Stop Smoking

Tobacco dependence is recognised as a life-threatening disorder with serious oral health consequences which responds to treatment in the form of behavioural support and medication. While cigarette smoking is the most hazardous and prevalent form of tobacco use in the west, consideration also needs to be given to other forms such as bidi smoking in India, reverse smoking by several rural populations and use of snuff and chewing tobacco. The evidence that the use of tobacco is the major risk factor for oral cancer and potentially malignant lesions of the mouth is clear. Counseling to quit smoking is not applied in a systematic or frequent manner to people presenting with potentially malignant lesions of the oral cavity.

Much progress has been made in recent years in treating tobacco dependence. The 2000 USPHS Guideline extends the understanding of effective treatments and encourages clinicians to be more diligent in recognizing tobacco users in the practice and more aggressive in treating every tobacco user. The guideline outlines the potential use of the five first-line medications (Bupropion, Zyban Sr, nicotine patches, gum, nasal spray, and inhaler) and the two second-line medications (nortriptyline and clonidine). The use of these medications can be tailored to meet the patients needs and combinations of these medications can be used when appropriate. More intensive treatment, such as residential treatment, may be needed for more addicted smokers.

Many smokers claim that their habit helps them to relax, but there is no doubt that smoking is harmful to health and has a detrimental effect on athletic performance. Tobacco smoking is a major, preventable factor leading to death. Almost 20 per cent of deaths in the USA have been attributed to diseases associated with inhaling the products of combustion from the tobacco plant, Nicotiana tobacum. These products include nicotine, carbon monoxide, and tars.

Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), emphysema, and cancer (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer).

The World Health Organization estimate that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."

Rates of smoking have leveled off or declined in the developed world. Smoking rates in the United States have dropped by half from 1965 to 2006 falling from 42% to 20.8% in adults. In the developing world, tobacco consumption is rising by 3.4% per year.

A number of studies have established that cigarette sales and smoking follow distinct time-related patterns. For example, cigarette sales in the United States of America have been shown to follow a strongly seasonal pattern, with the high months being the months of summer, and the low months being the winter months.

Similarly, smoking has been shown to follow distinct circadian patterns during the waking day-with the high point usually occurring shortly after waking in the morning, and shortly before going to sleep at night.