1. Heart disease

Smokers in their thirties and forties have a heart attack rate that is five times higher than their nonsmoking peers. Cigarette smoking may be directly responsible for at least 20% of all deaths from heart disease, or about 120,000 deaths annually. Smoking cigars may also increase the risk of early death from heart disease, although evidence is much stronger for cigarette smoking.

Its damaging effects on the heart are multifold:

Smoking lowers HDL levels (the so-called good cholesterol) even in adolescents.

It causes deterioration of elastic properties in the aorta, the largest blood vessel in the body, and increases the risk for blood clots. It increases the activity of the sympathetic nervous system (which regulates the heart and blood vessels).

Tobacco smoke may increase cardiovascular disease in women through an effect on hormones that causes oestrogen deficiency.

2. Cancer

Smoking is the cause of 85% of all cases of lung cancer in 2000, account for 28% of all cancer deaths. Quitting reduces the risk for lung cancer, even well into middle age.

Smoking and smokeless tobacco also cause between 60% and 93% of cancers of the throat, mouth, and oesophagus. Smokers also have higher rates of leukaemia and cancers of the kidney, stomach, bladder, and pancreas. About 30% of cervical cancers have been attributed to both active and passive smoking. Lung cancer patients who survive and continue to smoke face a serious risk of developing a second tobacco-related tumour within ten years.

3. Dementia and neurologic diseases

People who smoke a pack a day have almost two and a half times the risk of stroke as non-smokers. The best current research suggesting that smoking makes little difference in the risk for Alzheimer’s, and if it does, the risk for dementia is slightly higher in smokers. Certainly, smoking can affect blood vessels in the brain as it does in the heart, increasing the risk for dementia from small or major strokes.

4. Lung disease

Smoking is associated with a higher risk for nearly all major lung diseases, including pneumonia, flu, bronchitis, and emphysema. There is also a link between smoking and increased asthma symptoms. Heavy smokers with asthma are also more likely to seek emergency treatment for their condition during times of heavy ozone pollution.

5. Female infertility and pregnancy

Studies have now linked cigarette smoking to many reproductive problems. Women who smoke pose a greater danger not only to their own reproductive health but, if they smoke during pregnancy, to their unborn child. Some of these risks include the following:

Greater risk for infertility in women.

Greater risk for ectopic pregnancy and miscarriage.

Greater risk for stillbirth, prematurity, and low-birth weight.

Smoking reduces folate levels, a B vitamin that is important for preventing birth defects.

Women who smoke may pass genetic mutations that increase cancer risks to their unborn babies.

6. Male sexuality and reproduction

Men’s sexual and reproductive health is not immune from the effects of smoking.

Heavy smoking is frequently cited as a contributory factor in impotence because it decreases the amount of blood flowing into the penis.

Smoking also reduces sperm density and their motility, increasing the risk for infertility.

7. Behavioural and Social Problems

Children of smoking mothers are more likely to have more motor control problems, perception impairments, attention disabilities, and social problems than children of non-smoking mothers. Some reasons for these associations have been suggested:

Women who breast feed and smoke pass nicotine by-products to their babies, which may contribute to these problems.

Women smokers tend to be less educated than women non-smokers, which may cause increased stress at home.

Smoking mothers and their children may share certain inherited psychologic factors, such as depression, which cause addictive and behavioural problems that are unrelated to smoking itself.

8. Effects on bones and joints

Smoking has many negative effects on bones and joints:

Smoking impairs formation of new bone and women who smoke are at high risk for osteoporosis.

Postmenopausal women who smoke have 17% greater risk for hip fracture at age 60, a 41% greater risk at 70, and a 108% greater risk at age 90.

Smokers are more apt to develop degenerative disorders and injuries in the spine.

Smokers have more trouble recovering from spinal surgery.

Smokers whose jobs involve lifting heavy objects are more likely to develop low back pain than non-smokers.

In women, smoking may also pose a small increased risk for developing rheumatoid arthritis

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