Cigarette smoking: health effects and control strategies

Active cigarette smoking causes a broad spectrum of diseases that extend to many different organ systems. Its numerous deleterious health effects, combined with the substantial prevalence of cigarette smoking, make it a major worldwide cause of death. Smoking contributes so heavily to the mortality burden because it is a major cause of vascular disease, cancer and chronic obstructive pulmonary disease. In addition to these diseases, cigarette smoking also causes other respiratory symptoms, adversely affects reproductive outcomes and is a cause of diminished health status. Furthermore, exposure to secondhand smoke is an established cause of coronary heart disease and lung cancer, as well as a host of other adverse health effects. Given that cigarette smoking is such a major threat to global public health, controlling the worldwide epidemic of cigarette smoking would lead to enormous public health benefits. Strategies to control cigarette smoking at the societal level include smoke-free workplace legislation, increasing cigarette taxes and regulating cigarette advertising. On the individual level, preventing the initiation of cigarette smoking among youths is the optimal strategy; in practice, discovering efficacious primary prevention interventions has proven challenging. During the past two decades, major advances have been made in extending the menu of options available to assist dependent smokers in successfully quitting smoking. Successfully combating cigarette smoking requires a broad-based commitment to smoking control from multiple stakeholders, along with a multifaceted strategy that addresses both societal and individual factors.