smoking; cigarette smoking; tobacco smoking

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Etiology

Epidemiology

  • cigarette smoking among U.S. high school students has dropped to the lowest level in more than 20 years (16%)[37]
  • hispanic youth most susceptible to smoking[49]
  • smoking during pregnancy[57]
    • most common among women age 20-24
    • most common among Native Americans (17%)
    • least common among Asian women (< 1%)
    • most common in West Virginia > Kentucky, Montana, Missouri, & Vermont -least common in California, Connecticut, & Texas[57]

Pathology

Some known carcinogens in smoke

Genetics

Laboratory

Diagnostic procedures

Radiology

Complications

* Unfiltered high-tar cigarettes associated with greatest risk Amount of tar in filtered cigarettes has little effect on risk[11]

# 26-fold increase risk of lung cancer for 1 pack/day relative to non-smoker

reduction in smoking reduces lung cancer risk[16]

even consistent smoking < 1 cigarette/day is associated with excess mortality relative to never smokers (RR=1.6)[52]

Diseases associated with or aggravated by smoking:

Other increased risks:

Pipe & cigar smoking also associated with COPD[25]

Water pipe smoking with pulmonary effects similar to cigarettes[27]

2nd hand smoke or passive smoking:

Management

Notes

  • menthol cigarettes*
    • increase initiation of smoking by youth
    • increase dependence
    • reduce likelihood of successfully quitting smoking
    • do not increase smoke toxicity
    • do not increase risk for disease[33]

smoking bans in US prisons reduces smoking-related mortality by 9%[38]

FDA announces plans to reduce nicotine levels in combustible cigarettes to nonaddictive levels[54][58]

* comparisons relative to non-menthol cigarettes

More general terms

More specific terms

Additional terms

References

  1. ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 738-39
  2. ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 18. American College of Physicians, Philadelphia 1998, 2018.
  3. ↑ 3.0 3.1 Journal Watch 20(18):144, 2000 Christen WG et al Smoking cessation and risk of age-related cataract in men. JAMA 284:713, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10927779
  4. ↑ 4.0 4.1 Journal Watch 21(1):4, 2001 Lasser K et al Smoking and mental illness: A population-based prevalence study. JAMA 284:2606, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11086367
  5. ↑ 5.0 5.1 5.2 Journal Watch 22(3):24, 2002 Janson C et al Effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study. Lancet 358:2103, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11784622
  6. ↑ 6.0 6.1 Journal Watch 22(6):46, 2002 Moller AM et al Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 359:114, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11809253
  7. ↑ Journal Watch 22(8):62-63, 2002 Cornuz J et al Efficacy of resident training in smoking cessation: a randomized, controlled trial of a program based on application of behavioral theory and practice with standardized patients. Ann Intern Med 136:429, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11900495
  8. ↑ 8.0 8.1 Journal Watch 22(8):62, 2002 McMartin KI Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS). J Pediatr 140:205, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11865272
  9. ↑ Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  10. ↑ 10.0 10.1 Journal Watch 23(13):106, 2003 Enstrom JE & Kabat GC Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ 326:1057, 2003 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12750205 <Internet> http://bmj.com/cgi/content/full/326/7398/1057
    Davey Smith G Effect of passive smoking on health. BMJ 326:1048, 2003 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12750182 <Internet> http://bmj.com/cgi/content/full/326/7398/1048
  11. ↑ 11.0 11.1 Journal Watch 24(5):42, 2004 Harris JE et al Cigarette tar yields in relation to mortality from lung cancer in the cancer prevention study II prospective cohort, 1982-8. BMJ 328:72, 2004 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/14715602 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7431/72
  12. ↑ 12.0 12.1 Journal Watch 24(12):99, 2004 Hill S, Blakely T, Kawachi I, Woodward A. Mortality among 'never smokers' living with smokers: two cohort studies, 1981-4 and 1996-9. BMJ. 2004 Apr 24;328(7446):988-9. Epub 2004 Apr 05. No abstract available. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15066889 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7446/988
  13. ↑ 13.0 13.1 Journal Watch 24(16):131, 2004 Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519. Epub 2004 Jun 22. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15213107 <Internet> http://bmj.bmjjournals.com/cgi/content/full/328/7455/1519
  14. ↑ Journal Watch 25(6):49, 2005 Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE; Lung Health Study Research Group. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005 Feb 15;142(4):233-9. Summary for patientsin: Ann Intern Med. 2005 Feb 15;142(4):I12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15710956
  15. ↑ Journal Watch 25(13):106, 2005 Chinn S, Jarvis D, Melotti R, Luczynska C, Ackermann- Liebrich U, Anto JM, Cerveri I, de Marco R, Gislason T, Heinrich J, Janson C, Kunzli N, Leynaert B, Neukirch F, Schouten J, Sunyer J, Svanes C, Vermeire P, Wjst M, Burney P. Smoking cessation, lung function, and weight gain: a follow-up study. Lancet. 2005 May 7;365(9471):1629-35; discussion 1600-1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15885295
    Colditz GA, Stein C. Smoking cessation, weight gain, and lung function. Lancet. 2005 May 7;365(9471):1600-1. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15885280
  16. ↑ 16.0 16.1 Godtfredsen NS, Prescott E, Osler M. Effect of smoking reduction on lung cancer risk. JAMA. 2005 Sep 28;294(12):1505-10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16189363
  17. ↑ Barnfather KD et al Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme: randomized controlled trial. BMJ 331(7533): 999, 2005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16210250
  18. ↑ 18.0 18.1 Vollset SE, Tverdal A, Gjessing HK. Smoking and deaths between 40 and 70 years of age in women and men. Ann Intern Med. 2006 Mar 21;144(6):381-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16549850
  19. ↑ 19.0 19.1 Teo KK et al, Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case control study. Lancet 2006, 368:647 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16920470
  20. ↑ Prescriber's Letter 13(12): 2006 Smoking Cessation Drug Therapy Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=221212&pb=PRL (subscription needed) http://www.prescribersletter.com
  21. ↑ Klement E et al, Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis 2006, 43:1239 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17051486
  22. ↑ 22.0 22.1 Lavi S, Prasad A, Yang EH, Mathew V, Simari RD, Rihal CS, Lerman LO, Lerman A. Smoking is associated with epicardial coronary endothelial dysfunction and elevated white blood cell count in patients with chest pain and early coronary artery disease. Circulation. 2007 May 22;115(20):2621-7. Epub 2007 May 7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17485580
  23. ↑ Prescriber's Letter 15(7): 2008 Comparison of Smoking Cessation Drug Therapy CHART: Comparison of Smoking Cessation Drug Therapy COMMENTARY: Smoking Cessation Drug Therapy: An Update GUIDELINES: Treating Tobacco Use and Dependence: 2008 Update Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240706&pb=PRL (subscription needed) http://www.prescribersletter.com corresponding NGC guideline withdrawn Jan 2013
  24. ↑ U.S. Preventive Services Task Force. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2009 Apr 21; 150:551 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19380855 <Internet> http://www.ahrq.gov/clinic/uspstf/uspstbac2.htm
    NGC guideline updated Feb 2016
  25. ↑ 25.0 25.1 Rodriguez J et al. The association of pipe and cigar use with cotinine levels, lung function, and airflow obstruction: A cross-sectional study. Ann Intern Med 2010 Feb 16; 152:201. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20157134
  26. ↑ Cote GA et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol 2011 Mar; 9:266 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21029787
  27. ↑ 27.0 27.1 Raad D et al. Effects of water-pipe smoking on lung function: A systematic review and meta-analysis. Chest 2011 Apr; 139:764 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20671057
    Hakim F et al. The acute effects of water-pipe smoking on the cardiorespiratory system. Chest 2011 Apr; 139:775. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21030492
  28. ↑ 28.0 28.1 Hackshaw A et al, Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls Hum. Reprod. Update (2011) Published online: July 11, 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21747128 <Internet> http://humupd.oxfordjournals.org/content/early/2011/07/09/humupd.dmr022.full#aff-1
  29. ↑ 29.0 29.1 Gellert C et al Smoking and All-Cause Mortality in Older People: Systematic Review and Meta-analysis Arch Intern Med. 2012;172(11):837-844 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22688992 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1182214
    Lam TH Absolute Risk of Tobacco Deaths: One in Two Smokers Will Be Killed by Smoking: Comment on "Smoking and All-Cause Mortality in Older People" <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22688993 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1182209
  30. ↑ 30.0 30.1 30.2 Sakata R et al Impact of smoking on mortality and life expectancy in Japanese smokers: a prospective cohort study BMJ 2012;345:e7093 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23100333 <Internet> http://www.bmj.com/content/345/bmj.e7093
  31. ↑ 31.0 31.1 31.2 Pirie K et al The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK The Lancet, Early Online Publication, 27 October 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23107252 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61720-6/abstract
    Huxley RR and Woodward M Full hazards of smoking and benefits of stopping for women. The Lancet, Early Online Publication, 27 October 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23107253 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61780-2/fulltext
  32. ↑ 32.0 32.1 32.2 Sandhu RK et al Smoking, Smoking Cessation and Risk of Sudden Cardiac Death in Women Circulation: Arrhythmia & Electrophysiology. December 11, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23233741 <Internet> http://circep.ahajournals.org/content/early/2012/11/16/CIRCEP.112.975219.abstract
  33. ↑ 33.0 33.1 FDA News Release: July 23, 2013 FDA invites public input on menthol in cigarettes http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm361966.htm
    FDA. July 2013 Preliminaty Scientific Evaluation of the Possible Public Health Effects of Menthol versus Nonmenthol Cigarettes. http://www.fda.gov/downloads/TobaccoProducts/ResourcesforYou/UCM361953.pdf
  34. ↑ Moyer VA et al Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. Published online 26 August 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23974179 <Internet> http://annals.org/article.aspx?articleid=1731189
  35. ↑ 35.0 35.1 Jutberger H, Lorentzon M, Barrett-Connor E et al Smoking predicts incident fractures in elderly men: Mr OS Sweden. J Bone Miner Res. 2010 May;25(5):1010-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19929437
  36. ↑ Tverdal A, Bjartveit K. Health consequences of reduced daily cigarette consumption. Tob Control. 2006 Dec;15(6):472-80. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17130377
  37. ↑ 37.0 37.1 Kann L et al Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance - United States, 2013. MMWR. June 13, 2014 / 63(ss04);1-168 http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6304a1.htm
  38. ↑ 38.0 38.1 Binswanger IA et al. Prison tobacco control policies and deaths from smoking in United States prisons: Population based retrospective analysis. BMJ 2014 Aug 5; 349:g4542. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25097186 <Internet> http://www.bmj.com/content/349/bmj.g4542
  39. ↑ 39.0 39.1 Dumanski JP et al. Smoking is associated with mosaic loss of chromosome Y. Science 2014 Dec 4 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25477213 <Internet> http://www.sciencemag.org/content/347/6217/81
  40. ↑ 40.0 40.1 40.2 Carter BD, Abnet CC, Feskanich D et al Smoking and mortality - beyond established causes. N Engl J Med. 2015 Feb 12;372(7):631-40 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25671255 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMsa1407211
  41. ↑ 41.0 41.1 41.2 41.3 41.4 Siegel RL et al Deaths Due to Cigarette Smoking for 12 Smoking-Related Cancers in the United States. JAMA Intern Med. Published online June 15, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26076120 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=2301375
  42. ↑ 42.0 42.1 Regan EA et al Clinical and Radiologic Disease in Smokers With Normal Spirometry. JAMA Intern Med. Published online June 22, 2015 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26098755
  43. ↑ 43.0 43.1 U.S. Preventive Services Task Force (USPSTF) Screening for Abdominal Aortic Aneurysm: U.S. Preventive Services Task Force Recommendation Statement. DRAFT. Summary of Recommendations and Evidence. http://www.uspreventiveservicestaskforce.org/draftrec.htm
    Guirguis-Blake JM et al Ultrasonography Screening for Abdominal Aortic Aneurysms: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Ann Intern Med. Published online 28 January 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24473919 <Internet> http://annals.org/article.aspx?articleid=1817257
    LeFevre ML on behalf of the U.S. Preventive Services Task Force Screening for Abdominal Aortic Aneurysm: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. Published online 24 June 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24957320 <Internet> http://annals.org/article.aspx?articleid=1883339
    US Preventive Services Task Force. Screening for abdominal aortic aneurysm: US Preventive Services Task Force recommendation statement. JAMA 2019 Dec 10; 322:2211. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31821437
    Guirguis-Blake JM et al. Primary care screening for abdominal aortic aneurysm: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2019 Dec 10; 322:2219. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31821436
    Freischlag JA. Updated guidelines on screening for abdominal aortic aneurysm. JAMA 2019 Dec 10; 322:2177. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31821419
  44. ↑ Vassallo R Diffuse lung diseases in cigarette smokers. Semin Respir Crit Care Med. 2012 Oct;33(5):533-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23001806
  45. ↑ Jones MR et al Cigarette Smoking and Prostate Cancer Mortality in Four US States, 1999-2010. Prev Chronic Dis 2016;13:150454. April 14, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27079649 Free Article <Internet> http://www.cdc.gov/pcd/issues/2016/15_0454.htm
  46. ↑ 46.0 46.1 46.2 Woodruff PG et al. Clinical significance of symptoms in smokers with preserved pulmonary function. N Engl J Med 2016 May 12; 374:1811. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27168432
    Fabbri LM. Smoking, not COPD, as the disease. N Engl J Med 2016 May 12; 374:1885 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27168438
  47. ↑ 47.0 47.1 Niemela S et al. Prenatal nicotine exposure and risk of schizophrenia among offspring in a national birth cohort. Am J Psychiatry 2016 May 24; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27216261 <Internet> http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.15060800
  48. ↑ Cigarette smoking. Early Release of Selected Estimates Based on Data From the National Health Interview Survey, 2015. http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201605_08.pdf
  49. ↑ 49.0 49.1 El-Toukhy S, Sabado M, Choi K Trends in Susceptibility to Smoking by Race and Ethnicity. Pediatrics Oct 2016, e20161254 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27940778
  50. ↑ 50.0 50.1 Lloyd A, Steele L, Fotheringham J et al Pronounced increase in risk of acute ST-segment elevation myocardial infarction in younger smokers. Heart. Nov 29, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27899428 <Internet> http://heart.bmj.com/content/early/2016/10/31/heartjnl-2016-309595
    Arbel Y When will we learn that smoking is bad? Heart. Nov 29, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27899429 <Internet> http://heart.bmj.com/content/early/2016/10/31/heartjnl-2016-310687
  51. ↑ 51.0 51.1 Chang L, Oishi K, Skranes J et al. Sex-specific alterations of white matter developmental trajectories in infants with prenatal exposure to methamphetamine and tobacco. JAMA Psychiatry 2016 Nov 9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27829078
    Roos A, Donald KA. Refining the understanding of the effects of prenatal methamphetamine and tobacco exposure on the developing brain. JAMA Psychiatry 2016 Nov 9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27829080
  52. ↑ 52.0 52.1 Inoue-Choi M, Liao LM, Reyes-Guzman C et al Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health-AARP Diet and Health Study. JAMA Intern Med. Published online December 5, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27918784 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2588812
  53. ↑ 53.0 53.1 53.2 Quinn PD, Rickert ME, Weibull CE et al Association Between Maternal Smoking During Pregnancy and Severe Mental Illness in Offspring. JAMA Psychiatry. Published online May 3, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28467540 <Internet> http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2625170
    Kendler KS Causal Inference in Psychiatric Epidemiology. JAMA Psychiatry. Published online May 3, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28467524 <Internet> http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2625167
  54. ↑ 54.0 54.1 FDA News Release. July 28, 2017 FDA announces comprehensive regulatory plan to shift trajectory of tobacco-related disease, death. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm568923.htm
  55. ↑ 55.0 55.1 Hackshaw A, Morris JK, Boniface S, Tang JL, Milenkovic D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ 2018;360:j5855 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29367388 <Internet> http://www.bmj.com/content/360/bmj.j5855
    Johnson KC Just one cigarette a day seriously elevates cardiovascular risk. BMJ 2018;360:k167 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29367307 <Internet> http://www.bmj.com/content/360/bmj.k167
  56. ↑ 56.0 56.1 Christensen CH, Rostron B, Cosgrove C et al Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population. JAMA Intern Med. Published online Feb 19, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29459935 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2672576
  57. ↑ 57.0 57.1 57.2 Centers for Disease Control & Prevention (CDC) Cigarette Smoking During Pregnancy: United States, 2016 NCHS Data Brief No. 305, February 2018 https://www.cdc.gov/nchs/products/databriefs/db305.htm
  58. ↑ 58.0 58.1 Ault A FDA to Lower Nicotine in Cigarettes to 'Nonaddictive' Levels. Medscape - Mar 15, 2018. https://www.medscape.com/viewarticle/893990
    FDA Statement. March 15, 2018 Statement from FDA Commissioner Scott Gottlieb, M.D., on pivotal public health step to dramatically reduce smoking rates by lowering nicotine in combustible cigarettes to minimally or non-addictive levels. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm601039.htm
    Apelberg BJ, Feirman SP, Salazar E et al Potential Public Health Effects of Reducing Nicotine Levels in Cigarettes in the United States. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29543114 N Engl J Med. March 15, 2018 http://www.nejm.org/doi/full/10.1056/NEJMsr1714617
  59. ↑ 59.0 59.1 Duncan MS, Freiberg MS, Greevy RA Jr et al Association of Smoking Cessation With Subsequent Risk of Cardiovascular Disease. JAMA. 2019;322(7):642-650. Aug 20, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31429895 https://jamanetwork.com/journals/jama/fullarticle/2748507
    Cole TB Smoking Cessation and Reduction of Cardiovascular Disease Risk. JAMA. 2019;322(7):651. Aug 20, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31429880 https://jamanetwork.com/journals/jama/fullarticle/2748488

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