The Power of One
This month, United States Surgeon General Dr. Regina Benjamin released her first report on the effects of tobacco smoke. (This is Dr. Benjamin’s first such report, but it is the 30th in a series of similar reports since 1964.) The 700-page report outlines, in much detail, the effects that cigarettes and smoking have on a person’s body. It is the first report to claim that even one cigarette is enough to cause cancer, heart attack, and other organ damage.
The report emphasizes that tobacco smoke contains more than 7000 chemicals, hundreds of which are toxic and 70 of which are carcinogenic. These chemicals assault the body, leading to cancer, lung damage, cardiovascular disease, and fertility problems. Smoking also makes blood sugar levels hard to control, and decreases the effectiveness of many medications. Even brief exposure to cigarettes or secondhand smoke, the report claims, is enough to trigger cardiovascular disease and acute cardiovascular events.
As if harming one’s own body were not enough, the report also reiterates the fact that exposure to cigarettes during the prenatal period or early infancy can lead to sudden infant death syndrome. Countless studies have also documented an increased risk of hormone dysregulation, allergic diseases, respiratory illnesses, and immune system dysfunction among infants and young children exposed to cigarette smoke early in life.
Approximately 85% of lung cancers, one of the most documented risks of cigarette smoking, are attributed to smoking. Additionally, 13 other cancers are directly linked to cigarette exposure, including cancers of the esophagus, trachea, stomach, pancreas, kidney, bladder, and cervix, as well as leukemia. More than 440,000 people die every year in the United States due to tobacco-related illnesses.
Since 1964, and the proclamation that smoking was, indeed, harmful to health, the prevalence of cigarette smoking has steadily declined. However, the rates of adult smokers have plateaued in the last decade. Currently, an estimated 46 million American adults — approximately 1 in 5 — are smokers. (The prevalence of smoking among adults throughout the world — particularly European countries — is 2 to 3 times higher than in the United States.) The fact that so many people still choose to smoke, despite evidence of its harm, is due, in part, to the fact that cigarette manufacturers have made cigarettes more addictive in recent years. Until last year, the Food and Drug Administration had no power to regulate the tobacco industry, but that has changed as the Obama administration has launched a multi-pronged attack against tobacco use, also increasing funding for smoking cessation programs through local and state agencies, as well as Medicare and the Federal Employees Health Benefits Program. (It will be interesting to see if President Obama himself takes advantage of these offerings in an attempt to kick his own bad habit once and for all.)
While the Surgeon General’s report is full of sound, detailed, scientific information, will it change anyone’s mind — or smoking habit? People already understand that smoking is unhealthy, and plenty still choose to smoke. More scientific data is not going to break the habit for most smokers. The report, and related legislation and regulation, may provide more ammunition for health care practitioners to convince smokers to take advantage of government-sponsored smoking cessation programs, but it is doubtful that an individual will hear that the Surgeon General thinks smoking even one cigarette is bad, and finally decide to quit. At best, the information will discourage anyone from starting to smoke in the first place.
How tobacco smoke causes diseases: A report of the Surgeon General. US Dept of Health and Human Services. Dec 9, 2010.
PRESCOTT, S. (2008). Effects of early cigarette smoke exposure on early immune development and respiratory disease Paediatric Respiratory Reviews, 9 (1), 3-10 DOI: 10.1016/j.prrv.2007.11.004
Roethig HJ, Munjal S, Feng S, Liang Q, Sarkar M, Walk RA, & Mendes PE (2009). Population estimates for biomarkers of exposure to cigarette smoke in adult U.S. cigarette smokers. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 11 (10), 1216-25 PMID: 19700523
Schuetze, P., Lopez, F., Granger, D., & Eiden, R. (2008). The association between prenatal exposure to cigarettes and cortisol reactivity and regulation in 7-month-old infants Developmental Psychobiology, 50 (8), 819-834 DOI: 10.1002/dev.20334
Vrieling A, Bueno-de-Mesquita HB, Boshuizen HC, Michaud DS, Severinsen MT, Overvad K, Olsen A, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Kaaks R, Rohrmann S, Boeing H, Nöthlings U, Trichopoulou A, Moutsiou E, Dilis V, Palli D, Krogh V, Panico S, Tumino R, Vineis P, van Gils CH, Peeters PH, Lund E, Gram IT, Rodríguez L, Agudo A, Larrañaga N, Sánchez MJ, Navarro C, Barricarte A, Manjer J, Lindkvist B, Sund M, Ye W, Bingham S, Khaw KT, Roddam A, Key T, Boffetta P, Duell EJ, Jenab M, Gallo V, & Riboli E (2010). Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. International journal of cancer. Journal international du cancer, 126 (10), 2394-403 PMID: 19790196
The Tobacco Atlas, 3rd ed. World Health Organization Tobacco Free Initiative, the American Cancer Society, and World Lung Foundation.
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