Heart Attack Prevention - Smoking

Takeheart Health Check       [Heart Attack Prevention Smoking]

Heart Attack Prevention - Smoking
The British Doctors Study (516, 517 ) has followed 40,000 British male doctors over 50 years and clearly demonstrtaes the dangers of cigarette smoking. Of persistent smokers half will be killed by their habit. However the good news is that giving up at the age of 50 halves the hazard, whilst giving up at 30 avoids almost all of it.

A cigarette smoker has 2 or 3 times the risk of a coronary attack than a non-smoker.
A doctor who can persuade 5% of his patients to stop smoking each year is likely to be more effective in reducing the burden of coronary disease in the community than are the therapeutic efforts of many cardiologists and thoracic surgeons.(34)

Women appear to be at a 50 per cent greater risk from myocardial infarction from smoking tobacco than men.(420)

The increase in the risk of myocardial infarction attributable to cigarette smoking is largely reversible within a few years.(59)

Smoking responsible for 50,000 - 100,000 deaths per year. Average reduction in life expectancy of 10 yrs. Smoking related illness cost the National Health Service £370 million in 1984. (But how much does the exchequer save in old age pensions? GC). (63, 468, 467) Worldwide deaths estimated to be 3,000,000 per year through tobacco smoking. (484)

Smoking costs (health care, absenteeism, fires etc.) are thirteen times as great as the "benefits" (savings on pensions, health care, housing etc.). (501)

Half of all British persistent smokers are killed by tobacco. (517)

Lifelong smoking can cut 18 years from a man's life. 30 yr old man will live to 64 if he smokes and to 82 if not Based on 8308 interviews in Erie Pennsylvania.(80)

Smoking and raised cholesterol are risk factors for the 65-74 age group as well as younger people.(97)

Smoking among student nurses. Royal Free Hospital.
350 replies to a questionnaire
43% Smokers
19% Ex Smokers
37% Never smoked (150)

The number of smokers has declined in the UK, from 52 per cent of men in 1972 to 31 per cent in 1990. Two thirds want to stop and about a third intend to give up within a year. (469, 470)

Prevalence is higher in social classes lV and V.

Young men now smoke more than older men - 38 per cent of male smokers are 20 to 24 years old.

People with smoking related diseases cost the National Health Service £437 million/year. At any time they occupy 9000 beds. "Smoking is the largest single cause of preventable, premature death in this country (Health Education Authority The Big Kill). 17 million smokers in UK. 110,000 die each year from smoking related diseases (this excludes passive smoking). Highest deaths in UK Manchester, lowest Maidstone & Kent.

Smoking doubles the chance of men dying before 65. 70% more women who smoked would die before the age of 65 than those who never smoked (Dr Spencer Haggard, Chief Executive Health Education Authority).(211)

"In Britain today more than 120,000 people are going to die over the next year from illnesses directly related to smoking. And the year after that, and the year after that. Unless we all do something." The Prime Minister, 1999 (465)

The consistent demonstration that smoking is a strong, dose related, independent predictor of the incidence of coronary heart disease. Case against smoking is based upon convincing observational epidemiology.(216, 411)

Children. 1 in 4 15 year olds already regular smokers. 450 children start smoking every day.
Tobacco industry spends £72 million on advertising in Britain each year.
Cigarette smoking makes subarachnoid haemorrhage six times more likely in young smokers and doubles or trebles the chance of female infertility.
Parental smoking and asthma and middle ear effusion and allergic diseases during infancy.
More girls than boys now smoke, and the prevalence of maternal smoking in pregnancy is high. This results in more miscarriages and cases of premature labour and higher perinatal mortality and has effects extending beyond infancy, with a reduction in growth and educational achievement.(253)

"The fall in smoking prevalence in this country owes more to people giving up the habit than fewer people taking it up."

In the United Kingdom 1 in 4 15 year olds is already a regular smoker.
The tobacco industry spends £72 million each year on advertising.
Subarachnoid haemorrhage is six times more likely in young smokers than non-smokers.
Smoking raises the risk of female infertility threefold.

Stopping smoking :- advice only from General Practitioner 6% success after 1 year. Combined with other components up to 23% success.(261)

Numbers of people out of 200 living to be 90
Heavy 35yr smokers 3
Light smokers 9
Non smokers 30 (278)

For passive smoking at work in China statistically significant linear trends of increasing risks (of coronary heart disease) with increasing exposures were observed.(301 )

A crushing condemnation of smoking. 34,500 doctors monitored from 1951 over 40 years, 20,000 deaths. Half of all regular cigarette smokers will be killed by the habit, the hazards are even greater than we thought. If you stop before the age of 35, you can probably reach the age where you can cash in the financial benefits of your life insurance policy since your survival pattern will be the same as a previous non-smoker. Survival prospects significantly improved by stopping, even in the 70s.(316)

8,000 men followed up for 15 years.
Lived to celebrate 75th birtday:-
42% who started smoking by 20 and who never stopped
78% of those who never smoked (358)

Smoking more than 20/day doubles the risk of age-related macular degeneration (blindness).(359)

Evidence of increased risk of coronary heart disease by passive smoking. 32,000 United States nurses followed for 10 years. 60% greater risk in those occasionally exposed. Twice the risk for those regularly exposed.(373) For alternative view

Professor Martin Jarvis, of the Department of Epidemiology & Public Health at University College, London was asked; "In an average night in a pub, how many fags will I passively smoke?" "About one. In a very smoky atmosphere, a non-smoker takes in about a quarter of a milligram of nicotine an hour. With the average cigarette having a milligram of nicotine, that's one passive cigarette every four hours. This might not seem a lot but there's no safe level of exposure to tobacco smoke and the impact is greater on babies and children." Quoted in People, Spring 2000, UCL London.

Secondary smoking. Nonsmokers who live with smokers have 30% greater risk of coronary heart disease at age 65 than those not exposed to tobacco smoke. Equivalent to one cigarette a day.(388)
In another paper the authors estimate that after allowing for dietary confounding the excess risk of coronary heart disease in a non-smoker who lives with a smoker is 23%.(406). Exposure to other people's smoke has a significant effect upon the progression of atherosclerosis. (411)

1,000 deaths a year in Europe attributed to spouse's smoking. (415)

A study led by Professor Martin Jarvis found that "living with someone who smoked 15 cigarettes a day resulted in four times the exposure to second-hand smoke as someone living in a smoke-free household." Professor Jarvis of University College London's department of Epidemiology & Public Health and Psychology, said: "There seems little doubt that the home is now the major source of exposure to second-hand smoke for most non-smokers. These findings are very worrying as they mean that a large group of people are being exposed to a significantly increased risk of lung cancer." (London Evening Standard 9/1/2002)

Impotence is a risk for smokers. An 80 percent increase in the risk has been reported. (464)

Carbon monoxide gas is one of the poisons found in the blood of smokers - about ten times the level found in non-smokers. It is slow suicide.

There is some evidence that the smoking habit can be promoted through the mother's milk. (443)

The reduction in tobacco deaths in middle age has been greater in Britain than in any other country. About ½ of those who smoke are killed by the habit, while among those who have never smoked or who have stopped 80% survive to 70 and 33% to 85. Two thirds of ex-smokers who have survived to 85 would have died if they had carried on smoking. They owe their lives to Sir Richard (Doll). (401)

Smokers are twice as likely as non-smokers to develop Alzheimer's disease. (426)

For a summary of public smoking policies in the UK and abroad see 429.

Tobacco use by men increased up to the end of the Second World War, when it fell slightly before stabilising. After the 1960s it fell substantially. Use by women started much later, and increased rapidly in the Second World War and continued to increase until the 1970s when it began to fall. In 1996 in Great Britain, 29% of males and 28% of females were cigarette smokers, compared with 65% and 41%, respectively, in 1948. However, there has been little change amongst the youngest adults over the last ten years, and cigarette smoking among children has increased during the 1990s. (434)

The chinese consume a third of the world's cigarettes. They are killing millions of them.(446, 447)

Fires started by cigarettes cost England & Wales £151 million a year, while the 34 million working days lost annually to smoking-related illness cost an estimated £328 million. With the added cost of smoking breaks, the total was well over the £600 million a year earned by taxing tobacco.
If 40% of smokers gave up the habit 150,000 jobs would be created because most ex-smokers would spend the money saved on leisure.
The direct cost to the National Health Service of smoking is £1.5 billion a year.
If Britain could increase the rate of people giving up smoking by 5%, it would save the NHS £44 million in the next 20 years. (477)

"Smoking is the cause of a third of all cancers." (490)

If the Government of the United Kingdom achieved its target of cutting the proportion of adults who smoke to 26% by 2005 and to 24% by 2010, it would save the NHS £524million in prevented strokes and heart attacks alone. Slightly more ambitious targets - cutting smoking rates to 17% by 2010 - would save more than £1billion over the next ten years. More importantly, over 14,000 people would keep their functioning myocardium, and over 11,000 people would be saved from a stroke. (492)

Smoking doubles the risk of stroke and coronary heart disease. After smoking cessation, risk of stroke and coronary heart disease returns to that of people who have never smoked. (493)

Maternal smoking in pregnancy is linked to subsequent diabetes and obesity in the offspring.(500)

A mother who smokes quadruples the chance of her child developing a wheezing illness. (527)

Heavy smokers treble their chance of developing Age Related Macular Degeneration. The also are more likely to develop bladder cancer. (548, 549)

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© G.M.Clayton 1997
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