Tobacco Consumption in the Twentieth Century
2.2 Cigarette Smoking in the USA Since 1965
Overtheperiodfrom1965to1993,smokersintheUSAandtheirtobacco-usebehaviour weremonitoredinasurveyofallsmokersabovetheageof18yearswithaminimumannual consumptionof100cigarettes [6] .Witheffectfrom1991and1992,thesurveyincludedall thosewhosmokeddaily [29,30] .Deinedintheseterms,theannualprevalenceofcigarette smokingintheUSAwas42in1965and25in1993 [6,30] .Smokingcessationwas achievedby24in1965comparedwith50in1993 [30] .Inthe30–39-year-oldcategory, 89irsttriedsmokingbeforetheageof18and71becameregularsmokers [21] .The averageageatwhichsmokingwasirsttriedwas14.6yearsandtheageatwhichsurvey respondentsbecameregularsmokerswas17.7years [21] .Incontrast,after1980,thesurvey revealedthatthetransitiontoregularsmokingdidnotoccuruntilaftertheageof20 [31] . Smokingwasinitiallyamalepreserve;however,from1965to1993,smokingprevalence amongmendeclinedfrom52to28.Smokingprevalenceamongwomenwas34in1965, fallingto22in1993.Overall,theprevalenceofcessationamongex-smokersin1993was 52formenand47forwomen [30] .Nevertheless,theprevalenceofmalepipeandcigar smoking,chewingtobaccoandusingsnuffrosecontinuously [3,32] .Amongadolescent smokers,therewasgenderequality.From1967onwardsinparticular,therewasanincrease inthenumberoffemalesmokersfollowingtheintroductionof“femalecigarettes” [31] , whereassmokingprevalenceamongyoungwomenwithacollegeeducationdeclinedover theperiodfrom1983to1991 [6] . 50 Male Smokers Female Smokers Frequency [] 45 40 35 30 25 20 15 10 5 15 16- 20 21- 25 26- 30 31- 35 36- 40 41- 45 46- 50 51- 55 56- 60 61- 65 66- 70 71- 75 75 Fig. 2.2 Smokingprevalence amongmenandwomenasa functionofage.Datafrom theMicrocensusStudy1999 [27] ,bykindpermissionof theGermanFederal StatisticsOfice Differencesineducationallevelarealsoapparentamongsmokers:37ofindividuals ineducationfor9–11yearsweresmokerscomparedwithonly14ofthosewhowerein educationfor16years [30] .Highereducationallevelswerecorrelatedwithawillingness toquitsmoking [6,33] .Willingnesstoquitsmokingalsoincreasedwithage,witheduca- tionallevelalsobeingadecisivefactorinthiscontext [21,34,35] . Smokingprevalencewashighestamongpeoplelivingbelowthepovertyline [30] ,blue- collarworkers [2,36] ,singleordivorcedpeople [13] andmilitarypersonnel [37,38] .Tobacco usedeclinedmostrapidlyamongthemedicalprofessionals;atthebeginningofthe1990s, only3ofdoctorsintheUSAweresmokers [35] ,comparedwithsome20ofdoctorsin Germany [27] .However,thereseemstobearethinkingofsmokinghabitsintheUnitedStates. TheprevalenceofcigarettesmokingamongUSadultshasdeclinedbyalmosthalfsince 1965,withpositivetrendsobservedamongpeopleinalmostallsociodemographicgroups andeffortstoreducedisparitiesrecognizedasanimportantgoalinpublichealth [39] .2.3 Smoking Habits in Germany
InGermany,inpeoplebetweentheageof21and50years,smokingprevalenceisabout 33inwomenand44inmenFig. 2.2 .Simultaneously,asdirectconsequencesofciga- rette smoking, approximately 80,000–90,000 new cases of cardiovascular disease and 30,000newcasesofbronchialcarcinomaarerecordedeveryyear.Abovetheageof35, tobacco-attributablemortalityratesinthefederalGermanstatesrangefrom5.6to13.2 forwomenandfrom24.3to29.2formen.Thehighestmortalitystatisticsarerecorded forwomeninHamburg,BerlinandBremen [27] .WithanoverallmortalityrateinGermany of17,smokingrepresentsthecommonestavoidableandexclusivelybehaviour-related causeofdeath [40] . AccordingtotheMicrocensusStudy,arepresentativesurveyconductedin1995among the population in Germany, interesting conclusions can be drawn concerning smoking behaviourasafunctionofgrossincomeandeducationallevelseeFig. 2.3 .Similarresults arealsoevidentfromthelatestMicrocensusStudy [27] withregardtothepostulatedcon- nectionbetweenschoolanduniversityeducationandsmokingbehaviourFig. 2.3 .The inluenceoftheeducationallevelonsmokingpatternindifferentsocialclassesmightbe explainedbytheeficiencyofanti-smokingcampaignsandtheawarenessabouthealth effectsofsmokingamongpersonswithdifferenteducationallevels [41] . Thus,accordingtoself-reportedinformationinApril1995,30.9ofmenand18.2of womenwereregularcigarettesmokers.Inbothsexes,smokingprevalencefellwithincreas- ingage:amongmenandwomenovertheageof64,smokingprevalencewasonly12.9 and4.9,respectively [42] .ThedatasummarisedinFigs. 2.4 and 2.5 indicatethatthe relationshipbetweenmonthlyincomeandsmokingbehaviourappliesmoreformenthanfor women.Smokingprevalenceishigher42.6amongmeninthelowestincomecategory 700EURthanamongthosewithahighmonthlyincome6,500DM,thoughtherate isstill23.1.Forwomen,themostpronouncedincome-speciicdifferencesarefoundin theyoungestagegroup18–29-yearolds.Heretoothereisaconsiderabledifferencein smokingprevalence41.4vs.18.5forthelowestandhighestincomegroups [42] .Parts
» Tobacco Plants and Their Origin Use of Tobacco for Religious Purposes
» The Appropriation of Tobacco by Europeans
» Development of the Cigarette
» Objections to Smoking on Health Grounds
» Women Won Over by the Cigarette
» The Medical Use of Tobacco in the Nineteenth Century
» Tobacco Research in the Twentieth Century
» Tobacco Consumption in the Twentieth Century
» Cigarette Smoking in the USA Since 1965
» Cigarette-Related Mortality in Different Countries
» Smokers and Other Risk Factors
» Smoking Behaviour and Educational Level in the EU
» Non-Disclosure of Findings by the Tobacco Industry
» The Cigarette as a Vehicle for Nicotine Release
» Modifications of Nicotine Release
» Maintaining Nicotine Dependence Nicotine and Dependence
» Marketing of Cigarettes with a “Reduced” Health Risk
» Compensatory Behaviour by Smokers
» Optimising Nicotine Release Nicotine and Dependence
» Importance of Absorption Rate
» Ammonium and pH Manipulation
» Cigarettes with Reduced Tar Yield
» Agonists and Antagonists of the nAChR and its Subtypes
» Effects of Nicotine on Receptors in Different Organs
» Metabolic and Hormonal Effects of Nicotine
» Central Nervous System Effects of Nicotine
» Types of Dependence Nicotine Dependence
» Molecular Biological Aspects of Dependence
» Genetic Aspects Nicotine Dependence
» Withdrawal Symptoms Nicotine Dependence
» Immunological Reactions Caused by Cigarette Smoking
» Association Between Smoking and Lung Cancer
» Tobacco-Specific Carcinogens Genetic Factors That Increase the Risk for Bronchial Carcinoma
» The Cytochrome P450 and GST System and Carcinogenesis
» Peptide Receptors, Genetic Factors That Increase the Risk for Bronchial Carcinoma
» Exogenous Factors and Lung Cancer
» Pathophysiology of COPD Cigarette Smoking and COPD
» Genetic Factors Important Risk Factors for COPD
» Occupational and Environmental Factors
» Caveats Concerning the Informative Value of Studies
» Cigarette Smoking and Bronchial Asthma in Adults
» Bronchial Asthma in Children
» Other Lung Diseases Influenced by Cigarette Smoking
» Coronary Artery Disease and Myocardial Infarction
» Changes in Endothelial Function and Microcirculation
» Microcirculation and O Systemic Vascular Changes
» Arteriosclerotic and Inflammatory Vascular Reactions
» Genetic Factors Blood Coagulation and Fibrinolysis
» Nicotine and Ischaemic Heart Disease
» Cognitive Impairment Central Nervous System
» Influence on Cognitive Performance
» Intellectual Impairment in Childhood
» Smoker Personality Profiles and Genetic Inheritance of Smoking
» Peculiarities of the Smoker’s Personality
» Reasons for Increased Cigarette Consumption
» Comorbidity Between Depression and Smoking
» Extent of Cigarette Consumption
» Effects of Smoking in Forms of Dementia
» Smoking and Parkinson’s Disease
» Diabetic Retinopathy Ocular Diseases
» Graves’ Ophthalmopathy Ocular Diseases
» Macular Degeneration Ocular Diseases
» Ocular Tumours Ocular Diseases
» Retinal Detachment Ocular Diseases
» Lipid and Cholesterol Metabolism
» Insulin Resistance Diabetic Nephropathy
» Oesophageal Cancer Gastrointestinal Tract
» Gastrointestinal Ulcers Gastrointestinal Tract
» Cancers of the Gastrointestinal Tract
» Pancreatic Cancer Gastrointestinal Tract
» Toxic Substances and Inducers
» Kidney Cancer Urinary Tract Diseases
» Bladder Cancer Urinary Tract Diseases
» Prostatic Hyperplasia and Prostatic Cancer
» Fertility Disorders Urinary Tract Diseases
» Vitamin D and Oestrogen Metabolism
» Osteoporosis Disorders of Mineral Metabolism and Bone
» Hip Fractures Disorders of Mineral Metabolism and Bone
» Skin Changes Skin and Mucosa
» Skin Tumours Skin and Mucosa
» Breast Cancer Skin and Mucosa
» Effects of Smoking on the Placenta
» Malformations Possibly Caused by Smoking
» Smoking and Sudden Infant Death Syndrome SIDS
» Effects of Nicotine on the Foetus
» Medical Care Costs Attributable to Smoking During Pregnancy
» ETS in the Workplace and at Home
» Fibrinogen Cholesterol Endothelium and Platelets
» Markers of Inflammation Changes at the Molecular and Cellular Level
» Passive Smoking During and After Pregnancy
» Coronary Heart Disease Cardiovascular Disease
» Stroke and Subarachnoid Haemorrhage
» Respiratory Tract in Children and Teenagers
» Bronchial Carcinoma Respiratory Tract
» Indications and Diagnostic Considerations
» Self-Help Interventions by the Smoker
» Physician Advice for Smoking Cessation
» Group Behaviour Therapy Programmes
» Mass Media Communication Strategies
» E-Learning, Email and Internet for Smoking Cessation
» Evaluation of Nicotine Products
» Nicotine Chewing Gum Nicotine
» Nicotine Sublingual Tablet Nicotine Nasal Spray
» Treatment and Dosage Nicotine
» Nicotine Chewing Gum Adverse Events Associated with NRT
» Nicotine Patch Adverse Events Associated with NRT
» Nicotine Nasal Spray Adverse Events Associated with NRT
» Nicotine Inhaler Adverse Events Associated with NRT
» Nicotine Sublingual Tablet Adverse Events Associated with NRT
» Nicotine Lozenge Adverse Events Associated with NRT
» Drug Interactions During Smoking Cessation
» Contraindications for the Use of Nicotine Products
» Nicotine Formulations as OTC Products
» Contraindications and Drug Interactions
» Tranquillisers and Buspirone Other Pharmacotherapies
» Various Antidepressants Other Pharmacotherapies
» Opioid Antagonists Other Pharmacotherapies
» Silver Acetate Other Pharmacotherapies
» Therapeutic Monitoring in Smoking Cessation
» Ischaemic Heart Disease Special Therapeutic Situations
» Pregnancy Special Therapeutic Situations
» Weight Gain Special Therapeutic Situations
» Alcohol Consumption Special Therapeutic Situations
» Organic Depression Organic Depression and Schizophrenia
» Schizophrenic Patients Organic Depression and Schizophrenia
» Interactions Between Cigarette Smoking and Administration of Psychopharmaceuticals
» Pre-operative Smoking Cessation Special Therapeutic Situations
» Social Influence Inoculation Strategy
» Life Skills Strategy Prevention Programmes for Schools
» Class 2000 Health Promotion Programme
» Trier University Health Programme Long-Term Studies
» Role of Teachers in Primary Prevention
» Prevention by Restricting Sales of Tobacco Products to Minors
» Role of the Mass Media in Sales of Tobacco Products to Adolescents
» Role of Government and Community in Primary Prevention
» Effect of Tobacco Industry Advertising Messages
» Tobacco Advertising and Adolescent Smoking Initiation
» Advertising with “Light” Cigarettes
» Smoking Bans in Public Buildings and Public Spaces
» Tobacco Industry, Governmental and Non-governmental Organisations
» Politicians and Their Attitude to Smoking
» Scientists and the Tobacco Industry
» Governmental Control of Toxic Tobacco Constituents
» Bans on Advertising in Various Countries
» Tobacco Industry: Playing Down the Risks of Smoking and Passive Smoking
» Smoking and Non-smoking: Weighing the Benefits
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