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Smoking and Quitting Smoking (cont.)

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Is secondhand smoke from e-cigarettes harmful?

e-Cigarettes expel vapors that contain nicotine, which is known to be addictive. Depending on the composition of the fluid in the cartridge, nitrosamines or other dangerous chemicals may also be expelled. It is not known at this time how significant the risk is to the health of those who breathe secondhand vapors from e-cigarettes.

Are e-cigarettes safe to use during pregnancy?

Little is known about the long-term health effects of e-cigarettes, but nicotine has been shown to be harmful to the developing fetus. Nicotine narrows blood vessels and interferes with circulation of blood to the fetus. It can interfere with development of the fetal brain and may harm fetal lung function. It also increases the risk for sudden infant death syndrome (SIDS). Doctors recommend that pregnant women abstain from both smoking and e-cigarette use.

What is in the future for smoking?

Health care workers have become extremely active in publicizing the negative effects of smoking. In fact, health care workers have been instrumental in passing various legislation to limit smoking in public. As a result, the proportion of people in the US who smoke has dropped from 40.4% in 1965 to around 17% in 2013 (data from the US Department of Health).

This reduction in the percent of people who smoke has been significantly less in women than in men. From 1965 to 2010, smoking among men dropped from 50.2% to 20.5% while during the same period, smoking among women dropped from 31.9% to 15.3%. So, in the future, efforts need to be made to understand and eliminate this difference between the genders.

One interesting area of the current research on smoking is the study of the population distribution of the genes for smoking (genetic epidemiology). (Genes determine an individual's inherited characteristics.) Only a small fraction of individuals who start smoking as an adolescent will actually become nicotine dependent. So, what determines which individuals will become nicotine-dependent? Investigators have found that smoking initiation (the obligatory first step) and the development of nicotine dependence are both influenced by genetic factors. The genetic factors appear to play a larger role in nicotine dependence than in smoking initiation. The next step will be to identify these genes and learn how they work in order to facilitate the development of effective prevention and treatment strategies for tobacco addiction.

Teen smoking rates remain of concern. In 2011 19% of high school girls and 28% of boys had used some form of tobacco in the prior month.. According to the American Cancer Society, the majority of cigarette use- in almost 90% of people who smoke- begins before a person reaches 18 years of age. Very few people start smoking after age 25. Statistics show that 99% of adult smokers had started by age 26. Education of the at-risk teen population is therefore critical for prevention of tobacco use. Various celebrities and activist groups actively promote campaigns aimed at a teen audience that educate about the consequences of smoking and offer advice on smoking cessation and prevention. While teen smoking rates increased during the 1990s (36% of teens smoked in 1997), prevention and education campaigns have brought about a decrease in teen smoking in recent years.

Medically reviewed by James E. Gerace, MD; American Board of Internal Medicine with subspecialty in Pulmonary Disease


American Cancer Society. Child and Teen Tobacco Use.

American Cancer Society. Cigarette Smoking.

Medically Reviewed by a Doctor on 9/7/2016


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