An NCI-designated Comprehensive Cancer Center
By City of Hope | May 31, 2016



What's In Cigarette Smoke? Click to download the What's in Cigarette Smoke? infographic.



Today is World No Tobacco Day, and the World Health Organization hopes to use the annual opportunity to draw attention to the many dangers of tobacco use and the endless benefits of avoiding or ceasing it.

Dan J. Raz, M.D., M.A.S., is co-director of City of Hope's Lung Cancer and Thoracic Oncology Program. As an assistant professor in the Division of Thoracic Surgery who specializes in esophageal and lung cancer surgery, he has seen more than his share of damaged breathing apparatuses and the challenges involved in repairing them.

“The lungs of someone who has been a longtime smoker almost always appear abnormal,” said Raz. “They are usually darker from pigment and tobacco residue and often have a different consistency compared to healthy lungs. Healthy lungs have a spongy consistency, whereas smokers’ lungs are often baggy, like a deflated balloon.”

City of Hope’s Lung Cancer Screening Program can be instrumental in detecting a tobacco-related disease early enough to increase the chances of a cure dramatically. The most effective way to avoid the devastating effects of smoking, of course, is to never start. But if you already smoke, do whatever you can to stop. Your body, your loved ones, (and your doctors) will be eternally grateful.

“Quitting smoking is the single most important thing a smoker can do for his or her health,” said Raz, who notes that an initiative to raise the tax on cigarettes by $2 to raise money for tobacco cessation and tobacco-control research will be on the California ballot in November. “Raising the tobacco tax has been proven to substantially decrease smoking rates, particularly among young people who are at risk for starting smoking. This initiative will save lives and has the support of a number of important organizations, such as the American Cancer Society, American Heart Association and American Lung Association.”

To combat the many misunderstandings and falsehoods about smoking, vaping and other tobacco products, here, Raz debunks 10 common myths about smoking, in honor of No Tobacco Day.

1. MYTH: Only a handful of dangerous toxins can be found in tobacco smoke.

FACT: Actually, the number is closer to 250. Of these harmful chemicals, at least 70 of them have been proven to cause cancer, a list that includes arsenic, formaldehyde, nickel and chromium. The other 180, such as carbon monoxide, ammonia and hydrogen cyanide, are harmful to the human body in other ways.

Put another way, these same chemicals could be ingested by sucking on an exhaust pipe, eating rat poison, drinking lighter fluid or licking a car battery, actions no sane person would take. And nonsmokers who happen to walk through a cloud of tobacco smoke are exposed to all the same toxins.  

2. MYTH: Cigarette smoking has been shown to only cause lung cancer.

FACT: “One common misunderstanding is that smoking just causes lung cancer,” said Raz. “Although lung cancer is an incredibly devastating disease and is by far the most common cause of cancer death in both men and women, estimates are that only a quarter of the tobacco-related deaths yearly in the U.S. are from lung cancer. Heart disease, COPD (chronic obstructive pulmonary disease), other tobacco-related cancers and less common harmful effects such as premature birth and house fires are also attributed to smoking.”

According to the National Cancer Institute, the full list of cancers that can result from tobacco-related causes includes esophagus, throat, larynx, mouth, kidney, bladder, liver, stomach, pancreas, cervix, colon and rectum cancer. Simply put, smoking has been found to damage nearly every organ and organ system in the human body.

This means that even if cancer is avoided, additional potential effects include chronic bronchitis, diabetes, osteoporosis, stroke and cataracts, among other things. Plus, smoking impairs immune function generally, leaving the smoker susceptible to many other ailments.

3. MYTH: Cigarettes and tobacco smoke cause 100,000 premature deaths per year in the U.S., which is much more than the annual deaths caused by cars and guns combined.

FACT: The death toll is five times that. While it’s true that annual motor vehicle and gun-related fatalities, which each tally around 33,000 deaths per year, pale in comparison, close to half a million people die prematurely every year in the U.S. because of cigarette smoking and exposure to tobacco smoke. Of those, about 36 percent (approximately 173,000) are from cancer. Smoking retains its spot at the top of the list of preventable death in America.

4. MYTH: Other types of tobacco products are not harmful the way cigarettes are.

FACT: Everything from pipes and hookahs to snuff and cloves has been shown to cause or increase the risk of lung cancer, throat cancer, mouth cancer, heart attacks and other lung diseases. “Among people in their teens and twenties, cigarette smoking alone has been replaced by mixed use of cigarette smoking, e-cigarette vaping, other forms of tobacco use (such as hookahs), and marijuana smoking or vaping,” said Raz.

“These alternative forms of tobacco/nicotine delivery and the use of marijuana are often perceived as not harmful or less harmful than cigarette smoking, but unfortunately that is not true. For example, the chemicals released in e-cigarette ‘vapors’ are numerous and contain carcinogens, and marijuana smoke contains similar levels of carcinogens to tobacco smoke.”

5. MYTH: Because of medical advances, the risk of a smoker developing lung cancer has decreased in recent decades.

FACT: Over the last 50 years, the risk of lung cancer and COPD (frequent bronchitis and emphysema) for smokers has actually gone up, even as the number of cigarettes consumed per smoker has gone down.

6. MYTH: The main risk to pregnant women who smoke is premature delivery.

FACT: First of all, smoking makes it harder for a woman to conceive in the first place. But then it also increases risk of miscarriage, ectopic pregnancy, low birth weight and cleft lip/palate. Sudden Infant Death Syndrome (SIDS) also becomes more likely when a woman smokes during or after pregnancy.

7. MYTH: Smoking is sexy.

FACT: Men who smoke have a greater risk of erectile dysfunction.

8. MYTH: Nonsmokers cannot get lung or other cancers from tobacco smoke.

FACT: Secondhand smoke is a carcinogen and inhaling it can cause lung cancer in nonsmoking adults. Living with a smoker increases a nonsmoker’s chances of developing lung cancer by an estimated 20 to 30 percent. Approximately 7,300 nonsmokers die every year in the U.S. from lung cancer caused by secondhand smoke.

9. MYTH: Once a smoker has smoked for a while, his or her system is already permanently damaged.

FACT: Quitting produces immediate results for most smokers. Within days, weeks or months, heart rate and blood pressure return to normal levels, circulation and lung function improve, coughing declines, smell and taste get better, and life expectancy extends.

“No matter how long you have smoked, you reduce the risk of lung cancer, heart disease and other tobacco-related diseases,” said Raz. “In addition, smokers who quit smoking have a better sense of well-being and serve as positive role models for their families by making healthier choices.”

10. MYTH: A smoker who has been diagnosed with cancer would see no benefit from quitting.

FACT: For some cancer patients, quitting smoking can decrease the risk of death. It also reduces the risk of developing other dangerous health complications as a result of a weakened immune system and makes it easier to heal and rebound from treatments such as surgery and chemotherapy. Quitting may also help prevent the cancer from recurring or a second cancer from developing.




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