This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
This booklet for schools, medical personnel, and parents contains highlights from the 2012 Surgeon General's report on tobacco use among youth and teens (ages 12 through 17) and young adults (ages 18 through 25). The report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population have been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco.
Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.
"Science tends to generalize, and generaliza tions mean simplifications . . . . And generaliza tions are also more satisfying to the mind than details. Of course, details and generalizations must be in proper balance: Generalizations can be reached only from details, while it is the generalization which gives value and interest to the detail:' . . . (A. Szent-Gyorgy, Science 1964) The first edition of this book, published in German as Tabak abhiingigkeit in 2001, was prompted by the fact that no single volume was available in Germany or elsewhere summarising the adverse repercussions of cigarette smoking on human health. As far as my own research was able to ascertain, the last comprehensive work dealing with this subject was writ ten in Germany by the Dresden internist, F. Lickint, whose Tabak und Organismus was published in 1939 by the Hip pokrates-Verlag. All subsequent monographs in this field have tended to focus on detailed aspects, and there has been no shortage of publications on subjects such as how smokers can quit smoking, healthy eating for smokers etc. Friends and colleagues abroad have urged me to prepare an English language version of Tabakabhiingigkeit. In gladly complying with this suggestion, I have intentionally prepared an up dated and slightly enlarged new edition, taking account of the rapidly proliferating literature on the subject up to the start of 2002. The harmful sequelae of smoking are played down by politicians in many industrialised countries, including Ger many.
This book comprehensively covers the science and policy issues relevant to one of the major public health disasters of modern times. It pulls together the aetiology and burden of the myriad of tobacco related diseases with the successes and failures of tobacco control policies. The book looks at lessons learnt to help set health policy for reducing the burden of tobacco related diseases. The book also deals with the international public health policy issues which bear on control of the problem of tobacco use and which vary between continents. The editors are an international group distinguished in the field of tobacco related diseases, epidemiology, and tobacco control. The contributors are world experts drawn from the various clinical fields. This major reference text gives a unique overview of one of the major public health problems in both the developed and developing world. The book is directed at an international public health and epidemiology audience includng health economists and those interested in tobacco control.
Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes. Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.
This is the 11th IARC Handbook of Cancer Prevention, and the first in a series focusing on tobacco control. It reviews the scientific literature and evaluates the evidence on changes in the risk of cancer, coronary heart disease, cerebrovascular disease, abdominal aortic aneurysm, peripheral artery disease and chronic obstructive pulmonary disease observed following smoking cessation. It considers whether the risk of dying from or of developing these diseases decreases after smoking cessation, the time course of the change in risk and whether the risk returns to that of never-smokers? The review and evaluation presented in the Handbook goes on to identify relevant public health and research recommendations.
This new volume of the IARC Handbooks of Cancer Prevention in Tobacco Control presents a critical review and evaluation of the evidence by 25 international experts from twelve countries on the economics, epidemiology, public policy and tobacco control aspects of tax and price policies. The working group draws conclusions about the effectiveness of tax and price measures to control tobacco use in the population. The Handbook covers an overview of tobacco taxation; industry pricing strategies and other industry initiatives diluting the effects of taxes on consumption; tax, price and aggregated demand for tobacco, as well as demand at the individual level in adults, young people and the economically disadvantaged; tax avoidance and tax evasion and the economic and health impacts of tobacco taxation. This body of evidence and the consensus evaluation of 18 concluding statements on the impact of interventions to increase the price of tobacco products, can assist policy makers, government officials, evaluators and researchers working in tobacco control and disease prevention, to base their decisions on the latest scientific evidence.
Tobacco smoking is a major public health issue worldwide. Smoking causes more than a quarter of all cancer deaths, with nearly 80% of deaths from lung cancer, 80% of deaths from bronchitis and emphysema and almost one fifth of deaths from cardiovascular disease. The role of tobacco smoke in the development of cancer, cardiovascular and respiratory diseases is widely discussed in the chapters of this book. It is responsible for many preventable diseases, contributes to a large number of premature deaths and accounts for enormous economic costs. The chapters in this book review a variety of topics related to the sociodemographic characteristics of people consuming tobacco, tobacco product promotion and merchandising consequences of smoking on health, the studied mechanism of damage and the different interventions promoted for tobacco control. The mechanisms by which cigarette smoke affects health are diverse. Thousands of chemical components -- mainly toxins and carcinogens -- are part of tobacco smoke. These components could act through specific or nonspecific mechanisms in the development of cancer, cardiovascular and respiratory disease. Common pathways include DNA damage, gene mutations, vasomotor dysfunction and oxidative stress, among others. The effects on health of first-hand and second-hand smoke exposure have been widely studied, and there is growing evidence regarding consequences of third-hand smoke exposure. The constituents, dynamic transformation and distribution of third-hand smoke are a fruitful area of study, as much as the quantification of its exposure. In this book, many useful indicators of exposure to environmental tobacco smoke, ranging from surrogate indicators to direct measurements of the components that reflect dose are analysed. Advances in this field can provide useful information on the extent and effects of smoking, implementing and assessing tobacco control policies. Furthermore, the World Health Organization developed a framework for an international treaty that provides evidence-based recommendations for health promotion and tobacco control. After more than ten years of its implementation, the effectiveness of different strategies adopted worldwide is analysed and reflections on the new challenges of its implementation are presented. In this book, smoking is reviewed pertaining to the effects and implications for health, as well as the current challenges on implementation and evaluation of tobacco control interventions.
