Tobacco: A Global Crisis

Tobacco has become one of the biggest problems facing the world today. It is the leading cause of preventable death in the world (Ross, Powell, Tauras, and Chaloupka, 2005). Tobacco can include smokeless tobacco, cigarettes and cigars. Those using the products are not the only ones feeling the effects but those people who receive second-hand effects are also at a great risk for experiencing chances at diseases. Developing countries are seeing dramatic increases in tobacco use, leading to a major epidemic of the twenty-first century (Yach, 2002). Today, there has been a large increase in children and teenage smokers and the problem is only getting worse.

Currently, tobacco leads to four million deaths per year, but is expected to rise to ten million deaths per year by the year 2030 (www.who.int). There are 1.1 billion tobacco users in the world today and this amount is going to increase within the next few years (www.who.int). The amount of tobacco users in developed countries is decreasing slowly, but tobacco users in developing countries are on the increase. Brundtland (1999) said, "A long-term tobacco user has a 50% chance of dying prematurely from tobacco-caused disease."

The main form of tobacco use is cigarettes and it affects the user and the people receiving second-hand smoke. Smoking in the United States has decreased in recent years and currently is only 23% of the population (www.cancer.org). One in five high school students admit to smoking cigarettes (www.cancer.org). The younger someone starts smoking the more likely they will become addicted and the more health problems they will suffer (www.cancer.org).

Athlete's using smokeless tobacco is a growing problem. A study was conducted in 1997 on NCAA athletes showed 22.5% of college male and female athletes use smokeless tobacco (Horn, Maniar, Dino, Gao, & Meckstroth, 2000). More than half of the athletes reported using smokeless tobacco in high school or before for the first time (Horn et al., 2000). Majority of younger athletes did not realize that there was a comparable amount of nicotine in cigarettes and smokeless tobacco (Horn et al., 2000). The study showed that the blue-collar, southern population of the United States is at the greatest risk for using smokeless tobacco.

Besides parental influence and peer pressure, there are three other factors influencing teenage smoking, the sale of tobacco to minors, school policies on smoking, and the advertising and promotion of tobacco (DiFranza, 1992). In the 70's and 80's teenagers were allowed to smoke on school grounds, but when schools implemented a no tolerance policy dropped significantly. Around the country, the legal age to purchase cigarettes is 18, however reports show that 75% of tobacco retailer's sale to minors (DiFranza, 1992). In the United Kingdom, the smoking age is currently 16, but they want to raise it to 18 to lower the percentage of children smoking (http://news.bbc.co.uk/1/hi/health/3621398.stm). Currently in the UK, 38% of 20 to 24 year olds smoke making it the largest group with the smallest group being 11 to 15 year olds making up 9% (http://news.bbc.co.uk/1/hi/health/3631670.stm). In the United States, law enforcement has tried to catch the sale of tobacco to minors from retailers. They ask a person under the age of 18 to go in to a retailer and purchase a tobacco product if they sell to the minor then law enforcement steps in and issues fines. Forty-four% of high school smokers report that they would like to quit and 30% have tried but failed to do so (www.healthypeople.gov). Studies also show that teenage smokers have a greater risk at trying other drugs.

African-American and Puerto Rican students tend to be the largest group of smokers among high school students. A study reported that 20% of African Americans and 33% of Latinos in high schools currently use cigarettes (Brook, Balka, Rosen, Brook, and Adams, 2005). Researchers believe that smoking at the high school level will lead to behavioral problems as young adults (Brook et al., 2005). The students that participated in this study were in grades 7th to 10th in the Harlem area of New York City (Brook et al., 2005). The study revealed that," continuous smokers acted out more than that of nonsmokers, had high measures of antisocial behavior, and the higher proportion of peers who smoked, associated with peers who were tolerant of smoking (Brook et al., 2005)." The study reports that those choosing to engage in smoking probably do it because of friends who smoke and they select friends that are similar to them (Brook et al., 2005).

African-Americans also face the problem of smoking menthol cigarettes that could potentially be more dangerous than nonmenthol cigarettes (www.cancer.org). When using a menthol cigarette they tend to take deeper inhales and hold it the inhaled smoke longer, because of the cooling sensation they receive from the menthol in the cigarette (www.cancer.org). Menthol cigarettes came about in the 1920s and 30s and were targeted mainly at women (Clark, Gardiner, Djordjevic, Leischow, & Robinson, 2004). European smokers are greater than that of African-American smokers, however there are more deaths among African-Americans. Currently, there are studies being conducted to determine whether this has any relationship between menthol cigarettes. In a 1999 study, in Massachusetts, a machine smoked 24 of the most popular brands of cigarettes. The study showed, "levels of tar, nicotine, carbon monoxide, and other carcinogenic compounds were 30%-50% higher than that of nonmenthol cigarettes (Clark et al., 2004)."

Secondhand smoke is the cause for many other health effects. Women choosing to smoke during pregnancy have the potential to cause their babies mental retardations and birth defects. There are 43 types of cancers that can be caused by secondhand smoke (http://www.healthypeople.gov/Document/HTML/Volume2/27Tobacco.htm#_Toc489766214). There are reports that 3,000 people die each year from lung cancer, because of secondhand smoke. Also, 150,000 to 300,000 infants and children under the age of 18 have problems with respiratory infections because of secondhand smoke (www.healthypeople.gov). In 1996, a study reported that, "22 percent of children under the age of 18 were subject to secondhand smoke in their homes (www.healthypeople.gov)."

Women are not only at risk for potentially harming their babies, but are also at a great risk for lung cancer. Lung cancer mortality is greater in men than women but there has been a large increase in lung cancer in women. It is believed that women have a different vulnerability to the carcinogens than men do and that could be the cause of the rise in lung cancer in women (Pauk, Kubik, Zatloukal, and Krepela, 2005). Lung cancer is not