Tobacco use remains the single largest preventable cause of disease and premature death among both men and women in the United States. 与烟草使用有关的健康影响包括心脏病, 多种癌症, 肺病, 不良生殖结局, 以及多种慢性疾病的症状加剧.

美国每年有超过48万人死于吸烟. 大约七分之一的美国成年人仍然吸烟,大约三分之一.9 million middle school and high school students use at least one tobacco products, 包括电子烟. 近90%的成年吸烟者在18岁之前第一次尝试吸烟.  

吸烟几乎损害身体的每一个器官. 吸烟者会耽误更多的工作, 多去看医生, 住院的次数更多, 比不吸烟者早死10到12年. Cigarette smoking has been linked to about 80 to 90 percent of all cases of lung cancer, 是男性和女性癌症死亡的主要原因, 大约80%的死于这种疾病的人都是死于这种疾病. Smoking increases lung cancer risk five to tenfold, with greater risk among heavy smokers. 除了癌症, 吸烟会导致慢性支气管炎和肺气肿等肺部疾病, 而且已经发现它会加重成人和儿童的哮喘症状. 吸烟也会大大增加患心脏病的风险, 包括中风, 心脏病, 血管疾病, 和动脉瘤.

  • 对健康的影响
  • 关于烟草
  • 治疗

烟草对使用者的健康有严重影响. 烟草使用的后果在许多方面威胁着美国人,包括:

  • 吸烟是引起心血管疾病的主要原因, 美国的头号死因是什么. 心血管疾病导致的死亡中有三分之一是吸烟造成的.
  • 吸烟会增加中风的风险. Deaths from 中风 are more likely among smokers than among former smokers or people who have never smoked.
  • 在美国,三分之一的癌症死亡与吸烟有关. 吸烟几乎会导致身体任何部位的癌症, 包括肺, 口腔, 胃, 膀胱, 肾脏, 子宫颈癌, 结肠和直肠, 和肝脏. 卫生局局长的报告已经确认了至少12种由吸烟引起的癌症.
  • 吸烟会增加患2型糖尿病的风险. 美国有超过2500万成年人患有糖尿病. 患有糖尿病的吸烟者更容易出现严重的健康问题, 包括心脏病和肾病, poor blood flow in the legs and feet that can lead to foot infections and other problems, 还有视网膜病(一种可导致失明的眼病). 
  • Nearly 8 in 10 cases of chronic obstructive 肺病 (COPD) are caused by smoking. 美国患有慢性阻塞性肺病的人数正在增加,而且无法治愈.

大多数吸烟者经常吸烟,因为他们对尼古丁上瘾. 可燃烟草产品产生的烟雾含有7000多种化学物质. Nicotine is the primary reinforcing component of tobacco; it drives tobacco addiction. Hundreds of compounds are added to tobacco to enhance its flavor and the absorption of nicotine.

Cigarette smoking is the most popular method of using tobacco; however, 许多人也使用无烟烟草产品, 比如鼻烟和咀嚼烟草, 也含有尼古丁. 电子烟, 在烟草中没有其他化学物质的情况下,它们会释放尼古丁, 近年来越来越受欢迎吗.

香烟是一种非常高效和高度设计的药物传递系统. By inhaling tobacco smoke, the average smoker takes in 1–2 milligrams of nicotine per cigarette. When tobacco is smoked, nicotine rapidly reaches peak levels in the bloodstream and enters the brain. A typical smoker will take 10 puffs on a cigarette over the roughly 5 minutes that the cigarette is lit.

接触尼古丁后立即服用, there is a “buzz” caused in part by the drug’s stimulation of the adrenal glands and resulting discharge of epinephrine (adrenaline). The rush of adrenaline stimulates the body and causes an increase in blood pressure, 呼吸, 和心率.

有支持戒烟的有效治疗方法, 包括行为疗法和fda批准的药物. FDA-approved pharmacotherapies include various forms of nicotine replacement therapy as well as bupropion and varenicline. Research indicates that smokers who receive a combination of behavioral treatment and cessation medications quit at higher rates than those who receive minimal intervention. 

Behavioral counseling is typically provided by specialists in smoking cessation for four to eight sessions. Both in-person and telephone counseling have been found beneficial for patients who are also using cessation medications.

认知行为疗法(CBT) - CBT帮助患者识别触发因素——人, 的地方, and things that spur behavior—and teaches them relapse-prevention skills (relaxation techniques) and effective coping strategies to avoid smoking in the face of stressful situations and triggers.

动机性访谈(MI) ——在心肌梗死, counselors help patients explore and resolve their ambivalence about quitting smoking and enhance their motivation to make healthy changes. 心梗以病人为中心,非对抗性, and providers point out discrepancies between patients’ goals or values and their current behaviors. They adjust to patients’ resistance to change and support self-efficacy and optimism.

正念 -正念戒烟疗法, 病人学习如何提高对感觉的意识和脱离感觉, 的想法, 这种渴望可能会导致复发. 在这个治疗, patients purposely focus on the 的想法 that trigger cravings and urges for tobacco and cognitively reframe them as expected and tolerable. Patients learn techniques that help them tolerate negative emotions—including stress and cravings—without returning to tobacco use or other unhealthy behaviors.

尼古丁替代疗法(NRT) – A variety of formulations of nicotine NRTs are available over the counter—including the transdermal patch, 喷雾, 口香糖, 还有含片,对戒烟同样有效.

二手烟

大约有5800万不吸烟的美国人暴露在二手烟中, 其中包括1500万3至11岁的儿童. 二手烟每年导致近5.4万人死亡. 二手烟的暴露程度没有安全标准. 即使是低水平的二手烟也会在许多方面对儿童和成人造成伤害. 二手烟 exposure also causes many serious illnesses – such as heart disease, 中风, 不吸烟的成年人患肺癌.

The US Surgeon General estimates that living with a smoker increases a nonsmoker’s chances of developing lung cancer by 20-30%. 接触二手烟会增加学龄儿童患耳部感染的风险, 下呼吸道疾病, 哮喘发作更频繁、更严重, 减缓了肺的生长, 它还会引起咳嗽, 喘息, 痰, 和呼吸困难. 对于婴儿来说,二手烟会导致婴儿猝死综合症. 婴儿猝死综合征(SIDS)是一种原因不明的死亡, 通常在睡眠中, 一个不到一岁的健康婴儿. 

间接吸烟

吸烟也会在吸烟过的表面留下化学残留物, which can persist long after the smoke itself has been cleared from the environment. 这一现象, 被称为“三手烟”,越来越多的人认为这是一种潜在的危险, 尤其是对孩子们, who not only inhale fumes released by these residues but also ingest residues that get on their hands after crawling on floors or touching walls and furniture.

青年和烟草

没有任何烟草产品对年轻人来说是安全的. 尼古丁非常容易上瘾,会损害青少年发育中的大脑. 根据2017年监测未来调查,9.12年级7%,10年级5%,还有一个.9%的八年级学生在过去的一个月里吸烟. 

青少年接触尼古丁是一个问题. 青少年的大脑仍在发育, and nicotine has effects on the brain’s reward system and brain regions involved in emotional and cognitive functions. Research suggests that the nicotine-related changes to these areas of the brain during adolescence may perpetuate continued tobacco use into adulthood. 

青少年吸烟通常遵循代际模式, 有遗传, 表观遗传, 和环境影响. Data from parents and adolescents suggests that current parental nicotine dependence is strongly linked with adolescent smoking and dependence. 其他因素,比如父母的教育, 婚姻状况, 父母教养行为也会影响青少年吸烟.

怀孕和吸烟

怀孕前、怀孕中、怀孕后吸烟会影响婴儿的健康. Smoking in pregnancy has been linked to a number of serious health effects, including:

  • 妊娠并发症风险较高(早产和分娩)
  • Infants born to mothers who smoked during pregnancy are at a higher risk of low birth weight, 肺部发育不正常, 还有婴儿猝死综合症.
  • 吸烟会降低妇女的生育能力.

戒烟的好处

一旦戒烟,你的身体就开始修复吸烟造成的损害. You’ll notice the health benefits you’ll experience as soon as 20 minutes to 15 years after quitting.

戒烟后20分钟:

  • 你的心率下降到正常水平.

戒烟后12小时:

  • 你血液中的一氧化碳含量降至正常水平.

戒烟后2周至3个月:

  • 你心脏病发作的风险开始下降.
  • 你的肺功能开始改善.

戒烟后1至9个月:

  • 你的咳嗽和呼吸急促减轻了.

辞职一年后:

  • 你增加的冠心病风险是吸烟者的一半.

戒烟5至15年后:

  • 你患中风的风险降低到非吸烟者的水平.
  • Your risk of getting cancer of the mouth, throat, or esophagus is half that of a smoker’s.

辞职10年后:

  • 你死于肺癌的风险大约是吸烟者的一半.
  • 你得膀胱癌的风险是吸烟者的一半.
  • Your risk of getting cervical cancer or cancer of the larynx, 肾脏 or pancreas decreases.

辞职15年后:

  • 你患冠心病的风险与不吸烟者相同.

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