Health Concerns of Tobacco and Cigarettes

Health Concerns About Tobacco

By now, the majority of the public understands that cigarettes and tobacco are ‘unhealthy’, but the extent of the dangers associated with their products, and the implications it has on their health and the health of others remains a bit murky for some.

In this guide, we explore health concerns associated with tobacco and cigarette use, how harmful it really is, and the impact it is having on public health worldwide.

Is Tobacco Harmful?

Short answer: YES.

Undoubtedly, and unequivocally, tobacco and cigarettes have been proven beyond all doubt to be harmful if consumed or even if you’re exposed to these products (such as second-hand smoke).

According to the World Health Organization (WHO), the tobacco epidemic is “one of the biggest public health threats the world has ever faced, killing more than 8 million people a year around the world.”

It's not just tobacco and cigarette users who are dying. Although 7 million deaths per year are attributed to the direct use of tobacco products, another 1.2 million deaths are attributed to non-smokers exposed to secondhand smoke.

As reported by the American Medical Association’s Council on Science and Public Health, there is no safe level of exposure to tobacco.

What Body Systems Does Tobacco Use Affect and How?

There is an extensive body of evidence to confirm and prove that the use of tobacco leads, contributes to or directly causes harm, damage, and disease of nearly every organ present in the human body.

It is largely cited by health organizations such as the American Medical Association, the Centers for Disease Control that cigarette smoking is the leading cause of PREVENTABLE death in the United States.

Tobacco and Smoking: Overview of Increased Health Risks

Smoking and Cardiovascular Disease

• Known to contribute to and directly cause coronary artery and coronary heart disease, with estimates showing an increased risk of between 2-4x
• Can increase the risk blood clots and strokes by 2-4x
• Contributes to atherosclerosis, scarring, thickening and narrowing of blood vessels
• Contributes to reduced blood flow (especially to lower limbs)

Smoking and Respiratory Disease

• Known to directly damage airways and alveoli (small air sacs in the lungs)
• Can cause chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis
• Is the leading cause of lung cancer
• 80% of all deaths caused by COPD (8 out of 10) are caused by smoking

Smoking and Cancer

Data supports evidence that if no one smoked cigarettes, one of every three (1/3) of ALL cancer deaths could be prevented in the United States.

• Increases the risk of lung cancer by 25-25.7x
• Increases the risk of developing most forms of cancer
• Has been shown to increase the risk of developing the following cancers:
  • Lung
  • Esophagus
  • Mouth
  • Throat
  • Tongue
  • Stomach
  • Pancreas
  • Larynx Liver
  • Colon and rectum
  • Kidney
  • Bladder
  • Cervix
  • And more…

Other Health Risks Associated with Tobacco and Smoking

Smoking has been proven to damage virtually every organ and tissue in the body, as well as impacting a broad range of health parameters ranging from blood pressure to metabolism.

Below is a brief overview of ‘other’ health risks of using tobacco or smoking cigarettes:

• Difficulty achieving pregnancy
• Negatively affects the health of a baby both in the womb and after birth, increasing the risk of low birth weight, medically premature delivery, stillbirths, SIDS (sudden infant death syndrome), development of orofacial clefts, ectopic pregnancies and more
• Can reduce fertility in men
• Can negatively affect bone health, resulting in weaker bones more prone to fractures
• Can contribute to gum disease and tooth decay
• Increases the risk of developing cataracts and age-related macular degeneration
• Smoking increases the risk of developing diabetes by an astonishing 30-40%
• Smoking and tobacco use cause inflammation throughout the body
• Smoking is associated with decreased immune function
• Is a contributing cause of rheumatoid arthritis

References:

Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual Causes of Death in the United States. JAMA: Journal of the American Medical Association 2004;291(10):1238–45 [cited 2017 Apr 20].

Centers for Disease Control and Prevention. QuickStats: Number of Deaths from 10 Leading Causes—National Vital Statistics System, United States, 2010. Morbidity and Mortality Weekly Report 2013:62(08);155. [accessed 2017 Apr 20].

U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001 [accessed 2017 Apr 20].

U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: What It Means to You.

U.S. Department of Health and Human Services.The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.

U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General.

(H2) How Many People Worldwide Are Affected By Tobacco Health Problems?

Globally there are more than one billion smokers at any given time, representing nearly 19% of the entire adult population. Considering that tobacco kills up to 50% of its users, this is a significant cause for concern.

Each year tobacco is responsible for the deaths of more than 8 million people.

Let’s take a closer look at those stats:

• At the current pace, nearly ONE BILLION people will die from tobacco use in the 21^st century
• 1.2 million people die yearly from second-hand exposure to smoking
• Illnesses attributed to tobacco account for 10% of adult deaths globally
• More than 16 million Americans are living with a smoking-related illness
• For every death caused by tobacco, another 30 individuals are left suffering from chronic or terminal smoking-related illnesses

The Societal Costs of Tobacco Use and Smoking

When tallied, the global economic cost of tobacco and smoking on society is staggering. Total economic costs linked to smoking are in excess of 1.8% of the TOTAL WORLD GDP, with expenditures on medical care and treatment as a result of smoking representing nearly 6% of all health spending.

This puts the estimated global economic damages at over 1.4 trillion USD yearly, with $170 billion attributable to the USA, $114 in India, $173 billion in Indonesia and $48 billion in Brazil.

Nearly two-thirds of the economic costs as a result of smoking and tobacco are the result of premature death. Other costs are attributable to lost productivity due to sick workers.

Environmental Concerns

Worldwide, tobacco production is a major contributor of environmental damage, with tobacco crops particularly susceptible to disease and pest infestation, requiring large quantities of pesticides and chemicals.

The clearing of land required for tobacco fields, in addition to substantial amounts of wood required for curing tobacco, results in the deforestation of nearly 200,000 hectares annually.

References:

Eriksen M et al. The Tobacco Atlas. Fifth Ed. Atlanta, GA: American Cancer Society; 2015.

Global Burden of Disease (GBD) 2017. Seattle, WA: Institute for Health Metrics and Evaluation (IHME), University of Washington; 2020. Available at: http://vizhub.healthdata.org/gbd-compare/

Goodchild M et al. Global economic cost of smoking-attributable diseases. Tobacco Control. 2018;27:58-64

Ross H. Economic and public health impact of 2007-2010 tobacco tax increases in Ukraine. Tobacco Control. 2012 June;21:429-435.

Tobacco Fact Sheet. World Health Organization; 26 July, 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco  

U.S. NCI and WHO. The Economics of Tobacco and Tobacco Control. NCI Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda: U.S. DHSS, NIH, NCI, and Geneva: WHO; 2016.

WHO Report on the Global Tobacco Epidemic, 2019: The MPOWER package. Geneva: World Health Organization; 2019.

Does Tobacco Use Affect COVID-19?

The novel coronavirus known as COVID-19 is largely a respiratory virus, making those who smoke highly susceptible to complications.

According to researchers at the University of California, both e-cigarettes and smoking tobacco can critically exacerbate inflammation for those infected with COVID-19, resulting in significantly worse clinical outcomes.

This research discovered that smoking tobacco increased the expression of ACE2 receptors on host cells, enabling more efficient viral entry.

Experts from Johns Hopkins Medicine echo similar sentiments, with specialists at the Tobacco Treatment Clinic at Johns Hopkins Bayview Medical Center reporting that, “We are seeing worse cases of COVID-19 in smokers…Your lungs, which are at the forefront of your immune system, are interacting with the environment with every breath. When you inhale cigarette smoke, germs or allergens, your lungs can get irritated, and that irritation unleashes the immune system to fight that irritation. A coronavirus infection on top of that means that your symptom response is going to be amplified.”

How Does Socioeconomic Status Affect Health Impact Data of Tobacco?

Tobacco accounts for nearly 1 out of every 10 deaths worldwide, with estimations claiming that by 2030, nearly 80% of these deaths will be in low- and middle-income countries and impoverished communities.

According to the CDC, tobacco companies have historically targeted low-income neighborhoods and communities with advertising and marketing campaigns, resulting in a higher tendency of tobacco retailers in these impoverished neighborhoods.

Other research has shown that big tobacco has targeted women of low social-economic standing with coupons and discounts.

Despite the overall decrease in tobacco use dating back to 1964, there remains today a large disparity in tobacco use, illness and deaths among minority groups, low to middle-income households, the undereducated, and other types of minority and low-income communities.

According to the US Surgeon General’s Report on Tobacco Use:

• Alaskan natives and American Indians have the highest prevalence of use
• African Americans and men of Southeast Asian descent also have a high prevalence of use
• African American and Hispanic youth have experienced a ‘particularly striking’ increase in use

The Surgeon General went on to identify key factors that were attributed to increased risk of tobacco use and smoking:

• Cultural characteristics
• Acculturation
• Stress
• Socioeconomic status
• Targeted advertising to these groups

Other concerns include the fact that some countries employ the use of child labor in tobacco farming. This exposes children (and adult workers) to chemicals, pesticides, nicotine and greatly increases the risk of developing a range of medical conditions including “Green Tobacco Sickness”.

References:

Brown-Johnson CG, England LJ, Glantz SA, Ling PM. Tobacco Industry Marketing to Low Socioeconomic Status Women in the USA. Tobacco Control. Published online first: 2014 Jan 21, doi:10.1136/tobaccocontrol-2013-051224 [cited 2018 Jun 13].

Yu D, Peterson NA, Sheffer MA, Reid RJ, Schneider JE. Tobacco Outlet Density and Demographics: Analysing the Relationships with a Spatial Regression Approach. Public Health, 2010;124(7):412–6 [cited 2018 Jun 13].