The main ingredient in tobacco responsible for its addictive character is nicotine. Unfired tobacco contains nicotine, carcinogens and other toxins that can cause gum disease and oral cancer. When tobacco ignites it creates smoke. In addition to nicotine and carbon monoxide, tobacco smoke contains more than 40 carcinogens and over 4,000 other toxic ingredients.
It is estimated that approximately 40% of smokers will die prematurely if they do not quit smoking. With the age of smokers, the absolute mortality rate increases compared to smokers. Smokers are more prone to developing atherosclerosis of large and small blood vessels. Approximately 50% of aortic aneurysms and 90% of peripheral blood vessel diseases (in the population without diabetes) are caused by smoking. There is a multiple interaction between smoking and other risk factors for the development of coronary heart disease. A person who smokes has a higher risk of getting the disease. At the same time, they have arterial hypertension and elevated serum lipids. Smoking increases the possibility of myocardial infarction and sudden cardiac death because it favors platelet aggregation and vascular occlusion. Fifteen years after smoking cessation, the risk of developing a new myocardial infarction and the mortality rate due to coronary heart disease are equalized between smokers and non-smokers. Cigarette smoking is associated with a 50% higher risk of stroke in all age groups. The risk is twice as high with regular smokers compared to people who occasionally smoke cigarettes. Smoking cessation returns the risk to normal in two to five years. Passive smoking should be avoided because it increases the risk of cerebro-cardiovascular disease. Cancers of the lungs, larynx, esophagus, oral cavity, pancreas, kidneys and bladder are caused by smoking.
Compared to continuing to smoke, the process of quitting smoking reduces the risk of cancer. Some studies show that even 20 years (after smoking cessation) there is a risk of developing lung cancer. Smoking is responsible for 90% of chronic obstructive pulmonary disease. After 20 years of smoking, changes in the lungs develop and progress in proportion to the intensity and duration of smoking. 80% of smokers over the age of 60 have a chronic and productive cough. Hornic inflammation and narrowing of the small airways lead to pulmonary emphysema and reduced lung function. Cigarette smoking slows down the healing of peptic ulcers, increases the risk of osteoporosis, senile cataracts and macular degeneration. It causes premature menopause, the appearance of wrinkles and faster skin aging, calculosis and cholecystitis in women and impotence in men. Prolonged exposure to tobacco smoke increases the risk of lung cancer and coronary heart disease in non-smokers. It increases the incidence of respiratory infections, chronic otitis media and the occurrence of asthma in children.
Quitting cigarette smoking is a long process
The process of quitting smoking is usually cyclical. Sometimes there are multiple attempts by smokers to stop smoking cigarettes. Approximately 70-80% of smokers would like to quit smoking. Approximately 30% of current smokers try to quit smoking each year. About 90% of self-smoking cessations are unsuccessful. When a doctor advises to stop smoking, especially during an acute illness, almost half of the patients will try to stop smoking, which is a strong incentive. Physicians can contribute to the smoking cessation process among their patients. Physicians can promote successful smoking cessation according to the model of the organization for health care and research. Research has developed a number of successful clinical procedures for smoking cessation.
Smoking during pregnancy can lead to premature rupture of the amniotic sac, disruption of the structure of the placenta and miscarriage. Babies of mothers who smoke are at risk of premature birth. Such babies are small for their age. There are indications that they are lagging behind in development for at least the first few years of life.
Successful smoking cessation
All patients should be asked if they are smokers. What are their previous experiences with smoking cessation, and whether they are currently interested in quitting cigarettes. People who are interested in quitting cigarettes should be motivated and encouraged. They need to be presented with a clear and strong message that smoking is one of the important health interests. There are a variety of nicotine replacement products including nicotine gum or patches. There are nicotine nasal and oral inhalation products that the doctor prescribes. Clonidine and antidepressants (Bupropion) have been shown to be effective. Current recommendations are to offer pharmacological treatment to all persons who would accept it. To provide them with counseling regarding smoking. An approach with counseling with appropriate pharmacological support can almost triple the number of future non-smokers.