Thursday, September 17, 2009

TOBACCO AND CARDIOVASCULAR IMPACT

WHAT IS TOBACCO?

Tobacco is made from the dried leaves of the tobacco plant. Tobacco smoke is a mixture of almost 4,000 different chemical compounds, including nicotine, tar, carbon monoxide, acetone, ammonia and hydrogen cyanide. Forty three of these chemicals have been proven to be carcinogenic (causing cancer).
Tobacco is ingested through smoking cigarettes, pipes and cigars. In the form of a fine powder, it may also be sniffed as snuff, or it is sometimes sold in blocks to be chewed. It can also be ingested through passive smoking.
Tobacco remains the single most preventable cause of death and disease in the United States today. Tobacco use is a major risk factor for heart disease and stroke. Between 1997 and 2001, smoking resulted in an es-timated annual average of 137,979 deaths in the US from cardiovascular disease. In 1998, smoking related health care expenditures in the US were estimated at $75.5 billion.
After a steady decline in adult smokers since 1995, the adult smoking rate in Texas increased between 2006 and 2007 from 17.9 percent to 19.3 percent.3 The Texas high school smoking rate in 2007 (that is smoked cigarettes on one or more days during the past 30 days) was 21.1 percent compared to the Healthy People (HP) 2010 goal of 16 percent.
Epidemiologic studies have demonstrated that exposure to second-hand smoke is causally associated with coronary heart disease. Meta-analyses estimate that involuntary exposure to smoking increases the risk of heart attack by 25-35 percent.21 Many Texas communities are working to adopt or have already passed smoke-free ordinances that reduce exposure to second-hand smoke in public places, including bars and restaurants. Still, 75 percent of Texans are not protected by strong smoke-free ordinances that cover municipal workplaces, private workplaces, restaurants, bars in restaurants, and bars not in restaurants.
Tobacco-related health disparities are reflected in unequal treatment of tobacco use, incidence, morbidity, mortality, burden of illness, and access to resources. Racial/ethnic minorities, people with low socio economic status, and people with lower levels of education are at higher risk for tobacco use and exposure to second hand smoke, and they experience more tobacco related illness and death.22 In Texas, we see the highest rates of smoking among young adults between 18 and 29 (24.3 percent), males (21.9 percent), Whites (20.5 percent) and Af-rican Americans (21.4 percent).3
The Texas Cancer Council, now the Cancer Prevention and Research Institute of Texas, a state agency charged with implementing the Texas Cancer Plan, published the Texas Tobacco Control Plan 2008, A Statewide Action Plan for Tobacco Prevention and Control in Texas (Tobacco Plan). Partners from across the state, including the Tobacco Prevention and Control Program at the DSHS; the American Cancer Society, High Plains Division; and many community level stakeholders are actively working to reduce tobacco use in Texas.
Investments in state-level, evidence-based prevention programs have produced significant reductions in cigarette consumption, demonstrating the need for fully funded state-wide tobacco prevention programs at levels recommended by the CDC. According to the Tobacco Plan, the most significant barrier to tobacco prevention and control in Texas is the lack of funding to implement these evidence-based programs. Currently, less than 1 percent of the 25 year estimate of $17.5 billion in Texas tobacco settlement funds has been invested in comprehensive community level programs.

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