Allan.britton@ntlworld.com

Health risks related to exposure to environmental tobacco smoke (ETS) are well established. The revised WHO Air quality guidelines for Europe conclude: “ETS has been found to be carcinogenic in humans and to produce a substantial amount of morbidity and mortality from other serious health effects.... Acute and chronic respiratory health effects on children have been demonstrated in homes with smokers ... and even in homes with occasional smoking … there is no evidence for a safe exposure level.” The WHO International Consultation on Environmental Tobacco Smoke and Child Health (Geneva, 11–14 January 1999) called for “swift action to highlight the need for strong public policies to protect children from exposure to tobacco smoke”.

Tobacco what is it, where does it come from, how does it grow, and who grows it, at what cost

The species Nicotiana tabacum is widely cultivated in warm, dry climates for use in both cigars and cigarettes. The leaves are dried, and matured in storage for two to three years before use. Introduced to Europe as a medicine in the 16^th century, tobacco has been recognised from the early 1950s as one of the world’s major health hazards. The leaves also yield nicotine, colourless oil, which has been shown to be one of the most powerful poisons known, and addictive in humans, and is used in insecticides.

Plantations are found away from cities, which are usually large plots of fertile land staffed by qualified farmers, who are responsible for producing superior tobacco destined to become the world’s finest premium cigars.

Once planted it takes tobacco 45-60 days to reach maturity. From 30-40 days onward, leaves are systematically removed from the plants. The plants are not allowed to flower, this extends the useful growing period to 4-5 months, and harvesting takes place from January through to the end of March. During the harvesting period leaves are picked two at a time, from here the leaves go on to be processed and made into cigars or cigarettes.

What are the Facts? The 1992 Surgeon General's Report estimates that the total lifetime excess medical care costs for smokers exceed those for non-smokers by $501 billion (£400 billion)

Tobacco smoke contains over 4,000 chemical compounds including 43 different carcinogenic substances.

Each year about 3,000 non-smoking adults die of lung cancer as a result of breathing the smoke of other's cigarettes. A non-smoker married to a smoker has a 30% greater risk of developing lung cancer than the spouse of a non-smoker.

The total smoking-attributable costs for Texans age 35 or older is $4,135,322,468.

Eighty-five percent of adolescent smokers who buy their own cigarettes usually buy Marlboro, Newport or Camel cigarettes, the most heavily marketed brands.

Maternal smoking is responsible for 35% of all SIDS deaths in the U. S. Smoking during pregnancy triple the risk of SIDS (Sudden Infant Death Syndrome). 

Fires from cigarettes cause 25,000 deaths each year in the U. S. and in the UK

In 1999, 65% of all secondary students reported having used some type of tobacco product during their lifetime.

Nicotine taken in by cigarette smoking takes only seconds to reach the brain but has a direct effect on the body for up to 30 minutes.

Smoking causes Eighty percent of lung cancer.

One in 5 deaths in the U.S results from the use of tobacco.

Each year, smoking claims 400,000 lives in the U.S.

Forty-eight million (24.7%) of adult’s aged 18 and older currently smokes in the U.S. (27.6% of men and 22.1% of women).

There was a 16% increase in smoking among high school seniors between 1996 and 1999.

Other information on tobacco can be found at FAQ's About Tobacco from the Texas Commission on Alcohol & Drug Abuse.

Sources: "Annual Cost of Cigarette Smoking in Texas," Texas Department of Health and M. D. Anderson Cancer Centre, 1993; "Cancer Facts and Figures," American Cancer Society, 1994; "Trends in Tobacco Use Among Youths," "Effect of Maternal Cigarette Smoking on Pregnancy: Complications and Sudden Infant Death Syndrome," DeFranza and Lew, Journal of Family Practice, 1995; "Tobacco if You Use . . . You Lose," Texas Department of Health, 1989; "NIDA Capsules: Cigarette Smoking," National Institute on Drug Abuse, 1993; "Health Problems Attributed to Use of Alcohol, Tobacco and Other Drugs," National Council on Alcoholism and Drug Dependence, 1993; Do It Now Foundation, 1996; American Cancer Society, 2/99; NIDA, 1999 Monitoring the Future Study, Secondary School Students; DoItNow Foundation.

Smoking is proving to be one of the world’s biggest killers and the most costly for health services. The costs are mounting up day by day and it is getting to the point where the costs are so high countries are close to bankruptcy. In the USA for instance smoking is responsible for something in the region of 40 to 50 per cent of all SSA (Social Security) disability cases, which adds up to a cost of approximately $2.5 billion per year. It is also estimated that private medical care insurance pays out in the region of $90 billion per year. So it can be seen that not only does smoking have a life threatening effect on the population it also poses a threat to the economic well being of each country.

But given the above what do the public really know about cigarettes for example what they are made of and what they produce. Each cigarette produces over 4000 different chemicals; some of which are known to attack the central nervous systems others are known to be carcinogens.

Each year, smoking around children is responsible for:

1. 15,000 children hospitalised
2. 26,000 new cases of asthma
3. 150,000 - 300,000 lung infections, such as bronchitis and pneumonia, in children less than 18 months old

Over 40% of SIDS is due to mothers smoking during and/or after pregnancy or another person smoking in the house

A few of the dangerous chemicals in tobacco smoke that can affect you and your children

1. 4-aminobiphenyl.... Promotes liver/bladder cancer
2. Ethyl 2-furoate... A liver poison, considered for use as a chemical warfare agent
3. Hydrogen Cyanide. A poison used in gas chambers, responsible for paralysing and killing the cilia in lung airways
4. Arsenic.................... A poison used to kill rats
5. Formaldehyde.......... Used to preserve dead bodies
6. Carbon Monoxide... Replaces the oxygen in red blood cells can mimic anaemia
7. Ammonia................. An irritant and poison used to help vaporize nicotine so it can be easily inhaled
8. Nickel....................… An organ specific carcinogen
9. Naphythlamine…A bladder carcinogen
10. Toluidine................. A bladder carcinogen
11. Benzo (a) pyrene... A cancer promoter
12. Acetylene................ Used for fuel in welding torches
13. Cadmium................. Used in rechargeable batteries
14. Benzene................... Used as an industrial solvent

Now think about it, if tobacco contains even half of the above poisons, what are smokers doing to themselves let alone their children. Some of the illnesses children can catch are detailed below,

Ear Infections, The toxic chemicals in smoke irritate the lining of the Eustachian tube, which leads from the back of the nose to the ear. The irritated lining creates mucous which collects behind the eardrum. The ear may become infected and cause pain or hearing loss.

Pneumonia, Children have small airways; when an airway is irritated by smoke, mucous is produced. Sometimes one drop of mucous can close a child's airway and cause it to become infected.

Asthma, Irritants in tobacco smoke can cause the lining of the airways to swell making it difficult for a child to breathe. Tobacco smoke or even the stale odour of old smoke in a car can trigger an asthma attack in a child.

Problems after birth, Mothers who smoke during and after pregnancy may have children who are more likely to suffer behavioural problems such as hyperactivity. In one study, children from similar backgrounds who had parents that smoked scored 6% lower on tests than children whose parents did not smoke.

Birth defects, some studies suggest that smoking during pregnancy can cause birth defects such as cleft (split) lip or cleft palate (an opening between the nose and the roof of the mouth). Smoking is also responsible for low birth weight babies, miscarriages, and SIDS. Low birth weight babies.

What is passive smoking? Non-smokers cannot avoid inhaling smoke when sharing the same room as smokers. This is 'passive smoking'.

The smoke is mainly 'side stream' smoke from the burning tip of cigarettes, cigars, or pipe tobacco. Smokers also exhale some 'mainstream' smoke. Both mainstream and side stream smoke contain globules of tar together with nicotine and a wide range of vapours and gases such as carbon monoxide, ammonia, hydrogen cyanide, and acrolein. Some of these substances have been shown in laboratory tests to induce cancer in animals.

What are the risks of passive smoking?

It has been shown that smoking is the single most important cause of disease and premature death. Many independent scientific bodies worldwide have also shown that passive smoking can cause lung cancer in non-smokers. In 1988, an advisory body to the UK Government, the Independent Scientific Committee on Smoking and Health, reviewed all the available scientific evidence and concluded that it was consistent with passive smoking causing a small increase in the risk of lung cancer. The Committee estimated that passive smoking might be causing several hundred-lung cancer deaths a year in the United Kingdom.

What is the legal situation? Under section 2 of the Health and Safety at Work Act 1974, employers have to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all their employees. This means that if a risk to health can be demonstrated, for example if a worker with a respiratory condition is forced to work in a smoky atmosphere which may make that condition worse, the employer must take action to deal with this risk. Health and safety inspectors can take enforcement action if necessary in these circumstances, but ultimately it would be for the courts to decide, whether a risk to health was significant.

Employers also have a common law responsibility to provide a safe place and system of work. They need to resolve complaints from employees in order to ensure that their health is not at risk from a smoky environment.

Good ventilation will reduce the effects of tobacco smoke, but will not completely prevent exposure. In buildings with mechanical ventilation, employers should consider discharging air from smoking areas separately rather than allowing it to enter the recirculating system. If this is not reasonably practicable, the recirculated air should be brought up to an appropriate standard by suitable decontamination systems. Tobacco smoke building up in the workplace is a sure sign that the ventilation system is inadequate.

The main question people, that is non smokers should be asking which has been mentioned already in many quarters and has raised the temperature of the debate, is why should these people continue to be paid benefits from taxes when the disability is self inflicted. Smokers will argue that it is addictive and they cannot give up, it may be, however some people and I know of one in particular, have given up when a smoking related disease has been diagnosed and I’m sure there are many more but for the ones who don’t even try why then should we as tax payers continue to pay for their medical expenses and other benefits.

Money saved on not paying out benefits to people with smoking related diseases who do not following treatment, could then be redirected into the social security budgets for payment to the unemployed and the genuine disabled. And I’m sure that most politicians would agree that these are the people who need financial help. Or as Mr Milburn has stated cancer treatment is going to the top of the list for treatment, why when most people chose to smoke. Why do the rest of us have to pay

According to the Centre for Disease Control and Prevention, roughly 419,000 people die in the United States from tobacco use every year. Teenagers make up the largest percentage of new cigarette smokers and studies show that tobacco is one of the most common "gateway drugs" there is. Obviously, the problem of tobacco use among today’s youth must be addressed.

For many years the debate over whether or not cigarettes cause cancer has angered many people, and been unresolved. Meanwhile, smokers continue to drop like flies, and increasingly it's becoming clear that children are also being made ill and placed at risk for cancer and neurological disease. The point is that both the cigarette industry and the scientific community have known for at least three generations that these chemical contaminants are in cigarettes and that they are carcinogenic and potential killers. Both the UK and U.S. governments have placed a warning on all cigarette packages. The various national health organizations have concluded that cigarette smoking is indeed dangerous and have expended many millions in research into the mechanisms behind cancer, heart disease, neurological damage, etc. Millions of people have stopped smoking cigarettes, and millions more have switched to "Low Tar & Nicotine" brands in the mistaken notion that these were less dangerous. Despite these warnings people still persist in killing themselves and others by smoking.

Dr Allan Britton

36 The Mead

Darlington

United Kingdom

DL1 1EX

Tel: 44 1325 257187 Mob: 44 7855 742 151

Technical College - Bourgas,
All rights reserved, © March, 2000