Smoking

Prepared for:

Ms. Yasmeen khatoun, English lecturer in University of Lahore.

Prepared By:

Ali Raza

Ahmed Zubair Khan Lodhi

Warda Komal

Wajahat Elahi

Faizan Farhad

May 20, 2014

Transmittal letter

Respected Madam:

Here is the assignment that we were assigned on 15th April 2014.

We are thankful to all those persons/webpages that provided us important information and gave us valuable advices. We would be happy if you read the report carefully and we will be try to answer all the questions that you have about the assignment.

We have tried our best to complete this assignment meaningfully and correctly, as much as possible. However, if you need any assistance in interpreting this assignment then please guide us.

Thank you.

Yours sincerely,

Ali Raza

Ahmed Zubair Khan Lodhi

Warda Komal

Wajahat Elahi

Faizan Farhad

Abstract

Smoking is injurious to health and should be stopped. But, most of the countries are not taking any strong actions to prevent the smokers from smoking or refrain people to start smoking. We are writing this report to point out the harms of smoking and to describe some methods that can prevent people from smoking.

In this report we have majorly discussed the harms of smoking, why do people smoke, what gets them addicted. We have divided smokers by age, gender, economic condition. The most harmful disease that is caused by smoking is cancer. Lung cancer in Pakistan is caused directly by tobacco in 90% of cases. It claims lives of 100,000 people every year.28% of the youth is addicted to tobacco smoking. It has become a trend for students to smoke hookah or Shisha. To quit, smokers need apart from heightened awareness of the issue, continuous motivational messages, enhanced social skills and specific smoking-cessation skills .While it is best not to start smoking, there is evidence that quitting smoking at any age is beneficial for health. This evidence is consistent with the conclusion that there is a cause and effect relationship between smoking and depression in which cigarette smoking increases the risk of symptoms of depression. In this report we have also discussed useful information on the extent of smoking.

The report also examines various factors that influence the risks of becoming a smoker, and the chances of successfully quitting smoking. This report is intended to assist in the development, implementation, and evaluation of programs and strategies aimed at smoking prevention, reduction and cessation in smokers.

List of Abbreviations

International Agency for Research on Cancer (IARC)

Environmental Tobacco Smoke (ETS).

Secondhand Smoke (SHS)

Government’s Scientific Committee on Tobacco and Health (SCOTH)

Chronic Obstructive Pulmonary Disease (COPD)

Table of Contents

Introduction

i. Historical Backgroundii. Results

Leading cause of death and illness Gradual killer Children and young people Health inequalities Smoking and cancer Percentage of population who smoke Smokers by age Secondhand smoke The cost of a smoker Tobacco users need help to quit Picture warnings work Ad bans lower consumption Taxes discourage tobacco use Age limit The myths about smoking

Introduction

Like most people, you already know that smoking is bad for your health. But do you really understand just how dangerous smoking really is? Tobacco contains nicotine, a highly addictive drug that makes it difficult for smokers to kick the habit. Tobacco products also contain many

poisonous and harmful substances that cause disease and premature death. Did you know that out of a group of 1000 smokers (age 30), that a full quarter of them (250) will die of smoking-related illnesses prior to completing middle age, an additional quarter will die prematurely from smoking-related illnesses shortly after retirement age, and another large group will develop debilitating chronic illnesses as a result of their smoking. Most people don't know the odds of getting sick as a result of smoking are really that bad, but when you do the numbers, that is how they come out. For many people, truly understanding the very real dangers associated with smoking becomes the motivating factor that helps them to quit. Although it can be a very difficult habit to break, smoking is ultimately a choice; it is your responsibility to choose whether or not you will continue to smoke. This article provides a brief synopsis of the risks associated with smoking; an overview of nicotine addiction, including why it is so difficult to give up smoking; and an outline of the advantages and disadvantages of quitting. Once you have decided to quit, you will benefit from the information in this article about the physiological, psychological, and behavioral aspects of nicotine addiction; the different methods available to help you quit; and the steps you can take to make the process easier. Learning about and understanding the many facets of the smoking habit can put you on the right track to successful smoking cessation.

Historical Background

As the Mayans dispersed and populated different areas, such as North and South America, they took with them their precious tobacco leaves and plants. Hundreds of years later during the time of some of the world's greatest European explorers, tobacco was discovered and later brought back to the new world.Columbus was probably the first European to see tobacco leaves although he did not smoke them himself. A fellow explorer, Rodrigo de Jerez, shortly after, landed in Cuba and observed some of the inhabitants smoking the tobacco leaves. He then proceeded to partake in the smoking act himself. On his return to Spain, laden with heaps of tobacco, Jerez startled his fellow countrymen by smoking in front of them. Never in their lives had they seen a man with smoke coming out of his mouth and nose. People thought that he was possessed by the devil and members of the Spanish Inquisition imprisoned him for several years. During his imprisonment, smoking actually became quite popular in Spain. In the 1530's a number of Europeans saw the potential money making in tobacco and they decided to cash in and make their wealth from the cultivation of this popular plant. They began to colonize areas of the Caribbean and established large tobacco growing areas, from which they exported all the tobacco back to Europe. It is said that Sir Francis Drake was the first man to bring back a consignment of tobacco into the UK in 1573, although Sir Walter Raleigh later went on to make tobacco smoking popular in the court of Queen Elizabeth I. During the year 1586 Sir Walter Raleigh embarked on a trip to the Americas where he met Ralph Lane, who at the time was Governor of Virginia. Lane introduced Raleigh to the pleasures of smoking a clay pipe, which was popular there in that era. A year later a number of colonists who had previously left England to settle in Virginia, returned to their homeland and introduced the fashion of smoking clay pipes into English society. Over the years many English families travelled to Virginia to settle in order to try and make a wealthy living from growing tobacco in the plantations there. Pipe smoking was also gradually becoming extremely popular in severalother European countries, including Spain and France.

Results

The health effects of smoking are the circumstances, mechanisms, and factors of tobacco consumption on human health. Tobacco is the single greatest cause of preventable death globally. Tobacco use leads most commonly to diseases affecting the heart, liver and lungs, with

smoking being a major risk factor for heart attacks, strokes, COPD including emphysema and

chronic bronchitis, and cancer (particularly lung cancer, cancers of the larynx and mouth,

and pancreatic cancer. It also causes peripheral vascular disease and hypertension. The effects depend on the number of years that a person smokes and on how much the person smokes. Starting smoking earlier in life and smoking cigarettes higher in tar increases the risk of these

diseases. 

Leading cause of death and illness

The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600,000 are the result of non-smokers being exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease. Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest. Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development. In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to "green tobacco sickness", which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves. Experts attribute the link between smoking and mental illness to a number of factors. Biochemistry probably plays some part. Nicotine is a very powerful drug, and that's true whether somebody has a mental illness or not. In some cases, people with mental illness may be using tobacco to mask symptoms or medication side effects. Some might also be more affected by nicotine withdrawal. "People with panic attacks, for instance, may have a harder time quitting because the symptoms of withdrawal such as increased heart rate can trigger an attack. Often, people with mental disorders experience a laundry list of risk factors for tobacco use: They're more likely to have lower socioeconomic status and to experience more homelessness or other stressful living situations, for instance. Plus, they often lack medical insurance and access to resources that could help them quit.

Gradual Killer

Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of tobacco-related disease and death has just begun. Tobacco caused 100 million deaths in the 20th century. If current trends continue, it may cause one billion deaths in the 21st century. Unchecked, tobacco-related deaths will increase to more than eight million per year by 2030. More than 80% of those deaths will be in low- and middle-income countries.

Children and Young People

One in seven fifteen year olds is a regular smoker. Millions of children and young people are exposed to tobacco smoke in homes and cars every day. These shocking facts must be addressed head on: the protection of children and young people from the harms of tobacco should lie at the very heart of a new national tobacco control strategy. Nearly all smokers start young so deep, long-term cuts in smoking prevalence will only be achieved by preventing children and young people from starting smoking. Every effort should be made to reduce the attractiveness of smoking and the accessibility of cigarettes to young people. The context of everyday life is crucial; children and young people who live with adult smokers are much more likely to start smoking than those who live in smoke free homes. Reducing adult prevalence is therefore essential to stopping youth initiation. Smoke free homes and cars are also vital in cutting the exposure of children and young people to the toxins in secondhand tobacco smoke.

Health inequalities

The more deprived you are, the more likely you are to smoke. Almost every indicator of social deprivation, including income, socio-economic status, education and housing tenure, independently predicts smoking behavior. Consequently individuals who are very deprived are also very likely to smoke. These differences in smoking behavior translate into major inequalities in illness and mortality, inequalities which have deepened over the last thirty years. Smokers in lower socio-economic groups are just as likely to try to quit as affluent smokers but are less likely to succeed. Their lower success rate is partly due to stronger nicotine addiction. In every age group, smokers from deprived backgrounds take in more nicotine than more affluent smokers, even when the number of cigarettes smoked is the same. As smoking prevalence is highest in the population groups least able to afford to smoke, smoking deepens deprivation, social inequalities and child poverty. Smokers from disadvantaged backgrounds are also more likely to die or suffer injury from smoking-related fires. Even though the terms ‘light’ and ‘mild’ are now prohibited, many people still identify low tar cigarettes as less harmful, signaled by subtle differences in pack branding, when in reality tobacco smoke is always toxic and dangerous. Any standard for tobacco product content or emissions risks being exploited in this way. Tobacco advertising and branding encourage children and young people to start smoking. These young people then have little difficulty obtaining tobacco products: enforcement of the minimum age limit is weak and vending machines offer under-age smokers easy access to cigarettes. Young people are also sensitive to the glamorization of smoking in films, on TV and on the internet. There are many ways of discouraging initiation into smoking and encouraging quitting. Mass media public communication campaigns are particularly cost-effective. Overall,

however, the most effective way of reducing smoking prevalence is to increase the price of tobacco. The affordability of cigarettes has barely changed in the last ten years and the illicit market share is still substantial. The illicit trade reduces the real price of tobacco, especially in more deprived communities, and so exacerbates health inequalities. About one in eight cigarette packs and one in two packs of hand-rolled tobacco are illicit. Despite the huge step forward of smoke free legislation, millions of people, especially children and young people, are exposed to secondhand smoke in homes and cars every day.

Smoking and cancer

More than half a century ago, the causal link between lung cancer and tobacco smoking was established. Since then a wealth of information has been assembled on the tragic health consequences of tobacco consumption and the highly addictive nature of nicotine in cigarettes, which makes smoking cessation so difficult. Today, tobacco consumption is recognized as the UK’s single greatest cause of preventable illness and early death, with an estimated 102,000 people dying in 2009 from smoking-related diseases including cancers. Around 86% of lung cancer deaths in the UK are caused by tobacco smoking and, in addition, the International Agency for Research on Cancer (IARC) states that tobacco smoking can also cause cancers of the following sites: upper aero-digestive tract (oral cavity, nasal cavity, nasal sinuses, pharynx, larynx and esophagus), pancreas, stomach, liver, bladder, kidney, cervix, bowel, ovary (mucinous) and myeloid leukemia. Overall, tobacco smoking is estimated to be responsible for more than a quarter of cancer deaths in the UK, that is, around 43,000 deaths in 2009. Tobacco smoke is estimated to have caused around 60,000 cases of cancer in the UK in 2010.

Percentage of population who smoke

In Britain in 1948, when surveys of smoking began, smoking was extremely prevalent among men: 82% smoked some form of tobacco and 65% were cigarette smokers. By 1970, the percentage of male cigarette smokers had fallen to 55%. From the 1970s onwards, smoking prevalence fell rapidly until the mid-1990s. Since then the rate has continued to fall slowly and in 2007 around a fifth (22%) of men (aged 16 and over) were reported as cigarette smokers. Between 2007 and 2009, the rate remained stable, and fell to 21% in 2010 Trends in lung cancer incidence rates (shown here from 1975 onwards) reflect the trends in smoking prevalence in past years. Smoking has never been a majority habit among women and the percentage of female smokers remained remarkably constant between 1948 and 1970 (41% in 1948 and 44% in 1970). By 2007, the percentage of women who smoke had decreased to around 20%, and has stayed

around this level since then. Between 1974 and 2007, smoking prevalence was significantly higher in men than women, but in 2008 and 2010, the difference between the sexes was not statistically significant .There are estimated to be around 10 million adults in Britain who smoke cigarettes. Recent research suggests that self-reported cigarette smoking rates may underestimate true tobacco smoking prevalence by 2.8% in England.

Smokers by age

Since 1986, the highest rates of smoking in adults in Great Britain have been in the 20-24 age-group (27% in 2010), followed by the 25-34 age-group (26% in 2010). The lowest prevalence of smoking since 1974 has been in persons aged 60 and over 13% in 2010. The difference between the age-groups has historically been smaller and has increased over time. For example, in Britain, among people aged 60 and over, the prevalence of smoking decreased by more than half between 1974 and 2010, from 34% to 13%, whereas among people aged 20-24, the decrease was smaller, from 48% to 27% over the same time period.

In men in Great Britain, the highest rates of smoking were also in the 20-24 age-group between 1986 and 1998, but in 2000, the peak rate of smoking was in the 25-34 age-group. Rates of smoking were similar in both these age-groups until 2008, since when the rate has been higher in the 25-34 age-groups. Trends data have been smoothed using estimated values for some years. Estimated years are indicated in the download. In women in Great Britain, the highest rates of smoking have been in the 20-24 age-group since 1986 (29% in 2010), followed by the 25-34 age-group (25% in 2010). The lowest prevalence of smoking since 1974 has been among women aged 60 and over 13% in 2010.

Secondhand smoke

Research has consistently shown that non-smokers are put at risk by exposure to other people’s smoke. This may be called passive or involuntary smoking and is also referred to as secondhand smoke (SHS) or environmental tobacco smoke (ETS).Tobacco smoke is made up of ‘side stream’ smoke from the burning tip of the cigarette and ‘mainstream smoke’ from the filter or mouth end: it is the side stream smoke that makes up the majority (85%) of ETS. The government’s Scientific Committee on Tobacco and Health (SCOTH) concluded in 1998 that ETS caused lung cancer and heart disease in adult non-smokers. The most recent meta-analyses have confirmed these findings and estimate that non-smokers exposed to passive smoking at home or in their occupation have their risk of lung cancer raised about a quarter, while heavy exposure at work doubles the risk.

Passive smoking also contributes to continuing the “family circle” of smoking and there is much evidence of the harmful effects on children in ‘smoking’ households including respiratory disease, asthma attacks, cot deaths and middle ear infections. The Acheson report highlights the fact that while one third of children in the UK live with at least one adult smoker, among low-income families the figure is 57%.It is estimated that exposure to ETS in the home causes around 11,000 deaths in the UK each year from lung cancer, stroke and ischemic heart disease.

In Scotland out of the 865 annual deaths caused by ETS, an estimated 5% (44) are from lung cancer. Applying this percentage to the UK, an estimated 600 deaths from lung cancer may be caused each year by ETS. The case for reducing exposure to ETS is incontrovertible and led to legislation in England making enclosed public places and workplaces smoke free from 1st July 2007, following earlier legislation in Scotland, Wales and Northern Ireland.

The cost of a smoker

A smoker costs a private employer in the United States an extra $5,816 per year compared with a nonsmoker, according to an analysis of data collected from earlier studies on the costs of smoking. Researchers at The Ohio State University estimated that the largest cost, at $3,077 annually, came from taking smoking breaks. Smokers took, on average, about five breaks a day, compared with the three breaks typically sanctioned for most workers. The second largest cost, at $2,056, was related to excess health care expenses. Smokers typically have more health problems than nonsmokers, including heart and lung disease and various cancers.

The remaining costs came from increased absenteeism — the researchers found that smokers miss about two-and-a-half extra workdays each year — and lost productivity at work, perhaps because of nicotine’s withdrawal effects. The findings appeared online in June in the journal Tobacco Control.

Tobacco users need help to quit

Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27% knew that it causes stroke.Among smokers who are aware of the dangers of tobacco, most want to quit. Counseling and medication can more than double the chance that a smoker who tries to quit will succeed.National comprehensive cessation services with full or partial cost-coverage are available to assist tobacco users to quit in only 21 countries, representing 15% of the world's population.There is no cessation assistance of any kind in one-quarter of low-income countries.

Picture warnings work

Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit.Graphic warnings can persuade smokers to protect the health of non-smokers by smoking less inside the home and avoiding smoking near children. Studies carried out after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand consistently show that pictorial warnings significantly increase people's awareness of the harms of tobacco use.Just 30 countries, representing 14% of the world's population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs. Most of these countries are low- or middle-income countries.Mass media campaigns can also reduce tobacco consumption, by influencing people to protect non-smokers and convincing youths to stop using tobacco.Over half of the world's population live in the 37 countries that have implemented at least one strong anti-tobacco mass media campaign within the last two years.

Ad bans lower consumption

Bans on tobacco advertising, promotion and sponsorship can reduce tobacco consumption. A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco consumption by an average of about 7%, with some countries experiencing a decline in consumption of up to 16%.Only 24 countries, representing 10% of the world’s population, have completely banned all forms of tobacco advertising, promotion and sponsorship. Around one country in three has minimal or no restrictions at all on tobacco advertising, promotion and sponsorship.

Taxes discourage tobacco use

Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young people and poor people. A tax increase that increases tobacco prices by 10% decreases tobacco

consumption by about 4% in high-income countries and by up to 8% in low- and middle-income countries. Even so, high tobacco taxes is a measure that is rarely used. Only 32 countries, less than 8% of the world's population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.

Age Limit

The age required to use/get tobacco products is 18 in most of the countries around the globe. Even though there is an age limit but it hardly applies anywhere. Anyone under 18 can easily have access to tobacco products whenever they want to. Vending machines make it even easier for youngsters to get what they want. This age limit restriction should be practiced more seriously.

New York City is banning people younger than 21 from buying or being sold cigarettes under tobacco age limits that will be among the toughest in the US.The city council voted overwhelming on Wednesday (10/30/2013) to raise the age from 18 to 21 for cigarettes, certain tobacco products and electronic vapor smokes. Another measure sets a minimum price of $10.50 a pack for tobacco cigarettes and steps up law enforcement on illegal tobacco sales.

Appendix

While many students are aware of the long-term health problems associated with smoking, this knowledge is not enough to prevent smoking. Some adolescents believe that smoking can benefit them in the short-term. We asked some people some questions regarding to smoking at your school to reveal about some common myths about smoking.

• Myth: smoking helps people to relax (41% of students believe this and 35% “don’t know”).

Fact: nicotine is a stimulant and smoking causes rises in pulse rate and blood pressure. Considering the short and long term social and health consequences of smoking, smoking is likely to increase overall stress levels.

• Myth: smoking can help people stay slim (19% believe this and 37% “don’t know”).

Fact: research has shown that smokers gain as much weight as non-smokers in the same age range. This common misperception may especially influence young females to consider smoking.

• Myth: smokers can quit anytime (25% believe this and 18% “don’t know”).

Fact: nicotine is highly addictive and quitting is often very difficult even for youth and adults who are motivated to quit.

• Myth: smoking helps relieve boredom (18% of students believe this and 22% “don’t know”). Fact: there are much healthier activities that are truly able to reduce boredom.

Conclusion

In conclusion, we think that smoking should be illegal. The amount of harm it does to the smoker's body and the people around him is too great to ignore. Smoking kills over 430,000 people in the United States each year and costs them thousands of dollars in health care for smoking related medical issues. And although health care for smokers also costs the government millions they refuse to ban the easily addictive drug from hands of civilians. This is because of the profits that tobacco production and sales make for the economy each year.

This is inexcusable because this is putting the importance of money and the stimulation of the economy before citizens' health and lives. And it is also important to outlaw cigarettes because not only will it save thousands of smokers' lives but it will keep the people around them safe from their bad decisions. The babies and small children especially will be saved because then their lives and health will be up to them instead of their parents' bad decisions. When the con side says nobody will follow the law, we can just reinforce it more. Overall, we think extracting this addictive drug from society will improve the health and well being of our citizens and our country.

References

http://www.who.int/mediacentre/factsheets/fs339/en/

http://well.blogs.nytimes.com/2013/08/07/the-cost-of-a-smoker-5816/?_r=0

http://www.theguardian.com/world/2013/oct/31/new-york-usa

https://sites.google.com/site/smokingoutlaweddebate/home/conclusion-smoking-should-be-illegal

http://www.helpwithsmoking.com/history-of-smoking.php

http://en.wikipedia.org/wiki/Health_effects_of_tobacco

http://www.nhs.uk/news/2013/03March/Pages/Smoking-and-drinking-down-survey-reveals.aspx

http://object.cato.org/sites/cato.org/files/serials/files/regulation/2006/12/v29n4-4.pdf

http://www.apa.org/monitor/2013/06/smoking.aspx

http://www.cancerresearchuk.org/cancer-info/cancerstats/types/lung/smoking/