Making the decision to quit tobacco

Tobacco and vascular disease

Tobacco and chemicals

Tobacco and cancer

Secondhand smoke and lung cancer

Respiratory cilia

Tobacco health risks

Alternative Names

Secondhand smoke; Cigarette smoking; Tobacco cessation; Smoking and smokeless tobacco

Information

Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed for a variety of effects.

• It is considered an addictive substance because it contains the chemical nicotine.
• Tobacco also contains more than 19 known cancer-causing chemicals (most are collectively known as "tar") and more than 4,000 other chemicals.

Most smokers in the United States would like to quit smoking. Most people who have quit smoking made at least one unsuccessful quit attempt in the past. Try not to view past attempts to quit as failures, but rather as learning experiences.

HEALTH RISKS OF SMOKING OR SMOKELESS TOBACCO

Many smokers come to depend on the positive effects of nicotine, such as boosting their mood, improving short-term memory and concentration, and producing a sense of well-being.

There are many more reasons to quit using tobacco. Knowing the serious health risks may help motivate you to quit. When used over a long period, tobacco and related chemicals such as tar and nicotine can increase your risk of many health problems.

• Heart and blood vessel problems:
  • Blood clots and aneurysms in the brain, which can lead to strokes
  • Blood clots in the legs, which may travel to the lungs
  • Coronary artery disease, including angina and heart attacks
  • High blood pressure
  • Poor blood supply to the legs
  • Problems with erections because of decreased blood flow into the penis
• Cancer (especially in the lung, mouth, larynx, esophagus, bladder, kidney, pancreas, and cervix)
• Poor wound healing, especially after surgery
• Lung problems such as emphysema and chronic bronchitis, or asthma that is harder to control
• Problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip
• Other health risks or problems:
  • Decreased ability to taste and smell
  • Harm to sperm, which contributes to infertility
  • Loss of sight due to an increased risk of macular degeneration
  • Tooth and gum diseases
  • Wrinkling of the skin

Smokers who switch to smokeless tobacco instead of quitting tobacco completely still carry a number of health risks:

• Increased risk of mouth or nasal cancer
• Gum problems, tooth wear, and cavities
• Worsening high blood pressure and angina

HEALTH RISKS OF SECONDHAND SMOKE

Those who are regularly around the smoke of others (secondhand smoke) have a higher risk of:

• Heart attacks and heart disease
• Lung cancer
• Sudden and severe reactions, including those involving the eye, nose, throat, and lower respiratory tract

Infants and children who are regularly exposed to secondhand smoke are at risk of:

• Asthma (children with asthma who live with a smoker are much more likely to visit the emergency room)
• Infections, including virus-caused upper respiratory infections, ear infections, and pneumonia
• Lung damage (poor lung function)
• Sudden infant death syndrome (SIDS)

THE BENEFITS OF QUITTING

You will notice many benefits of quitting right away:

• Your breath, clothes, and hair will smell better
• Your sense of smell will return and food will taste better
• Your fingers and fingernails will slowly appear less yellow
• Your stained teeth will slowly become whiter

Your home, work, and social life will also improve immediately:

• Your children will be less likely to start smoking themselves
• It will be easier and cheaper to find an apartment or hotel room
• You will miss fewer work days, or you may have an easier time getting a job
• The constant search for a place to smoke when you're out will be over
• Friends will be more willing to be in your car or home
• Your dating prospects will become much wider, because 80% of the population does not smoke
• You will have more money available (one pack per day smokers spend around $1,800 per year on cigarettes)

Some health benefits begin almost immediately too, but every week, month, and year without tobacco use only improves your health.

• Within 20 minutes of quitting - your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal.
• Within 8 hours of quitting - your blood carbon monoxide levels drop and your blood oxygen levels increase, both to normal levels.
• Within 24 hours of quitting - your risk of a sudden heart attack decreases.
• Within 48 hours of quitting - nerve endings begin to regenerate and your senses of smell and taste begin to return to normal.
• Within 2 weeks to 3 months of quitting - your circulation improves and walking becomes easier; your lung function increases by up to 30%.
• Within 1 to 9 months of quitting - your overall energy typically increases and symptoms like coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities.
• Within 1 year of quitting - your risk of coronary heart disease is half that of someone still using tobacco.
• Within 5 years of quitting - your lung cancer death rate decreases by nearly 50% compared to one pack per day smokers; your risk of cancer of the mouth is half that of a tobacco user.
• Within 10 years of quitting - your lung cancer death rate becomes similar to that of someone who never smoked; precancerous cells are replaced with normal cells; your risk of stroke is lowered, possibly to that of a nonsmoker; your risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas all go down.

Like any addiction, quitting tobacco is difficult, especially if you are acting alone. There are a lot of ways to quit smoking and many resources to help you. See: Smoking - tips on how to quit

• Family members, friends, and coworkers may be supportive or encouraging.
• Talk to your doctor about nicotine replacement therapy and smoking cessation medications.
• If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. See: Stop smoking support programs

References

Benowitz NL. Tobacco. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 30.

Boffetta P, Hecht S, Gray N, Gupta P, Straif K. Smokeless tobacco and cancer. Lancet Oncol. 2008;9:667-675.

Parkes GT, Greenhalgh T, Griffin M, Dent R. Effect on smoking quit rate of telling patients their lung age: the Step 2 quit randomised controlled trial. BMJ. 2008:336:598-600.

Boffetta P, Straif K. Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis. BMJ. 2009;339:b3060. doi: 10.1136/bmj.b3060.

U.S. Preventive Services Task Force. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women. U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2009;150:551-555.

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Review Date: 10/31/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.