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• Highlights
• Introduction
• Nicotine Addiction
• Health Risks
• Quitting Smoking
• Symptoms of Withdrawal
• Failure to Quit
• Lifestyle Changes
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Smoking

Description

An in-depth report on the health risks of smoking and how to quit.

Introduction

More than 20% of adults in the United States smoke, according to a 2005 report by the U.S. Centers for Disease Control and Prevention (CDC). Over the past 10 years, smoking has continued to decline among older adults. Although for many years smoking rates were not declining among young people, this trend is now changing for the better.

Smoking in Childhood and Adolescence

While smoking rates among high school students have been declining since 1997, the rate of smoking among teenagers is equal to and, in some cases, higher than that of adults.

The younger children start smoking, the more likely they will smoke as an adult. Smoking is often immediately addictive. According to the American Cancer Society, the earlier you start smoking, the more likely you are to develop long-term nicotine addiction.

In the past, advertising was responsible for encouraging some teens to smoke. New regulations have made it much more difficult for advertisers to promote smoking to young people. However, scenes that show people smoking are still common in movies and television shows, often in a positive light. This may be a major influence on the attitude toward smoking in children and adolescents.

To prevent children from smoking, parents should not smoke, and they should tell their child that they disapprove of smoking. One study reported that preschoolers whose parents smoke are more likely to view themselves as future smokers. School children who believed that both their parents strongly disapproved of smoking were less than half as likely to smoke as those kids whose parents did not show as much disapproval towards smoking.

Other research has supported these findings.

Children whose parents closely monitor their television and music-listening habits are less likely to drink, use drugs, and smoke cigarettes.

Neglected children, or children with absentee parents, were four times as likely to abuse drugs, drink, and smoke as children living with parents who were regularly present and who offered a structured lifestyle.

In a 2002 study, children who regularly attended religious services were also less likely to smoke.

Doctors can have a major effect on young people. However, in one survey, less than half of teenagers had ever been asked by their doctors if they smoked or were counseled not to smoke, even though most teen smokers said they would admit to it if asked.

Gender, Age, and Ethnicity

More American men smoke than women. The following chart details the rate of current smoking in the United States among adults aged 18 years and over, grouped by age and sex:

Age	Total	Men	Women
18 - 44 years	24.1%	27.1%	21.2%
45 - 64 years	21.9%	25.2%	18.8%
65 years and older	8.6%	8.9%	8.3%
Source: CDC/National Health Interview Survey 2005

While the number of adults over 65 who smoke is lower than those in other age groups, older adults usually have smoked for a long time (about 40 years) and tend to be heavier smokers, according to the American Lung Association. Because of this, older smokers are more likely to have smoking-related illnesses.

Caucasian students (under age 18) are more likely to smoke than Hispanics and African Americans. The rate of current smoking in people age 18 years and over, grouped by race and ethnicity, is as follows:

• Hispanic or Latino: 15.4%
• Caucasian: 22.5%
• African American: 21.1%

Source: CDC/National Health Interview Survey, 2005

Geography

In general, the rate of smoking is highest in the Midwest and South and lowest in the Northeast and West. Utah has the lowest rate of smoking in the United States.

The U.S. government's "Healthy People 2010'' guidelines call for reducing cigarette smoking among adults to 12% by the year 2010. The overall goal of the program is to reduce illness, disability, and death related to smoking, including secondhand smoke.

Smoking bans have spread across the country. In 2005 six states (Georgia, Montana, North Dakota, Rhode Island, Vermont, and Washington) passed stronger smoke-free air laws. All 50 states and Washington, D.C. have some type of law banning smoking in certain places, ranging from designated smoking areas to complete bans in restaurants and other facilities.

As of January 1, 2006, nine states were considered "smoke-free" -- California, Connecticut, Delaware, Massachusetts, Maine, New York, Rhode Island, Vermont, and Washington.

Educational Level

A major U.S. government study reported that people who have not graduated from high school or received their General Education Development (GED) certificate tend to have higher smoking rates than those who attended college.

Rate of current cigarette smoking in the United States in 2003 for adults 25 years of age and over, according to education:

• No high school diploma or GED: 29.7%
• High school diploma or GED: 27.8%
• Some college, no bachelor’s degree: 21.1%
• Bachelor’s degree or higher: 10.2%

Sources: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey

Psychologic Factors

People with low self-esteem and adolescents with behavioral problems have a higher risk for smoking. Men and women with mental disorders are 50% more likely to smoke than those without such illness.

For example, depression and schizophrenia are known risk factors for smoking. Both may actually have biologic effects that are responsible for this higher risk.

Genetic Factors

Evidence now strongly supports the idea that genes play a role in a person's dependence on nicotine. Researchers are now targeting specific genes that may be responsible for nicotine dependence. So far, it has been shown that there is a common genetic vulnerability to both nicotine and alcohol dependence.

Economic Factors

Some studies suggest that the cheaper it is to buy cigarettes and smoke, the more widespread smoking will be. For example, states that have low taxes on cigarettes have a high proportion of smokers. Making it more expensive to smoke may reduce the number of smokers.

• Review Date: 9/18/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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