Cigarette Smoke Toxicity

Smoking causes and contributes to a large number of human diseases, yet due to the large number of potentially hazardous compounds in cigarette smoke -- almost 5,000 chemicals have been identified, establishing the link between smoking and disease has often proved difficult. This unbiased and scientifically accurate overview of current knowledge begins with an overview of the chemical constituents in cigarette smoke, their fate in the human body, and their documented toxic effects on various cells and tissues. Recent results detailing the many ways components of cigarette smoke adversely affect human health are also presented, highlighting the role of smoking in cardiovascular, respiratory, infectious and other diseases. A final chapter discusses current strategies for the treatment and prevention of smoking-induced illness. Despite the obvious importance of the topic, this is the first comprehensive reference on tobacco smoke toxicity, making for essential reading for all toxicologists and healthcare professionals dealing with smoking-related diseases.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

This Surgeon General's report returns to the topic of the health effects of involuntary exposure to tobacco smoke. The last comprehensive review of this evidence by the Department of Health and Human Services (DHHS) was in the 1986 Surgeon General's report, The Health Consequences of Involuntary Smoking, published 20 years ago this year. This new report updates the evidence of the harmful effects of involuntary exposure to tobacco smoke. This large body of research findings is captured in an accompanying dynamic database that profiles key epidemiologic findings, and allows the evidence on health effects of exposure to tobacco smoke to be synthesized and updated (following the format of the 2004 report, The Health Consequences of Smoking). The database enables users to explore the data and studies supporting the conclusions in the report. The database is available on the Web site of the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/tobacco.

Despite overwhelming evidence of tobacco's harmful effects and pressure from anti-smoking advocates, current surveys show that about one-quarter of all adults in the United States are smokers. This audience is the target for a wave of tobacco products and pharmaceuticals that claim to preserve tobacco pleasure while reducing its toxic effects. Clearing the Smoke addresses the problems in evaluating whether such products actually do reduce the health risks of tobacco use. Within the context of regulating such products, the committee explores key questions: Does the use of such products decrease exposure to harmful substances in tobacco? Is decreased exposure associated with decreased harm to health? Are there surrogate indicators of harm that could be measured quickly enough for regulation of these products? What are the public health implications? This book looks at the types of products that could reduce harm and reviews the available evidence for their impact on various forms of cancer and other major ailments. It also recommends approaches to governing these products and tracking their public health effects. With an attitude of healthy skepticism, Clearing the Smoke will be important to health policy makers, public health officials, medical practitioners, manufacturers and marketers of "reduced-harm" tobacco products, and anyone trying to sort through product claims.

Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question. Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong. Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations.

Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes. Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.

The IARC Monographs series publishes authoritative independent assessments by international experts of the carcinogenic risks posed to humans by a variety of agents, mixtures and exposures. They are a resource of information for both researchers and national and international authorities. This volume is particularly significant because tobacco smoke not only causes more deaths from cancer than any other known agent; it also causes more deaths from vascular and respiratory diseases. This volume contains all the relevant information on both direct and passive smoking. It is organised by first looking at the nature of agent before collecting the evidence of cancer in humans. This is followed by carcinogenicity studies on animals and then any other data relevant to an evaluation.

This completely revised and enlarged 2nd edition of The Tobacco Epidemic provides a comprehensive update of the clinical, public health and political aspects of tobacco smoking. Since its 1st edition in 1997, knowledge on the health hazards of tobacco and nicotine addiction has increased considerably, but recent data has shown that the global problem has become more aggravated in low- and middle-income countries: if current trends continue, tobacco smoking will be responsible for the deaths of 1 billion people in the 21st century. Written by outstanding international experts, the book covers the history of tobacco production and use, the economics of tobacco use and control, as well as the health consequences of active and passive smoking in both adults and children. Special chapters discuss the impact of media, movies and TV on tobacco consumption in young people, the patterns and predictors of smoking cessation in the general population and in different social subgroups, and initiatives supported by the WHO Framework Convention on Tobacco Control. Readers will find the latest information on how nicotine dependence is treated with nicotine replacement products, what role health care professionals play in helping smokers to quit and what effects smoke-free environments, advertising bans and price increases have on smoking prevalence. The potential harms and benefits of smokeless tobacco, waterpipe tobacco smoking and electronic cigarettes are also evaluated. This book is a must-read for anyone in the medical profession who treats patients with smoking-related diseases and for those engaged in tobacco control. It will also be appreciated by interested nonmedical readers like journalists and legislators.