Cigarette

Aka: Cigarette, Tobacco

1. See Also
   1. Tobacco Cessation
   2. Passive Smoke Exposure
2. Epidemiology
   1. Smoking is the top cause of preventable death in U.S.
      1. Dwarfs Alcohol and Drug Abuse deaths and HIV combined
   2. Mortality in the United States
      1. Deaths per year: 434,000
      2. Deaths per day: >1000
   3. Prevalence of smoking in United States
      1. Overall adults: 25% (47 Million smoking)
      2. Ages 18-24 years: 33%
   4. Medical costs of Tobacco abuse
      1. Direct: $50 billion
      2. Indirect: may approach additional $50 billion
3. Risk Factors
   1. Lower socioeconomic groups
   2. Lower education Levels
   3. Adult smokers begin in adolescence (95% before age 20)
4. Complications: Tobacco abuse in Pregnancy
   1. Low Birth Weight Infant
   2. High Carbon Monoxide load for fetus
   3. High Hematocrit for fetus
5. Labs
   1. Spirometry in 10 pack year smokers over age 40
      1. Evaluate for COPD
   2. References
      1. Zielinski (2001) Chest 119:731-6 [PubMed]
6. Adverse Effects
   1. Low tar Cigarettes carry the same risk of Lung Cancer
      1. Harris (2004) 328:72-6 [PubMed]
   2. College student smokers have impaired quality of life
      1. Martinez (2004) Chest 125:425-8 [PubMed]
   3. Infections with increased risk related to Tobacco use
      1. Upper Respiratory Infections
      2. Pneumonia
      3. Tuberculosis
      4. Influenza
      5. Legionnaire's Disease
      6. Periodontal Disease and ulcers
      7. Otitis Media (Passive Smoke Exposure)
      8. Arcavi (2004) Arch Intern Med 164:2206-16 [PubMed]
7. Management
   1. See Tobacco Cessation
8. Resources
   1. CDC Tobacco Page
      1. http://www.cdc.gov/tobacco