CANCER PREVENTION AND SCREENING: TOBACCO OR HEALTH

If you're a smoker, you probably won't want to read this - but you should. And if you know or live with a smoker, you may want to read this, too.

I don't have to tell you that tobacco is a dangerous product. The evidence is everywhere and it's widely published. Year after year, study after study, all show the same thing: that tobacco use causes heart and lung disease, cancer, stroke and all too often, even death. Right now, tobacco is responsible for taking 3 million lives each year - nearly half a million in the United States alone. When pregnant women smoke, it reduces the birth weight and even the intelligence of their unborn children. When non-smokers are exposed to secondhand smoke from a family member or loved one, they, too, are at risk for disease. Yet with all of this evidence, there are literally millions who continue to use tobacco.

So, why do smokers keep lighting up? Is it a desire to live dangerously? A deep streak of self-destructiveness? A naive, "it won't happen to me" mentality? I don't think so.

Smokers aren't immune to the messages that surround them, any more than they're immune to the dangerous effects of tobacco itself. What they are - is addicted. And it's one of the most ferocious, tenacious, agonizing addictions in the world.

It's said that the addictive power of tobacco is greater than that of heroin. Yet for years, heroin was perceived as an underground phenomenon, while smoking was a social choice. We now know that it takes very, very little nicotine to establish the seeds of addiction. And once addicted to tobacco, it can be very difficult to stop using it. Most smokers who try to quit make at least three attempts before succeeding. It's hard work, and it takes determination.

But now your doctor may be able to do more to help. There are new pharmacologic treatments available to help treat nicotine addiction and its symptoms. While your doctor may also recommend nicotine replacement therapy, these newest medications don't provide a substitute source of nicotine - they help reduce the craving for it. If you or someone you know has tried and failed to quit, ask your doctor about prescriptions that can help.

Your doctor also may be one of many physicians who are helping to see that more people never start smoking at all. Physicians have been working to fight tobacco's influence nationally and worldwide - from making sure that state tobacco settlement dollars are used for education and prevention, to helping to keep the dialogue going. In fact, the American Medical Association, in coordination with the American Cancer Society and the Robert Wood Johnson Foundation, hosted the World Conference on Tobacco OR Health, held August 6-11 in Chicago.

More than 4,500 people attended this international gathering, ranging from physicians to leaders in government health ministries, cancer societies and other interested groups. Together, they looked at the latest scientific and sociological information on tobacco. And together, they began to build on individual successes to find solutions to the global health problem of tobacco use.

Still doubt that it's a problem? Just two weeks ago, The Wall Street Journal reported on the tobacco industry's efforts to discredit the work of the World Health Organization in preventing tobacco addiction. That can only mean that they know that the health choices are clear. Despite the overwhelming evidence against it, tobacco remains a global problem; by 2029, it is predicted to be the greatest killer in the world.

As a physician, however, I know that tobacco addiction is primarily an individual, personal problem, and the real battles are being won one smoker - or one person who never starts - at a time. If you want to know more about the risks of tobacco use and how to stop, talk to your physician. He or she can help - not only with medications, but also with counseling and information and support. And to read more about tobacco and what smoking means to your health, visit your physician's practice site on Medem.com. If your physician doesn't yet have a site, ask her or him to create one. And always feel free to visit my practice Web site for information as well. Just go to http://www.familymedicine_brazosvalley.yourmd.com to see articles I've selected, or type "tobacco" into the search engine to see the latest research and information from the Medem library. Above all, remember this: when the choice is Tobacco OR Health, your doctor is there - to help you make the decision you can live with. Good luck and good health.

Sincerely,

Nancy W. Dickey, M.D.
Editor-In-Chief
Medem