Periodontitis Increases The Risk Of A First Myocardial: Fill & Download for Free

If I quit smoking now, will my lungs return to their original condition?Quitting cigarettes Have you thought about it several times without ever keeping your promise? Too hard to abstain, too tempting to see others around you smoking… What if you were given good reasons to quit smoking? We start now.Summary20 minutes after the last cigarette8 hours after the last cigarette24 hours after the last cigarette48 hours after the last cigarette72 hours after the last cigarette1 month after the last cigarette1 to 9 months after the last cigarette1 year after the last cigarette5 years after the last cigarette10 to 15 years after the last cigaretteFocus on the benefits of smoking cessationhealth benefits of quitting smokingDo you want to quit but are worried you won't be able to? To help you, think of the health benefits of smoking cessation, whether short, medium or long term, there are many and you can benefit from the first effects 20 minutes after the last cigarette.20 minutes after the last cigaretteThe blood pressure subsides. This is one of the effects of stopping nicotine which almost immediately loses its powers of over-excitability. The pulse slows down, the heartbeat returns to normal after undergoing an increase of almost 40%. And it's the whole organism that regains its calm.8 hours after the last cigaretteThe amount of carbon monoxide in the blood is cut in half. And this is very good news! This poisonous gas, passing into the blood with each puff of an inspired cigarette, prevented the muscles from receiving the oxygen necessary for the production of energy. By limiting this gas in our blood, we allow our body to regain all its physical capacities. The oxygenation of the muscles is better, chronic fatigue, the headaches evaporate. We breathe better and our resistance to the effort is improving day by day.24 hours after the last cigaretteThe risk of myocardial infarction begins to decrease. First, because the lungs clear mucus and smoke residue, then because the nicotine is gone. These two factors contribute to no longer clogging the arteries, thus letting blood circulate in a fluid way towards the organs (in particular the heart) without risk of spasms or of increasing the blood pressure at the origin of the cardiovascular accidents, infarction or stroke.48 hours after the last cigaretteWe find taste and smell for the greatest pleasure of our palate. The strong smell of tobacco no longer masks that of food. The mouth is less dry. The nerve endings in taste begin to grow back. The less inflamed, better-irrigated taste buds regain all their sensitivity. Dishes and foods are gradually gaining flavor.72 hours after the last cigaretteWe breathe easier. The bronchi relax and you also feel more energetic.1 month after the last cigaretteWe look better! The skin also detoxifies itself from the effects of cigarettes. And we don't stop there! The teeth become whiter again and the breath more pleasant.1 to 9 months after the last cigaretteThe bronchial eyelashes grow back, allowing certain residues caused by tobacco to rise and be expelled. The breath is back! The lungs gain in amplitude, the cough and fatigue take advantage of it to fade even more. The cold again becomes lighter without overreaction of the immune system. Walking becomes easier and the voice becomes clearer too.1 year after the last cigaretteThe risk of myocardial infarction is halved this time!The good cholesterol goes up, blood clots normally, inflammation disappears vessels thus reducing clots cause cardiovascular and cerebrovascular accidents.5 years after the last cigaretteThe risk of lung cancer is almost halved. The incidence of cancer of the mouth, throat, esophagus, bladder, and pancreas is also decreasing. And it's never too late to feel the benefits! Including when you have lung cancer detected early. The 5-year survival rate would be 33% among smokers, compared to 70% for those who quit.The risk of myocardial infarction becomes equivalent to that of a non-smoker.10 to 15 years after the last cigaretteLife expectancy becomes the same as that of people who have never smoked. After smoking cessation, many things could have improved without being able to say exactly when it happened. But they are real. The problems of gingivitis, periodontitis, cavities disappear, the risk of macular degeneration decreases, sexual performance is back, fertility is less impaired, early menopause is ruled out, the risks of osteoporosis reduced ...Focus on the benefits of smoking cessationON THE SKINTobacco reduces the production of collagen, destroys elastic fibers, decreases the water naturally present in the layers of the epidermis. And that's not all: it hinders the supply of oxygen and nutrients to skin cells. Weakened, it ages prematurely. By stopping tobacco consumption the cell regeneration process is restarted. It is essential for the skin to regain its radiance, elasticity, and firmness.ON THE LUNGSThe toxic products contained in tobacco attack the cells that line the walls of the organs of the respiratory system . Tar is inhaled at the same time as the smoke, it is deposited in the bronchi and the lungs. The breath is greatly reduced. The carbon monoxide that enters the bloodstream will disrupt oxygenation. Also; smokers are more sensitive to certain diseases, be they infectious (otitis, angina), inflammatory (chronic bronchitis), allergic or cancerous. Quitting smoking quickly has beneficial effects on the lungs. From the third day, the breathing improves. After 3 weeks to 1 month, the bronchial eyelashes grow back, the lungs can clean themselves again overnight. After 5 years, the risk of lung cancer is halved.ON THE HEARTThe heart is the first to suffer from smoking, even if we smoke little. 80% of infarction victims before the age of 45 are smokers. Tobacco promotes the occurrence of artery spasm, the formation of clots and the development of heart rhythm disturbances. It also gradually damages the arteries and the carbon monoxide in cigarettes will take the place of oxygen in the blood, which is necessary for the heart.All of these risks decrease in the short and long term when you quit smoking. As we have seen, from the first 24 hours spent without smoking, the risk of heart attack begins to decrease and after 5 years, it becomes equivalent to that of a non-smoker.

The term heart attack and cardiac arrest are often used interchangeably, but actually differ in meaning.A heart attack is a “circulation” problem and sudden cardiac arrest is an “electrical” problem:A heart attack is when one of the coronary arteries becomes blocked. The heart muscle is robbed of its vital blood supply and, if left untreated, will begin to die because it is not getting enough oxygen.A cardiac arrest is when a person's heart suddenly stops pumping blood around their body and they stop breathing normally.heart attack=blood flow to heart blockedSince the heart muscle needs oxygen to survive, when blood flow is blocked, the muscle begins to die. This is why heart attack sufferers need to be rushed into surgery to resolve the obstruction and restore blood flow.Symptoms may start slowly and persist for hours, days, or weeks before the heart attack. The heart continues to beat, but because of the blockage, it is not receiving all the oxygen-rich blood it requires.cardiac arrest=heart ‘electrical system’ malfunctions and stops pumping blood.In cardiac arrest, the heart stops beating and needs to be restarted.Most heart attacks do not lead to cardiac arrest. However, when cardiac arrest happens, a heart attack is a common cause.In many cases, cardiac arrest is a temporary condition experienced during a medical emergency. It is not necessarily preceded by heart disease, but many patients experience warning symptoms up to a month before cardiac arrest.Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis)— a condition called coronary artery disease.(1) Coronary artery disease is the most common cause of sudden cardiac death, accounting for up to 80% of all cases.Interesting: The International network of cholesterol skepticsThe current literature does not support the notion that dietary cholesterol increases the risk of heart disease in a healthy individuals. However, there is an ample evidence that saturated fatty acids and trans-fats increase cardiovascular disease risk. The fact that dietary cholesterol is common in foods that are high in saturated fatty acids might have contributed to the hypothesis that dietary cholesterol is atherogenic. In contrast, eggs are affordable, rich in protein and micronutrients, nutrient-dense and low in saturated fatty acids. [1] [2](2) Cardiomyopathies and genetic channelopathies account for the remaining causes.Cardiomyopathy is a disease of the heart muscle which affects its size, shape and structure.Cardiomyopathy is usually inherited which means it can run in families. Some members of a family may be affected more than others and some family members may not be affected or have any symptoms.Channelopathies are diseases caused by disturbed function of ion channel subunits or the proteins that regulate them.Channelopathies may be either congenital (often resulting from a mutation or mutations in the encoding genes) or acquired (often resulting from autoimmune attack on an ion channel).The most common causes of non-ischemic sudden cardiac death are cardiomyopathy related to obesity, alcoholism, viral infection and fibrosis.The third term, heart failure, often describes a chronic condition:Heart failure occurs when the heart muscle fails to pump as much blood as the body needs. It is usually a long-term, chronic condition, but it may come on suddenly.In people with heart failure, the heart doesn’t pump normally, causing the hormone and nervous systems to compensate for the lack of blood. The body may raise blood pressure, making the heart beat faster and causing it to hold on to salt and water. If this retained fluid builds up, the condition is called congestive heart failure.In the early stages of congestive heart failure, there may be no symptoms. When symptoms do develop, they may include weight gain, nausea, and others not normally associated with the heart. Difference Between Heart Attack, Failure & ArrestHeart failure is often the result of a number of problems affecting the heart at the same time.Heart attacks can present differently in different populations (contested):Older adults and people with diabetes may have no or very mild symptoms of a heart attack, so it's especially important not to dismiss heart attack symptoms in people with diabetes and older adults even if they don't seem serious.Heart disease in men is more often due to blockages in their coronary arteries (CAD).Women more frequently develop heart disease within the very small arteries that branch out from the coronary arteries. This is referred to as microvascular disease (MVD) and occurs particularly in younger women.Women may be at risk for coronary MVD if they have lower than normal estrogen levels at any point in their adult lives. [3]It was thought that the failure to diagnose heart attacks in women may have something to do with atypical presentation, however a recent study disputes that:The British Heart Foundation-funded research puts into question a long-held medical myth that women tend to suffer unusual or 'atypical' heart attack symptoms, and emphasises the need for both sexes to recognise and act on the warning signs.Women experience the same key symptoms as men, however they are less likely to be diagnosed correctly and in time:More women had pain that radiated to their jaw or back and women were also more likely to experience nausea in addition to chest pain (33 per cent vs 19 per cent).Less typical symptoms, such as epigastric pain (heartburn), back pain, or pain that was burning, stabbing or similar to that of indigestion, were more common in men than women (41 per cent in men vs 23 per cent in women)."Our concern is that by incorrectly labelling women as having atypical symptoms, we may be encouraging doctors and nurses not to investigate or start treatment for coronary heart disease in women."Both men and women present with an array of symptoms, but our study shows that so-called typical symptoms in women should always be seen as a red flag for a potential heart attack."Women more likely to have 'typical' heart attack symptoms than menScary: Heart attacks are becoming more common in younger people, especially women.People with depression have an increased likelihood of developing heart disease, and vice versa: If you have heart disease, you’re at risk of becoming depressed.The link is strong enough that anyone with depression should be screened for heart disease, and heart patients should be evaluated for depression.Treating one disease can reduce the risk of the other.Study: Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia: a cross-sectional studyA complex interaction exists between the nervous and cardiovascular systems. A large network of cortical and subcortical brain regions control cardiovascular function via the sympathetic and parasympathetic outflow. A dysfunction in one system may lead to changes in the function of the other....Cardiac changes after TBI are probably less common but similar to the site-specific damage caused by brain injuries described above, including electrographic changes (QT prolongation and T wave inversion) and SIC (stress-induced cardiomyopathy), especially when the areas involved in regulation of the cardiovascular function are affected....Apneic episodes during sleep are associated with transient hypertension and tachycardia. In obstructive sleep apnea syndrome, repeated apnea attacks driven by higher cortical and brain stem areas is associated with long-lasting sympathetic hyperactivity, which in turn increases risk of cardiovascular diseases and mortality.https://www.ahajournals.org/doi/full/10.1161/circresaha.116.308446Frequent cerebral complications of cardiac disease include embolic stroke, syncope, and intracerebral bleeding. Rare complications are watershed infarction, brain abscess, meningitis, metastasis, dementia, or aneurysm formation. The most frequent and most well-known cardiac cause of neurological complications is cardiac embolism.Neurological complications of cardiac disease (heart brain disorders).Many things can feel like a heart attack, including:Pericarditis: inflammation of the pericardium, two thin layers of a sac-like tissue that surround the heart, hold it in place and help it work. A small amount of fluid keeps the layers separate so that there's no friction between them. The cause of pericarditis is not always known (idiopathic)— It can be caused by:a virus or bacterial infectionanother inflammatory condition (such as rheumatoid arthritis)inflammation of the myocardium (the heart muscle) rubbing against the pericardium. This can happen after a heart attack or heart surgery.However, the cause is thought to be most often due to a viral infection.. Pericarditis is usually acute—it develops suddenly and may last up to several months. [4]Heart Burn:is a burning pain in your chest, just behind your breastbone. The pain is often worse after eating, in the evening, or when lying down or bending over.is a symptom of GERD (gastroesophageal reflux disease), and is caused by acid refluxing back into the esophagus.Risk factors include those that increase the production of acid in the stomach, as well as structural problems that allow acid reflux into the esophagus.Anxiety Attack:People who suffer from panic attacks often say their acute anxiety feels like a heart attack, as many of the symptoms can seem the same.Both conditions can be accompanied by shortness of breath, tightness in the chest, sweating, a pounding heartbeat, dizziness, and even physical weakness or temporary paralysis.The chest pain from an anxiety attack is sharper and more localised, while the pain from a heart attack is duller and radiates more.Most panic attacks don’t last very long—about 10 minutes or fewer—and they often come out of the blue.Texidor's Twinge or Precordial Catch Syndrome (PCS):is a condition in which sharp, severe left-sided chest pain occurs and is likely musculoskeletal in origin.The pain can be stunning. But it typically leaves as quickly as it comes — with no explanation.The pain frequently occurs in children, however can occur in adults as well. The pain is worse with respiration and is only brief in duration (seconds).Takotsubo syndrome.Somewhat romantic—Takotsubo syndrome::Under exceptional circumstances, emotional stress, such as bereavement, relationship-, or job-loss, can lead to cardiomyopathy.The increased risk of cardiac arrest [during bereavement] can last up to 6 months. It is highest in the first days following bereavement and remains at four times the risk between 7 days to 1 month after the loss,” —Dr. Geoffrey Tofler, a professor of preventive cardiology.Though, cardiac arrest triggered by stress normally only happen in people with underlying heart disease.It turns out, that experiencing extreme happiness, can also trigger life-threatening heart abnormality with symptoms similar to a heart attack.Positive events can include birthday parties, weddings, reunions, sporting triumphs and jackpot wins.The condition can also be triggered by a serious physical illness or surgery.Most people’s hearts recover naturally within a few months, but three to five per cent of people die, the same death rate as for conventional heart attacks.Alex Lyon, who runs a clinic at the Royal Brompton Hospital in London offering a specialist service for takotsubo cases, says that the most likely cause of the condition is a massive surge of adrenaline into the heart following a physical or emotional shock.“It could be anything that suddenly sends adrenaline through the roof,”..Adrenaline may also explain why 90% of the cases they looked at affected post-menopausal women. Oestrogen dampens down the effects of adrenaline in younger women but this protective effect is lost when oestrogen production shuts down in the menopause.‘Broken Heart Syndrome’— (Takotsubo Cardiomyopathy): It occurs when there is a sudden ballooning of the base of the left ventricle, the chamber in the heart from which blood is pumped round the body. As the ventricle distorts – assuming the shape of the “takotsubo” pot used to catch octopuses in Japan – it becomes partially paralysed. This produces the sort of pain and breathlessness normally associated with heart attacks, triggered by blocked arteries. Read more: Shock of good news can hurt your heart as much as griefHopeful: Research suggests that combo of beta-blockers and aspirin may protect the heart during bereavement. [5]The Heart and Connective Tissue Disease (Including Marfan Syndrome, Loeys-Dietz Syndrome and the Ehlers Danlos Syndromes).Connective tissues are tissues throughout the body that support and bind cells together. Containing proteins such as collagen and elastin, connective tissues can be injured or inflamed as a result of inherited diseases, autoimmune diseases, and environmental exposure.Connective tissue disorders as is located through the entire body, and so can affect many parts of the body including the bones, eyes, skin, nervous system, and lungs.Importantly, connective tissues significantly affect the aorta because the aorta is exposed to high shear stress, or pressure from the constant flow of blood.So connective tissue disorders can be associated with heat problem— where the weakening of the aorta increases the risk of aortic aneurysm and dissection.However, recent research suggests that heart problems (dilated aorta), may not be a feature of hypermobility-type Ehlers-Danlos, which is in clear contradiction with the 2017 guidelines for diagnosing hEDS. Moreover, the study found that “All four vascular EDS patients analyzed had normal echocardiograms, but seven out of the 16 people with classic EDS showed dilation of the aorta.”Besides a diagnosis of classical EDS, researchers found that other predictors of abnormal heart scans included a family history of aneurysm, and an abnormal cardiac examination. Patients whose primary symptom was pain were less likely to have an abnormal heart scan than those without pain. [6]For more: Connective Tissue Disease (Including Marfan Syndrome)Interesting: “This pattern of cardiovascular defects appears to be expressed along a spectrum of severity in many heritable connective tissue disorders and raises suspicion of a relationship between the normal development of connective tissues and the cardiovascular system.” [7]Autoimmune disorders can also affect the heart.Autoimmune heart diseases are the effects of the body's own immune defence system mistaking cardiac antigens as foreign and attacking them leading to inflammation of the heart as a whole, or in parts. The commonest form of autoimmune heart disease is rheumatic heart disease or rheumatic fever.However, autoimmune diseases such as psoriasis, lupus and rheumatoid arthritis more than double the risk of cardiovascular disease— even though none of these conditions seem to target the cardiovascular system directly.Autoimmune diseases are thought to increase the risk of cardiovascular disease through chronic inflammation and accelerated atherosclerosis.A new study using mice shows that immune cells that arise during autoimmune disease cause cholesterol to become trapped inside blood vessels.Read: Link between autoimmune, heart disease explained in mice: Immune cells cause cholesterol to be trapped in blood vesselsCardiac Valve Involvement in Systemic Diseases: A Review: https://onlinelibrary.wiley.com/doi/pdf/10.1002/clc.22099Non-Ischemic cardiomyopathy is a generic term which includes all causes of decreased heart function, other than those caused by heart attacks or blockages in the arteries of the heart.Cardiomyopathy is a disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy is a major cause of heart failure and one of the most common conditions leading to heart transplantation. The condition can also cause abnormal heart rhythms.Cardiomyopathy can affect people of all ages and races.The main types of (non-ischemic) cardiomyopathy include Dilated-, Hypertrophic-, Restrictive- cardiomyopathy and Arrhythmogenic Right Ventricular Dysplasia.Hypertrophic cardiomyopathy is a condition in which a portion of the heart becomes thickened without an obvious cause. This results in the heart being less able to pump blood effectively.In most cases, hypertrophic cardiomyopathy will not have an impact on daily life. Some people do not have any symptoms and do not need treatment.But that does not mean the condition cannot be serious— Hypertrophic cardiomyopathy is the most common cause of sudden unexpected death in childhood and in young athletes.The long-term outcome for people with HCM is generally excellent, especially in those diagnosed later in life. With the contemporary cardiovascular treatments available for HCM patients today, mortality due to the disease is very low. Indeed, the vast majority of patients with HCM have normal life expectancy without incurring any significant limiting symptoms or adverse disease complications.However, a small number of patients with HCM are at risk for adverse disease-related events, including heart failure and sudden death. —UpToDateMore: Most Americans with hypertrophic cardiomyopathy (HCM) live normal life spans, guideline findsThe majority of young persons who suffer a sudden cardiac death (SCD) due to hypertrophic cardiomyopathy (HCM) demonstrate cardiac symptoms prior to death.The majority of symptomatic young persons who suffer a SCD due to HCM seek medical attention because of cardiac symptoms experienced prior to death.The majority of SCDs caused by HCM occur in relation to mild exertion or sedentary activities.Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy: a nationwide study among the young in DenmarkInfected HeartEndocarditis is an infection of the endocardium, which is the inner lining of your heart chambers and heart valves. Myocarditis is the inflammation of the heart muscle and pericarditis is the inflammation of the lining outside the heart.In all three cases, the body's immune system is causing inflammation either to try to get rid of the infection or in response to some other trigger.It generally occurs when bacteria, fungi or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.Gum disease (periodontitis) is associated with an increased risk of developing heart disease. Poor dental health increases the risk of a bacterial infection in the blood stream, which can affect the heart valves. Oral health may be particularly important if you have artificial heart valves.Lyme carditis occurs when Lyme disease bacteria enter the tissues of the heart. This can interfere with the normal movement of electrical signals from the heart’s upper to lower chambers, a process that coordinates the beating of the heart. The result is something physicians call “heart block,” which can vary in degree and change rapidly. Lyme carditis occurs in approximately one out of every hundred Lyme disease cases reported to CDC.Primary bacterial infection of myocardial tissue without associated endocarditis occurs only rarely. It is generally seen in the setting of overwhelming bacteremia. The most common bacterial cause of myocarditis is Staphylococcus aureus and usually occurs in the setting of bacteraemia and sepsis, although infections with a broad range of bacterial pathogens have been described. https://www.bioscience.org/2003/v8/s/1021/fulltext.htmMRSA-associated bacterial myocarditis causing ruptured ventricle and tamponade.Significance of psychosocial factors in cardiology: update 2018For coronary heart disease, chronic heart failure, arterial hypertension, and some arrhythmias, there is robust evidence supporting the relevance of psychosocial factors, pointing to a need for considering them in cardiological care. However, there are still shortcomings in implementing psychosocial treatment, and prognostic effects of psychotherapy and psychotropic drugs remain uncertain. There is a need for enhanced provider education and more treatment trials.Footnotes[1] Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease[2] Seven Countries Study[3] Coronary Microvascular Disease (MVD)[4] Pericarditis: Symptoms, Treatment, Causes, Diagnosis, and More[5] Beta-blockers and aspirin may protect the heart during bereavement[6] Routine Heart Tests Not Needed for Hypermobile EDS Patients Unless...[7] Connective Tissue Disorders and Cardiovascular Complications: The indomitable role of Transforming Growth Factor-beta signaling

Tobacco forms and typesTobacco use is responsible for nearly one in five deaths in the United States.”“For each 1,000 tons of tobacco produced, about 1,000 people eventually will die. Lifelong smokers on average have a 50 percent chance of dying from tobacco-related illnesses, with half of these dying before the age of 70.”The single greatest risk factor for oral cancer is tobacco. Oral cancer cases are seen in patients who do not use tobacco, (see the HPV connection link on the home page navigation bar) and there are also people who develop the disease with no known risk factors. The numbers as a percentage of these is are very small. Tobacco, in spite of these other causes and unknowns still is the largest contributor to the development of oral cancers. All forms of tobacco have been implicated as causative agents including cigarette, cigar and pipe tobacco, as well as chewing tobacco. It is important to differentiate between conventional loose leaf (traditional) forms of smokeless tobaccos and the newer types such as snus, as evidence from outside the US suggests that there is a significant difference in risk. But it must be remembered that these products are currently a very small part of the US smokeless tobacco sales number, and the US products that mimic the Swedish snus products are NOT the same product, and the data cannot be transferred from one to the other interchangeably. Studies need to be done on US products to see if they actually have reduced risk. In India and Sri Lanka, where chewing tobacco is used with betel nuts and reverse smoking is practiced (placing the lit end in the mouth), there is a striking incidence of oral cancer – these cases account for as many as 50 percent of all cancers. (WHO)Tobacco can damage cells in the lining of the oral cavity and oropharynx, causing cells to grow more rapidly to repair the damage. Researchers believe that DNA-damaging chemicals in tobacco are linked to the increased risk of oral cancer, according to the American Cancer Society.Cigarettes“Each year, smoking kills more people than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires – combined!”“Cigarette smokers die younger than nonsmokers. In fact, smoking decreases a person’s life expectancy by 10-12 years. Smokers between the ages of 35 and 70 have death rates three times higher than those who have never smoked.”“…while the odds for those trying crack or alcohol and becoming addicts are 1 in 6 and 1 in 10 respectively, they’re 9 in 10 for cigarette smokers,” reports the chief of clinical pharmacology, National Institute on Drug Abuse.“Smoking is the single most preventable cause of death in our society.”“More than 47 million adults in the United States smoke cigarettes despite the fact that this single behavior will result in the death or disability of half all its regular users.”“Cigarette smoking is responsible for more than 430,000 deaths in the United States each year, or one in every five deaths.”Cigarette smoking causes several lung diseases that can be just as dangerous as lung cancer. Chronic bronchitis, a disease in which the airways produce excess mucus, forcing the smoker to cough frequently, is a common ailment for smokers. Cigarette smoking is also the major cause of emphysema, a disease that slowly destroys a person’s ability to breathe. Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, kills about 81,000 people each year; cigarette smoking is responsible for more than 65,000 of these deaths.Smoking cigarettes also increases the risk of heart disease, which is America’s number one killer. Almost 180,000 Americans die each year from cardiovascular disease caused by smoking. Smoking, high blood pressure, high blood cholesterol and lack of exercise are all risk factors for heart disease, but smoking alone doubles the risk of heart disease. Among those who have previously had a heart attack, smokers are more likely than non-smokers to have another.In addition to being responsible for 87 percent of lung cancers, smoking is also associated with cancers of the mouth, pharynx, larynx, esophagus, pancreas, uterine cervix, kidney and bladder. Other popular forms of smoking include bidis (tobacco wrapped in a temburni leaf) and kreteks (commonly referred to as cloves), both equally as dangerous as tobacco alone.Cigars and pipes“It is not unusual for some premium cigars to contain the tobacco equivalent of an entire pack of cigarettes.”“Cigars are a major source of secondhand smoke which contains over 4,000 chemicals – 200 are poisons, 63 of which cause cancer.”It is a common misconception that smokers, particularly those who smoke pipes or cigars without inhaling, are excluded from physical harm or danger. In fact, anytime smoke touches living cells, it harms them. Even if cigarette, pipe or cigar smokers never inhale, they are at an increased risk for lip, mouth, tongue, throat and larynx cancers. Because it is virtually impossible to avoid inhaling any trace of smoke, these smokers are also increasing their risk of getting lung and esophageal cancer.There are, however, some differences between cigar and cigarette smoke due to the different ways cigars and cigarettes are made. Cigars go through a long aging and fermentation process. During the fermentation process, high concentrations of carcinogenic compounds are produced. These compounds are released when a cigar is smoked. Also, cigar wrappers are less porous than cigarette wrappers. The nonporous cigar wrapper makes the burning of cigar tobacco less complete than cigarette tobacco. As a result, compared with cigarette smoke, the concentrations of toxins and irritants are higher in cigar smoke. In addition, the larger size of most cigars (more tobacco), and longer smoking time, produce higher exposures to nonsmokers of many toxic compounds (including carbon monoxide, hydrocarbons, ammonia, cadmium and other substances) than a cigarette.Like cigarette smoking, the risks from cigar smoking increase with enhanced exposure. For example, compared with someone who has never smoked, smoking only one to two cigars per day doubles the risk for oral and esophageal cancers. Smoking three to four cigars daily can increase the risk of oral cancers to more than eight times the risk for a nonsmoker, while the chance of esophageal cancer is increased to four times the risk for someone who has never smoked. Both cigar and cigarette smokers have similar levels of risk for oral, throat and esophageal cancers.Although cigar smoking occurs primarily among males between the ages of 35 and 64 who have higher educational backgrounds and incomes, recent studies suggest new trends. Most new cigar users today are teenagers and young adult males (ages 18-24) who smoke occasionally (less than daily). According to two large statewide studies conducted among California adults in 1990 and 1996, cigar use has increased nearly five times among women and appears to be increasing among adolescent females as well. Furthermore, a number of studies have reported high rates of use among not only teens, but also preteens. Cigar use among older males (age 65 and older), however, has continued to decline since 1992.Celebrities have recently publicized cigar smoking, and multiple nightclubs and restaurants are promoting new cigar smoking sections. The introduction of “cigar bars” and the sub-culture of cigar paraphernalia such as humidors and clippers have combined to create a glamorous aura around a deadly product. Total cigar consumption declined by about 66 percent from 1973 until 1993. Cigar use has increased more than 50 percent since 1993. The increase in cigar use in the early 1990’s coincided with an increase in promotional media activities for cigars. Many new cigar aficionados may not be aware that smoke from cigars contains the same deadly carcinogens as those from cigarettes. Congress did not explicitly include cigars in the 1984 law requiring health warnings on cigarettes, so cigar packages bear no warning from the US Surgeon General. Overall cancer deaths among men who smoke cigars are 34 percent higher than nonsmokers. Studies also indicate that cigar smokers have 4-10 times the risk of nonsmokers of dying from laryngeal, oral, or esophageal cancers. According to the U.S. Department of Agriculture Economic Research Service, cigar consumption hit an estimated 3.7 billion in 1999.Smokeless tobaccoDid you know that the average age of first-time users of smokeless tobacco is 10 years old? Or that female youth are turning to smokeless tobacco as a means to lose or control weight?Statistics & Facts on Smokeless Tobacco*Journal of Nicotine and Tobacco Research, November of 2008. Surveillance of Moist Snuff, Nicotine and Tobacco Nitrosamines. By Richter, Hodge, Stanfill, Zhang, Watson. A detailed analysis of smokeless tobacco contents.http://oralcancerfoundation.org/wp-content/uploads/2016/09/Smokeless-Richter-et-al.pdf*Smokeless tobacco is a known carcinogen (U.S. Dept. of Health & Human Services, Report on Carcinogens, December 2002)*Approximately 31,000 new cases of oral cancer will be diagnosed in the U.S. in 2006; nearly two-thirds are male. Estimated deaths from oral cancer in 2004 are at 4,830 men and 2,400 women. (American Cancer Society Cancer Facts & Figures 2004)*Long term snuff users may be 50 percent more at risk for cancer of the cheek and gums. (American Cancer Society) Please note that snuff use in the US is low compared to other smokeless products. (OCF)*Smokeless tobacco is also believed to contribute to cardiovascular disease and high blood pressure because the nicotine gets into the bloodstream through the lining of the mouth and/or the gastrointestinal tract. Nicotine will cause the heart to beat faster and blood pressure to rise. (American Cancer Society)*Smokeless tobacco users increase their risk of cancers of the oral cavity, throat, larynx and esophagus when compared to people who do not use tobacco products. (American Cancer Society / OCF)*Nearly 600,000 females over age 12 in the U.S. use smokeless tobacco (National Institute of Drug Abuse – an agency of the National Institutes of Health, March 2001)*Leukoplakia, oral lesions that appear as white patches on the cheeks, gums or tongue, are commonly found present in smokeless tobacco users. Leukoplakia can be a pre-cancerous lesion which may convert to oral cancer. About 75 percent of daily users of smokeless tobacco will get leukoplakia. (American Cancer Society)*Dipping 8 to 10 times a day can bring as much nicotine into the body as smoking 30-40 cigarettes (Spit Tobacco: Does Smokeless Mean Harmless, 2001 Mayo Clinic report)*Smokeless tobacco users absorb two to three times the amount of addictive nicotine as those who smoke cigarettes. (National Cancer Institute) Note: While not considered the primary cause of tobacco related malignancy, nicotine is responsible for the addiction of people to tobacco products, and the following long term use.*”I cannot conclude that the use of any tobacco product is a safer alternative to smoking. This message is especially important to communicate to young people, who may perceive smokeless tobacco as a safe form of tobacco use.” (U.S. Surgeon General Richard H. Carmona, MD, June 2003 testimony) While OCF agrees with this statement, especially in relationship to young individuals, there may be some harm reduction benefit when traditional loose leaf chewing tobacco is compared snus style products, and certainly when compared to with smoking tobacco where combustion of the tobacco is present. This does not mean that we endorse the use of smokeless products, as their contribution to disease processes outside the known realm of oral cancer is not completely understood. (OCF)*46.4 percent of current tobacco users who are in Ohio middle school live in a household where someone else uses smokeless tobacco. (2002 Ohio Youth Tobacco Survey, Ohio Department of Health)*Chewing tobacco contains 28 carcinogens, including tobacco-specific nitrosamines. Other cancer-causing substances include formaldehyde, acetaldehyde, crotonaldeyde, hydrazine, arsenic, nickel, cadmium, benzopyrene and polonium (which gives off radiation). (National Cancer Institute) While some of these occur in trace amounts, published studies do not exist to prove these amounts harmless, or which address long term exposure and accumulative effect. (OCF)Tips to Reduce the Prevalence and Use of Smokeless Tobacco Among Youth and Teens*Support organizations that oppose advertising and glorification of tobacco and tobacco products.*Support warning labels on all such products.*Support your dentist’s and doctor’s anti-tobacco messages and efforts.*Support – through local and state legislators – the Tobacco Use Prevention and Cessation Trust Fund, specifically for a portion of its use to further research and education about the potential dangers of smokeless tobacco and other tobacco products.*Encourage youth to focus on strong role models, including athletes, who endorse a no-use policy of smokeless tobacco.*Stress how much money can be saved by not using tobacco products.*School and community-based anti-use programs have proven successful in lowered incidence and prevalence and higher influence to not use on teens, according to the CDC.*Restrict access to minors; create and implement tighter restrictions and penalties. Support those business that refuse to sell to minors.*Parents, coaches and others with influence need to learn about the perils of smokeless tobacco, and speak informatively to youth. Parents, coaches and others with influence who smoke or use smokeless tobacco will set the best example for youth by quitting. Emphasis should be on not starting tobacco use.*Talk with youth about ways to refuse without feeling peer pressure.*Explain that the glamorization of tobacco products is a false image.*Ensure that youth activities, whether in-home or in another setting, are tobacco, drug, and alcohol free.*Encourage your school district to adopt a no-use, no-tolerance policy against tobacco, alcohol and drugs. Then support that policy, and insist that coaches and teachers adhere to such policies, even when the star athlete is involved.“People who consume 8 to 10 dips or chews per day receive the same amount of nicotine as a heavy smoker who smokes 30 to 40 cigarettes a day.”“Many athletes, especially baseball players, use smokeless tobacco. A study conducted from 1988-1990 found that 37.5 percent were smokeless tobacco users. Most preferred moist snuff.”“According to the 1997 National Household Survey on Drug Abuse, 92 percent of smokeless tobacco users are male.”“Smokeless “spit” tobacco contains over 2,000 chemicals, many of which have been directly related to causing cancer.” While some occur in trace amounts, which might indicate reduced risk, conclusive data on their safety DOES NOT exist.There are two types of smokeless tobacco – snuff and chewing tobacco. Snuff, a finely ground tobacco, is packaged as dry, moist, or in sachets (tea bag-like pouches). Typically, the user places a pinch or dip between the cheek and gum. Sniffing (inhaling) dry snuff through the nose is more common in European countries than in the United States. Chewing tobacco is available in loose leaf, plug, or twist forms, with the user putting a wad of tobacco inside the cheek. Smokeless tobacco is sometimes called “spit” or “spitting” tobacco because people spit out the tobacco juices and saliva that build up in the mouth. Snus is separated from other smokeless forms as it does not produce the need to spit.Chewing tobacco and snuff contain 28 carcinogens (cancer causing agents). The most harmful carcinogens in smokeless tobacco are the tobacco specific nitrosamines (TSNA’s). Snuff dippers consume on average more than 10 times the amount of cancer causing substances (nitrosamines) than cigarette smokers. They are formed during the curing, fermenting and aging of tobacco. TSNA’s have been detected in smokeless tobacco at levels 100 times higher than the levels of other nitrosamines that are allowed in bacon, beer and other foods. Other cancer causing substances in smokeless tobacco include formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium (a radioactive element from the soil it is grown in). Some may argue that many of these are in spit tobacco in very small volumes, and that volume of exposure dictates risk. However, we have no significant research on what the effects of even the smallest amounts of some of these are when a person is exposed to them over decades of intimate exposure/use.Another element found in smokeless tobacco is nicotine. Nicotine is absorbed by smokeless tobacco users at a rate 2 to 3 times higher than that of cigarette smokers, facilitating rapid addiction. Also, the nicotine stays in the bloodstream for a longer time. It has been reported that some chewing tobacco products actually contain microscopic abrasives which speed the absorption of nicotine, and carcinogens into the cell membranes. This is denied by tobacco manufacturers. In OCF’s opinion, a group which has proven their willingness to lie under oath (none admitted that they knew nicotine was addictive contrary to their internal company memos) cannot be trusted as a source of information. NO peer reviewed published study addresses this question with any conclusion. In this same light, more recently tobacco research dollars were spent to convince the public that “light” cigarettes were a safer alternative to conventional cigarettes. This has subsequently been proven to be notthe case, and recent scientific revelations to the contrary have forced them to suspend such claims. The history of the big tobacco companies has been one of deception, and misdirection. An August 2006 U.S. District Court ruling declared that cigarette companies knowingly misled consumers with claims that low-tar and “natural” cigarettes were less harmful than other cigarettes. These so-called “harm-reducing” cigarettes marketed between 1998 and 2004 delivered more nicotine than their predecessors, upping the delivery of smoking’s addiction factor in each cigarette by an average of 10 percent. People should be very skeptical about the tobacco industry’s newest claims about smokeless tobacco given their history of deception and lies.Smokeless tobacco is not a completely safe substitute for cigarettes. There are those who argue that IF it replaced smoking tobacco use in the US, we would see a reduction in tobacco (smoking) related death rates, and they are correct; if all smokers used spit tobacco it would reduce the number of lung cancers, and perhaps heart disease significantly. We agree that this is a likely scenario. But we do not think that given other nicotine replacement strategies, (nicotine containing gums, patches, lozenges, nicotine nasal sprays, nicotine inhalers, lotions, and among a variety of herbal nicotine containing chews, even a black tea based chewing tobacco now available on the market (Blue Whale), which appears to contain no known carcinogens, but only the nicotine found in existing spit tobaccos), that their argument is justification for endorsing smokeless tobacco use. These alternatives run from OTC low nicotine level products to Rx strength products.It seems those advocating for “harm reduction” are only interested in tobacco being the delivery vehicle for the nicotine. If they are so interested in public good, what difference does it make to them the mechanism of delivery? It seems that the funders of their interest in smokeless as the method of choice are …of course are smokeless tobacco companies. A coincidence? We find their passion for this perspective suspect because of the significant tobacco dollars that have been behind their direction, their research work, and their chairs in harm reduction. Arguments that they have had other funding will only be met with skepticism until revelation of all funding sources in specific terms is made evident. So for the record OCF is in favor of nicotine replacement therapy. We just do not believe that tobacco is the ideal vehicle for delivering it to the patient / consumer.There are also prescription medications to help people quit the use of tobacco. The most common of these is Zyban (bupropion hydrochloride) which will dramatically reduce withdrawal symptoms when trying to quit. OCF prefers non tobacco nicotine replacement therapies, with the eventual goal of a release from the addiction completely, not the continued long term addiction to an alternate product, even a non tobacco one. Other nicotine replacement strategies, such as inhalers, nasal sprays, etc. would allow an individual to wean themselves from the addiction, without introducing additional risks for other ailments. Spit tobacco, besides its ties to oral cancer, is also tied to other serious cancers such as pancreatic cancer, and there is still much we do not know about all the possible negative biological implications of its use over long terms.The TRUTH which the harm reduction advocates do not speak to, is that there is more that we do not know about the long term negative effects than what we do. Research done in Sweden (decades in depth) for instance which is widely quoted by them is on a product which is not identical to products made in the US. The research dollars which exposed the extensive harm from smoking tobacco and brought down any belief that smoking was harmless, were not directed towards research of smokeless spit tobacco products. As a result, they frequently will talk about how little scientific evidence there is to argue against spit tobacco as a harm reduction strategy from an evidence based perspective. But remember if you find that argument attractive, that the research dollars are only now being spent to explore the negative biological implications of spit tobacco use. The lack of numerous published studies at the current time, indicates that the are NO long term US STUDIES, it does not indicate that the product is safe. In our opinion beginning the use of smokeless tobaccos is a step in the wrong direction, and their use as a harm reduction strategy is misguided when other options exist.Having taken a position of endorsing nicotine replacement for those who cannot quit but wish to reduce their risk of harm, OCF also acknowledges that there is conflicting information about the long term use of nicotine and its effects on the body. It is likely not as benign as caffeine as some insinuate, but until more data is available we find this to be the lesser of evils when it comes to the bigger picture of harm reduction. Bottom line, OCF cannot endorse a policy of adding to the cases of other cancers, including very deadly pancreatic cancers, but as a contributor to other serious ailments, even if there s a greater good (harm reduction in tobacco smokers) to be served if it means additional mortality and morbidity sacrifices via new cancer patients of a different type, or other disease states. If we are willing to advocate a different tobacco poison only on the basis that it will help one group, but hurt another to a lesser extent, then there is a moral, not a science question here which needs to be addressed.Studies indicate that the use of conventional snuff and chewing tobacco is associated with an increased risk for oral cancer. Our Patient to Survivor message board has plenty of real life people that can speak to their addictions and their development of oral cancers, for those who doubt. It is particularly alarming that an increasing number if young people are using such products. The marketing strategies of the tobacco companies to sell these products with fruity flavors that are particularly attractant to our youth is particularly deplorable. Smokeless tobacco users increase their risks of cancers of the oral cavity, pharynx (throat), larynx, and esophagus. Oral cancer can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth, as well as the tonsils and oropharynx (back of the throat) and it kills readily via metastasis out of the oral environment to vital organs of the body. People who use snuff have a much greater risk for cancer of the cheek and gum than people who do not use tobacco.While some advocates for smokeless state that the tobacco companies are not aggressively marketing their products to our youth, they mistakenly think that the viral spread of tobacco marketing on the web, is going unnoticed. This effort is in many respects under the radar to adults who spend less time in the social networking world of the web, and are less conversant in how this cyber world functions. It is s medium without regulation, and ideas spread rapidly, whether on personal blog sites or front sites for tobacco advocates.Some of the other effects of smokeless tobacco include addiction to nicotine, oral leukoplakia (white mouth lesions that can become cancerous), gum disease (periodontal disease), gum recession (when the gum pulls away, or recedes from the teeth), loss of bone in the jaw, tooth decay (a result of sugar additives to enhance the flavor of smokeless tobacco), tooth loss, tooth abrasion (worn spots on the teeth), yellowing of the teeth, chronic bad breath, unhealthy eating habits (smokeless tobacco lessens a person’s sense of taste and ability to smell, so users tend to eat saltier and sweeter foods which are both harmful in excess), high blood pressure (spit tobacco contains high concentrations of salt), and increased risk for cardiovascular (heart) disease and heart attacks.Remember that this is a a product which has been historically UNREGULATED and no one in the tobacco industry has to release any information about what it contains, what they know about its effects, or harms that it may cause. This is an industry that has a history of lying to the American public about their products that goes back for decades. OCF feels that any data supported by tobacco dollars, even if through university grants, is suspect and should be confirmed by independent sources. In the long run we believe that tobacco products should be regulated as any other addiction producing product in our marketplace.Also note that the tobacco industry stays away from making claims about the safety of spit tobacco products, relying instead on paying or providing lucrative grants to 3rd party investigators, medical professionals, and others to publish materials supporting their desired strategic claims. In our opinion these individuals are nothing more than shills for the industry. This situation exists because the smokeless tobacco makers face a difficult balance in marketing the products. If they tout them as being safer, they face scrutiny from the Federal Trade Commission and state attorneys general, and would have to prove their claims based on clinical trials they now are not required to conduct. These trials would last many years and the likely outcome from them would be disastrous to the tobacco industry as independent documentation of harm would be there for all to see. Not able to talk about harm reduction themselves, to implement their “marketing strategies,” it makes sense to pay these professionals, who have documented financial benefit in their medical positions, to be the facilitators of the tobacco agenda. Follow the money yourself. Then decide if you find these medical authorities credible or not. But there is no question that the companies benefit from these third parties creating the dialog in public. The smokeless manufacturers certainly cannot make it themselves. It is a very smart strategy to pay for chairs in harm reduction, and research that finds that everyone changing to smokeless would be of benefit. They know that this scenario is not going to take place in the real world. Smokers will continue to smoke, and use smokeless in environments where smoking is banned. But everyone switching to smokeless tobacco…. no one really believes the smoking population will ever embrace that.Spit tobacco causes oral cancer by the following process: as tissue cells in these areas divide in an attempt to form a barrier against the tobacco, they are exposed to carcinogenic agents and can become cancerous. Pinpointing how long a spit tobacco user can chew or dip before getting oral cancer is difficult to do since it is impossible to predict when and if cells will become cancerous. Consequently, spit tobacco users risk beginning the process to develop oral cancer every time they use. Spit tobacco can also cause other types of cancers. Exposure to tobacco juice which is not intentionally swallowed may induce cancers of the esophagus, larynx, stomach, pancreas and prostate. Clearly the investigation of all the possible mechanisms of harm, particularly in areas remote from the site of use, are not fully explored as of now, and making the ASSUMPTION based on today’s data that spit tobacco is safe, would be foolish.The “new” smokeless tobacco productsThe smokeless tobacco companies are increasingly moving their marketing and advertising dollars to the new “tea bag” type of smokeless commonly known as snus. There are also a variety of dissolvable tobacco products on the market that resemble breath strips, and others that appear like candy Tic Tac’s. Of these last two, we know very little about their health consequences as you are ingesting the tobacco product completely. Long-term studies on their safety do not exist, but because of the lack of regulation they are already being sold in the marketplace. These are very different products than conventional loose leaf spit tobaccos that we have been discussing. OCF is still against snus for a variety of reasons and the jury is out on the safety of the actual US manufactured products, which appear to not be exactly the same as those from overseas. We believe that there is evidence that it is safer than old style spit tobacco, but it is not harmless, though likely much less of a risk in our area of concern, oral cancer, than the previous incarnations of smokeless. In December of 2009, we will put up a page dedicated to the new generation of smokeless, the marketing rhetoric, the paid medical shills for the products, and more. At this time there is evidence that it is less harmful than combustion based tobacco use. BUT THERE IS NOT CONCLUSIVE EVIDENCE THAT IT IS HARM FREE. And we are unconvinced that it is designed as a harm reduction product by the manufacturing companies given the viral marketing of it to our youth on the web. These customers that are rapidly becoming an addicted, profit center for the smokeless tobacco companies, are not inveterate, “I can’t quit” cigarette smokers as they would have us believe the market is for the product. We are more convinced that it is a product that will coexist with cigarettes in smokers who continue to smoke where they can, and will use these new smokeless products in workplaces, theaters, etc. where smoking is prohibited. One will not replace the other. It is market expansion, not product replacement. Arguments made by academics on the payroll or supported in other ways by the manufacturers that would have us believe that this is a serious harm reduction strategy are only playing a very well thought out marketing game in our opinion.New research from The Department of Environmental Medicine at the Swedish medical university Karolinska Institutet demonstrates that users of Swedish smokeless tobacco called ‘snus’ run a higher risk of dying from cardiac arrest and stroke. Although the study did not show an increased risk of snus use and[incidence of] myocardial infarction, it did show a 30 per cent increased risk of fatal heart attack compared with people who have never used the product. Amongst those who suffer non-fatal heart attacks, users of snus have a higher fatality rate in general than non-users, and from cardiovascular diseases in particular.Users also ran a higher risk of developing high blood pressure, which is a known factor of cardiovascular disease and they were also more likely to suffer a fatal stroke. Two major population studies were used for the research. The first comprised Swedish men between the ages of 45 and 70, living in the counties of Stockholm or Västernorrland between 1992 and 1994. A total of 1,432 men diagnosed with first-episode myocardial infarction were compared in terms of tobacco habits and other factors with a control group of men from the same regions without heart problems. The second was a study using data from health checks of all workers in the building industry between the years of 1978 and 1993. Information recorded at these checks included tobacco habits and blood pressure. Episodes of non-fatal and fatal myocardial infarction, strokes and blood pressure readings for over 100,000 snus users and non-users were followed until 2003/4.Update – April 2010. Initial surveys published by individual states and other sources indicate that smokeless tobacco is the growth portion of the tobacco marketplace. Given the amount of money and effort that has gone into viral internet marketing of these products to our youth this comes as little surprise. In 2010, smoking remains at pre snus introduction levels in the US. It would seem clear that this is not gong to replace smoking, but co-exist along side of smoking in those that use tobacco.