Smoking and Lung Cancer

Among young people, the short-term health effects of smoking include damage to the respiratory system, addiction to nicotine, and the associated risk of other drug use. Long-term health consequences of youth smoking are reinforced by the fact that most young people who smoke regularly continue to smoke throughout adulthood. (CDC. Preventing tobacco use among young people—A report of the Surgeon General. 1994, p. 15) Smoking hurts young people’s physical fitness in terms of both performance and endurance—even among young people trained in competitive running.

(CDC. Preventing tobacco use among young people, p. 28) Smoking among youth can hamper the rate of lung growth and the level of maximum lung function. (CDC. Preventing tobacco use among young people, p. 17) The resting heart rates of young adult smokers are two to three beats per minute faster than those of nonsmokers. (CDC. Preventing tobacco use among young people, p. 28) Among young people, regular smoking is responsible for cough and increased frequency and severity of respiratory illnesses. (CDC.

Preventing tobacco use among young people, p. 9) The younger people start smoking cigarettes, the more likely they are to become strongly addicted to nicotine. (CDC. Preventing tobacco use among young people, p. 9) Teens who smoke are three times more likely than nonsmokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is associated with a host of other risky behaviors, such as fighting and engaging in unprotected sex. (CDC. Preventing tobacco use among young people, p. 36,104)

Smoking is associated with poor overall health and a variety of short-term adverse health effects in young people and may also be a marker for underlying mental health problems, such as depression, among adolescents. High school seniors who are regular smokers and began smoking by grade nine are 2. 4 times more likely than their nonsmoking peers to report poorer overall health 2. 4 to 2. 7 times more likely to report cough with phlegm or blood, shortness of breath when not exercising, and wheezing or gasping 3. 0 times more likely to have seen a doctor or other health professional for an emotional or psychological complaint.

The PHS guideline, “Treating Tobacco Use and Dependence: A Clinical Practice Guideline,” contains evidence-based information about first-line pharmacologic therapies (bupropion SR, as well as nicotine gum, patches, inhalers, and nasal sprays) and second-line therapies (clonidine and nortriptyline). It also highlights new evidence about how telephone counseling can help patients quit. “There has never been a better time for health professionals to help their patients break free from the deadly chronic disease we know as tobacco addiction,” said David A.

Satcher, MD, Assistant Secretary for Health/Surgeon General. “Starting today, every doctor, nurse, health plan, purchaser, and medical school in America should make treating tobacco dependence a top priority. ” The guideline is aimed at practicing clinicians. Studies have shown that more than 25 percent of U. S. adults smoke and that 70 percent of them would like to quit. Of those smokers who try to quit, those who have the support of their physician or other health care provider are the most successful.

“Anyone who uses tobacco and is committed to quitting needs to know that tobacco dependence is a chronic disease that, like high blood pressure or diabetes, frequently requires treatment over time to get it controlled,” said Michael C. Fiore, MD, MPH, chair of the guideline panel and director of the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School in Madison. “In my view, a doctor isn’t providing an appropriate standard of care for his or her patients if he or she doesn’t ask two key questions — ‘Do you smoke? ‘ and ‘Do you want to quit?

‘ — and then work with that individual to make it happen. ” Data show that only half of the smokers who see a doctor have ever been urged to quit, even though smoking is the single greatest preventable cause of illness and premature death in the United States. People who smoke are at increased risk of heart disease, cancer, and other smoking-related illnesses that contribute to more than 430,000 deaths a year. Nationwide, medical care costs attributable to smoking (or smoking-related disease) have been estimated by the Centers for Disease Control and Prevention (CDC) to be more than $50 billion annually.

In addition, the CDC estimate the value of lost earnings and loss of productivity to be at least another $47 billion a year. The guideline concludes that tobacco dependence treatments are both clinically effective and cost-effective relative to other medical and disease prevention interventions. The guideline urges health care insurers and purchasers to include, as a covered benefit, the counseling and pharmacotherapeutic treatments identified as effective in the guideline and to pay clinicians for providing tobacco dependence treatment, just as they do for treating other chronic conditions.

The tobacco cessation guideline was developed by a consortium convened by the U. S. Public Health Service that includes: The Centers for Disease Control and Prevention; the National Cancer Institute; the National Institute on Drug Abuse; the National Heart, Lung, and Blood Institute; the Agency for Healthcare Research and Quality; the Robert Wood Johnson Foundation; and the University of Wisconsin Medical School’s Center for Tobacco Research and Intervention. It builds on a smoking cessation guideline first issued by the government in 1996.

In addition, more than 100 organizations are supporting this effort. An article by Dr. Fiore that presents the findings of the updated guideline appears in the June 28 issue of the Journal of the American Medical Association. Copies of “Treating Tobacco Use and Dependence: A Clinical What is chemotherapy? Treatment with drugs to kill cancer cells is called chemotherapy. How is chemotherapy given? Most anticancer drugs are injected into a vein (IV) or a muscle. Some are given by mouth.

Chemotherapy is systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body. Often, patients who need many doses of IV chemotherapy receive the drugs through a catheter (a thin flexible tube). One end of the catheter is placed in a large vein in the chest. The other end is outside the body or attached to a small device just under the skin. Anticancer drugs are given through the catheter. This can make chemotherapy more comfortable for the patient. Patients and their families are shown how to care for the catheter and keep it clean.

For some types of cancer, doctors are studying whether it helps to put anticancer drugs directly into the affected area. When and where is chemotherapy given? Chemotherapy is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient at the hospital, at the doctor’s office, or at home. However, depending on which drugs are given and the patient’s general health, the patient may need to stay in the hospital for a short time.