2014 Children’s Health Concerns

The University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health is out for 2014 listing the top 10 health concerns adults have for their children and communities.  This is the eighth year for the report, and the first time adults have also been asked about their concerns nationwide as well as in their own communities.

In 2007, out of a list of 17 concerns, smoking was #1 of the top 10 health concerns compiled for the report.  Even with declining smoking rates among teens through the years, parents still see smoking and tobacco use as a health concern, enough so that it remains near the top of the list each year.

The newest report shows that childhood obesity is now the top concern at the local community level, followed by smoking/tobacco use, drug abuse and bullying.   The national level lists the same health concerns in a slightly different order:  childhood obesity, bullying, drug abuse and smoking/tobacco use.

MottDr. Matthew M. Davis, director of the C.S. Mott Children’s Hospital National Poll on Children’s Health, says the newest top 10 report gives “a national agenda of the top health problems of the kids that adults would like to see policy-makers address.”

Click HERE to read the entire article.




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Keep Miss Kitty Safe

LucyHappy World Cat Day!  Ok, we understand you may not be a cat person, not everyone can be so special.  But be honest, you’ve smiled at some of those pictures of kittens seeing their reflection in a mirror, or hissing at each other.  It’s just plain cute.  But something that is not so cute is what secondhand smoke can do to your cat.

Secondhand smoke has over 4,000 chemicals, and while you can get away from the smoke, your inside cat is, well…stuck.  That blue haze of smoke is falling on everything in the house, including your pet.

Cats are not only breathing in the carcinogens from your secondhand smoke, they are Lucy1also ingesting all those chemicals each time they groom themselves, making them more prone to develop cancer of the mouth and lymph nodes. Living with a pack-a-day smoker means the cat is “three times more likely to develop malignant lymphoma than a cat living with a nonsmoker.”  Even a cat living with a light smoker, someone who smokes less than a pack-a-day, is “four times more likely to be diagnosed with squamous cell carcinoma which is the most common and an aggressive type of oral cancer in cats.”

Keep cigarettes and cigarette butts out of reach of your curious cat as tobacco products contain nicotine, and even small amounts are toxic to your pet.

Talk to your vet about how to keep Miss Kitty safe from secondhand smoke and other dangers that lurk in your house.  Your fur baby will thank you.

Click HERE to read how secondhand smoke affects your pet.




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The FDA is Seeking Opinions

In 2009 The Family Smoking Prevention and Tobacco Control Act became law, giving the Food and Drug Administration “the authority to regulate the manufacture, distribution, and marketing of tobacco products to protect public health,” according to a consumer fact sheet on the FDA website.  One of the aims of the Tobacco Control Act was to curb youth use of tobacco since the majority of new users of tobacco products are under 18, the legal age to purchase tobacco products.  But the tobacco industry has introduced products that not only appeal to youth, but get around loopholes in the law and cost the U.S. billions in tax revenue.  Changes need to be made to the Act, and the FDA is asking for your input on these matters and others that fall under the Tobacco Control Act

For one, the cigar industry wants out from under any FDA regulation, but adults aren’t the only ones smoking cigars.  According to the Campaign for Tobacco Free Kids, “high school students are twice as likely as adults – 13.1% compared to 6.6% – to report smoking cigars in the past month.”

When flavors were banned in cigarettes, manufacturers flavored other cigarette-sized products, wrapped them up in a thin brown paper-type leaf, and called them little cigars or cigarillos.  Some manufacturers increased the weight of the products by adding additional tobacco or adding clay filler, like that in cat litter, to give the products additional weight and classify them as cigars.  According to the 2013 Florida Youth Tobacco Survey, 8.6% of high school students reported they had smoked a cigarette at least once during the past 30 days, while 9.3% reported they had smoked cigars.

While teens have been putting cigarettes down, they have also been using e-cigarettes in increasing numbers with use among high school age teens increasing over 100% in just two years.  Controlling sales of e-cigarettes and the flavored nicotine liquid would help reduce these numbers as well as the number of poisonings happening across the U.S.

20140215_163416Another area the FDA needs to look at is tobacco and e-cigarette display placements in retail establishments.  All tobacco products, including cigars of all types, and nicotine delivery devices such as e-cigarettes and e-liquids, should follow the rules applied to cigarettes and smokeless tobacco and be placed behind the counter.  This will minimize confusion between candy and tobacco.  It will also mean sales clerks can control who has access to the products.  Note the picture with the NJOY e-cigarette display on the counter to the right and the candy sign in front of it.  The placement and bright colors of the packaging make it difficult for kids to know

In this day and age of the internet, it is too easy for youth to access websites and purchase tobacco products and e-cigarettes online.  Age-verification procedures should be required to purchase all e-cigarettes and the liquids that go in them, much like those in place to purchase cigarettes.

The Food and Drug Administration is looking for public input as to these issues and others regarding tobacco and nicotine delivery systems, and has extended the deadline for public comment to Friday, August 8th.

You can read more about the issues HERE and HERE.
You can CLICK HERE to submit your comments directly to the FDA.

CLICK HERE for more information on this topic.


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Smokeless Tobacco Stats

New statistics are out on smokeless tobacco and the report shows there hasn’t been much change between 2005 when about 2.7% of working adults used the product to about 3.0% in 2010.  The report Copetracked smokeless users by age, education, geographical location, and by industry worked.  The report also measured whether the respondents were dual users of both cigarettes and smokeless tobacco.   Those who used “chewing tobacco or snuff more than 20 times in their lifetime” and used “chewing tobacco or snuff everyday or some days” were considered current users.  A current cigarette user was someone who smoked more than 100 cigarettes in their lifetime and currently smoked every day or some days.

In 2005 the survey found the smokeless tobacco numbers were highest among working adults in the 18-24 year old age group, male, non-Hispanic whites, high school educated, and living in the Midwest Skoalor South.  By the 2010 survey the smokeless tobacco users had aged and taken their habit with them as the 25-44 year old group was the highest users.  Males, non-Hispanic whites, high school education, and living in the Midwest and South were still dominant factors.  It should be noted that the number of smokeless tobacco users living in the Midwest did drop by 0.5% between the 2005 and 2010 survey.  Percentages were also given by industry and by occupation.

While cigarette smoking for adults (older than 18) had dropped between 2005 (22.2%) and 2010 (19.1%), dual users of cigarettes and smokeless tobacco increased slightly from 4.1% in 2005 to 4.2% in 2010.  In 2010, 5.6% of males reported using smokeless tobacco, but 7.3% reported being a dual user.  In the category “with no more than a high school education,” 3.9% reported using smokeless, but 4.5% reported dual use.  While smokeless use went down in the Midwest in 2010 (3.3%), dual use increased to 5.3%.  It also showed that dual users smoked more cigarettes (15.5) “compared with those who used cigarettes only (12.1).”

Our Florida Youth Tobacco Survey provides us with statistics for our middle school and high school populations. and some of those numbers for smokeless tobacco users appear higher than for the adults in the MMWR.  In smokeless_youth2005 3.9% of middle school and 4.9% of high school students said they considered themselves current smokeless tobacco users meaning they used the products at least once during the past 30 days.  In 2010 those numbers were down for middle school students, at 3.0%, but up for high school students at 6.4%.  The numbers were higher still for those students who reported “ever tried” smokeless in 2005 at 7.0% for middle school students and 12.2% for high school students.  Those numbers were down in 2010 at 5.7% and 11.9% respectively.   There were no figures given for dual tobacco use.

The  MMWR report suggests that the “lack in reduction” in the smokeless tobacco rates could be due to “novel smokeless tobacco products,” tobacco industry advertising encouraging cigarette smokers to use smokeless tobacco as an alternative when they can’t smoke, switching to smokeless for “purposes of harm reduction or smoking cessation,” and increases of tobacco industry marketing in the smokeless tobacco area.

Copenhagen2Smokeless used to mean using your fingers to dig into a can to put loose tobacco into your mouth and spitting out the juices.  Now some smokeless brands have individual pouches to make that part of smokeless tobacco easier, and no spitting means you can use it anyplace.  Smokeless has also changed their image from working men, like the Copenhagen cowboy image (2004 ad at the top) riding the range to a more youthful image (2007 ad) having fun riding a motorcycle.  Removing flavors, adding larger warning labels, and increasing taxes on the products could be a good start to decreasing use.  But unless you educate students early and often about the dangers of smokeless tobacco, you won’t deter them from ever picking up the habit.

Morbity and Mortality Weekly Report in its entirety.
Tobacco pictures from trinketsandtrash.org







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World No Tobacco Day 2014: Raising Tax on Tobacco

WHOIf we want to improve public health worldwide, we have to start by decreasing or ending tobacco use worldwide.  Clean air laws, graphic tobacco warning labels, education campaigns and banning advertising help, but raising tobacco taxes is “the most cost-effective way to reduce tobacco among young people and poor people,” according to the World Health Organization (WHO) which has made this their campaign for the 2014 World No Tobacco Day on May 31st.

Studies have shown that a “10% increase in the price of cigarettes in developed countries will result in a 4% to 5% reduction in overall cigarette consumption.”  In fact, a 2010 study in 20 lower-middle income countries found that a price increase of 10% would reduce consumption in youth aged 14 by 18%, more than three times higher than the consumption reduction achieved by the same measure among adults.”

Raising taxes on tobacco is a “win-win situation because they are good for both public health and government revenues.”  Increasing the taxes saves lives by improving the health and “reducing the burden of disease and death” on governments as more people end their tobacco use.    Collecting higher taxes means the government will earn a higher revenue.  Those who no longer spend their earnings on tobacco, will now be able to purchase other consumer products and services.  Youth and “lower income people are sensitive to price increases” and will “alter their consumption behavior by either quitting or reducing the level of tobacco consumption more than higher-income consumers,” thus improving their health.

The tax rate on a pack of cigarettes here in Florida is 133.9¢, which includes a surcharge of $1 per pack, ranking us 27th in the nation in cigarette tax rate.  Loose tobacco/snuff is taxed at 85% of the wholesale price while cigars are not taxed at all.  In 2009 when the Food and Drug  Administration banned flavored cigarettes, except menthol, from being sold in the U.S. many products were reclassified by tobacco companies as “cigarillos” to avoid taxation and regulations by the FDA. The public should question why the tobacco industry is allowed to continue to sell these addictive tobacco products at prices below $1, which is easily affordable to many children.  While the legal age to purchase tobacco products is 18 in Florida (as well as most of the nation), in 2013 3.1% of middle school and 9.3% of high school students reported smoking cigars in the past month, less than the 2.6% and 8.6% respectively who reported smoking cigarettes.  Raising the taxes on all tobacco products here in Florida would decrease the number of youth not only trying tobacco but become regular tobacco users.

During this World No Tobacco Day, encourage your government leaders to put public health before the concerns of the tobacco industry.

Click here for the World Health Organization “Raising Tax on Tobacco.”



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E-Cigarettes: What You May Not Know

A safer alternative to tobacco or a gateway for youth to become another generation hooked on nicotine?  Depending on with whom you speak to regarding electronic cigarettes, you may get different answers.  Since electronic cigarettes don’t have the hundreds of ingredients or the thousands of chemicals when burned, some can argue the product is safer than a traditional tobacco product.  But unlike traditional cigarettes, e-cigarettes, as they are commonly known, have candy flavorings which are banned in regular cigarettes.  And they have a digital technology that may appeal to a youth population who have been raised with other digital products.

Did you know that many users of electronic cigarettes believe they safe to use?  The truth is, no one can answer that question at this time because not enough research has been completed.   Electronic cigarettes first entered the U.S. market in about 2007 and their newness means studies on their ingredients and the long-term health effects are still ongoing.  Right now there is no regulation on the products by the FDA, although many states have passed laws banning the sale of the products to minors.  The state list banning e-cigarettes was last updated on April 2014, but many states introduced legislation this spring to ban the sale of e-cigarettes to minors and bring public use of e-cigarettes in line with that of traditional cigarettes.

Did you know that most e-cigarettes generally have three ingredients: propylene glycol, flavoring, and nicotine?  Propylene glycol is a syrupy synthetic liquid that is colorless, slightly sweet and is “generally recognized as safe” (GRAS) by the FDA.  It is used in cosmetics such as soaps and shampoos, as a food addictive in cupcakes and soft drinks, and in medicines such as cough syrups and toothpaste.  However, it is unknown what damage it can cause to the lungs when heated and inhaled, and researchers “have little information about what happens to propylene glycol in the air” in terms of secondhand vapor.

One reason why e-cigarettes are so popular is you can get a dose of nicotine in the flavoring of your choice.  But did you know that while flavorings are food-grade, they are “by definition, not tested for inhalation?”  One  e-cigarette forum even stated their own caution about flavorings and warns users “there are no flavors known to be safe for inhalation.”  Obviously they are protecting themselves from possible litigation, but it’s a precaution about flavorings e-cigarette users should heed.

e-liquidsDid you know the liquid nicotine in e-cigarettes is more powerful then the nicotine in regular cigarettes because it is absorbed by the body more quickly?  Not only can the nicotine hook you into a lifetime of addiction, the liquid nicotine refills could poison you whether ingested by mouth or absorbed through your skin.  Calls to poison control centers in 2013 saw a “300% increase from 2012.”  The majority of the cases involve young children under 5 who are curious about the flavored, colored liquid in easy to open vials, like these pictured.  According to a New York Times article, “a teaspoon of even highly diluted e-liquid can kill a small child.”  Did you also know that the e-liquids you buy to refill your electronic cigarette are not regulated by federal authorities?  Anyone can make e-liquids and sell them at this point in time; there are no quality control measures in place.  Meanwhile, the use of e-cigarettes by youth here in the U.S. has risen dramatically as the debate on the safety of e-products continues.

According to the data from the 2012 National Youth Tobacco Survey, “e-cigarette experimentation and recent use doubled among U.S. middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012.”  Scientists already know what addiction to nicotine can do to the human body.  Combining nicotine with candy flavoring in e-cigarettes is turning our youth “back to the future,” into another nicotine addicted generation.  The e-cigarette industry promotion of their products to our youth is an unconscionable act against the future health of our nation.

Click Smoke Screen: Are E-Cigarettes Safe? for the entire article.












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Smoking and Poverty

According to the Centers for Disease Control and Prevention, “cigarette smoking is the leading cause of preventable death in the U.S. accounting for more than 480,000 deaths every year.”  Although the adult smoking rate is the lowest it has been in decades, those adults in the poverty level are smoking more; current U.S. smoking rate is at 18.1%, but jumps to 27.9% for those adults living below the poverty level.  Researchers already know that adults in poverty tend to smoke more, but results of a recent study looked at Earned Income Tax Credit (EITC) benefits and combined it with the tobacco use data from the Census Bureau to “establish whether an increase in these payouts caused recipients to smoke more.”  What they found may surprise you.

The IRS.gov site says “the EITC is a benefit for working people who have low to moderate income”  The idea of this tax credit is to reduce the amount of tax you owe and provide you with more money in your pocket.  What researchers found was that a 10% increase in EITC income caused smokers to consume 20% more cigarettes per day or 3.37 more cigarettes.”  The 3.37 cigarettes may not sound like a substantial number, but it adds up to 101.1 cigarettes over a 30-day time period, or five extra packs of cigarettes in a month.

Not every person receiving EITC payouts is a smoker and for those non-smokers the additional income may help improve their health.  But smokers appear less likely to quit as they smoke more with the additional income.   While economists believe the EITC policy is effective, the researchers believe “it might be a good idea to provide anti-smoking programs alongside anti-poverty programs.”

The researchers admit that the scope of the study “wasn’t just to study the effects on the EITC on smoking”, but “to better under how lower-income Americans spend additional income.”  Sounds as if the researchers will have ideas for a new study.

Click here for the entire story.

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E-Cigarettes – Made You Look

Blu_001What does a tiny bikini bottom have to do with nicotine?  Absolutely nothing other then it grabs your attention and that seems to be the idea behind electronic cigarette advertising… making you look twice.  If the picture doesn’t grab you then the tech names and words used to describe the devices may appeal to those who have grown up in the digital age of robots and “i-” and “e-” prefaced devices.   And if all else fails, advertisers can always rely on the reliable adage that sex sells.

HiTechElectronic cigarette makers know that in order to grab market share they need to appeal to specific groups, like the young, Nanowho are driven by technology and tuned into their electronic devices.  If potential customers are caught up in the “i-” world phenomenon, they might find comfort in using products with names such as iSmoke, iCig or even Nano, which back in the day was the name of a mp3 player.  The “HiTech” brand proclaims it’s the “No. 1 E-Cigarette.”  Or maybe No. 1 means this is the first of several that will be coming out.  The Nano product calls itself an ePuffer for those who would rather “puff” on their electronic device than appear to “smoke” it.   Same difference, sounds less dangerous.   It’s all in the semantics, and the advertisers know it.

iPhone_adaptorThose who never leave home without their iDevice can now have a handy adapter that attaches itself directly to your phone, sort of like a pacifier.  And if you didn’t have time to plug your e-cig into a charger, no problem.  There is also a WiFi electronic cigarette that will connect to the charger via Wi-Fi; no more wall charger.

For the true smokioelectronic geek, perhaps the Smokio appeals to them.  It is the first connected electronic cigarette with “an app for iOS and Android, so you can track smoking, check the battery and regulate the amount of vapor you’re getting with each puff.”  Hopefully, it also tells you about the chemicals and amount of nicotine you are inhaling.

Hookah_hoseNo need to go to smoky hookah bars when you have the “hookah hose.” This e-device is about 12 inches long, contains approximately 1,500 puffs per cartridge and holds 2 cartridges, allowing you to mix flavors.  The only thing it doesn’t provide is the bubbling sound of water you get from a hookah.   Wonder if it will also build up bacteria in the hose like real hookahs?

Hookah_PenIf the e-device manufacturer can’t come up with a catchy name for their device, just use something eye-catching or sexy to get attention.  The tobacco industry has been using the same type of advertising ploys for years with cigarettes.   Never mind that you don’t quite know what brand the robot is selling, it still looks cool.  Of course, you will ecig_guynever look this good using the device, but that doesn’t matter, sexy robots catch your attention, just as sexy guys do.  The name of the product on the right is barely visible and the model isn’t even using it, but it still caught your attention.

Smoking a cigarette is dangerous for your health.  Using an e-device and calling it vaping,  puffing, piping, cloud chasing, or “modernizing life with technology” doesn’t make using an e-cigarette any safer.  You are still inhaling addicting nicotine and harmful chemicals into your body.  Know your facts and don’t be duped by the e-cigarette industry.

E-cigarette pictures are from Stanford School of Medicine

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New Proposed Regulations for E-Cigarettes

If you listened to the morning news on April 24, 2014, you heard that for the first time “the Food and Drug Administration will propose new rules that would extend its regulatory authority from cigarettes to other products such as electronic cigarettes.  This new change will also cover cigars and pipe tobacco which many smokers buy to roll-their-own cigarettes.   The new ban would mean minors under 18 would be prohibited from purchasing these products, and others would have to show proof of age with photo identification, rules already established in many states.  So what else do the new regulations mean?

It means producers of e-cigarettes and cigars would have to register with the FDA, provide a detailed ingredient list, and “disclose their manufacturing processes and scientific data.”  It also means if you plan on selling these products, you will be subject to FDA inspections.  Internet sales of e-cigarettes and cigars to minors would no longer be allowed.  The ban would also cover sales of these products in vending machines where minors have access.

e-cigarettes sample1It would also mean that companies can not offer free samples of products at events.  Considering e-cigarettes and other tobacco products contain nicotine, it would make sense to ban free samples of substances which could lead to a life-long addiction.  E-cigarettes would also have to have nicotine warning labels to let users know they are addictive. Currently, there are no such warnings on packages (see example at left).

While the cigar industry wants premium cigars (those hand-rolled using a tobacco leaf as the outer wrapper) to not be subjected to FDA authority, the FDA is requesting public comment on the subject.  It should be noted that while the cigar industry has been lobbying Congress to be exempt from the rules, cigars are more dangerous then cigarette products.  Premium cigars contain more tobacco than cigarettes with some containing the tobacco equivalent of an entire pack of cigarettes.  According to the National Cancer Institute, cigar smoke has a higher level of cancer-causing substances, more tar, and higher levels of toxins.  And a single premium cigar, which is usually smoked over several hours, can provide as much nicotine as a pack of cigarettes.  While cigar smoke is not typically inhaled into the lungs, the smoke is absorbed through the lining of the mouth, and toxins mix with saliva and are carried through the body.

flavorsThese bans the FDA are proposing are necessary, but they still don’t cover two elements that would help make these products less desirable to youth:  flavors and marketing.

Whether it is experimentation with a new digital product on the market, or the lack of the cigarette smell, use of e-cigarettes have more than doubled among middle and high school aged students between 2011-2012.  Another more simple reason for the increase is the e-cigarettes come in a variety of flavored nicotine such as chocolate, grape, and bubble gum, which replace tobacco flavor with a sweet candy-coating, making this addictive product seem like….well, candy.

e-cig_001While cigarette marketing is banned on television, the same can’t be said for e-cigarettes.  In fact, according to Campaign for Tobacco Free Kids, e-cigarette marketing uses the same marketing ideas used by cigarettes in years past such as celebrity endorsement, sexy ads, sponsorships at music and sports events, glamorous women, and cartoon characters.  The ads promote e-cigarette use with no harmful side effects, such as carcinogens found in cigarettes.  The industry as a whole advertise that e-cigarettes emit “harmless water vapor,” yet California Proposition 65, which was enacted to protect California citizens from chemicals known to cause cancer, provides a list of potentially deadly chemicals they have identified in mainstream or sidestream e-cigarette vapor.

While health experts and smoker’s rights advocates argue over tobacco and the role that e-cigarettes play, it’s the children who are increasing their use of flavored tobacco products and nicotine delivery systems that could cause them a lifetime of nicotine addiction.

Click here to read the article.



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Tobacco Free Florida Week: Team Up to Quit

Team_Up Team Up to Quit is the 2014 theme of the 6th annual Tobacco Free Florida Week April 21-27 currently in progress.  It encourages tobacco users to partner with their doctor as those who do are more successful in their quit attempts.  While everyone should know that tobacco is bad for your health, here some reasons why now is a good time to have that conversation.

Did you know smoking can cause cancer almost anywhere in the body?  Smoking doesn’t just affect the lungs, it affects the entire body, including the heart, circulatory system, respiratory system, digestive system, and reproductive systems of both men and women.   And if you get cancer, did you also know smoking may keep cancer treatments from working as well as they should?

Did you know that smoking is a major cause of cardiovascular disease (CVD)?  Even a person smoking fewer than 5 cigarettes a day can show signs of early stages of this disease. The more cigarettes and the longer you smoke, the greater the risk.  CVD includes narrow or blocked arteries in and around the heart (coronary heart disease), high blood pressure, heart attack, and heart-related chest pain (angina).  Did you know that exposure to secondhand smoke can cause these same diseases in non-smokers?



Did you know smoking causes peripheral arterial disease (PAD) or peripheral vascular disease (PVD) by narrowing blood vessels and reducing the flow of blood?   According to the American College of Cardiologists, “the risk of developing the disease is as much as three times higher for people who smoke as that of non-smokers.” People with PAD or PVD may have pain when they walk and the cells can die from a lack of oxygen if left untreated.  Gangrene could then develop in fingers and toes and the infected body part will have to be removed.  It appears that non-smokers exposed to secondhand smoke are also at an increased risk for PAD.  A Chinese study on women found “a 67% increased risk of PAD in those exposed to secondhand smoke compared to those who were not exposed.”



Did you know smoking can cause coronary heart disease, stroke or abdominal aortic aneurysm?   Chemicals in cigarette smoke causes some of the oxygen in the blood to be replaced with carbon monoxide which causes the blood to thicken and form clots inside veins and arteries.   Smoking also promotes the formation of plaque in the walls of arteries and clots can form where there is plaque.  If the arteries are already narrowed from smoking, these clots can block the arteries, and oxygen to nearby organs is cut off.  This blockage can lead to a heart attack and sudden death.  Strokes can happen when arteries that carry blood to the brain become blocked from a narrowing or a clot causing the blood vessel to leak or burst inside the brain.  Smoking is a known cause of early hardening of the abdominal aorta which supplies blood to the abdomen, pelvis and legs.  If a rupture happens, it causes life-threatening bleeding.  Almost all deaths from abdominal aortic aneurysm are caused by smoking and other tobacco use.  Women smokers have a higher risk of dying from this than men. diabetesDid you know that smoking causes type 2 diabetes?  If you smoke, you are 30% to 40% more likely to develop type 2 diabetes than nonsmokers.  Smokers are likely to have more trouble regulating insulin and controlling the disease.  According to the Philip Morris website, the third ingredient in Marlboro cigarettes by weight is…SUGAR, including sucrose and/or invert sugar and/or high fructose corn syrup.  Did you know smokeless tobacco also contains high amounts of sugar added to make the product taste good? Did you know, according to the 2012 Surgeon General report “Preventing Tobacco Use Among Youth and Young Adults,” that tobacco use is a pediatric epidemic, not only in the U.S. but around the world?   Did you know that “school based programs with specific components, can produce at least short-term effects and reduce the prevalence of tobacco use among school-aged youth?”  Did you know that “early signs of heart disease and stroke can be found in adolescents who smoke?”  Did you know that children and teens “who smoke 2 or 3 cigarettes a day can get hooked in as short as two weeks?”  Did you know children and teens who smoke are more likely to develop asthma, have reduced lung function and impaired lung growth?   Disease caused by smoking is not just for older smokers. Did you know that the benefits of quitting smoking start almost immediately?  Within one year, “the excess risk of coronary heart disease is half that of a continuing smoker’s.”  Within five years “risks of certain cancers are cut in half.”  Stroke risk can equal that of a non-smoker after 2-5 years of quitting.  After 15 years of quitting “the risk of coronary heart disease is that of a non-smoker’s.” Did you make the appointment with your doctor yet?  What are you waiting for?

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