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Smoking, inhalation and exhalation of the fumes of burning tobacco. Leaves of the tobacco plant are smoked in various ways. After a drying and curing process, they may be rolled into cigars or shredded for insertion into smoking pipes. Cigarettes, the most popular method of smoking, consist of finely shredded tobacco rolled in lightweight paper. About 46 million people in the United States smoke an estimated 420 billion cigarettes each year.

Until the 1940s smoking was considered harmless, but laboratory and clinical research has since confirmed that tobacco smoke presents a hazard to health. Smoke from the average cigarette contains around 4,000 chemicals, some of which are highly toxic and at least 43 of which cause cancer. Nicotine, a major constituent of tobacco smoke, is both poisonous and highly addictive. According to the American Cancer Society, smoking is the most preventable cause of death in America today.

II  History

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European explorers who arrived in the Western Hemisphere in the 1500s observed Native Americans smoking tobacco plant leaves in pipes. The colonists who followed them grew tobacco plants as a cash crop for export, and smoking became part of European culture by the 1600s. Most tobacco was consumed in pipes and cigars or as snuff (finely pulverized tobacco inhaled into the nostrils). This pattern changed by the early 20th century, by which time smokers consumed more than 1,000 cigarettes per capita each year in the United States and some European countries. The general attitude of society was that smoking relieved tension and produced no ill effects. During World War II (1939-1945) American physicians endorsed sending soldiers tobacco, and cigarettes were included in the field ration kits of U.S. armed forces personnel until 1975.

Some scientists noticed, however, that lung cancer, which was rare before the 20th century, had increased dramatically since about 1930. The American Cancer Society and other organizations initiated studies comparing deaths among smokers and nonsmokers over a period of several years. All such studies found increased mortality among smokers, both from cancer and other causes. In addition, experimental studies in animals showed that many of the chemicals contained in cigarette smoke are carcinogenic.

In the United States, the first direct action to curb smoking after the U.S. surgeon general’s 1964 report on smoking was the mandate of a warning on cigarette packages by the Federal Trade Commission. This warning took effect in 1964 and was strengthened in 1969 to read: “Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health.” A stronger sequence of four alternative warnings was developed in 1984. In 1971 all cigarette advertising was banned from radio and television, and cities and states passed laws requiring nonsmoking sections in public places and workplaces.

This trend has continued and smoking is now banned at the federal and state levels in most government buildings and in many private businesses. As of February 1990 federal law banned smoking on all domestic United States airline flights under six hours in duration. By 1998 more than 90 percent of nonstop flights between the United States and all foreign countries were also smoke free.

In 2002 President George W. Bush signed into law the Safe and Drug-Free Schools and Communities Act. The law bans smoking within any indoor facility used for childhood education. By 2003 a number of states (including New York, Connecticut, Maine, and California) and cities (including Boston, Massachusetts and Austin, Texas) passed laws banning smoking in all bars, restaurants, and clubs.

The tobacco industry has been increasingly criticized for its role in encouraging smoking, particularly in young people. Various lawsuits have been brought against tobacco companies to reclaim damages due to disease or death associated with smoking. The first major successful suit occurred in March 1996 when the Liggett Group, a consortium of companies, agreed to pay damages to five states. An onslaught of litigation against the tobacco industry followed. In part to avoid potentially ruinous lawsuits filed by states, in 1998 the tobacco industry and attorneys general from 46 U.S. states agreed to a $206-billion settlement. The settlement, to be paid over 25 years, will be used to compensate states for the costs of treating smoking-related illness, to finance nationwide antismoking programs, and to underwrite health care for uninsured children.

Nicotine: A Powerful Addiction
If you have tried to quit smoking, you know how hard it can be. It is hard because nicotine is a very addictive drug. For some people, it can be as addictive as heroin or ****.
Quitting is hard. Usually people make 2 or 3 tries, or more, before finally being able to quit. Each time you try to quit, you can learn about what helps and what hurts.

Quitting takes hard work and a lot of effort, but you can quit smoking.




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Good Reasons for Quitting
Quitting smoking is one of the most important things you will ever do.

You will live longer and live better.

Quitting will lower your chance of having a heart attack, stroke, or cancer.

If you are pregnant, quitting smoking will improve your chances of having a healthy baby.

The people you live with, especially your children, will be healthier.

You will have extra money to spend on things other than cigarettes.




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Five Keys for Quitting
Studies have shown that these five steps will help you quit and quit for good. You have the best chances of quitting if you use them together.

1. Get ready.
2. Get support.
3. Learn new skills and behaviors.
4. Get medication and use it correctly.
5. Be prepared for relapse or difficult situations.


1. Get Ready

Set a quit date.

Change your environment.
1.Get rid of ALL cigarettes and ashtrays in your home, car, and place of work.
2.Don't let people smoke in your home.

Review your past attempts to quit. Think about what worked and what did not.

Once you quit, don't smoke—NOT EVEN A PUFF!


2. Get Support and Encouragement

Studies have shown that you have a better chance of being successful if you have help. You can get support in many ways:

Tell your family, friends, and co-workers that you are going to quit and want their support. Ask them not to smoke around you or leave cigarettes out.


Talk to your health care provider (for example, doctor, dentist, nurse, pharmacist, psychologist, or smoking counselor).


Get individual, group, or telephone counseling. The more counseling you have, the better your chances are of quitting. Programs are given at local hospitals and health centers. Call your local health department for information about programs in your area.


3. Learn New Skills and Behaviors

Try to distract yourself from urges to smoke. Talk to someone, go for a walk, or get busy with a task.


When you first try to quit, change your routine. Use a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.


Do something to reduce your stress. Take a hot bath, exercise, or read a book.


Plan something enjoyable to do every day.


Drink a lot of water and other fluids.



4. Get Medication and Use It Correctly
Medications can help you stop smoking and lessen the urge to smoke.

The U.S. Food and Drug Administration (FDA) has approved five medications to help you quit smoking:
1.Bupropion SR—Available by prescription.
2.Nicotine gum—Available over-the-counter.
3.Nicotine inhaler—Available by prescription.
4.Nicotine nasal spray—Available by prescription.
5.Nicotine patch—Available by prescription and over-the-counter.


Ask your health care provider for advice and carefully read the information on the package.

All of these medications will more or less double your chances of quitting and quitting for good.

Everyone who is trying to quit may benefit from using a medication. If you are pregnant or trying to become pregnant, nursing, under age 18,
smoking fewer than 10 cigarettes per day, or have a medical condition, talk to your doctor or other health care provider before taking medications.



5. Be Prepared for Relapse or Difficult Situations

Most relapses occur within the first 3 months after quitting. Don't be discouraged if you start smoking again. Remember, most people try several times before they finally quit. Here are some difficult situations to watch for: �

Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.


Other Smokers. Being around smoking can make you want to smoke.


Weight Gain. Many smokers will gain weight when they quit, usually less than 10 pounds. Eat a healthy diet and stay active. Don't let weight gain distract you from your main goal—quitting smoking. Some quit-smoking medications may help delay weight gain.


Bad Mood or Depression. There are a lot of ways to improve your mood other than smoking.

If you are having problems with any of these situations, talk to your doctor or other health care provider.



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Special Situations or Conditions
Studies suggest that everyone can quit smoking. Your situation or condition can give you a special reason to quit.

Pregnant women/new mothers. By quitting, you protect your baby's health and your own.


Hospitalized patients. By quitting, you reduce health problems and help healing.


Heart attack patients. By quitting, you reduce your risk of a second heart attack.


Lung, head, and neck cancer patients. By quitting, you reduce your chance of a second cancer.


Parents of children and adolescents. By quitting, you protect your children and adolescents from illnesses caused by second-hand smoke.




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Questions to Think About
Think about the following questions before you try to stop smoking. You may want to talk about your answers with your health care provider.

1. Why do you want to quit?

2. When you tried to quit in the past, what helped and what didn't?

3. What will be the most difficult situations for you after you quit? How will you plan to handle them?

4. Who can help you through the tough times? Your family? Friends? Health care provider?

5. What pleasures do you get from smoking? What ways can you still get pleasure if you quit?



What is Secondhand Smoke?
Secondhand smoke (SHS), sometimes referred to as environmental tobacco smoke (ETS), is a mixture of the smoke given off by the burning ends of a cigarette, pipe, cigar, bidis, and kreteks (sidestream smoke) and the smoke emitted at the mouthpiece and exhaled from the lungs of smokers (mainstream smoke).1,2

The widespread practice of smoking in buildings exposes nonsmoking occupants to combustion by-products under conditions where airborne contaminant removal is slow and uncertain. Over the past two decades, medical science has shown that nonsmokers suffer many of the diseases of active smoking when they breathe secondhand smoke.

Environmental Tobacco Smoke contains at least 250 chemicals known to be toxic or cause cancer. Unfortunately, the general public’s exposure to secondhand smoke is much higher than most people realize.



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Working to Reduce Secondhand Smoke Exposure
In January 2000, the U.S. Department of Health and Human Services launched Healthy People 2010, a comprehensive, nationwide health promotion and disease prevention agenda. Healthy People 2010 contains 467 objectives designed to serve as a road map for improving the health of all people in the United States during the first decade of the 21st century.

Several of these objectives relate to tobacco use and exposure to secondhand smoke. One objective is to reduce nonsmoker exposure to secondhand smoke from 65% to 45% nationwide by 2010.

Do you smoke? Have you ever stopped to think about how smoking is affecting your body and your life? Most teens are aware that people who have smoked for awhile can get lung cancer and emphysema and eventually die, but many don't know about all of the bad things that smoking can to them right now. If you smoke, you owe it to yourself to find out about the effects of smoking on your life now. Here, we've listed some information about what smoking is doing to your body and some of the common reasons why people keep smoking even though they know it's bad for them. These are important things to think about to help you decide if you should continue smoking.


Why is cigarette smoking bad for me?

Everyone knows that smoking can cause cancer when you get older, but did you know that it also has bad effects on your body right now? A cigarette contains about 4000 chemicals, many of which are poisonous. Some of the worst ones are:

Nicotine: a deadly poison
Arsenic: used in rat poison
Methane: a component of rocket fuel
Ammonia: found in floor cleaner
Cadmium: used in batteries
Carbon Monoxide: part of car exhaust
Formaldehyde: used to preserve (to keep in perfect condition) body tissue
Butane: lighter fluid
Hydrogen Cyanide: the poison used in gas chambers
Every time you inhale smoke from a cigarette, small amounts of these chemicals get into your blood through your lungs. They travel to all the parts of your body and cause harm.

What do all these chemicals do to my body?

As you might imagine, even small amounts of the poisonous chemicals in cigarettes can do bad things to your body. Here are some facts about what smoking cigarettes does to you:

Smoking makes you smell bad, gives you wrinkles, stains your teeth, and gives you bad breath.
Smokers get 3 times more cavities than non-smokers.
Smoking lowers your hormone levels.
When smokers catch a cold, they are more likely than non-smokers to have a cough that lasts a long time. They are also more likely than non-smokers to get bronchitis and pneumonia.
Teen smokers have smaller lungs and a weaker heart than teen non-smokers. They also get sick more often than teens who don't smoke.

I know smoking is bad for me, but I really like it.

Many teens like the feeling that smoking gives them. This good feeling is from the nicotine in the cigarettes. Some teens think smoking will help them lose weight or stay thin. Many teens also feel like smoking gives them a sense of freedom and independence, and some smoke to feel more comfortable in social situations. If this sounds like you, you should stop and think about whether the things you like about smoking are really worth the risks.

Nicotine can make you feel good, but is feeling good (a feeling you can also get from healthy activities like playing sports) really worth all the bad things cigarettes do to you? If you smoke, you'll get sick more often. You also have the chance of getting lung cancer or emphysema, which will make you really sick for a long time before you die. If you are very sick, that good feeling from nicotine won't seem so important anymore.
Smoking doesn't really help people lose weight. If that were true, every smoker would be thin.
Smoking lowers your hormone levels.
Do you think that smoking is a sign that you can do what you want? That you are in control of your life? Think about it this way: When you decide to start smoking, you are doing exactly what tobacco companies want you to do. They spend millions of dollars every year on advertising to try to get new people, especially teens, to smoke. Once they have you hooked, THEY are controlling YOU. You are forced to buy their products in order to support your addiction. Do you really want a big corporation controlling your life and telling you how to spend your money?

I'll quit in a year or two when I'm ready.

A lot of people put off quitting smoking, thinking that they'll do it when the time is right. Only 5% of teens think they will still be smoking in 5 years. Actually, about 75% of them are still smoking more than five years later. If you smoke, it will never seem like the right time to quit and quitting will never be easy. The longer you smoke, the harder it will be to stop and the more damage you will do to your body. Here are some reasons to quit sooner rather than later:

Most teens would rather date a non-smoker.
You'll save money if you quit smoking. A pack of cigarettes costs about $5.00. Even if you only smoke a couple packs a week, you're spending about $40 per month and $480 per year on smoking. Think of all the other things you could use that money for.
You only have one pair of lungs. Any damage you do to them now will be with you for the rest of your life.
The longer you smoke, the better your chances are of dying from it. One out of 3 smokers die from smoking and many more become very sick. Think about your friends who smoke. 1/3 of them will die from smoking if none of you quit.
As you can see, smoking can have serious effects on your life. The longer you smoke, the more damage you do to your body and your health. Most people who begin smoking as teens say that they wish they had never started. The decision to start or continue smoking is entirely up to you and no one can make you stop, but you should think about whether it is really the best thing for your body and your life.

Life as a Smoker
 Everyone knows that "smoking is bad for you". You know that if you start smoking that 1/3 of you will eventually die from it. And for the most part, that's about all you know. Is this enough reason to not smoke? No, it's not, and here's why.

Teenagers are immortal. Teenagers live forever. At least that's the way it seemed when I was a teenager. People's perception of time is logarithmic and when your 18 a "half lifetime" is 9 years. Your parents are 2-3 half lifetimes older than you and your grandparents are 4-6 half lifetimes older than you and in your mind that is like eternity and beyond the scope of your imagination. Thus, in your mind, the health effect form smoking are so far off in the future that it's beyond the limits of your imagination. Besides, surely by then they will cure cancer, right?

 People of my generation (I'm 43) have a half lifetime of 21 years. We are looking at best at one more half lifetime of having good sex and then a half lifetime of growing old and dying. We are past the age where it is obvious that smoking is a bad idea. For those of you who don't know it, if you don't smoke before you're 20 you won't start. By the time you get to 25 you have developed the mental skills to be able to resist the social pressures to start. That's my theory at least. But the facts are that people over 20 don't start smoking. Smokers come from teen smokers who can't quit