Smoking

Smoking is the single most common cause of malignancy in humans (20% of all malignant cancer deaths). Aside from being human. Life expectancy is reduced by about 13 years. There are numerous other health effects, predominately cardiovascular and pulmonary, that also contribute to this.

Carcinogenesis

Smoking has been strongly linked to lung cancer on epidemiological grounds. It is also strongly associated with the majority of head and neck cancers, upper gastrointestinal cancers (including liver and pancreas), cervical cancer, bowel cancer, and renal cell carcinoma. Cigarette smoke contains numerous carcinogens; benzopyrene has been shown to cause point mutations in the TP53 gene.

Smoking Prevention Strategies

Criminalisation of Smoking

This doesn't seem to get much air time. It could be possible to outlaw smoking, although it would likely have significant social and political consequences. Outlawing of alcohol didn't go very well in the US and it is likely that similar problems would surface if tobacco was made illegal. Still, it would be considerably more difficult for people to get their hands on as many cigarettes as they do currently and there would likely be less tobacco related disease in the community; tobacco related crime would be another issue entirely.

Smoke Free Areas

The last 10-20 years has seen progressive introduction of smoke free areas, first inside and now in most public places (e.g. train stations, hospitals, cafes). This should prevent some of the social aspect of smoking and reduce its prevelence in the community; I don't believe this has been studied in great detail though.

No Smoking Advertisements

Smoking is usually marketed to teenagers and young adults by making it appear 'cool'. The outlawing of these ads helps to reduce the impact of cigarette use in society.
See here for some terrible ads: Amazing!

Smoking Cessation

Strategies for smoking cessation in an adult who is already smoking include:

  • Cognitive/behavioural techniques: Advising patients of the health benefits of smoking cessation, strategies to avoid smoking (e.g. avoiding smoking friends during the quitting period), and using physical exercise to distract from smoking
  • Pharmaceutical techniques: Nicotine replacement is one method of avoiding the nicotine craving that typically starts when a patient quits.
  • Alternative therapies: Acupuncture and other alternative health remedies are beneficial for some patients

A combination of behavioural and pharamceutical techniques works best when compared to either technique alone.


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