Smoking is considered a health hazard because tobacco smoke contains nicotine, a poisonous alkaloid, and other harmful substances such as carbon monoxide, acrolein, ammonia, prussic acid, and a number of aldehydes and tars; in all tobacco contains some 4,000 chemicals. In 1964 definitive proof that cigarette smoking is a serious health hazard was contained in a report by the Surgeon General's Advisory Committee on Health, appointed by the U.S. Public Health Service. The committee drew evidence from numerous studies conducted over decades. They concluded that a smoker has a significantly greater chance of contracting lung cancer than a nonsmoker, the rate varying according to factors such as the number of cigarettes smoked per day, the number of years the subject smoked, and the time in the person's life when he or she began smoking. Cigarette smoking was also found to be an important cause of cancers of the esophagus, nasopharynx, mouth, larynx, kidney, and bladder as well as a cause of chronic obstructive pulmonary disease, emphysema, and heart disease, stroke, and other cardiovascular diseases. Since then it has been found to be an independent risk factor in male impotence. Smoking also increases risks associated with oral contraceptive use and exposure to occupational hazards, such as asbestos. Pipe and cigar smokers, if they do not inhale, are not as prone to lung cancer as cigarette smokers, but they are as likely to develop cancers of the mouth, larynx, and esophagus. Those who use snuff or chewing tobacco (sometimes called "smokeless tobacco") run a greater risk of developing cancer of the mouth.
Inhalation of tobacco smoke by nonsmokers has been found to increase the risk of heart disease and respiratory problems; this has created a movement for smokeless environments in public spaces, including government buildings, office buildings, and restaurants. Fetal damage can be caused if a mother smokes or is exposed to smoke during pregnancy. Children of smokers have a higher risk of asthma and lung disease.
Because of mounting evidence of health risks, television advertisements for cigarettes were banned beginning in 1971. In the 1980s, Congress began to require stronger warning labels on all print advertising; soon afterward it banned smoking on domestic air flights. A 1988 report of the Surgeon General of the United States recognized nicotine as an addictive substance, leading the Food and Drug Administration (FDA) to consider treating nicotine as any other addictive drug and implementing stricter regulations. The authority of the FDA to regulate smoking was, however, denied by the Supreme Court. The habit of smoking continues to increase in the young despite the illegality of cigarette sales to those under 18 years of age in all 50 states.
The Framework Convention on Tobacco Control, a treaty adopted by World Health Organization members in 2003, will establish international standards for antismoking measures once it is ratified. The convention creates restrictions on the marketing and sale of tobacco products and require health warnings on packages of cigarettes. Indoor air quality laws, high taxes on tobacco, and meansures against cigarette smuggling are encouraged under the pact.
In the mid- and late 1990s the tobacco industry in the United States faced grave legal and financial threats. Under heavy attack from states seeking compensation to recover costs for smoking-related health care, from the federal government seeking further regulation, and from individual smokers seeking damages for illness, the major cigarette producers sought ways to protect themselves. After a tentative $368 billion settlement (1997) with state attorneys and plaintiffs' lawyers fell apart, lawsuits were brought against the industry by Florida, Minnesota, Mississippi, and Texas; the suits were settled for $40 billion, to be paid over 25 years. In 1998 the remaining 46 states accepted a $206 billion plan to settle lawsuits they had filed against the industry. Individual lawsuits continued to pose potential significant financial threats. The Framework Convention on Tobacco Control, which came into affect in 2005 and has been ratified by more than 55 nations, seeks to reduce the number of tobacco-related illnesses and deaths by such measures as banning tobacco product advertising and putting warning labels on tobacco packaging. The treaty has been signed, but not ratified, by the United States.
See publications of the Office on Smoking and Health of the Centers for Disease Control and publications of the American Cancer Society and the American Lung Association; see also E. C. Hammond, I. J. Selikoff, and J. Chung, "Asbestos exposure, cigarette smoking and death rates" from Annals of the New York Academy of Sciences (1979); R. J. Troyer and G. E. Markle, Cigarettes: The Battle over Smoking (1983); P. Taylor, The Smoke Ring (1984); Imperial Cancer Research Fund, World Health Organization, and American Cancer Society, Mortality from Smoking in Developed Countries 1950-2000 (1994); R. Kluger, Ashes to Ashes (1996); S. A. Glantz, J. Slade, L. A. Bero, P. Hanauer, D. E. Barnes, The Cigarette Papers (1996).
Breathing the fumes of burning plant material, especially tobacco, from a cigarette, cigar, or pipe. Despite social and medical arguments against tobacco use, smoking is widely practiced around the world. Nicotine is an alkaloid in tobacco that is addictive and can have both stimulating and tranquilizing psychoactive effects. The tar (residue) and gases produced by burning tobacco have many negative health effects. They include lung cancer, pancreatic cancer, and laryngeal cancer; heart disease and stroke; and emphysema and chronic bronchitis. Smoking also increases other health-related risk factors (see asbestosis). A nonsmoker who breathes secondhand smoke (such as the smoke from a lit cigarette) is at an increased risk of the same diseases that affect smokers. Secondhand smoke also increases the risk of sudden infant death syndrome. Doctor-run programs, along with nicotine patches and gums that provide diminishing doses of nicotine, are among the aids available to help those who wish to quit smoking. Hypnosis, acupuncture, herbal remedies, and other approaches are also widely advertised as ways to quit smoking. Smoking has been greatly reduced in the health-conscious West even as it rises in many less-developed countries.
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The Act establishes that, from 26 March 2006, it is an offence to smoke in any wholly or substantially enclosed public space in Scotland, with a small number of exceptions, such as prisons, care homes and police interview rooms. Private member clubs are not exempted. Hotel rooms may be designated by the proprietors as smoking rooms, but they are under no obligation to do so, and if they do not, the Act applies to them as any other space.
Since coming into force on the 26 March, the ban has been largely accepted by the vast majority of the Scottish public. Compliance rates have been high, and as of 14 June 2006, only one premises has been fined for permitting smoking, and that happened on the day the Act came into being. Additionally, the Swallow Group of hotels, who had launched a legal challenge to the legislation, formally abandoned their attempt on the 13 June 2006, after being advised that they would not succeed.
Cigarette litter continues to be a problem outside premises, especially bars and restaurants, and Environmental Health Officers have become more proactive in fining people dropping cigarette butts. Phonecalls to Smokeline (a smoking support line run by NHS Health Scotland) increased before and after the ban and smoking cessation services have reported that their number of clients have increased since the ban.
ASH Scotland was one of the main campaigners for smoke-free legislation, and recognition of their role was confirmed when Maureen Moore (Chief Executive of ASH Scotland) received an OBE in June 2006 for services to health care.
Smoking in the Weeks before an Operation Adds to the Health Risks; NHS Scheme Could Help Reduce Post-Operative Complications
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