Smoking has more than 50 ways of making life a misery through illness and more than 20 ways of killing you. In general, smokers endure poorer health than non-smokers. It has been estimated that, in England, 364,000 patients are admitted to NHS hospitals each year due to diseases caused by smoking. This translates into 7,000 hospital admissions per week, or 1,000 day. [1] In 1997/98, cigarette smoking caused an estimated 480,000 patients to consult their GP for heart disease, 20,000 for stroke and nearly 600,000 for COPD. 1
Half of all teenagers who are currently smoking will die from diseases caused by tobacco if they continue to smoke. One quarter will die after 70 years of age and one quarter before, with those dying before 70 losing on average 21 years of life. [2] It is estimated that between 1950 and 2000 six million Britons, 60 million people worldwide, would have died from tobacco-related diseases. [3]
Non-lethal illness
Smokers face a higher risk than non-smokers for a wide variety of illnesses, many of which may be fatal (see “Deaths caused by smoking” below). However, many medical conditions associated with smoking, while they may not be fatal, may cause years of debilitating illness or other problems. These include: [4]
|
Increased risk for smokers |
|
| Acute necrotizing ulcerative gingivitis (gum disease) | Muscle injuries |
| Angina (20 x risk) | Neck pain |
| Back pain | Nystagmus (abnormal eye movements) |
| Buerger’s Disease (severe circulatory disease) | Ocular Histoplasmosis (fungal eye infection) |
| Duodenal ulcer | Osteoporosis (in both sexes) |
| Cataract (2 x risk) | Osteoarthritis |
| Cataract, posterior subcapsular (3 x risk) | Penis (Erectile dysfunction) |
| Colon Polyps | Peripheral vascular disease |
| Crohn’s Disease (chronic inflamed bowel) | Pneumonia |
| Depression | Psoriasis (2 x risk) |
| Diabetes (Type 2, non-insulin dependent) | Skin wrinkling (2 x risk) |
| Hearing loss | Stomach ulcer |
| Influenza | Rheumatoid arthritis (for heavy smokers) [5] |
| Impotence (2 x risk) | Tendon injuries |
| Optic Neuropathy (loss of vision, 16 x risk) | Tobacco Amblyopia (loss of vision) |
| Ligament injuries | Tooth loss |
| Macular degeneration (eyes, 2 x risk) | Tuberculosis |
|
Function impaired in smokers |
|
| Ejaculation (volume reduced) | Sperm count reduced |
| Fertility (30% lower in women) | Sperm motility impaired |
| Immune System (impaired) | Sperm less able to penetrate the ovum |
| Menopause (onset 1.74 years early on average) | Sperm shape abnormalities increased |
|
Symptoms worse in smokers |
|
| Asthma | Graves’ disease (over-active thyroid gland) |
| Chronic rhinitis (chronic inflammation of the nose) | Multiple Sclerosis |
| Diabetic retinopathy (eyes) | Optic Neuritis (eyes) |
|
Disease more severe or persistent in smokers |
|
| Common cold | Pneumonia |
| Crohn’s Disease (chronic inflamed bowel) | Tuberculosis |
| Influenza | |
Deaths caused by smoking
One in two long-term smokers will die prematurely as a result of smoking – half of these in middle age. The most recent estimates show that around 114,000 people in the UK are killed by smoking every year, accounting for one fifth of all UK deaths. [6] Most die from one of the three main diseases associated with cigarette smoking: lung cancer, chronic obstructive lung disease (bronchitis and emphysema) and coronary heart disease. The table below shows the percentage and numbers of deaths attributable to smoking, based on the latest available detailed breakdown (2002 data).
|
Estimated percentages and numbers of deaths attributable to smoking in the UK by cause (based on 2002 mortality data) 1, [7] |
||||||
|
|
Deaths from disease estimated to be caused by smoking |
|||||
|
|
Number |
As % of all deaths from disease |
||||
|
Men |
Women |
Total |
Men |
Women |
Total |
|
| Cancer |
|
|
|
|
|
|
| Lung |
18002 |
10032 |
28034 |
89 |
75 |
84 |
| Upper respiratory | 525 | 85 |
610 |
74 |
50 |
66 |
| Oesophagus |
3248 |
1743 |
4991 |
71 |
65 |
68 |
| Bladder | 1521 |
318 |
1839 |
47 |
19 |
37 |
| Kidney |
788 |
72 |
860 |
40 |
6 |
27 |
| Stomach |
1385 |
266 |
1651 |
35 |
11 |
26 |
| Pancreas |
670 |
923 |
1593 |
20 |
26 |
23 |
| Unspecified site |
|
|
|
|
|
|
| Myeloid Leukaemia |
264 |
131 |
395 |
19 |
11 |
15 |
| Respiratory |
|
|
|
|
|
|
| Chronic obstructive lung disease |
13193 |
10685 |
23878 |
86 |
81 |
84 |
| Pneumonia |
3162 |
2900 |
6062 |
23 |
13 |
17 |
| Circulatory |
|
|
|
|
|
|
| Ischaemic heart disease |
14182 |
6361 |
20543 |
22 |
12 |
17 |
| Cerebrovascular disease |
3064 |
3764 |
6828 |
12 |
9 |
10 |
| Aortic aneurysm |
3652 |
1939 |
5591 |
61 |
52 |
57 |
| Myocardial degeneration |
6670 |
2936 |
9606 |
22 |
12 |
15 |
| Atherosclerosis |
63 |
56 |
119 |
15 |
7 |
10 |
| Digestive |
|
|
|
|
|
|
| Ulcer of the stomach or duodenum |
907 |
1008 |
1915 |
45 |
45 |
45 |
| Total caused by smoking | 71,296 |
43,219 |
114,597 |
|
|
|
| Preventable by smoking * : |
|
|
|
|
|
|
| Parkinson’s |
1369 |
549 |
1918 |
55 |
28 |
43 |
| Cancer of the endometrium |
|
260 |
260 |
|
17 |
17 |
| Total prevented by smoking |
|
|
|
|
|
|
| Deaths from all causes due to smoking (causes less prevented) |
69,927 |
42,410 |
112,337 |
|
|
|
* Studies have shown that smoking appears to have a protective effect against the onset of some diseases such as endometrial cancer. However, the positive effect is so small in comparison with the overwhelming toll of death and disease caused by smoking that there is no direct public health benefit.
Deaths caused by smoking are five times higher than the 22,833 deaths arising from: traffic accidents (3,439); poisoning and overdose (881); alcoholic liver disease (5,121); other accidental deaths (8,579); murder and manslaughter (513); suicide (4,066); and HIV infection (234) in the UK during 2002. 7 World-wide, almost 5 million die prematurely each year as a result of smoking. Based on current trends, this will rise to 10 million within 20 years. [8]
References
[1] Nicotine Addiction in Britain. A report of the Tobacco Advisory Group of the Royal College of Physicians. RCP, 2000 (for percentage of smoking-related deaths). Mortality statistics 2002., Office for National Statistics, 2002; General Register Office for Scotland, 2002; Registrar General Northern Ireland, Annual Report, Statistics & Research Agency, 2002.
[2] Peto R. Mortality in relation to smoking: 40 years’ observations on male British doctors. BMJ 1994; 309: 901-911
[3] Peto R et al. Mortality from smoking in developed countries, 1950-2000. Oxford Medical Publications, 1994.
[4] Cigarettes: what the warning label doesn’t tell you. American Council on Science & Health, 1997.
[5] Hutchinson, D et al. Annals of Rheumatic Diseases, 2001; 60: 223-7
[6] Peto, R. et al Mortality from smoking in developed countries 1950-2000 (2nd edition) Oxford University Press, Oxford. View report
[7] Mortality statistics 2002., Office for National Statistics, 2002; General Register Office for Scotland, 2002; Registrar General Northern Ireland, Annual Report, Statistics & Research Agency, 2002.
[8] The World Health Report 2003. World Health Organization, 2003.
