By Hao Lu
Smoking kills, even if you don’t smoke. As a result of widespread tobacco use, approximately 443,000 Americans die each year from tobacco-related illnesses, such as cancer and heart disease, according to a 2008 study conducted by the Centers for Disease Control and Prevention. Nearly 11 percent of these deaths resulted from secondhand smoke exposure.
“[Secondhand smoking] is a very serious problem,” said Geri Healey-Dame, System Director of Respiratory Care for Hallmark Health System. “I believe it’s pretty significant. We see a lot of patients with lung disease. They can be people who have never smoked, but work in a smoking environment, like waitresses and bartenders.”
Secondhand smoke, which is also called environmental tobacco smoke, refers to all the smoke that can be found in a room. When someone inhales smoke directly from a cigarette, he or she breathes a higher concentration of cigarette ingredients, such as tar and nicotine. The potential risks of secondhand smoke include asthma, heart disease, sudden infant death syndrome and respiratory problems.
There are higher risks for children affected by secondhand smoke, because their lungs are very tiny and still developing, Healey-Dame said. Children can be affected by either being where someone is smoking or where someone has smoked in the past, since secondhand smoke particles can be found in the air and dust.
Even if parents smoke outside their homes, they do not fully protect their children from the harmful effects of tobacco smoke. The particles can linger on household surfaces such as walls, carpets, clothes and inside automobiles. They move from room to room and can stay in the house for weeks or even months after smoking has occurred. When children breathe secondhand smoke, it is almost as if they are smoking themselves.
“All of those chemicals compounds are still in the environmental tobacco smoke, just at lower concentrations,” said Kevin McCusker, Director of Pulmonary, Critical Care and Hospitalist Services at Quincy Medical Center. “Children from households with smokers have more episodes of ear infection. That’s what we try to use to motivate people to quit smoking. If you don’t want to quit for yourself, think about what this is doing to your children.”
Smoking from the womb
Environmental tobacco smoke doesn’t just affect children, it also harms unborn infants. According to a U.S. Department of Health and Human Services study, smoking during pregnancy can have a negative impact on the health of women, infants and children by increasing the risk of complications during pregnancy, premature delivery and low birth weight. The risks are some of the leading causes of infant mortality.
“Smoking can be very much harmful to pregnancy,” said Lucy Chie, Director of Obstetrics and Gynecology at South Cove Community Health Center. “Evidence shows that smoking during pregnancy may affect the growth of the baby, so that babies are born early and smaller, or it may even lead to stillbirth.”
Smoking not only affects pregnancy, but also harms breast-feeding children, Chie said.
“Smoking, in general, can decrease breast-milk production,” she said. “Babies can also be directly affected by smoke in the environment during breast-feeding. There is a lot of evidence that secondhand smoke can cause health problems for children, lung problems and also infections.”
Chie said pregnant women and their families are encouraged to quit smoking as early as possible.
“In the Asian population, most mothers are not smokers, but their partners may be smokers,” she said. “So we encourage the partners to try to decrease or quit smoking, not only during the pregnancy, but also afterwards, when the baby is born. We also encourage smoking outside — not inside the home — to decrease the exposure to the mother and child.”
Other than children and pregnant women, McCusker said adults who work in a smoking environment should also be aware of the risks of tobacco smoke.
“Working a shift in a restaurant [which allows smoking] is about the same as smoking one pack cigarettes per day,” McCusker said.
How to stop smoking
Smoking does far more harm than good. A 1964 study of the dose-response relationship between smoking and tobacco-related disease showed that the greater the dose, the higher the likelihood of developing a disease, McCusker said. Even if an individual smoked for only a year, one would have much higher risk for tobacco-related disease than someone who never smoked at all.
“A lot of patients think ’I won’t stop smoke until I feel bad and then I’ll quit.’ That’s a really dangerous attitude,” McCusker said.
Experts found the most effective ways to quit smoking are nicotine replacement therapy — such as e-cigarettes, nicotine gum or nicotine patches — and doing the cessation as a group.
Some people do well when they initially quit smoking. However, difficult events in their life may cause them to start smoking again.
“We talk about the three chains of addiction, which are physical, psychological, and behavioral. You have to work on all three of those at the same time,” Healey-Dame said. “It’s a very complicated process.”
For pregnant smokers, it is important for them to find support from family and friends to encourage them to stop smoking, Chie said.
“Studies say about 45 percent of pregnant smokers completely stopped by the end of their pregnancy. However, many will go back to smoking [after giving birth],” she said. “Sometimes if your partner is a smoker, or if your friends are smokers, it’s very difficult to quit smoking since the environment you are in encourages it. So taking yourself out of that environment may be a way to decrease the chance of smoking again.”
Some people who quit smoking are concerned about weight gain after they give up cigarettes. This leads some people to smoke again to keep their weight down, McCusker said.
“What happens is that appetite improves after people quit smoking. And interestingly, their appetite for carbohydrates goes up. So their intake on a daily basis increases about 200 calories per day,” McCusker said. “It seems like 200 calories is not very much — just a few potato chips — so most people don’t think that would affect them very much. If you do the math, that would be three or four pounds per year.”
Stress and the fear of weight gain can deter people from quitting. “We try to help people with that, and we would recommend that they increase their exercise and make healthy choices in eating,” she said.
To make quitting easier without gaining weight, Healey-Dame suggested to eat healthy, exercise and never get too hungry, too angry or too tired.
This post is also available in: Chinese