Tobacco Cessation, Rural Residence, and Lung Cancer

Abstract

Tobacco use remains the leading cause of preventable mortality and morbidity in the U.S., responsible for nearly 443,000 deaths annually (Fu et al., 2014; CDC, 2011). Cigarette smoking has been causally linked to numerous types of cancer (lung, mouth, nasal cavity, throat, laryngeal, esophageal, stomach, colon, liver, pancreatic, bladder, cervical, acute myeloid leukemia); cardiovascular disease (heart disease, stroke, aortic aneurysm); diabetes; rheumatoid arthritis; age-related macular degeneration; and respiratory illness (chronic bronchitis, emphysema) (NCI 2014). Smoking also contributes to respiratory infections (e.g., pneumonia) and, if a mother smokes while pregnant, to low birth weight and premature birth, the primary causes of infant mortality. Use of other tobacco products such as cigars or pipes and electronic cigarettes also increase the risk of cancer. In the U.S., cigarette smoking causes about 90% of lung cancers. According to the Centers for Disease Control and Prevention (CDC), tobacco smoke is a toxic mixture of more than 7,000 chemicals, of which at least 70 are known to cause cancer. In addition to nicotine, tobacco users are exposed to several classes of carcinogenic and other toxicants such as tobacco-specific nitrosamines (TSNAs), volatile organic compounds (VOC), and polycyclic aromatic hydrocarbons (PAHs), all of which have been linked to cancer, heart and lung diseases (U.S. Department of Health and Human Services, 2010). Individuals who smoke are 15–30 times more likely to develop lung cancer and die from lung cancer than people who do not smoke (NCI 2014).