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Diseases & Conditions : Adolescent Medicine



According to the CDC, diseases caused by smoking kill more than 480,000 people in the United States each year. The CDC also states that smokers are 2 to 4 times more likely to develop heart disease and stroke. Even with anti-smoking campaigns and medical disclaimers in place, many people continue to smoke or start smoking every year. One out of 5 deaths of Americans is related to smoking, and it kills more Americans each year than suicides, homicides, AIDS, and car accidents combined. According to the CDC, 90% of new smokers are children and teenagers, in many cases, replacing the smokers who quit or died prematurely from a smoking-related disease.

Smokers not only have increased risk for lung disease, including lung cancer and emphysema, but also have increased risk for heart disease, stroke, and oral cancer. Almost one-third of all cancers are related to smoking. Smoking kills more women each year than breast cancer. 

Facts about smoking and teens

Consider the latest statistics available from the CDC and the Office of Adolescent Health:

  • Every day approximately 3,800 children 18 years of age or younger smoke their first cigarette

  • If the current trend in teen smoking does not decrease, 5.6 million of today's teens will die early from smoking-related illnesses.

  • Among 12th graders, 7% smoke cigarettes daily.

How does smoking affect the cardiovascular system?

In posing health risks on the body's cardiovascular system, smoking:

  • Causes immediate and long-term increases in blood pressure

  • Causes immediate and long-term increases in heart rate

  • Reduces cardiac output and coronary blood flow

  • Reduces the amount of oxygen that reaches the body's tissues

  • Changes the properties of blood vessels and blood cells, allowing cholesterol and other fatty substances to build up

  • Contributes to an increased risk for blood clot formation

  • Damages blood vessels

  • Doubles the risk for ischemic stroke (reduced blood flow to the brain)

  • Stimulates the blood clotting process

In addition, smoking has been associated with depression and psychological distress.

What are the risks of secondhand smoke?

The CDC reports that an estimated 34,000 nonsmokers die from coronary heart disease each year as a result of exposure to secondhand tobacco smoke. Secondhand smoke is smoke that is exhaled by smokers and smoke emitted from the burning end of a lit cigarette, cigar, or pipe. Secondhand smoke can also cause lung cancer and stroke.  

Both direct and indirect smoking exposure poses significant health hazards to pregnant women, infants, and young children. Children and infants exposed to tobacco smoke are more likely to experience ear infections and asthma, and are at a higher risk for sudden infant death syndrome (SIDS) than children and infants without the same exposure.

The following common symptoms may be associated with exposure to secondhand smoke. However, each individual may experience symptoms differently. Symptoms may include:

  • Irritation of the eyes, nose, and throat

  • Coughing

  • Excessive phlegm (mucus in the airways)

  • Chest discomfort from lung irritation

  • Chest pain, which may indicate heart disease

The symptoms of secondhand smoke exposure may resemble other medical conditions and problems. Always talk with your health care provider for a diagnosis.

Creating a smoke-free environment indoors and outdoors protects nonsmokers from secondhand smoke exposure. 

Smoking and cardiovascular disease

Smoking, in addition to high cholesterol, high blood pressure, physical inactivity, obesity, and diabetes, tops the list as a primary risk factor for cardiovascular disease. In fact, smoking has been classified as the single most preventable cause of premature death in the U.S.

Importance of smoking cessation

According to the Cancer Society, eliminating smoking has both immediate and long-term rewards. Within weeks of quitting, blood pressure lowers and blood circulation improves. One year after quitting, the risk of heart disease from smoking decreases by half. Five years after quitting, your risk of certain cancers caused by smoking decreases by half. Research also indicates that stopping smoking is crucial in the management of many contributors to heart attack. These include atherosclerosis, thrombosis, coronary artery disease, and cardiac arrhythmias.

Getting help to quit

Quitting smoking is both a mental and a physical undertaking. Mentally, you should be ready and relatively stress-free. Physically, you need to commit to exercising daily and getting plenty of sleep. A person trying to quit must overcome 2 obstacles: a physical addiction to nicotine and a habit. The American Cancer Society offers the following tips to help users quit using tobacco products:

  • Think about why you want to quit

  • Pick a stress-free time to quit

  • Ask for support and encouragement from family and friends

  • Start a daily exercise or activity to relieve stress and improve your health

  • Get plenty of rest

  • Eat a balanced diet

  • Join a smoking cessation program or other support group

In some cases, smokers benefit from nicotine replacement products to help break their smoking habit. Nicotine replacement products continue to give smokers nicotine to meet their nicotine craving. However, the benefit of nicotine replacement products is that they do not have the tars and poisonous gases that cigarettes give off. Pregnant or nursing women and people with other medical conditions should talk with their health care provider before using any nicotine replacement products. Some examples of nicotine replacement products include:

  • Nicotine chewing gum. An over-the-counter (OTC) chewing gum. It releases small amounts of nicotine to help reduce nicotine withdrawal symptoms.

  • Nicotine patch. An OTC patch applied to the upper body once a day. It releases a steady dose of nicotine to help reduce the urge to smoke.

  • Nicotine lozenge. A lozenge that dissolves in the mouth. It releases small amounts of nicotine to reduce any cravings to smoke. 

  • Nicotine inhaler or nasal spray. A prescription nicotine replacement product. It releases nicotine to help reduce withdrawal symptoms (needs a health care provider's approval before use).

Non-nicotine options to quit smoking: bupropion and varenicline

Bupropion, a non-nicotine alternative to help people stop smoking, was approved in 1997 by the FDA. Offered in pill form to smokers who want to quit, bupropion has been shown to change mood transmitters in the brain that are linked to addiction. Bupropion must be prescribed by a health care provider. It may not be right for everyone. You should talk with your health care provider for more information.

Varenicline is also a non-nicotine pill to help with quitting smoking. It was approved by the FDA in 2006. It is the first medicine that targets the nicotine receptors in the brain. Varenicline attaches to the receptors and blocks nicotine from reaching them. This decreases the desire for nicotine. Varenicline may not be right for everyone. You should talk with your health care provider.