Tobacco Documents Online

A HOLIDAY CHECK LIST While this publication has addressed itself periodicallyy to the dangers posed by inhaledd tobacco smoke; it has never gathered them into one list. Given the unequivocal fact that ciga- rette smoking is this nations number one injurious personal habit, it is time to do so: As you proceed down the following list -much as you would check off a list of holiday chores -you might conclude that the best gift you could give ourself is the decision to stop smoking. Smokers expose themselves to over 1,000 different chemicals each time they light up and' increase the risk of: LUNG' CANCER -Up to a 24-fold greater chance of heavy smokers developing this number one cancer killer (versus non-smokers) - not to mention an increased chance of developing MOUTH, LIP, VOICEBOX, PANCREAS, and URINARY BLADDER CANCER. HEART ATTACK-A two to three times greater chance of dying from a heart attack than a non.smoker -and, given the fact that 675,000 Americans will die of a heart attack next year, a doubling or tripling of the risk is no small item. EMPHYSEMA -(Chronic obstructive lung disease) -marked by diffieultyin breathing,with even minor exertion-nineteen times more:common in smokers versus non-smokers - the most common life-threatening chronic disease in America -almost a sure bet in a heavy smoker who lives long enough. STILLBIRTHS AI*LD SICK IhII• ANTS -A twofold increase in risk for spontane- ous abortions (miscarriages) in smoking mothers-children born to smoking mothers weigh 200 grams less on average than children born to non-smokers - studies in Britain and Israel show that infants of mothers who smoke are more likely to be admitted to the hospital during the first year of life for bronchitis or pneumonia. WRINKLES - Dermatologists are starting to report observations that women who smoke are more likely to develop facial wrinkles as they grow older-thi's may be the most convincing argument for those who tend to worry more about how they look than about how they feel. MONEY UP IN SMOKE -The cost of a two-pack a day habit now approaches $500 a year-enough to buy two tailor-made suits or a week at a resort. ETC. -hlot to mention a decreasedisense of smell and taste, a constant cough, an increased chance of dying in bed from a fire; a tell-tale odor on clothes and breath, and in the home and car, etc., etc., etc. EDITOR. G. Timolfiy./ohnrson, MD. ADVI50RYBOARD. Slephen E. Gu6dhngrr,.M.D., Ch-man..K'ennelhArndt: M.D;. Dermatof~.gr, Mary Ellen Avrry, M.D.. pediatn<s;.lpeter Bran, M D., Internal IMkdJcme, Thonnlon B.rown. M.D., (Jrlhoped-. Leon Eisenberg, M-D:, I'iych-rr. waBrr Gur.ln4rk, D.M.D.. OralSurgery;ThomasHutchm .M.D.,.Ophlh 1 olnR,RO K IIey,MD,Omology.IGeorgeK ti1.D.,M1vI~ u :)ohan p Imulter,h1.D.,Ob.le1r,rs, andGynecnlogy, Slephen Schoenbauro, M.D:, h le.l tited~rneMarshall Sleomq: M D-, C?lolaryng I gy; An~rew Narshaw, M D,. Svrgrrv..Edward walpow:. Neurology. GENERAL MAt.'AGE~R Lynn B.. Kargrnan: I Hirvand School ofPub.nc HeaIth, :'^ f.r•sident and IErllows of HJrrard ~olllge: 1977. Speaial Mritlen permission, is required lo reproduce, byanymann-, in whole or pan,.lhe malerill herrin ronuined.. . ® dcm~

The good thing about deciding to stop smoking is that benefits begin immediately. Within days, smell and taste begin to improve and the cough starts to disappear. More important, lung funct7on as measured by breathing tests improves within weeks. And, if you stay off cig- arettes long enough, you can return to the same risk'categoryfor lung cancer and'heart attacks as the noi~smoker. Why not give yourself these presents this year? (3) Therefore, the Committee for theStudy of PoliomyelitisVaccines'of the Institute~ of Medicine has unanimously recommended that the oral vaccine continue to be the vaccinee of choice for routine immunizations in child4-en. In addition, it recommends that: " POLIO VACCINES-SAFE OR NOT? In 1952, thirty=threethousand cases of paralytic polio resultingini3,145 deaths were reported in the United States; last year, eight cases and no deaths were reported. This astounding decrease in the incidence of a killer disease did not, of course, happen by accident; it happened'because large numbers of American children,(77% of whites and 60% of non- whites by 1965) were vaccinated against polio. By 1974, however, those figures had dropped to 67% and 45%, respectively, and last year's confusing experience with the swine flu vaccine is expected to further lower the public'sinterest in vaccination. In the specifiic case of polio, there is a further concern about the danger of contracting polio from the vaccine ~- and! about the relative safety of the oral (live, but weakened virus) versus the injected'(killed virus) vaccine. Many European countries use only the inj ected vac- cine, but since 1962, the official! policy in this country has been to use the oral vaccine. Recently,, the Institute of Medicine released a report addressed to this issue and the following are its summary points as presented4n the New England Journal of Medicine: (1)~ The safety of both vaccines is outstanding. No cases of polio have been, attributed to! the injected vaccine. The risk for the oral vaccine is estimated to be about one case of polio for every 11.5 million persons vaccinated, with a further risk of one household con- tact case for every 3.9 million vaccinated. Only one death since 1969 has been attributed' to the use of the oral vaccine -as compared'with the hundreds or even thousands of deaths annually from polio before the vaccine. (2) Given the very mini¢nalirisk fromioral vaccine versus no risk from injected vaccine, some ask why the injected vaccine is not recommended for the general population. The answer to the question invol~ves some sophisticated theory which can be summarized by saying that in the context of current immunizat'ion~levels in this country (60-70% versus the over 90% levels achieved by many European countries), the oral vaccine provides better immunity in the general population because of its ability to extend protection beyond the recipient. This is because the vaccine virus spreads to and immunizes somee contacts of the vaccinated person. Children receive an oral polio booster before entrance into the seventh grade (about age 11-12) to provide continued protection~into adult years. Injected vaccine be available for persons with immunological dihorders that make them unusualliy, susceptible to infections; for adults undergoing initial vaccination or traveling to areas where polio is a problem; and for persons who wish to receive this vaccine after understanding the issues described'. The Advisory Board of The Health Letter strongly urges adults to see that the children they care for receive the polio vaccine as recommended above. The risk of vaccination is very minimal -almost non-existent -when compared with the risk of polio in an unvaccinated population, I' , l r 4 (2)

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