WOMEN's AND TOBACCO---REFERENCE-2

• thetruth.com    - American Legacy Foundation tobacco education campaign covers cigarettes, smoking, other tobacco products. "The truth about how the cigarette industry operates".
• Tobacco BBS    - Cigarettes, tobacco, and smoking-related news and issues, addresses, tobacco history, information on quitting, and a quote of the day section.
• Addicted to Nicotine: A National Research Forum - Includes presentation summaries of papers presented at the conference held in 2001 at the (US) National Institutes of Health. Topics include nicotine delivery systems, pharmacology, individual and environmental risk factors, the psychobiology of addition, and treatment of nicotine dependence.
• Ammonia Added to Cigarettes Can Significantly Boost Availability of Nicotine - Independent research confirms that ammonia added to cigarettes can boost the availability of nicotine up to 100 times.
• Cancer Facts and Figures - Concise summary from the American Cancer Society of tobacco use, cigarettes, trends in smoking, profiling smokers, costs of tobacco, nicotine addiction, secondhand smoke, spit tobacco, and industrial hazards.
• CDC's TIPS: Tobacco Information and Prevention Source - Maintained by the CDC's Office on Smoking and Health. Covers tobacco-related issues, statistics, news, research, data, reports, quitting tips, educational materials, publications, . Also sections dedicated to youth.
• A Collection of Articles on Nicotine Addiction - Articles about research studies funded by the National Institute on Drug Abuse.
• eMedicine - Nicotine Addiction - Medical facts on the physiology of nicotine addiction, and the effect tobacco products have on the brain, lungs, and other vital organs, and a treatment options section.
• Good Health -- Healthy Lifestyle - This site is dedicated to convincing people to live a healthy lifestyle, to improve their quality of life, and avoid (or reduce the severity of) chronic disease.
• 'Impact Booster': Tobacco Firm Shows How Ammonia Spurs Delivery of Nicotine - 1996 Pulitzer prize-winning reporting on how the tobacco industry uses ammonia to engineer cigarettes for addiction.
• Infofax - Cigarettes and Other Nicotine Products - NIH short summary of nicotine effects.
• Low Tar Exposed - Site explains why "low tar", "light" and "mild" cigarettes are just as harmful as regular cigarettes.
• M. D. Anderson Cancer Center - Tobacco & Cancer - University of Texas medical center factsheets on effects of smoking and tobacco, and tips and support for quitting. One-third of M. D. Anderson patients have tobacco-related cancers.
• Nicotine Addiction - Concise factsheet.
• Nicotine Addiction in Britain - Complete online book by the Royal College of Physicians; covers physical. pharmacological, and psychological effects; addiction; the smoker's career; regulation of intake; treatment; regulatory approaches; recommendations.
• Nicotine Addiction in Britain - Includes report produced by the Royal College of Physicians. "Nicotine addiction is one of the major reasons why people continue to smoke cigarettes, and cigarettes are in reality extremely effective and closely controlled nicotine delivery devices".
• Nicotine and Addiction - ASH-UK factsheet on nicotine, its properties, difficulty in quitting, measures of dependence, withdrawal systems, genetic influence, and tobacco industry recognition of the its importance. [PDF]
• Nicotine and the Tobacco Industry - Science Week article focuses on 3 decades of tobacco industry efforts to engineer cigarettes for addiction.
• Nicotine Junkies - Information on kids and smoking, facts about smoking and addiction.
• Quit Victoria - "Tobacco smoking is the single most important cause of ill health and premature death in Australia." Not just quitting information -- health questions answered; effects of cigarettes; quit evaluation studies; information in languages other than English; smokefree workplaces and dining.
• Reducing the Addictiveness of Cigarettes - Can cigarettes be made less addictive? Scientific paper examines the question.
• Report of the UK Scientific Committee on Tobacco and Health - Report covers the scientific evidence on active smoking, passive smoking, nicotine addiction, price and marketing of cigarettes and other tobacco products, cessation, key conclusions.
• Research Report: Nicotine Addiction - Information from the National Institute on Drug Abuse about nicotine, addiction, the extent and impact of tobacco use, how nicotine delivers its effect, consequences of continued use, treatments, and gender differences.
• Smoking And Tobacco Factsheets - From the Missouri Health Department, a large set of factsheets on cigarettes, tobacco advertising, health effects, and secondhand smoke.
• Smoking Is Ugly - Created and sustained by Christy Turlington, an online resource guide, providing information and links to numerous lung cancer and smoking-cessation related websites. SmokingIsUgly.com is part of Turlington's campaign to raise awareness about the effects of smoking, smoking related diseases and lung cancer.
• TCSG - Tobacco and The Elderly - Papers and factsheets on: tobacco and minorities, state tobacco settlement funds, tobacco and older persons.
• Tobacco Advertising and Document Collections - Growing set of resources presenting and organizing tobacco industry documents; shows what the industry says in private about youth, advertising, promotions; features a poster on the history of youth cigarette brands.
• Tobacco Control Online - A quarterly scientific journal covering all aspects of tobacco use prevention and control.
• Tobacco in Australia: Facts and Issues - A complete, online, book, with all citations to the literature. Covers cigarettes, other tobacco products; statistics and trends; health effects; smoking in the workplace and public places; public policy; addiction; quitting; anti-smoking campaigns; and the tobacco industry.
• Tobacco Industry Hall of Shame - List of stars and performers killed by tobacco.
• The Tobacco Reference Guide - Online book provides quotes, summaries, and factsheets about hazards of smoking.
• TobaccoFree - Offers smoking cessation tips, research results, and tips for staying smoke free.
• WHO: The Tobacco Atlas - History of tobacco, types of use, male and female smoking, youth, cigarette consumption, health effects, secondhand smoke, deaths, costs; the trade, the industry, smuggling, tobacco promotion and marketing, Internet sales, politics; activism, research, tobacco control, policy initiatives; quitting, litigation, pricing, and futures.
• WHO Tobacco Free Initiative (TFI) - A WHO cabinet project created to focus international attention, resources and action on global tobacco use and problems caused by that use.
• WhyQuit - Cold Turkey Quitting - A support group and education forum dedicated exclusively to the science and art of successful abrupt nicotine cessation.
• "Crack" Nicotine in Cigarettes Varies Widely - New research measures amount of free-base nicotine in "the modern cigarette, a highly engineered nicotine delivery device". (July 28, 2003)
• OncoLink: The Control and Manipulation of Nicotine and Cigarettes - 1994 news article. Kessler report on how the tobacco industry controls and manipulates nicotine in its product. (June 21, 1994)
• ABC DayOne: Smoke Screen - Now-famous segment on nicotine manipulation in cigarettes. (February 28, 1994)

WOMEN's AND TOBACCO---REFERENCE

• ACSH: Tobacco and Women's Health: A Survey of Popular Women's Magazines, August 1999-August 2000 - Follow-up to earlier ACSH research finds women's magazines still give little or no coverage to lung cancer or other health effects of smoking, and still take plenty of cigarette ads, and still dispense plenty of other health advice.
• Background on Women & Girls and Tobacco - Campaign For Tobacco-Free Kids backgrounder covers cigarette promotions targeting women and girls. [PDF]
• Background on Women and Girls and Tobacco - Pamphlet from the Partnership for Smoking or Health (Missouri health group).
• Catching Our Breath: A Journal About Change for Women who Smoke - Written by women for women; explores some of the problems women must overcome to quit smoking, or to reduce the amount they smoke. Also explores why women smoke as well as ways to cope and relax without smoking.
• Cigarette Ads Targetting Women - A collection of cigarette ads targetting women, from a gallery of cigarette ads.
• Cigarette Advertising and Magazine Coverage of the Hazards of Smoking: A Statistical Analysis - Research concludes that "cigarette advertising in magazines is associated with diminished coverage of the hazards of smoking. This is particularly true for magazines directed to women."
• Cigarette Smoking During Pregnancy - New evidence that cigarette smoking during pregnancy can cause attention deficit disorder, hyperactivity, aggressive behavior disorders and lower math and reading scores in children.
• Cigarettes Linked to Breast Cancer - Summary of recent research.
• Cigarettes More Dangerous to Women - According to recent research.
• Creating a Global Tobacco Culture Among Women - Book chapter explores tobacco industry promotion worldwide targeting women.
• Facts on Women and Tobacco - Fact sheet from the Center for Disease Control (CDC).
• Independence From Smoking - National Women's Health Information Center provides information and resources to empower women and girls, and the people they love, to gain independence from smoking.
• International Network of Women against Tobacco (INWAT) - Founded in 1990 by women tobacco control leaders to address the complex issues of tobacco use among women and young girls.
• June Russell's Health Facts: Smoking - Women - Factsheet on tobacco products and their effects on women, children, and families.
• Ladies Home Journal on Smoking - Smoking quiz, quitting tips, and dealing with withdrawal symptoms.
• The Marketing of Cigarettes to Women - Academic article documents trends and effects of tobacco industry marketing to women.
• Our Health vs. Their Profits: the Lure of Smoking Continues for Girls - Essay from editors of Our Bodies, Ourselves reflects on the progress not made when it comes to women, girls, and smoking.
• Philip Morris: National Expert on Women - Once-secret memo, the Virginia Slims Opinion Poll Public Relations Plan, documents a PR campaign that Philip Morris ran to position itself as the "most authoritative chronicler of women's issues".
• Pregnancy and smoking: a lethal combination - Information on how much harm tobacco products cause during and after pregnancy.
• Review - The Female Smoker: From Addiction to Recovery. - Book review.
• Rite Aid Is Taking A Stand - Photo essay takes a hard look at Rite Aid's claim that it's taking a stand against heart disease in women.
• Secondhand Smoke Causes Women Decreased Lung Function - Secondhand smoke causes decreased lung function in women, especially women with asthma, according to a recent study.
• Smoking: A Guide for Teens - Center for Young Women's Health in Boston provides short factsheet aimed at teen women.
• Smoking and Women: The Next Wave of the Global Epidemic - World Health Organization fact sheet.
• Smoking: Effects on Mothers and Babies in West Virginia - Matched Birth and Death Certificate data tell a grim tale, and a short discussion gives the story behind the data.
• Smoking is a Women's Issue - Report from the Campaign for Tobacco-Free Kids covers harm to women from tobacco products, promotion to women and girls by the tobacco industry.
• Smoking Is Ugly - Created Christy Turlington to raise awareness about the effects of smoking, smoking related diseases and lung cancer. "More women died of lung cancer in 2002 than of breast, uterine, and ovarian cancer combined" Facts and quitting info.
• Smoking-Related Deaths On The Rise Among American, French Women - Smoking-related illnesses and deaths among American and French women have risen sharply in recent years, despite vigorous anti-smoking campaigns on a global scale, says a Penn State researcher.
• Tobacco Advertising and Women: Virginia Slims Advertising - You've come a long way baby. A collection of Virginia Slims ads shows how cigarettes were pushed in the 70's.
• Tobacco and Women's Health - Book review of book of same title.
• Tobacco as a Problem for Women - Collection of articles on tobacco impacts on women.
• Tobacco Companies Exploit Women, says WHO - Tobacco companies are exploiting women's struggle for equal rights by creating the impression that tobacco makes women more confident, more sexually attractive, and more in control of their own destiny, says a World Health Organization report.
• The Tobacco Reference Guide: Pregnancy and Fertility - Factsheets on tobacco and congenital anomalies, fertility and menopause, general effects, miscarriage, and low birth weight.
• The Tobacco Reference Guide: Women and Smoking - Current and historical trends documented from a book on tobacco.
• U.S. Tobacco Makers Targetted Women Since '20s - ABC News article provides a quick summary of the long history.
• Virginia SLAM! - Brief biography of Leslie Nuchow who began a counter movement against the Virginia Slims record label, Woman Thing Music.
• 16. Women and smoking - Chapter in a book on smoking in Australia.
• Women and Smoking - American Legacy Foundation tobacco education campaign features real women battling very real tobacco-related illnesses light emphysema, lung cancer, and throat cancer, and highlights their real parting letters to their family and loved ones.
• Women and Smoking - Discusses effects of smoking on women and the steps to smoking cessation.
• Women and Tobacco - WHO report. Women as the tobacco industry sees them; health effects of tobacco specific to women; women's brands and 'light' cigarettes.
• Women, Girls and Tobacco: The Global Facts and the Challenge - Short paper on women and tobacco; tobacco promotion to women and girls; global impact of tobacco on women; recommendations for action.
• Women's Health Project: Tobacco Advertising and Women - NOW Foundation fact sheet.
• Women's Magazines Cover Up Health Risks - Congressional testimony on why women's magazines, while reporting widely on health topics, have a near complete lack of coverage on smoking.
• "You've Gone the Wrong Way, Baby" - Women's smoking, targetting of women in tobacco marketing, and resulting cancer rates, with a focus on Canada.
• Women More Vulnerable To Tobacco Carcinogens, New Results Show - Women may be more vulnerable than men to the cancer-causing effects of smkoing tobacco, according to new results. (, 2009)
• Women More Vulnerable To Cigarette Harm - Twin studies reveal that women are more susceptible to lung disease caused by tobacco product. (March 5, 2009)
• Christy Turlington: Not Just A Cover Model- A Role Model - Turlington writes about her own story of tobacco addiction and losing a loved one to lung cancer.(May 14, 2001)
• This Kills Women: Do Feminist Groups Even Care? - Washington Post article examines why women's groups say little about the leading cause of preventable death among women; one factor covered is tobacco industry money accepted by women's groups. (April 11, 2001)
• The New Face of Tobacco: Women - Znet article surveys tobacco industry marketing to women in the US and worldwide. (February 14, 2001)
• You're Going Too Far, Baby: Cigarette Makers Woo Women in the Developing World - Village Voice article. Tobacco industry developed its "smoking = liberation" message for women in the U.S. in the 1970's; now it's exporting that message to promote tobacco to women globally. (August 15, 2000)
• OnHealth: Smokeless Tobacco Increases Breast Cancer Risk - Spit tobacco increases a woman's risk of breast cancer. (May 9, 2000)
• Why Cigarettes Can be a Woman's Worst Enemy - Smoking increases your risk of cervical and rectal cancer; worsens your period; damages your fertility; hurts your unborn baby; ages you; attacks your heart. (November 8, 1999)
• You've Come a Long Way...or Have You? - From the American Council on Science and Health a survey of 13 magazines over two years shows that women's magazines still downplaying health effects of smoking. The ratio of cigarette ads to articles on smoking is actually increasing. (March, 1999)

RESEARCH STUDY-1

A Research Study In Saint louis University, America
Cigarette Smoking And Weight Loss In Nursing Home Residents
By

Margaret-Mary G. Wilson, MD,MRCP 
Assistant Professor
Division of Geriatric Medicine,
Saint Louis University

Shahnaz Habib MBBS,
Clinical research assistant
Division of Geriatric Medicine,
Saint Louis University

Carolyn Philpot CGNP
Clinical Nurse Practitioner
Division of Geriatric Medicine,
Saint Louis University

OBJECTIVE:

To evaluate body weight trends of elderly smokers following admission into a Long Term Care Facility.

STUDY DESIGN AND POPULATION:

Cross-sectional survey of 88 nursing home residents with six month follow-up.

MAIN OUTCOME MEASURES:

Fifty-one of 88 residents were included in the study. Body weight, height, body mass index (BMI) and serum albumin were documented on admission into the nursing home. Data collection was repeated at monthly intervals over a six-month period.
RESULTS: The study population comprised 17(8M, 9F) smokers and 34(19M, 15F) non-smokers. Smokers had a lower body mass index on admission compared with non-smokers (24.2"3 and 27.4"9 respectively; p=0.04; Odds ratio [95% CI] for smokers versus non-smokers = 1.629 [0.498 to 5.32] ).Twelve (71%) smokers and 20 (59%) non-smokers gained weight (p=0.2). Four (24%) smokers and 12 (35%) non-smokers lost weight (p=0.3). Smokers who lost weight did so at a faster rate than non-smokers (13.3 "3.8 lbs and 7.8"2.4 lbs respectively over six months; p=0.02). Similarly, weight gain occurred at a slower rate in smokers compared with non-smokers (5.6"1.3lbs and 8.2lbs respectively over six months; p=0.004)

CONCLUSIONS:

Weight loss in cigarette smokers may occur at a more rapid in residents who smoke compared with non-smokers. Similarly, weight gain occurs at a slower rate in smokers. Smoking cessation should be encouraged as a critical adjunct to nutritional intervention in nursing home residents with nicotine dependence and weight problems.

Introduction

Intensive public health education has led to a decline in cigarette smoking over the past four decades. Increasingly, organizations and institutions are adopting non-smoking policies 1,2. Within long-term care (LTC), residents' rights to autonomy and self-determination preclude the enforcement of mandatory non-smoking policies 3. Epidemiological studies show that cigarette smoking is associated with progressive weight loss 4,5,6. However, although weight loss is an index of poor outcomes and increased mortality in nursing home residents, smoking cessation strategies are excluded from most nutritional and weight management LTC pathways 7,8. 9,10.
Our study was designed to examine the relationship between cigarette smoking and body weight of residents admitted to a long-term care facility over a six-month period. Non- smokers were compared with smokers.

Methods

The study was conducted in a long-term care geriatric facility affiliated with Saint Louis University. All residents of the facility were screened for the study. Exclusion criteria included congestive cardiac failure, malabsorption syndrome, chronic diarrhea, chronic obstructive airway disease, cor pulmonale, liver cirrhosis, or chronic renal failure. Residents with a Mini-mental State Examination score < 18 or a Geriatric Depression score > were also excluded 11,12. Enteral tube feeding and life expectancy less than six months were additional exclusion criteria.
Data collated included admission weight and monthly weights for six months following admission into the facility. The height and body mass index (BMI) on admission and monthly thereafter for six months were also obtained. Serum albumin levels within one month of admission and within one month of termination of the study were obtained. Residents were identified as smokers or non-smokers. Smokers were defined as residents who had smoked 10 cigarettes daily for at least ten years. Non-smokers were defined as residents who had not smoked any cigarettes over the preceding ten years. Residents who fell into neither category were excluded from the study. Data obtained from non-smokers were compared with data obtained from smokers. Significant differences between groups was evaluated using Sato's method to determine odds ratios (OR) and 95% confidence intervals (CI) and the Student's t-test with two-tailed tests of significance for continuous variables 13. A p value of less than 0.05 was considered significant. Informed consent was obtained from all subjects. The study was approved by the Institution Review Board of the Saint Louis University and the Executive Board of the Long Term Care facility.

Results

Eighty-eight residents were screened for the study. Fifty-one residents were eligible for inclusion, comprising 17 (8M, 9F) residents who smoked and 34 (19M, 15F) residents who were non-smokers. Eight (7M, 1F) smokers were admitted with body mass indices (BMI) less than 22, compared with 12 (7M, 5F) non-smokers (OR [95% CI] for smokers versus non-smokers = 1.629[0.498 to 5.32] ).
Table 1 shows the admission data for both smokers and non-smokers.
Fig 1 shows the trend of weight change over the six-month study period among smokers and non-smokers. Among the subset of residents that gained weight the mean weight gain among smokers was 5.6 "1.3lbs compared with 8.2"2.4lbs among non-smokers (p=0.004). Among the subset of residents that lost weight over the study period, the mean weight lost among smokers was 13.3"3.8lbs compared with 7.8"2.4lbs among non-smokers (p=0.02).

Discussion

Approximately 25% of nursing home residents smoke cigarettes 10, 14. Available evidence indicates that smoking cessation strategies are less successful within the long-term care setting. Studies show that adults who continue to smoke into late life are less likely to cease smoking out of concern for long-term health effects. Some older smokers erroneously believe that the passage of time has proven that they are no longer susceptible to the adverse health consequences of smoking. Likewise, older adults who suffer from smoking related illness often consider the damage permanent and irreversible and are therefore difficult to convince of the benefits of smoking cessation 15. Within the nursing home environment, low levels of perceived self-efficacy, the presence of other smokers and the reluctance of some health professionals to aggressively educate residents regarding the dangers of smoking pose additional obstacles to smoking cessation 16.
Currently, in most long-term care facilities in the United States, the institutional smoking policy is driven mainly by fire and safety concerns 17,18. Thus, residents are more likely to perceive smoking cessation policies as intrusive legislation rather than as an integral component of effective health maintenance. Development of more comprehensive smoking policies that highlight specific adverse health effects relevant to nursing home residents may be more successful in encouraging smoking cessation.
Body weight is a critical parameter of care and outcomes determinant within the nursing home setting. Convincing evidence indicates increased mortality in long term care residents with weight loss 19,20,21. Our data showed that smokers admitted into long term care had a BMI compared with non-smokers possibly as a result of the long-term effect of smoking on suppressing weight gain 5,8,22. In addition, although the prevalence of weight loss was not significantly different between smokers and non-smokers, smokers who lost weight in the nursing home, did so at a faster rate than non-smokers (Fig 1). Our study also showed that nursing home residents who smoked gained weight at a slower rate, compared with their non-smoking counterparts. It is conceivable that negative effects of smoking on food intake, such as anorexia and reduced olfactory and gustatory receptor sensitivity, may have a synergistic effect in the presence of other adverse nutritional risk factors, thereby accelerating weight loss 23,24,25, 26.

Cytokine-mediated weight loss is an attractive hypothesis to explain smoking related weight loss. However, available data is controversial. Cancer related cachexia is driven by increased elaboration of pro-inflammatory cytokines. The resultant metabolic abnormalities have been thought to account for the failure of conventional nutritional supplementation to maintain weight in affected cancer patients 27. Similar studies in smokers have failed to reveal a consistent alteration in cytokine levels 28,29. However, evidence indicates that smoking reduces baseline levels of soluble IL-1 receptor antagonist serum levels thereby resulting in reduced antagonism of pro-inflammatory interleukins 30. Weight loss in smokers may therefore result from a dual mechanism involving increased catabolism and reduced energy consumption.

Applications

These findings justify a more aggressive approach to nutritional support in smokers with low body weight or significant weight loss. Effective strategies include the administration of fortified meals and frequent nutritional supplementation with energy dense food supplements. Additionally, flavor-enhanced foods may be effective in increasing energy intake in older smokers as enhanced gustatory stimulation may combat the hypoageusia associated with both smoking and aging 31.
In smokers who continue to lose weight despite aggressive nutritional supplementation, orexigenic agents, such as megesterol acetate and dronabinol, may be helpful. Recent evidence indicates that megesterol acetate may enhance weight gain in nursing home residents. However, the absence of relevant data mandates cautious use of megesterol in smokers to avoid the possibility of a synergistic or additive increase in the risk of thrombo-embolic events. Dronabinol (delta-9-tetrahydrocannabinol) is the active ingredient of Cannabis sativa, approved for use by the Food and Drug Administration (FDA) as an orexigenic agent in Acquired Immune Deficiency Syndrome (AIDS). Recent evidence indicates that Dronabinol induces weight gain in older persons with dementia. However, it remains unclear whether weight gain in such patients is due to a direct orexigenic effect or a reduction in physical energy expenditure. Further research is needed to determine the precise role of Dronabinol as an orexigenic agent in older persons 32,33,34.

Effective weight loss intervention programs in long term care must incorporate parallel smoking cessation strategies. Clinical Practice Guidelines, such as those issued by the United States Department of Health and Human Services offer practical templates for such strategies 35,36, 37. In addition, emphasis should be placed on the immediate benefits of discontinuing smoking, such as enhanced taste, increased appetite, weight gain and an increased feeling of well-being. Residents with weight loss who opt to participate in a smoking cessation program may benefit from a structured support group directed toward both smoking cessation and weight maintenance.
The role of medication in LTC residents with weight loss is unclear. Nicotine replacement therapy may not be appropriate, as animal studies have shown that nicotine administration reduces food consumption and decreases body weight 38. Data in humans is lacking. However, residents who lose weight on nicotine replacement therapy may benefit from a trial of Bupropion in the absence of a history of seizures or co-existent antidepressant therapy.

Limitations of this study include lack body weight measurements prior to admission, small sample size and the imbalance in numbers between smokers and non-smokers. Larger prospective studies may prove helpful.

Conclusion

Smokers in long-term care facilities lost weight more rapidly than non-smokers. Similarly, weight was regained more slowly in smokers. Long term care health professionals must be cognizant of the role of smoking in perpetuating weight loss. Interdisciplinary programs that integrate nutritional support and smoking cessation strategies should be an integral component of resident care in LTC facilities that permit smoking. 

Acknowledgements: The authors gratefully acknowledge the valuable editorial assistance of Janice D. Hicks.

References

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20. Klesges RC, Klesges LM. Cigarette smoking as a dieting strategy in a university population. Int J Eating Disord. 1988;7:413-419
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WOMEN AND SMOKING-6

WOMEN AND SMOKING

An epidemic of smoking-related cancer 

and disease in women

When calling attention to public health problems, we must not misuse the word "epidemic." But there is no better word to describe the 600-percent increase since 1950 in women's death rates for lung cancer, a disease primarily caused by cigarette smoking. Clearly, smoking-related disease among women is a full-blown epidemic. --
David Satcher, MD, PhD 

Smoking is the most preventable cause of early death in this country. According to the Centers for Disease Control and Prevention (CDC), smoking-related diseases causes the deaths of about 178,000 women in the U.S. each year. On average, these women died 14.5 years earlier because they smoked. 

The most recent CDC survey (from 2008) showed that more than 1 in 6 American women aged 18 years or older (18.3%) smoked cigarettes. The highest rates were seen among American-Indian and Alaska-Native women (22.4%), followed by white (20.6%), African-American (17.8%), Hispanic (10.7%), and Asian women (4.7%). The less education a woman has, the more likely it is she will smoke. For instance, women with less than a high school education are more than twice as likely to smoke as college graduates. 

Overall, women are less likely to smoke than men. But it has been found that smoking is more popular among younger than older women. This is an alarming trend that will affect the future health of these young women. About 21% of women ages 25 to 44 smoke; only about 8% of women 65 and over do. If these younger women continue to smoke as they get older, they will have more smoking-related illness and disability. Smoking rates are slightly lower among women aged 18 to 24, about 19%.



Women who smoke nearly always begin as teenagers -- usually before high school graduation. And the younger a girl is when she starts, the more heavily she is likely to use tobacco as an adult. Teenage girls are just as likely to smoke as boys. The most recent CDC surveys showed that 19% of female high school students and 6% of middle school girls had smoked at least one cigarette in the past 30 days. More than 9% of 12th grade girls reported that they had smoked at least one cigar in the past month. Nearly 29% of the senior girls had used some form of tobacco in the past month.

WOMEN AND SMOKING-4

Cigarettes May Be More Damaging to Women

Women may be especially susceptible to the toxic effects of cigarette smoking, U.S. researchers said on Monday.

 

 

 

 

 

Read more: http://www.momlogic.com/2009/05/cigarettes_may_be_more_damaging_women.php#ixzz0lTEOoh2d

They said women who smoke develop lung damage earlier in life than men, and it takes less cigarette exposure to cause damage in women compared with men.

"Overall our analysis indicated that women may be more vulnerable to the effects of smoking," said Dr. Inga-Cecilie Soerheim of Brigham and Women's Hospital in Boston and the University of Bergen in Norway.

Soerheim, who presented her findings at the American Thoracic Society meeting in San Diego, California, said researchers had suspected this but until now had lacked proof.

Her team analyzed 954 people in Norway with chronic obstructive pulmonary disease, which includes lung problems from chronic bronchitis to emphysema.

COPD affects an estimated 210 million people worldwide. The most common symptoms include shortness of breath, coughing and a limited ability to exercise.

In the study, about 60 percent were men and 40 percent were women. All were current or former smokers.

Overall, both groups had similar lung impairments. But when they looked at younger people -- those under age 60 -- or those who had been lighter smokers, they found women had more severe disease and worse lung function than men.

Read more: http://www.momlogic.com/2009/05/cigarettes_may_be_more_damaging_women.php#ixzz0lTE8SzNY

COLLEGE STUDENTS' ATTITUDE TOWARD SMOKING-3

Discussion

Generally, college students view smoking as a bad habit but want the right to smoke as evidenced by their varied responses to the survey questions pertaining to stricter laws. For instance, even though 94% agreed "smoking is hazardous to one's health," the students were divided on whether tougher laws against smoking should be instituted. However, the majority of college students believe others should not be injured by their smoking; for example, by smoking in an enclosed area. In addition, students said that people should be advised about the harmful effects of smoking and prohibited from smoking near pregnant women or near children. They also believed that second-hand smoke could cause health problems.

Students responded similarly to prior research reported by Hines et al. (1998) concerning attractiveness. For instance, Hines et al. reported students that smoked were rated as less attractive. Research at the University of West Florida found that although students disagreed with strong statements, such as "no one likes a smoker," they often agreed that smoking is unattractive and preferred a non-smoker in a spouse or steady partner.

College Students' Attitude Toward Smoking-2

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Method
Instrument:          

The instrument consisted of one page with 14 demographic items on one side and 19 statements on the other side--all dealing with smoking. The statements were rated using a three point, Likert-type scale with the options "agree," "uncertain," or "disagree."

Procedure:

The subjects were approached on a face-to-face basis and invited to participate in the survey. To provide confidentiality, the subjects placed the finished form into a large brown, unmarked envelope.

Sample Population:

Approximately ten percent (810) of students were randomly selected after being stratified by gender and race from those attending the University of West Florida. The sample was stratified on gender and race and reflected the population of the University of West Florida with 40% male and 60% female. The racial distribution of the sample was 78% white, 10% black, 4% Hispanic, 5% Asian with 3% "other."

The largest percentage (43%) of the subjects were aged 19-21 with 22% being aged 22-25 and 19% being 26-40. Eight percent were 18 and below while 7% were 41 or above in age. Student classification showed that the majority junior/senior consisted of 58% of the sample with freshman/sophomore consisting of 33%. The rest were graduate students (7%) and special students (non-degree seeking students) 2%. Of the students participating in the research, 75% were full time undergraduate students with 16% being part-time students. Four percent were fulltime graduate students with 3% being part-time students.

Seventy percent were single and 21% separated, 6% divorced and 1% widowed. Seventy-five percent had no children, 13% had one child, 13% had two children, and 3% had three children with 1% having four or more children. Twenty-seven percent of the students lived alone while 22% lived with parents, 3% lived in a fraternity, 3% lived in a sorority, and 45% were living with others.

Twenty-seven percent were employed full-time, 46% part time and 27% were not employed at all. The largest percentage (30%) was earning $10,000 or less annually while 12% was earning $60,000 or more. In between, 21% were earning $10,001 to $20,000, 24% earned $20,000 to $40,000 and 14% earned $40,001 to $60,000.

Both Protestants and Catholics were represented in the sample by 25% each with 2% of the Jewish faith and 17% having no religious affiliation. Thirty-two percent indicated having some other faith but did not indicate the type. As to political registration, 36% were Republican, 30% Democrat and 12% Independent, while 18% were not registered; 3% were registered in other minority parties.

As to who smoked or not smoked, 33% reported that they smoked while 67% said they never smoked. Two percent said they smoked indoors, 15% smoked outdoors while 13% smoked both indoors and outdoors.

Findings

The study attempted to determine the college students' attitudes toward smoking at the University of West Florida in relation to the findings at other universities. For instance, some people believe that whether one smokes or not affects whether the person is liked. Nonetheless, to the statement, "no one likes a smoker," 67 % disagreed. Only 17% agreed and 16% were uncertain. Similarly, when asked whether "smoking is unattractive," 69% agreed while 21% disagreed and 10% were uncertain. As to how people feel about smokers, to the statement, "I would not date or marry a smoker," 41% agreed although 39% disagreed and 20% were uncertain. Some people are concerned about the personal and social effects of smoking. To the statement, "smoking is socially acceptable", 44% agreed while 35% disagreed; 21% were undecided. Some people are concerned with the implications of smoking. For example, to the statement, "people think less of you if you smoke," 43% disagreed; only 30% agreed and 27% were undecided.

Concerning health related issues, participants responded to the statement, "it is unwise to smoke in an enclosed area," with 81% agreeing and 10% disagreeing with 9% uncertain. Furthermore, whether "people should be advised about the harmful effects of smoking", 93% agreed. The rest (3%) disagreed or were undecided (4%). In addition, to the statement that "no one should smoke near a pregnant woman," 90% agreed. The rest were either uncertain (6%) or disagreed (4%). Whether smoking has any positive values, on the statement "smoking is helpful in reducing weight," only 24% agreed with 40% disagreeing; 36% were undecided. To the statement that "no one should smoke near children," a large majority (88%) agreed with the rest (4%) disagreeing or undecided (7%). Whether "second hand smoke can cause serious health problems," 81% agreed with only 4% disagreeing; but 15% were still undecided. Because of the impact of smoking upon one's health, the subjects were asked to respond to the statement that "smoking is hazardous to one's health" with 94% agreeing and the rest (3%) disagreeing or undecided (3%).

Regarding legal issues, many people believe that "there should be stricter laws against smoking" with 44% agreeing; 34% disagreed and 22% were undecided. To the statement that "the law should prohibit smoking in public places", 48% agreed although 35% disagreed; 17% were undecided. On the statement that "no one should smoke near someone who is eating," 69% agreed. 19% disagreed and 12% were undecided. Whether "people should tell a smoker to stop smoking", 51% disagreed; only 30% agreed while 19% were undecided.

Finally, in questions concerning the modeling effects of smoking, to the statement, "Smoking advertisements influence non-smokers to begin," only 32% agreed while 46% disagreed with 22% uncertain. However, some people were concerned about the influence that smoking has on children. To the statement, "children who see people smoke will more likely smoke," 51% agreed; 28% disagreed and 21% were uncertain. And whether "smokers have little power," 54% disagreed and 26% agreed (21% were uncertain).

                                                               
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