Millions of people start smoking, and then decide they want to get rid of this habit, thus the health industry products for smokers who try to quit their habit are also quite attractive to invest in. Nowadays everyone knows smoking is hazardous for the health of the smoker, and of people who inhale cigarette smoke; it leads to lung cancer, cardiovascular diseases, influences on prenatal development, and causes many other unpleasant and dangerous effects.
Nevertheless, the profits of tobacco sellers do not seem to get smaller; moreover, tobacco sale levels still continue to grow in some countries. This paper is targeted on analyzing the psychological effects of smoking in order to find out why individuals begin and continue to smoke while they know this habit is dangerous for their health, and for well-being of people who surround them.
The National Center of Health Statistics indicates that throughout past fifty years the percentage of smokers in the U. S has been decreasing gradually. S citizens were smoking. Centers for Disease Control and Prevention statistics says that still nearly one in every five deaths in the United States is a result of smoking, making tobacco use the leading preventable cause of death.
According to their data, more than , deaths in the United States each year are attributable to tobacco use, resulting in more than 6 million years of potential life lost each year. If we look on smoking from this viewpoint the impression is created that smoking is some kind of the nationwide suicide, taking thousands of lives each year; in addition it inflicts enormous damage to national health industry, as the sums spent by the U.
S government each year on dealing with the results of inhaling cigarette smoke, either actively or passively, are devastating. Whether to smoke, or not, is a matter of personal choice, and prohibiting smoking is the direct infringement of the freedoms guaranteed to the U. S citizens by the Bill of Rights and Constitution. Most of the smokers in our country know the consequences their bad habit leads to, they are reminded about the increasing threaten of lung cancer, heart diseases etc almost every day.
Another point of concern associated with ban on smoking is the employment of people, who work in the tobacco industry nowadays. According to the data, provided by the World bank in their study Understand and Evaluate the Impact of Tobacco Control Policies on Employment, the number of people, directly employed in this industry is about thousand. The stricter are the government policies on smoking, the more unemployment they create.
In addition, in case the U. S government will decide to ban smoking, the American economy may become unstable for some time, as tobacco production is a quite important sector. Thus it is obvious that people mostly start smoking in an early age. Scientists conducted numerous researches to find out the reasons of this phenomenon. For example in , Abernathy and Massad researched the interdependence between self esteem and smoking among youngsters.
Their target group was children and teenagers from ten to fifteen years old. Researchers conducted four stages of surveying, one in sixth grade of the Calgary Catholic or Board of Education schools, which included schools, one in seventh grade, and then in eighth and ninth grades subsequently.
They surveyed children for their levels of self-esteem and cigarette use; the surveys were anonymous. The results were ambiguous — as long as no consisted pattern was found between the self-esteem of boys and subsequent smoking, among girls a strong association was found between their self esteem in grade sixth and smoking in later years.
Their research revealed that females are more vulnerable towards the stereotypes concerning smoking that exist in contemporary society, and smoking is one of the ways to conquer low self-esteem for them. In the same time the study by Larson et al , showed that smoking frequency in their research was similar among males and females, and no significant differences in smoking frequency were observed according to weight status based on BMI.
These scientists researched the relation of diet and physical activity patterns towards cigarette smoking. According to their research smoking was associated with grade level, race and ethnicity, and with low-middle and middle SES but not with sex or weight status. They found that children who smoked tended to eat less healthy food and exercised less than their non-smoking coevals. Researchers detected the relation between regular smoking and irregular meal patterns at breakfast, lunch, and dinner.
They noted that irregular meals let to poor intake of key vitamins and microelements and increased sugar consumption, and provoked adolescents to consume fast food frequently. Larson et al also found out that frequency of smoking was not related to the amount of time adolescents spent watching TV, albeit they hypothesized that more frequent smoking would be directly related to time spent watching television and videos, as use of these media may be related to smoking initiation.
On the contrary Gidwani et al who researched the dependency between television viewing and smoking among adolescents found out that the relationship existed, and it was a strong one. The researchers concluded that the rise in number of smoking adolescents was caused by numerous images of smoking people in movies, TV shows, music videos and sporting events, where smoking was associated with being popular, being a part of the group of beautiful and successful people, accepted by their surroundings.
Children and teenagers who watched these programs subconsciously associated these traits with being a smoker, and thus bought their first pack of cigarettes. One of the widespread persuasions about smoking is that it reduces the levels of stress. The review conducted by Parrott proves this persuasion is erroneous. According to his findings the stress levels of adult smokers are slightly higher than those of nonsmokers, while adolescents who smoke tend to have stress levels much higher than that of their non-smoking coevals.
In the same time their research displayed that people who smoked felt irritated, angry and vulnerable when they could not have a cigarette for some time. Thus the researchers developed a hypothesis that explained the fact that smokers felt relaxed and less stressed, which was that smoking just helped to relieve the stress caused by not smoking, to get rid of the irritation caused by the absence of the doze of nicotine a smoker had got used to inhaling.
Abernathy and Massad found out that the dependency existed between the level of self esteem and subsequent smoking in women. Thus the conclusion may be that for females being a smoker is a characteristic trait of successful person. Moreover, it is obvious that the girls were more vulnerable towards tobacco advertizing targeted on youngsters.
One of the explanations for this phenomenon may be that many females share the commonly held persuasion that smoking provokes weight loss, while quitting smoking makes one gain weight. Researchers prove that women are strongly affected by the images they see on media, especially when they concern their weight. The research in by Vartanian et al showed that it was the influence of the media that was the most significant predictor of overall body satisfaction among females who were getting college education.
In addition the research showed that the media also impacts overall body dissatisfaction among men, though less than among females. The authors concluded that the influence of media on forming of the body image is growing both among men and women.
In the same time, Green and Pritchard showed that while media influences had significant impact on female's apprehension of their looks, men's body image wasn't formed by TV. Larson et al found a connection between race, grade, levels of SES and smoking.
Their study showed that teenagers who had low and middle SES were more likely to start smoking than the kids whose SES were high. This phenomenon can be explained by the assumption that for many kids smoking is a form of protest against being ideal, satisfying all the requirements of their parents, teachers and surroundings. Lots of parents try to stop their kids smoking. Some try to persuade their sons and daughters smoking is hazardous for health and social interactions; others just forbid their kid to smoke.
But smoking is quite a tricky thing to control. It is almost impossible to ban person from smoking if she does not want to quit it, even when the smoker is in her teens or tweens. Parrot in his review of literature concerning the bond between smoking and stress adduces the argument that nicotine relieves only the kind of stress brought by the absence of nicotine.
Both active and passive smoking are implicated in this increase, and several studies of smoking behaviour and disease incidence in women suggest greater susceptibility of women to tobacco carcinogens Because of the antiestrogenic protective effects of smoking, the role of smoking in breast cancer is controversial. However, recent studies suggest that both active and passive smoking may have a role in the occurrence of breast cancer. One example is a study that found an OR of 4.
Women who were first exposed to passive smoke after 12 years of age had a lower, although still elevated, OR In both men and women, cancers of the head and neck are also on the rise, and this has been attributed to increased use of smokeless tobacco products. Also, a synergistic interaction between cigarette smoking and radon exposure was confirmed in a large study that showed that lung cancer incidence due to an interaction between smoking and radon exposure exceeded incidence accounted for by additive effects and, therefore, indicated multiplicative effects Comparative toxicity studies have shown that in comparison with standard cigarettes, the new experimental cigarettes that heat tobacco have a relatively low toxicity One interesting observation relates to the nature of lung cancer, which has changed over the years with respect to the location and the types of lung tumours observed in smokers.
In the past, the primary tumours observed among smokers were the centrally located squamous cell carcinomas of the airways. Now, the predominant lung tumours in smokers are peripheral adenocarcinomas and other non-small-cell lung cancers. This shift in tumour types has been attributed to changes in the composition of cigarettes and its effect on the smoking patterns of tobacco users over the past 30 years 8 , Significant reductions in cigarette tar and nicotine and increased levels of nitrates in cigarettes have markedly altered the manner in which cigarettes are smoked.
These changes in smoking patterns have promoted greater deposition of smoke constituents into the peripheral lungs, where adenocarcinomas develop. Major advances are being made in the area of molecular epidemiology of tobacco-related cancers in human populations. Many recent epidemiological studies have focused on the differential susceptibility to tobacco-related cancers; they have employed polymerase chain reaction-based molecular assays that permit genotypic analysis of small human samples and supplement the information generated by enzymatic and immunological assays.
These assays are increasingly being used in human and experimental studies to examine various gene-gene and gene-environment interactions. One area that has received considerable attention in recent years is the role of polymorphic enzymes in the development of diseases. It is now well recognized that genetic polymorphism strongly influences cancer susceptibility and incidence.
The frequencies of mutated alleles of proto-oncogenes, tumour suppressor genes and xenobiotic bio-transformation genes vary significantly among different populations and impact substantially on their susceptibility to cancer. Some are even entirely absent in individuals, thereby influencing their susceptibility to disease development. The chemical complexity of tobacco smoke and the metabolic activation requirements for many of its carcinogenic constituents have drawn particular attention to genetic polymorphisms of biotransformation enzymes that metabolize tobacco smoke carcinogens.
Thus, genes for various activating enzymes such as cytochrome P CYP proteins, and deactivating enzymes such as glutathione S-transferase GST , N-acetyl transferase NAT and uridine diphosphate-glucose transferase have been the main target of many recent studies in the context of tobacco carcinogenesis.
Two polymorphic variants that interact with smoking to modify lung cancer risk have been identified 47 , Thus, a homozygous minor allele combined with smoking was found to increase lung cancer risk. Studies of the same gene in Western populations have, however, yielded negative or conflicting results 49 , although an interaction of CYP1A1 variants with the GST null genotype has been reported to significantly increase lung cancer risks in non-Japanese populations 50 , Depending on the presence or absence of a particular variant, individuals can be categorized as slow or fast acetylators, which in turn can influence the incidence of bladder cancer.
It was shown that slow acetylator NAT2 is an important modifier of the amount of aromatic amine-DNA adduct formation even at a low dose of tobacco smoke exposure Slow acetylator NAT2 genotype was also a significant risk factor for bladder cancer in moderate and heavy smokers, but had no effect in nonsmokers GSTs are another group of metabolic detoxification enzymes that have attracted a great deal of interest in recent years because of their association with risks for different types of cancers.
Based on their sequences, these enzymes are divided into five classes. Furthermore, the risk to individuals who carry homozygous deletions is generally small but increases significantly on interaction with cigarette smoking Among all metabolic cancer susceptibility genes, the association of GSTM1 deficiency with cancer risk is the most consistent and unidirectional.
Various experimental and epidemiological observations support the role of this gene in tobacco-related cancers. For example, it has been observed that the excretion of urinary mutagens and the number of lung tissue DNA adducts in GSTM1-deficient smokers is significantly greater than those carrying the wild-type allele 55 — Various epidemiological studies also support the premise that deficiency of this enzyme predisposes for lung and bladder cancers Furthermore, low activity alleles of GSTPi have been often found in association with different types of human cancers 59 , In addition to anomalies of biotransformation enzyme genes, inactivation of tumour suppressor genes such as p53 , and activation of the proto-oncogene K-ras are also involved in tobacco-related cancers.
Various mutated forms of tumour suppressor gene p53 have been commonly detected in lung tumours and it has been found that these mutations are predominantly located in exons 5 to 8. The nature of point mutations in this gene has been extensively investigated and studies show that the most common mutant allele of the p53 gene possesses a G: C transversion 61 , which is associated with tobacco use 62 , The above studies show that several genetically controlled polymorphic enzymes and enzyme systems are linked to tobacco carcinogen activation and deactivation.
Some of these genes have been identified and characterized, but others remain undiscovered. Not only the independent effects of single gene polymorphisms, but an interplay of multiple gene interactions appear to be involved. The complexity of epidemiological studies, which have many uncontrollable variables, makes it difficult to study such interactions and their control in human studies.
Additionally, many of the enzymes involved in tobacco carcinogen metabolism are also induced by other environmental factors such as alcohol use, dietary constituents, pesticide and xenobiotic exposure, hormonal status, etc, further complicating the interpretation of data.
The interaction of many of these genes with each other and the effect of environmental factors are just beginning to be examined. The adverse effects of cigarette smoke on human health are widely recognized. It is the main etiological agent in chronic obstructive pulmonary disease and lung cancer, and is a known human carcinogen. While the risks to human health from active smoking are accepted, evidence supporting the risk of involuntary exposure to environmental tobacco smoke ETS has accumulated in recent years.
It is the main source of toxicant exposure by inhalation in nonsmokers. Despite recent regulations, smoking in public enterprises is not uncommon. However, despite an occasional report on the effect of secondhand smoke in nonsmokers, little attention was given to this aspect of smoking until about ETS is now regarded as a risk factor for development of lung cancer, cardiovascular disease and altered lung functions in passive smokers In general, children exposed to ETS show deterioration of lung function, more days of restricted activity, more pulmonary infections, more days in bed, more absences from school and more hospitalization than children living in nonsmoking homes Passive smoking is also implicated in increasing atherosclerosis in individuals 15 to 65 years of age.
Children exposed to ETS are at higher risk of developing cardiovascular disorders. Quantitative risk estimates were obtained by measuring the intimal-medial thickness of the carotid artery in a large longitudinal atherosclerosis risk study of 10, individuals.
A recent meta-analysis 67 of 18 epidemiological studies 10 cohort and eight case-control further showed an increased RR of CAD in ETS-exposed individuals.
These investigators also identified a significant dose-response relationship between the intensity of smoke exposure and risk of CAD in passive smokers. Cardiovascular health risks of smoke-exposed women are of particular concern. Although the exposure to ETS is a current topic of debate in tobacco-related cancers and other lung diseases, the limited research at the basic experimental level provides a strong argument for launching experimental studies to support human data and explore disease mechanisms.
Follow-up of news stories, and local and state ordinances, leads to the conclusion that more communities and states are restricting exposure to secondhand smoke. The results are summarized below. A total of hits were obtained and a careful review of the abstracts provided the following distribution:. A similar search of the NIH database from to revealed grants in all award categories.
The grant distribution by category was as follows:. All the remaining grants generally supported behavioural and epidemiological studies in humans or other systems.
Thus, it is clear that the need for basic experimental research in the field of smoking-associated diseases and the mechanisms through which tobacco smoke causes various diseases remain as important as they ever were. The escalation of health care costs makes it even more necessary to find ways to protect the health of smokers and smoke-exposed individuals with any dietary or therapeutic interventions that hold promise.
The most benefit is likely to result from detailed epidemiological studies complemented by specific molecular genotyping of various populations. Ideally, studies of this type will re-evaluate the prevalence of smoking and tobacco use and determine the exact nature of tobacco-related disease incidence, the role of contributory factors such as dietary habits, exposure to other substances and the genetic composition of subpopulations most at risk.
Various biochemical and molecular assays will need to be applied to screen nonsmoker and smoker populations for a variety of health risks.
Analysis of the results from such studies will help identify the main interacting factors for various health risks and define relationships among various epidemiological parameters. It would appear necessary to assemble teams of multidisciplinary investigators to perform these coordinated human studies in the field and in the laboratory. By nature, such studies are expensive and will involve commitment of resources, time and substantial amounts of funds to obtain meaningful results.
Given the limited resources and competing priorities for research funding, it is not easy to undertake such human studies. Hence, the experimental studies in animal models using inhalation exposure to whole smoke, and not individual constituents of smoke, is probably the next best approach for smoking and health programs. The human epidemiological studies described in the present review have identified a number of genes that appear to have a distinct role in various tobacco-related diseases, and cancers in particular.
Inability to control all the different variables in human studies has made it difficult to clearly define the contribution of various suspect genes in tobacco carcinogenesis. With the recent commercial availability of a variety of transgenic and knock-out animals for research, it would be most desirable, as a first step, to use these animals to establish experimental models of various tobacco-related diseases which can then be used for determining the contribution of different genes to disease processes and for elucidation of the mechanism s of disease development.
Furthermore, these animal models can be used to identify various agents possessing protective and therapeutic potential. Research efforts in the area of smoking and health would benefit by focusing on studies of the in vivo effects of inhaled whole cigarette smoke in animal models of known specific genetic composition. Selection of the genetic composition would also require a thorough consideration of the information available from human molecular epidemiological studies.
As indicated earlier, there are a number of genes that clearly influence the development of smoke-related diseases. In this context, many relevant transgenic and knock-out animals that can be effectively used for the study of tobacco-related diseases are now becoming available. Tobacco abuse is a major public health problem and includes secondhand smoke exposure.
Continued efforts to control and eliminate this abuse are a medical necessity. National Center for Biotechnology Information , U. Journal List Int J Angiol v. Telephone , fax , e-mail ude. This article has been cited by other articles in PMC. Abstract A large volume of data has accumulated on the issues of tobacco and health worldwide. Atherosclerosis, Cancer, Smoking, Tobacco.
TOBACCO-RELATED CANCERS Tobacco carcinogenesis has remained a focus of research during the past 10 years, and various epidemiological and experimental studies have not only confirmed the major role of tobacco smoke exposure in lung and bladder cancers, but have also reported on its association with cancers of various other sites, such as the oral cavity, esophagus, colon, pancreas, breast, larynx and kidney.
A total of hits were obtained and a careful review of the abstracts provided the following distribution: A Global Status Report. World Health Organization; The Health Consequences of Smoking: A Report of the Surgeon General.
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This paper seeks to investigate both the benefits and side effects of smoking in public and finally argue a case for or against the ban on smoking in public places. Proponents of the ban of smoking in public places argue that because not everyone is a smoker, the smell of cigarette smoke is offensive to non-smokers.
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