Tobacco: Hazards to health and human reproduction

 Twenty years of adverse publicity have begun to affect cigarette smoking habits in the United States.  Between 1964-75 the percentage of males smoking declined from 52 to 39, females 34 to 52.  British surveys show half of 60,000 physicians quit smoking between 1951-65.  In the developing countries, however, tobacco is associated with western affluence and modernity.  Consumption increases 5% annually.  Tobacco is one of the foremost public health hazards.  It is associated with a higher incidence of lung cancer, heart disease, emphysema, and other related lung diseases.  Nicotine, which is likely the habit forming agent in cigarettes, with carbon monoxide reduces the amount of oxygen available to the heart while stimulating cardiac activity which increases the heart's need for oxygen.  Known and suspected cancer promoting agents reside in cigarette tar.  Smoking during pregnancy retards fetal growth and increases risks of spontaneous abortion, pregnancy complications, preterm delivery, and late fetal and newborn death.  The risk of fetal death for a pregnant smoker over 30 or poor or anemic is 100% greater than for a nonsmoker.  By 1974, 20 of 25 developing countries had taken some regulatory action against smoking, compared to 13 of 49 developing countries.  Finland, Norway, and Sweden lead the developed countries in health oriented, antismoking policy.  The tobacco industry represents 6 billion dollars to the United States government.  The strength of years of research demonstrating harmful effects should outweigh commercial considerations and persuade government to reduce export subsidies, raise taxes on tar and nicotine products, educate the public, limit or prohibit advertising, prohibit smoking in public areas and work places, and setting differential insurance rates for nonsmokers.

Johns Hopkins Bloomberg School of Public Health,Center for Communication Programs,Population Information Program