Smoking is harmful to health. Are new tobacco products such as e-cigarettes really harmless to people?

Many people know that smoking is harmful to health, but how many people can learn from it? It is understood that about 6 million people die from tobacco-related diseases every year, which is equivalent to one person dying every 6 seconds. This number is shocking, but despite this, people don’t seem to take the harm that smoking may cause to heart, and the number of "smokers" is still huge. Many people know that smoking is bad for the body, but there is no way to quit. What should we do? Coinciding with World No Tobacco Day, let us learn about the harm caused by smoking and the knowledge of scientific smoking cessation.

1. The harm caused by smoking has become a global behavioral problem

The World Health Organization points out that tobacco-related diseases are a threat to the whole world. About 6 million people die from tobacco-related diseases every year, which is equivalent to one person dying every 6 seconds. It is estimated that by 2030, the number of deaths from tobacco-related diseases will exceed 8 million per year.

The use of new tobacco products is gradually increasing

In recent years, new tobacco products such as e-cigarettes and low-temperature cigarettes have become increasingly popular, and the issue of new tobacco products has always attracted much attention. Although the overall use rate of new tobacco products in my country is not high, due to the large population base, the number of e-cigarette users is still at a high level.

2. Note ! Smoking affects more than just lung health

The "China Smoking Health Harm Report" mentioned that there are more than 300 million smokers in my country, and more than 1 million people die from smoking-related diseases each year. However, the public's awareness of the harm of smoking is seriously insufficient, and more than 3/4 of the people do not fully understand the harm of smoking to health.

Some people only know that lung cancer is related to smoking. In fact, smoking can cause a variety of respiratory diseases such as cough, tracheitis, pneumonia, asthma, chronic obstructive pulmonary disease, etc. Studies have shown that more than 25% of smokers will develop chronic obstructive pulmonary disease. About 3 million people die from chronic obstructive pulmonary disease every year in the world, of which 1.2 million are caused by smoking. In addition, smoking is also an important cause of acute asthma attacks. The harm of smoking is not limited to the respiratory system, but also causes harm to various systems and organs throughout the body.

(1) Malignant tumors : The smoke produced by burning tobacco contains more than 7,000 chemical components, of which more than 200 are harmful to the human body. Among these harmful components, 69 are currently known carcinogens that can cause a variety of malignant tumors, such as lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, etc. At present, smoking is recognized as one of the main factors causing lung cancer.

(2) Cardiovascular and cerebrovascular diseases : Smoking can lead to a variety of cardiovascular and cerebrovascular diseases, such as coronary heart disease, angina pectoris, stroke, atherosclerosis, etc. In China, 46% of sudden deaths due to cardiovascular diseases among people aged 30-44 are related to smoking.

(3) Addictive diseases : Nicotine in tobacco is the main substance that causes addiction, and smoking is also an addictive chronic disease.

(4) Impact on the reproductive system : In addition to being addictive, nicotine in tobacco can also inhibit the secretion of male sex hormones, hinder the combination of sperm and egg, and affect conception. It is worth noting that tobacco is more likely to affect women's health, leading to menstrual disorders, miscarriage, premature birth, stillbirth, early menopause and other problems. The incidence and degree of osteoporosis in postmenopausal women who smoke are higher. Pregnant women smoking can also increase the incidence of congenital malformations in the fetus.

3. Are new tobacco products such as e-cigarettes really beneficial and harmless to the human body ?

Electronic cigarettes are electronic products that imitate cigarettes. They look similar to cigarettes and can produce the same smoke, taste and feel as cigarettes. Electronic cigarettes have a rechargeable lithium polymer battery that powers the atomizer, which heats the oil to turn it into vapor for users to inhale. Through research and clinical evidence, the World Health Organization has clearly pointed out that electronic cigarettes are harmful to health and are not a means of quitting smoking. They must be strictly controlled. The hazards of electronic cigarettes mainly include the following four aspects:

1. E-cigarettes contain the same addictive substances as traditional cigarettes

The main ingredient of e-cigarettes is nicotine, which is a highly toxic substance and is listed in the "Catalogue of Highly Toxic Chemicals" in my country. Repeated use of nicotine can also lead to a decrease in appetite, increased heart rate and blood pressure. Large doses of nicotine can cause nausea, vomiting, and even death.

Studies have shown that even young people who do not smoke traditional cigarettes will still become addicted if they use e-cigarettes containing nicotine for a long time, and may eventually become real smokers.

Nicotine exposure during adolescence affects brain development

During adolescence, the brain is not fully developed, and the limbic system that controls cognition, emotion, and reward is maturing. This period is particularly susceptible to the effects of nicotine. In 2014, the U.S. Surgeon General's Report pointed out that there is evidence that long-term exposure to nicotine during infancy and adolescence can cause damage to brain development. Currently, many countries have clearly stipulated that the sale of e-cigarette products to minors is prohibited.

2. E-cigarettes release toxic aerosols

During use, electronic cigarettes release aerosols, the main components of which include ethylene glycol, aldehydes, nitrosamines, volatile organic compounds, polycyclic aromatic hydrocarbons, heavy metals, silicate particles, etc. Among these substances, aldehydes, nitrosamines, volatile organic compounds, polycyclic aromatic hydrocarbons, etc. are currently known carcinogens.

3. E-cigarettes can cause a series of diseases

Studies have pointed out that compared with smokers who use traditional cigarettes, smokers who use both traditional cigarettes and e-cigarettes have a higher degree of health damage. At the same time, the study found that the use of e-cigarettes increases the risk of disease, especially the risk of respiratory diseases. Long-term use of e-cigarettes may lead to a variety of lung diseases, epilepsy, asthma, allergies and other diseases, and even increase the risk of chronic obstructive pulmonary disease, lung cancer, heart disease, stroke and other diseases. In 2019 alone, the United States reported nearly 2,000 cases of lung damage caused by e-cigarette use, of which 37 patients died.

4. As the “ flavors ” increase, the harm also increases

In order to attract more people to use e-cigarettes and increase their appeal, current e-cigarette manufacturers have made e-cigarettes more fashionable, compact and sophisticated, and added various additives and flavorings to the e-liquid, such as fruity, chocolate, and minty flavors, to stimulate more people to use them. However, these additional additives or flavorings come in many types, and when heated, they will release more harmful substances, increasing the harm to the human body.

Due to the lack of clear supervision on the quality of e-cigarette products, there are problems such as the nicotine content in e-cigarettes not being consistent with the product labels. In addition, the number of explosions and burns caused by non-standard e-cigarette production is also increasing.

"New cigarettes" such as electronic cigarettes cannot reduce the risk of disease. Smoking will harm health, and there is no such thing as harmless tobacco products. "Low-temperature cigarettes", "low-tar cigarettes", and "Chinese herbal cigarettes" are as harmful to human health as ordinary cigarettes.

4. The harm caused by second-hand smoke and third-hand smoke should not be underestimated

In China, secondhand smoke causes more than 100,000 deaths each year, many of which are children. Secondhand smoke, also known as environmental tobacco smoke, refers to a mixture of smoke emitted during the burning of tobacco products and the gas exhaled by smokers. Studies have shown that secondhand smoke seriously harms human health and can increase the risk of lung cancer by 20%-30% and the risk of coronary heart disease by 25%-35% for non-smokers. Worldwide, more than 40% of children, 33% of men and 35% of women non-smokers are suffering from secondhand smoke.

There is no " safe level " of secondhand smoke exposure

The "China Smoking Health Harm Report" mentions that there is no so-called safe level of exposure to secondhand smoke. Even short-term exposure to secondhand smoke will have an impact on human health. Indoor smoking bans are an effective way to prevent secondhand smoke from harming human health.

Electronic cigarettes also cause harm from secondhand smoke

Studies have shown that e-cigarettes also have the problem of secondhand smoke. Aerosols are produced during the heating and atomization of e-cigarette liquid, which will cause secondhand smoke. Aerosols contain nicotine, particulate matter, volatile organic compounds, heavy metals and other harmful substances. The aerosols produced during the heating process of e-cigarettes have a PM1.0 value that is 1440 times higher than that of fresh air, and a PM2.5 value that is 686 times higher. In addition, the content of heavy metals such as nickel and chromium in e-cigarette aerosols is even higher than that of traditional cigarettes. This is harmful to both users and people around them. Therefore, e-cigarettes, like traditional cigarettes, have the problem of secondhand smoke and even thirdhand smoke.

The inevitable third-hand smoke

With the implementation of the smoking ban, people are becoming more aware of first-hand smoke and second-hand smoke, but they have neglected the issue of third-hand smoke. Third-hand smoke is the pollutant that remains on the surface of objects such as clothes, walls, carpets, furniture, and even hair and skin after smoking or exposure to second-hand smoke. These substances can be released back into the air and combine with certain substances in the environment to form new pollutants. For example, nicotine, nitrosamines, and cotinine (a substance produced after nicotine is metabolized by the human body) can be released back into the air to form third-hand smoke. When touching sofas, clothes, carpets, etc. contaminated by third-hand smoke, harmful substances can enter the human body and cause harm to the human body.

It should be noted that third-hand smoke has the greatest impact on children and pregnant women. Since children often crawl and play on the ground, they are more likely to be exposed to third-hand smoke than adults. In addition, children's systems are not yet fully developed, so they are more sensitive to third-hand smoke. Children who are frequently exposed to third-hand smoke are more likely to suffer from diseases such as asthma and pneumonia. When pregnant women are exposed to third-hand smoke, harmful substances will enter the blood through respiration, which can increase the chances of the fetus suffering from respiratory diseases and sudden infant death syndrome after birth.

5. I always fail to quit smoking . Why is smoking so addictive ?

"I must quit smoking this time." This sentence is very familiar to those who have quit smoking many times. Whenever they make up their minds to quit smoking, withdrawal symptoms such as insomnia, irritability, weight gain, and inability to concentrate begin to torture smokers. According to statistics, about half of smokers who quit smoking relapse within less than a week of quitting, and 80% of smokers who quit smoking relapse within 1 month of quitting. Why is smoking so addictive?

Nicotine dependence is the main cause of smoking addiction. A foreign study on addictive substances has studied the dependence of 19 addictive substances including drugs. It was found that the addiction caused by nicotine is second only to cocaine and heroin, and higher than marijuana, methamphetamine and other substances. Therefore, nicotine is a highly addictive substance. After nicotine enters the human body, it will affect the complex effects of brain neurochemical reactions, causing people to become dependent on tobacco and become addicted. It is precisely because of the strong addictiveness of nicotine that smoking has become a highly recurrent addictive behavior.

Surveys show that about 20% of smokers try to quit smoking, but after quitting they experience nicotine withdrawal symptoms such as irritability, anxiety, difficulty getting along with others, inattention, hunger and weight gain, and most people fail in quitting smoking.

E-cigarettes may lead to nicotine overdose

Nicotine is the main ingredient of e-cigarettes, so smoking e-cigarettes can also lead to dependence and addiction. Due to the lack of supervision in the domestic e-cigarette market, e-cigarettes are in a "three-no" state of no product standards, no quality supervision, and no safety evaluation. Some unqualified e-cigarette products have high nicotine content, and inhaling excessive nicotine can cause direct harm to the human body.

6. How to quit smoking scientifically ?

Compared with non-smokers, smokers' life expectancy is reduced by about 10 years on average. The earlier you quit smoking, the more obvious the increase in life expectancy. Scientific proof: the earlier you quit smoking, the better your health. Studies show that quitting smoking at the age of 60, 50, 40, and 30 can increase life expectancy by about 3, 6, 9, and 10 years respectively. The benefits of quitting smoking are obvious. After quitting smoking for 20 minutes, blood pressure and heart rate will be stable. After quitting smoking for 12 hours, the carbon monoxide content in the blood will return to normal. After quitting smoking for more than 1 month, problems such as coughing caused by smoking will gradually decrease, and cardiopulmonary function will be significantly improved. After quitting smoking for more than one year, the risk of cardiovascular disease and various cancers, especially lung cancer, can be reduced by more than half compared to the smoking period.

(Medical staff from Qinhuangdao First Hospital explain to students from Donghuali Primary School the knowledge that smoking is harmful to health)

Although there are many benefits to quitting smoking, many people fail to quit smoking due to the severe withdrawal symptoms and high relapse rate. Therefore, it is crucial to learn scientific methods to quit smoking.

Try to quit smoking on your own

(1) When you start to quit smoking, remember why you want to quit and record your feelings.

(2) When you want to smoke, you can keep yourself busy by eating snacks, working, doing housework, etc.

(3) Reduce the number of times you go to smoking places and go to places where smoking is not allowed, such as movie theaters, shopping malls, etc.

(4) Reasonably divert negative emotions. When you are under too much stress, angry, or frustrated, you should learn to distract yourself to avoid relapse due to negative emotions.

(5) Be sure to seek support from family and friends.

If self-smoking cessation fails, you can use medication, acupuncture, hypnosis, aversion therapy, five-day smoking cessation method and psychological behavioral therapy under the guidance of a professional doctor to undergo smoking cessation treatment.

1. Drug therapy

Drug therapy is a widely used smoking cessation method in recent years, mainly including nicotine replacement therapy and non-nicotine drug therapy. The smoking cessation effect of nicotine replacement therapy can reach 3%-36.8%, which can reduce or alleviate a series of mental and physiological symptoms caused by smoking cessation, but this method has a high relapse rate and is prone to high dependence. The smoking cessation effect of non-nicotine drug therapy can reach 18%-34.4%, which can reduce the withdrawal symptoms caused by the smoking cessation process, but the side effects are large.

In recent years, drugs such as bupropion and varenicline have also been used in clinical practice for smoking cessation treatment. Bupropion is an antidepressant that can relieve the pain caused by withdrawal symptoms in smokers. Varenicline is a newly developed special smoking cessation drug that can specifically inhibit the binding of nicotine to brain nerves and is a special drug for smoking cessation. However, it should be noted that when using drug treatment to quit smoking, you must follow the doctor's instructions to use the drug and do not take the drug without authorization. The right drug and dosage are the key to effective drug treatment.

2. Acupuncture

Acupuncture therapy can adjust the body's internal environment to achieve the purpose of quitting smoking. The average smoking cessation effect can reach about 30%, but there are still problems such as high relapse rate, lack of sufficient evidence support, and the smoking cessation effect decreases with time.

3. Hypnotherapy

Hypnosis therapy mainly helps smokers reduce or eliminate the desire to smoke, consolidate their confidence in quitting smoking, and correspondingly reduce the withdrawal syndrome caused by quitting smoking.

4. Five-day smoking cessation method

The five-day smoking cessation method starts from the three aspects of pharmacology, psychology and society, increases smokers' awareness of active smoking cessation, and helps smokers establish a healthy lifestyle through health education, psychotherapy, behavioral support and other methods, assists smokers to overcome various smoking cessation difficulties and obstacles, and thus achieve the purpose of smoking cessation. The smoking cessation effect of the five-day smoking cessation method can reach 20%-25%, but there is a high relapse rate.

5. Aversion therapy

Through malignant stimulation such as rapid smoking, the smoking dependence can be weakened or eliminated, making smokers feel disgusted with smoking. The smoking cessation effect can reach 20%-25%. However, it should be noted that rapid smoking can lead to nicotine poisoning, also known as "smoking drunkenness".

6. Psychological behavioral intervention therapy

The smoker's own desire to quit smoking is a prerequisite for whether quitting smoking can be successful. Once the smoker's motivation to quit smoking weakens, relapse will occur. Experts point out that no matter which method is used to quit smoking, the smoker's motivation to quit smoking is an important condition for the success of quitting smoking. Before quitting smoking, you must be clear about why you want to quit smoking, fully understand the early withdrawal reactions, and think of ways to deal with them.

Although each smoking cessation method has different degrees of effectiveness, they all have problems such as high relapse rates. Tobacco addicts have different degrees of nicotine dependence, and there are also large individual differences. According to the characteristics of different smokers, for those who are more addicted, combined smoking cessation intervention methods can be adopted. Therefore, when quitting smoking, smokers can combine the five-day smoking cessation method, drug therapy, acupuncture therapy and psychological behavioral intervention therapy.

If the above recommended methods are ineffective for smokers, they can use other methods such as aversion therapy and hypnosis therapy according to their actual situation under the guidance of professional medical staff.

Can e-cigarettes really help people quit smoking ?

Electronic cigarettes have always been promoted as an aid to quitting smoking, but can they really help people quit smoking? On the one hand, there is no sufficient scientific evidence to show that electronic cigarettes can help people quit smoking; on the other hand, due to the addictiveness of using electronic cigarettes, it can also cause non-smokers to smoke traditional cigarettes. The World Health Organization has issued a statement that clearly states that electronic cigarettes are not recommended as an aid to quitting smoking, and clinicians do not recommend smokers to use electronic cigarettes to quit smoking.

In fact, for smokers, whether they can successfully quit smoking mainly depends on their cognition of smoking behavior. Most smokers do not fully understand or underestimate the harmfulness of smoking, and do not have firm confidence in quitting smoking, which leads to failure in quitting smoking.

Quitting smoking, in addition to mastering scientific methods, is also something that requires long-term persistence. Although the process may not be pleasant, it is the most effective way to ensure health and stay away from various diseases. For the sake of our health, I hope everyone can recognize the harm of smoking, stay away from cigarettes, and quit smoking with scientific and healthy methods.

(Author: Zhang Jing)

Scientific review: Guo Xiheng, chief physician and professor of the Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital

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