawal syndrome when an addicted user stops using.

And while some of the symptoms of cold-turkey tobacco withdrawal -- frazzled nerves, tension, depression, and irritability -- are so universal that they're joked about, they're not funny to many would-be ex-smokers.

Maybe that's why like Mark Twain, they keep giving themselves the chance to quit all over again.

..Smoking Guns

The alternative to quitting is really no alternative at all. It's a list of diseases no one wants. And even though most smokers think (or, at least hope) serious problems won't happen to them, the numbers tell a different story:

  • Smokers die an average of 9.78 years earlier than non-smokers.
  • 177,000 Americans will die of smoking-related lung cancer this year alone.
  • 30 percent of all heart disease deaths are directly linked to smoking.

Others suffer emphysema, chronic bronchitis, pneumonia, and a range of other problems.

Smoking even affects the sexes differently.

It can be a factor in impotence among middle-aged men, and women smokers who take the Pill face almost twice the heart disease risk. Maternal smoking is also a frequent cause of fetal miscarriage and Sudden Infant Death Syndrome, or "crib death."

Additives add more problems. A recent study of esophageal cancer tied higher levels of the disease among African-Americans to their higher consumption of menthol cigarettes.

And contrary to their advertised image, low-tar brands aren't any "safer" than ordinary cigarettes. Studies show that smokers just smoke more to make up for lost nicotine.

And that brings us to one of the hottest hot-button issues in the current debate over smoking: Passive inhalation by nonsmokers of "sidestream" smoke.

They say where there's smoke there's fire, and in the case of passive smoking, there's plenty of both -- and plenty of evidence to confirm some of the worst fears of nonsmokers and researchers alike.

In fact, the American Heart Association, American Lung Association, and American Cancer Society estimate that passive smoking figures into as many as 43,000 U.S. deaths each year and raises the risk of cancer and other diseases among the children, co-workers, friends, and spouses of smokers.

The risk is so great, in fact, that the Environmental Protection Agency has declared sidestream smoke a "class A" carcinogen, and backed it up with new restrictions on workplace smoking.

It isn't just someone's opinion any more -- it's a fact. And it's such a big fact that not even Big Tobacco and its high-priced lawyers argue about it much any more.

..Dead Ends

One other fact about smoking that no one argues about much any more is this: It's the leading preventable cause of death and disease in the world today.

But just knowing that and knowing about smoking's health risks isn't enough. You have to act on what you know if you want to avoid volunteering for the kind of catastrophe that smoking can cause.

So what do you do, exactly?

If you smoke, quit. Period. End of discussion. Everybody stops smoking sooner or later, anyway.

If quitting sounds tough, it can be. If it sounds impossible, you're only kidding yourself -- or underestimating your own resilience and willpower.

If you don't smoke, don't start. On the basis of all that we know about health today, choosing not to smoke is one of the best single choices any of us can ever make to protect our health and well-being.

It's one area where we really do have total control, where we get to choose whether we stay healthy or not.

It's a choice that's worth some careful thought.

Because too many people have found out the hard way that smoking really is a dying habit. And all of them died for no good reason at all.

..Sidebar | Chill Factors

Any smoker can tell you that quitting's tough. And most who quit at quitting usually blame "nerves" when they throw in the towel.

The good news about that bit of bad news is that there are hundreds of ways to de-stress (and decompress) without cigarettes. Here are a few:

  • Substitute! Pop a carrot or a celery stick (or piece of nicotine gum) when the urge hits.
  • Get wet! It's a good idea to load up on H20, anyway, and cutting back on caffeine can't hurt since it can trigger tobacco craving.
  • Stay busy! Take a walk after dinner instead of lighting up. Even busy work like cleaning closets can keep your head and hands focused on something other than cigarettes.
  • Breathe! Just taking a deep breath and exhaling slowly can help blow away tension.

Actually, what you do isn't as important as simply doing something and doing it for as long as it takes to get de-stressed -- and away from the urge to light up.

Remember: The impulse to smoke will pass, but so will your good intentions unless you help them along.

This is one in a series of publications on drugs, behavior, and health by Do It Now Foundation.
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