Informed Employee

Tobacco Use and Health Articles

Lung cancer signs even in "healthy" smokers

Published October 2013 — Smokers who have been given a clean bill of health from their doctors after normal examination results may still have early signs of lung cancer, according to a study published in the journal, Stem Cells. 

Dr. Robert Crystal, chairman and professor of genetic medicine at Weill Cornell Medical College states, "Cells that are lining the airways in smokers are in a more primitive state and have some of the features that you see in lung cancers. So, basically, the guy smoking outside the building who thinks he is normal is already on his way to developing lung cancer."

Dr. Crystal says that occasional smokers and passive smokers are also at risk. "With any smoke you are exposed to, your airways cells are being programed in an abnormal fashion."

Quitting smoking is always worthwhile and lung cancer is not inevitable. According to the U.S. National Cancer Institute smokers who quit at about age 30 "reduce their chance of dying prematurely from smoking-related diseases by more than 90 percent." 

Source: Whiteman, H. (2013, July 18). "Lung cancer signs even in "healthy" smokers." Medical News Today.

Smoking and Bone Loss

Published July 2013 — Recent studies show a direct relationship between tobacco use and decreased bone density. Smoking is one of many factors—including weight, alcohol consumption, and activity level—that increase the risk for osteoporosis, a condition in which bones weaken and become more likely to fracture.

Significant bone loss has been found in older women and men who smoke. Quitting smoking appears to reduce the risk for low bone mass and fractures. However, it may take several years to lower a former smoker's risk.

In addition, smoking from an early age puts women at even higher risk for osteoporosis. Smoking lowers the level of estrogen in the body, which can cause one to go through menopause earlier, boosting the risk for osteoporosis.


Cigarettes and Cancer

Published February 2013 — Cigarette smoking kills an estimated 440,000 U.S. citizens each year—more than alcohol, illegal drug use, homicide, suicide, car accidents, and AIDS combined. Between 1964 and 2004, more than 12 million Americans died prematurely from smoking, and another 25 million U.S. smokers alive today will most likely die of a smoking-related illness.

Cigarette smoking accounts for about one-third of all cancer deaths. The overall rates of death from cancer are twice as high among smokers as nonsmokers, with heavy smokers having rates that are four times greater than those of nonsmokers. Foremost among the cancers caused by tobacco use is lung cancer—cigarette smoking has been linked to about 90 percent of all cases of lung cancer, the number one cancer killer of both men and women. Smoking is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, bladder, and acute myeloid leukemia.

National Institute on Drug Abuse

1 in 5 Adults Smoke

Published October 2012 — Tobacco use remains the single largest preventable cause of disease, disability, and death in the U.S. yet millions of people smoke. Almost 1 in 5 adults smoke. 

  • Each cigarette smoked damages lungs, blood vessels, and cells throughout the body.
  • 443,000 Americans die of smoking or exposure to secondhand smoke each year.
  • For every smoking-related death, another 20 people suffer with a smoking-related disease.
  • Smoking costs the US about $96 billion each year in direct medical costs. 

Reducing tobacco use is a public health priority with known, effective actions for success and saved lives.

Centers for Disease Control and Prevention

Secondhand Smoke Costs Rise Sharply

Published February 2012 — An Indiana University study released January 9, 2012, found that the economic costs of secondhand smoke in the state are more than $1 billion a year—triple a previous estimate.

The study, conducted by the Bowen Research Center at the Indiana University School of Medicine, calculated that in 2010, each Hoosier paid $201 because of the cost of secondhand smoke. That comes to $1.3 billion a year­‑—about $327.1 million in direct healthcare costs and $977.5 million from premature loss of life.

Secondhand smoke increases an individual's risk of heart disease, lung cancer, respiratory illness and many other diseases. Nationally, it is estimated that more than half of all children ages 3 to 11 live in homes where they are exposed to secondhand smoke.

Source: Rudavsky, S. (2012, January 10). 
Secondhand smoke costs rise sharply. The Indianapolis Star

What's in a Cigarette?

Published October 2011 — There are approximately 600 ingredients in cigarettes. When burned, they create more than 4,000 chemicals. At least 50 of these chemicals are known to cause cancer, and many are poisonous. 

Many of these chemicals are also found in consumer products, but these products have warning labels. While the public is warned about the danger of the poisons in these products, there is no such warning for the toxins in tobacco smoke.

Here are a few of the chemicals in tobacco smoke, and other places they are found:

  • Acetone – found in nail polish remover
  • Acetic Acid – an ingredient in hair dye
  • Ammonia – a common household cleaner
  • Arsenic – used in rat poison
  • Benzene – found in rubber cement
  • Butane – used in lighter fluid
  • Cadmium – active component in battery acid
  • Carbon Monoxide – released in car exhaust fumes
  • Formaldehyde – embalming fluid
  • Hexamine – found in barbecue lighter fluid
  • Lead – used in batteries
  • Napthalene – an ingredient in moth balls
  • Methanol – a main component in rocket fuel
  • Nicotine – used as insecticide
  • Tar – material for paving roads
  • Toluene - used to manufacture paint

Source: American Lung Association

Smoking and Cancer

Published August 2011 — Smoking harms nearly every organ of the body. Smoking causes many diseases such as cancer and reduces the health of smokers in general. While it is true that more people die from lung cancer than any other type of cancer, smoking also causes the following cancers which account for a large number of deaths.

  • Acute myeloid leukemia
  • Bladder cancer
  • Cancer of the cervix
  • Cancer of the esophagus
  • Kidney cancer
  • Cancer of the larynx (voice box)
  • Cancer of the oral cavity (mouth)
  • Cancer of the pharynx (throat)
  • Stomach cancer
  • Cancer of the uterus

Source: Centers for Disease Control and Prevention

Even Brief Exposure is Harmful

Published May 2011 — The 30th Surgeon General Report on tobacco-related issues was released in December 2010. This new report details the serious health effects of even brief exposure to tobacco smoke. It concludes that:

  • Tobacco smoke contains more than 7,000 chemicals and compounds, including hundreds that are toxic and at least 70 that cause cancer.
  • Every exposure to the cancer-causing chemicals in tobacco smoke can damage DNA in a way that leads to cancer.
  • Exposure to secondhand smoke has an immediate impact on the cardiovascular system: damaging blood vessels, making blood more likely to clot, and increasing risks for heart attack and stroke.
  • Smoking makes it harder for women to get pregnant and can cause miscarriage, premature birth and low birth weight. It also harms male fertility.

For a copy of the full report see

Economic Benefits of Smoking Cessation

Published October 2010 — Smoking costs Indiana more than $7 billion dollars every year. This, according to a new study conducted by researchers at Penn State University and released by the American Lung Association, is money that the state and consumers could be spending in other places. The study determined that smoking cessation programs are less costly to the public than not helping smokers who want to quit, and calculates that Indiana can save an average of nearly $15 million dollars annually by doing so.

Read more:

Parents: Help Keep Kids Tobacco-Free

Published July 2010 — Prevalence of cigarette use among children and teens in the U.S. is less than it was ten years ago but it is still higher than that of adults. Parents are the key in preventing a child’s tobacco use. Parents must take the lead not just once or occasionally, but in the context of a series of conversations that take place as a child learns and grows. Start the dialog about tobacco at age 5 or 6 and continue through the high school years. Many kids start using tobacco by age 11, and many are addicted by age 14.

Kids who use tobacco:

  • Are more likely to use alcohol and other drugs 
  • Become addicted to tobacco and find it extremely hard to quit 
  • Cough and have asthma attacks more often and develop respiratory problems, leading to more sick days, more doctor bills, and poorer athletic performance

Despite the impact of movies, music, and TV, parents can be the greatest influence in their kids’ lives.

  • Talk directly to children about the risks of tobacco use; if friends or relatives died from tobacco-related illnesses, let kids know.
  • Don’t use tobacco in the presence of children; don’t offer it to them; and don’t leave it where they can easily get it.
  • Know if a child’s friends use tobacco and talk about ways to refuse it.
  • Discuss the false glamorization of tobacco on billboards and in other media.

Summarized from the Centers for Disease Control and Prevention

Quitting Tobacco is Now More Possible than Ever

Published March 2010 — Research reviewed for the National Library of Medicine guideline, Treating Tobacco Use and Dependence: 2008 Update, suggests a bright future for treating tobacco dependence. Effective treatments exist that can significantly increase rates of long-term abstinence, and such treatments are effective across a broad range of populations. 

  • Counseling is an effective tobacco use treatment strategy. Counseling adds significantly to the effectiveness of tobacco cessation medications; quitline counseling is an effective intervention with a broad reach; and counseling increases abstinence among adolescent smokers.
  • There are many more medication options than in the past. Seven different effective first-line smoking cessation medications are now approved by the FDA for treating tobacco use and dependence. In addition, multiple combinations of medications have been shown to be effective.

Free & Clear® Quit For Life™ Program 
IU’s medical benefits cover the cost of a tobacco cessation plan with Free & Clear, Inc. Quit for Life program. The benefit is available to all full-time Academic and Staff employees and their family members 18 or older. The plan is fully paid for by the University.

Body Shape

Published August 2009 — The effect of smoking on the endocrine system (glands which secrete hormones) causes smokers to store even normal amounts of body fat in an abnormal distribution. Smokers are more likely to store fat around the waist and upper torso, rather than around the hips. This means smokers are more likely to have a higher waist-to-hip ratio (WHR) than non-smokers. A high WHR is associated with a much higher risk of developing diabetes, heart disease, high blood pressure, gallbladder problems and (in women) cancer of the womb and breast. A study of American men also found a dose-response relationship between the number of cigarettes smoked and waist-to-hip ratio. 

However, changes to WHR induced by smoking need not be permanent. The results of a Swedish study suggests that while some weight gain after stopping smoking can be expected, it is less of a health risk because it is not deposited in the upper torso, where it is associated with increased risk of heart disease. 

Excerpt from Fact Sheet no. 10, Action on Smoking and Health (ASH), August 2004

First Use of Cigarettes in Youth

Published October 2008

  • Eighty percent (80%) of all smokers have their first cigarette before age 18 and 90 percent of all smokers begin before age 20.
  • One third of all smokers began before the age of 14.
  • Each day, approximately 3,900 young people between the ages of 12 and 17 years initiate cigarette smoking in the United States.
  • Between one half and one third of youth who try a cigarette will go on to become a daily smoker.
  • Each day an estimated 1,500 young people become daily cigarette smokers in this country.
  • Within days or weeks of first cigarette use, symptoms of nicotine dependence may appear.
  • In 2002, 33 percent of middle school students and 57 percent of high school students reported having tried smoking at least once in their lives.

American Legacy Foundation (February 2008)