Cigarette Smoking: Health Effects And Challenges For Tobacco Control (public Health In The 21st Century)

Tobacco Smoking Is A Major Public Health Issue Worldwide. Smoking Causes More Than A Quarter Of All Cancer Deaths, With Nearly 80% Of Deaths From Lung Cancer, 80% Of Deaths From Bronchitis And Emphysema And Almost One Fifth Of Deaths From Cardiovascular Disease. The Role Of Tobacco Smoke In The Development Of Cancer, Cardiovascular And Respiratory Diseases Is Widely Discussed In The Chapters Of This Book. It Is Responsible For Many Preventable Diseases, Contributes To A Large Number Of Premature Deaths And Accounts For Enormous Economic Costs. The Chapters In This Book Review A Variety Of Topics Related To The Sociodemographic Characteristics Of People Consuming Tobacco, Tobacco Product Promotion And Merchandising Consequences Of Smoking On Health, The Studied Mechanism Of Damage And The Different Interventions Promoted For Tobacco Control. The Mechanisms By Which Cigarette Smoke Affects Health Are Diverse. Thousands Of Chemical Components -- Mainly Toxins And Carcinogens -- Are Part Of Tobacco Smoke. These Components Could Act Through Specific Or Nonspecific Mechanisms In The Development Of Cancer, Cardiovascular And Respiratory Disease. Common Pathways Include Dna Damage, Gene Mutations, Vasomotor Dysfunction And Oxidative Stress, Among Others. The Effects On Health Of First-hand And Second-hand Smoke Exposure Have Been Widely Studied, And There Is Growing Evidence Regarding Consequences Of Third-hand Smoke Exposure. The Constituents, Dynamic Transformation And Distribution Of Third-hand Smoke Are A Fruitful Area Of Study, As Much As The Quantification Of Its Exposure. In This Book, Many Useful Indicators Of Exposure To Environmental Tobacco Smoke, Ranging From Surrogate Indicators To Direct Measurements Of The Components That Reflect Dose Are Analysed. Advances In This Field Can Provide Useful Information On The Extent And Effects Of Smoking, Implementing And Assessing Tobacco Control Policies. Furthermore, The World Health Organization Developed A Framework For An International Treaty That Provides Evidence-based Recommendations For Health Promotion And Tobacco Control. After More Than Ten Years Of Its Implementation, The Effectiveness Of Different Strategies Adopted Worldwide Is Analysed And Reflections On The New Challenges Of Its Implementation Are Presented. In This Book, Smoking Is Reviewed Pertaining To The Effects And Implications For Health, As Well As The Current Challenges On Implementation And Evaluation Of Tobacco Control Interventions. Contents Preface Chapter 1 Epidemiology of Tobacco Consumption School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile Abstract Introduction Tobacco Consumption in Specific Population Groups Male Tobacco Consumption Female Tobacco Consumption Tobacco Smoking in Youth Factors Involved on Tobacco Consumption Country Level Environmental Level Individual Level Burden of Tobacco Consumption Discussion References Chapter 2 Human Insecurity and Tobacco Consumption Abstract Abbreviations Introduction Tobacco as a Result of Human Insecurity Tobacco and Vulnerability Global Level Country Level Economic Insecurity Relationship of Tobacco and Economic Insecurity Childhood Insecurity Health Insecurity Tobacco as a Threat for Human Security Health Security Environmental Security Use of Pesticides and Agrochemicals Deforestation Air Pollution Tobacco Product Wastes Human Insecurity and Tobacco Environmental Damage Poverty and Economic Security Facing Tobacco: From an Individual to a Population Approach Conclusion References Chapter 3 First, Second and Third Hand Tobacco Smoke: Measuring Exposure Abstract Introduction First Hand Smoke Composition Measuring the Exposure Questionnaires (Self-Report) Economic Measures Biomarkers New Population Measures Second Hand Smoke Composition Health Effects Measuring Exposure Questionnaires (Auto-Report) Environmental Measures Biomarkers Relation between Measures Third Hand Smoke Composition Composition and Formation Health Effects Experiments in Animals Measuring the Exposure Nicotine Dust and the Use of Wipes PAHs in Hands TSNAs as a Biomarker References Chapter 4 Nonspecific Mechanisms of Disease Production Abstract Introduction Oxidative Stress Role of Oxidative Stress in Pathogenesis of COPD Role of Oxidative Stress in Pathogenesis of Cardiovascular Disease Inflammation Role of Inflammation in Pathogenesis of COPD Role of Inflammation in Pathogenesis of Cardiovascular Disease Mutagenesis and Carcinogenesis Mutagenesis and Carcinogenesis in Tobacco Smoking Mechanisms of mutagenesis and carcinogenesis Preclinical evidence of unspecific carcinogenesis in smoking Indirect carcinogenesis associated to Cigarette Smoke Carcinogenesis and Mutagenesis Associated with Smokeless Tobacco products Mutagenicity of Smokeless Tobacco products Carcinogenicity of Smokeless Tobacco products References Chapter 5 Harmful Effects of Tobacco from a Life Course Perspective Abstract Introduction Harmful Effects of Tobacco Along Human Life Course Pregnancy, Fetal Development and Fetal Programming Infancy and Childhood Adolescence Adulthood and Human Aging Economic and Occupational Consequences Tobacco as a Risk Factor and Comorbidity Later Life Conclusion References Chapter 6 Tobacco and Cancer Abstract Tobacco Consumption and Cancer Epidemiology of Cancer Epidemiology of Tobacco-Related Cancers Epidemiology of Lung cancer Carcinogenesis Associated to Lung Cancer Tobacco Smoke and Lung Cancer DNA Adduct Formation Associated to Tobacco Smoke Mutagenesis Associated to Tobacco Smoke in Lung Cancer Clinical Aspects of Lung Cancer Screening Diagnosis Clinical aspects Changes in Diagnosis Staging Conclusion and Perspectives References Chapter 7 Tobacco and Cardiovascular Disease Abstract Introduction The Endothelium and Endothelial Dysfunction Atherosclerosis Regulation of Vascular Tone Effect of Smoking Cessation on Cardiovascular Health Biomarkers Lipids Arterial and Venous Thrombosis Hypertension Infarct and Sudden Death Tobacco Cessation Therapies References Chapter 8 Tobacco and Respiratory Diseases Abstract Abbreviations Introduction Epidemiology of Tobacco and Respiratory Diseases Pathology of Smoking-Related Lung Diseases Relation between Tobacco and Particular Diseases Chronic Obstructive Pulmonary Disease (COPD) Asthma Obstructive Sleep Apnea Pneumonia Tuberculosis Impact on Respiratory Diseases of Tobacco Control Interventions Conclusion References Chapter 9 Effectiveness of Interventions for Tobacco Control Abstract Abbreviations Introduction Different Types of Tobacco Control Interventions, MPOWER Strategy Tobacco Price Increases through Taxation Promotion of Smoke-Free Public Places Tobacco Packing and Labeling Health Warning Design, Size and Position Effects of Health Warnings on Cessation Behavior Health Warnings and Smoking Initiation Tobacco Advertising Tobacco and Advertising Advertising Banning Illicit Trade of Tobacco and Corruption New Interventions for Tobacco Use and Control Youth Interventions Conclusion References Chapter 10 The World Health Organization Framework Convention on Tobacco Control and the Challenges to Its Implementation Abstract Introduction: The Globalization of the Tobacco Epidemic The WHO Framework Convention on Tobacco Control Provisions of the WHO FCTC and Guidelines General Obligations Demand Reduction Measures Scientific Basis of Key Demand Reduction Measures Smoke Free Environments Cessation Aid Health Warnings Banning Tobacco Advertising, Promotion and Sponsorship Increasing Tobacco Price Through Raising Taxes Supply Reduction Measures Other Measures The Protocol to Eliminate Illicit Trade in Tobacco Products Progress in the Implementation of Key Provisions of the WHO FCTC Arrangements: Article 5.1 of the WHO FCTC Protection from Vested Interest of the Tobacco Industry: Article 5.3 of the WHO FCTC Increasing Real Price of Tobacco Through Tax Increases: Article 6 of the WHO FCTC Protection from Second Hand Tobacco Smoke: Article 8 of the WHO FCTC Health Warnings: Article 11 of the WHO FCTC Education, Communication, and Public Awareness: Article 12 of the WHO FCTC Banning Tobacco Advertising, Promotion and Sponsorship: Article 13 of the WHO FCTC Treatment of Tobacco Dependence: Article 14 of the WHO FCTC Combating Illicit Trade of Tobacco Products: Article 15 of the WHO FCTC Tobacco Sales to Minors: Article 16 of the WHO FCTC Challenges to the implementation of the WHO FCTC The Need for Consistency between the Tobacco Control and Trade and Investment Priorities Positioning Tobacco Control in the Global Health and Development Agendas Countering the Tobacco Industry’s Tactics to Undermine Tobacco Control Measures Derailing Tax Increases Circumventing Tobacco Promotion and Sponsorship Bans Exploitation of the Trade and Investment International Mechanisms Conclusion References Editors’ Contact Information Index Blank Page Tobacco smoking is a major public health issue worldwide. Smoking causes more than a quarter of all cancer deaths, with nearly 80% of deaths from lung cancer, 80% of deaths from bronchitis and emphysema and almost one fifth of deaths from cardiovascular disease. The role of tobacco smoke in the development of cancer, cardiovascular and respiratory diseases is widely discussed in the chapters of this book. It is responsible for many preventable diseases, contributes to a large number of premature deaths and accounts for enormous economic costs. The chapters in this book review a variety of topics related to the sociodemographic characteristics of people consuming tobacco, tobacco product promotion and merchandising consequences of smoking on health, the studied mechanism of damage and the different interventions promoted for tobacco control. The mechanisms by which cigarette smoke affects health are diverse. Thousands of chemical components — mainly toxins and carcinogens — are part of tobacco smoke. These components could act through specific or nonspecific mechanisms in the development of cancer, cardiovascular and respiratory disease. Common pathways include DNA damage, gene mutations, vasomotor dysfunction and oxidative stress, among others. The effects on health of first-hand and second-hand smoke exposure have been widely studied, and there is growing evidence regarding consequences of third-hand smoke exposure. The constituents, dynamic transformation and distribution of third-hand smoke are a fruitful area of study, as much as the quantification of its exposure. In this book, many useful indicators of exposure to environmental tobacco smoke, ranging from surrogate indicators to direct measurements of the components that reflect dose are analyzed. Advances in this field can provide useful information on the extent and effects of smoking, implementing and assessing tobacco control policies. Furthermore, the World Health Organization developed a framework for an international treaty that provides evidence-based recommendations for health promotion and tobacco control. After more than ten years of its implementation, the effectiveness of different strategies adopted worldwide is analyzed and reflections on the new challenges of its implementation are presented. In this book, smoking is reviewed pertaining to the effects and implications for health, as well as the current challenges on implementation and evaluation of tobacco control interventions.