Cigarette smoking harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general.

Quitting smoking lowers your risk for smoking-related diseases and can add years to your life.

Smoking and Death

Cigarette smoking is the leading cause of preventable death in the United States.

• Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths.
• Smoking causes more deaths each year than the following causes combined:
  • Human immunodeficiency virus (HIV)
  • Illegal drug use
  • Alcohol use
  • Motor vehicle injuries
  • Firearm-related incidents
• More than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States.
• Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths. More women die from lung cancer each year than from breast cancer.
• Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD).
• Cigarette smoking increases risk for death from all causes in men and women.
• The risk of dying from cigarette smoking has increased over the last 50 years in the U.S.

Smoking and Increased Health Risks

Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.

• Estimates show smoking increases the risk:
  • For coronary heart disease by 2 to 4 times
  • For stroke by 2 to 4 times
  • Of men developing lung cancer by 25 times
  • Of women developing lung cancer by 25.7 times
• Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

Smoking and Cardiovascular Disease

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular disease).

• Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
• Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
• Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form.
• A stroke occurs when:
  • A clot blocks the blood flow to part of your brain;
  • A blood vessel in or around your brain bursts.
• Blockages caused by smoking can also reduce blood flow to your legs and skin.

Smoking and Respiratory Disease

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.

• Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
• Cigarette smoking causes most cases of lung cancer.
• If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
• Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Smoking and Cancer

Smoking can cause cancer almost anywhere in your body:

• Bladder
• Blood (acute myeloid leukemia)
• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea, bronchus, and lung

Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors.

If nobody smoked, one of every three cancer deaths in the United States would not happen.

Smoking and Other Health Risks

Smoking harms nearly every organ of the body and affects a person’s overall health.

• Smoking can make it harder for a woman to become pregnant. It can also affect her baby’s health before and after birth. Smoking increases risks for:
  • Preterm (early) delivery
  • Stillbirth (death of the baby before birth)
  • Low birth weight
  • Sudden infant death syndrome (known as SIDS or crib death)
  • Ectopic pregnancy
  • Orofacial clefts in infants

• Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage.
• Smoking can affect bone health.
  • Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.
• Smoking affects the health of your teeth and gums and can cause tooth loss.
• Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). AMD is damage to a small spot near the center of the retina, the part of the eye needed for central vision.
• Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers.
• Smoking causes general adverse effects on the body, including inflammation and decreased immune function.
• Smoking is a cause of rheumatoid arthritis.

Quitting and Reduced Risks

• Quitting smoking is one of the most important actions people can take to improve their health. This is true regardless of their age or how long they have been smoking.

What Is Asthma?

Asthma is a chronic disease that affects the airways of the lungs. During an asthma attack, airways (tubes that carry air to your lungs) become swollen, making it hard to breathe. As the walls of the airways swell, they narrow, and less air gets in and out of the lungs. Cells in the airways can make more mucus (a sticky, thick liquid) than usual, which can make breathing even harder.

Symptoms of an asthma attack include:

• Coughing
• Shortness of breath or trouble breathing
• Wheezing
• Tightness or pain in the chest

Asthma attacks can be mild, moderate, or serious—and even life threatening.

How Is Smoking Related to Asthma?

If you have asthma, an asthma attack can occur when something irritates your airways and “triggers” an attack. Your triggers might be different from other people’s triggers.

Tobacco smoke is a common trigger for asthma. Tobacco smoke—including secondhand smoke—is unhealthy for everyone, especially people with asthma. Secondhand smoke is a mixture of gases and fine particles that includes:

• Smoke from burning tobacco products, such as cigarettes, cigars, or pipes
• Smoke that has been exhaled (breathed out) by someone who smokes

Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer.

If you have asthma, it’s important that you avoid exposure to secondhand smoke.

If you are among the 21% of U.S. adults who have asthma and smoke, get help to quit smoking; talk to your doctor about treatments that can help you, or call 1-800-QUIT-NOW.

How Can Asthma Attacks Be Prevented?

If you or a family member has asthma, you can manage it with the help of your health care provider (for example, by taking your medicines exactly as your doctor tells you) and by avoiding your triggers. Try to avoid asthma attacks by staying far away from tobacco smoke. Some other helpful tips are:

• Do not smoke or allow others to smoke in your home or car. Opening a window does not protect you from smoke.
• If your state still allows smoking in public areas, look for restaurants and other places that do not allow smoking. “No-smoking sections” in the same restaurant with “smoking sections” do not protect adequately from secondhand smoke—even if there is a filter or ventilation system.
• Make sure your children’s day care centers and schools are tobacco-free. For schools, a tobacco-free campus policy means no tobacco use or advertising on school property is allowed by anyone at any time. This includes off-campus school events.
• Teach children to stay away from secondhand smoke. Be a good role model by not smoking.

How Is Asthma Treated?

There is no cure for asthma. However, to help control your asthma and avoid attacks:

• Take your medicine exactly as your doctor tells you.
• Stay away from things that can trigger an attack.

Everyone with asthma does not take the same medicine. Some medicines can be breathed in, and some can be taken as a pill. There are two kinds of asthma medicines:

• Quick-relief (can help control symptoms of an asthma attack)
• Long-term control (can help you have fewer and milder attacks, but they don’t help you while you are having an asthma attack)

What Is Buerger’s Disease?

Buerger’s disease (also known as thromboangiitis obliterans) affects blood vessels in the body, most commonly in the arms and legs. Blood vessels swell, which can prevent blood flow, causing clots to form. This can lead to pain, tissue damage, and even gangrene (the death or decay of body tissues). In some cases, amputation may be required.

The most common symptoms of Buerger’s disease are:

• Fingers or toes that appear pale, red, or bluish
• Cold hands or feet
• Pain in the hands and feet that may feel like burning or tingling
• Pain in the legs, ankles, or feet when walking—often located in the arch of the foot
• Skin changes or small painful sores on the fingers or toes

How Is Smoking Related to Buerger’s Disease?

The exact cause of Buerger’s disease is unknown, however tobacco use is strongly linked to its development. Researchers believe that chemicals in tobacco may irritate the lining of the blood vessels, causing them to swell.

Almost everyone diagnosed with Buerger’s disease smokes cigarettes or uses other forms of tobacco, such as cigars and chewing tobacco.

If you want to prevent getting Buerger’s disease, don’t smoke cigarettes or use any other tobacco products.

How Is Buerger’s Disease Treated?

There is no cure for Buerger’s disease. The only way to keep Buerger’s disease from getting worse is to stop using all tobacco products. Medicines don’t usually work well to treat the disease, but can help control the symptoms.

Surgery may help restore blood flow to some areas. It may be necessary to amputate the hand or foot if infection or widespread tissue death occurs.

What is Cancer?

Cancer refers to diseases in which abnormal cells divide out of control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems, which help the body get rid of toxins.

There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start—for example, lung cancer begins in the lung and laryngeal cancer begins in the larynx (voice box).

Symptoms can include:

• A thickening or lump in any part of the body
• Weight loss or gain with no known reason
• A sore that does not heal
• Hoarseness or a cough that does not go away
• A hard time swallowing
• Discomfort after eating
• Changes in bowel or bladder habits
• Unusual bleeding or discharge
• Feeling weak or very tired

How Is Smoking Related to Cancer?

Smoking can cause cancer and then block your body from fighting it:

• Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill cancer cells. When this happens, cancer cells keep growing without being stopped.
• Poisons in tobacco smoke can damage or change a cell’s DNA. DNA is the cell’s “instruction manual” that controls a cell’s normal growth and function. When DNA is damaged, a cell can begin growing out of control and create a cancer tumor.

Doctors have known for years that smoking causes most lung cancers. It’s still true today, when nearly 9 out of 10 lung cancers deaths are caused by smoking cigarettes or secondhand smoke exposure. In fact, people who smoke have a greater risk for lung cancer today than they did in 1964, even though they smoke fewer cigarettes. One reason may be changes in how cigarettes are made and what chemicals they contain.

Treatments are getting better, but lung cancer still kills more men and women than any other type of cancer. In the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke. Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by someone smoking.

Smoking can cause cancer almost anywhere in your body, including the:

• Blood (acute myeloid leukemia)
• Bladder
• Cervix
• Colon and rectum
• Esophagus
• Kidney and renal pelvis
• Larynx
• Liver
• Lungs, trachea, and bronchus
• Mouth and throat
• Pancreas
• Stomach

Men with prostate cancer who smoke may be more likely to die from prostate cancer than nonsmokers.

Smokeless tobacco, such as chewing tobacco, also causes cancer, including cancers of the:

• Esophagus
• Mouth and throat
• Pancreas

How Can Smoking-Related Cancers Be Prevented?

The most important thing you can do to prevent smoking-related cancer is not to smoke cigarettes, or to quit if you do. It is also important to avoid secondhand smoke.

Quitting smoking lowers the risk for 12 types of cancer: cancers of the lung, larynx, oral cavity and pharynx, esophagus, pancreas, bladder, stomach, colon and rectum, liver, cervix, kidney, and acute myeloid leukemia (AML).

• Within 5-10 years of quitting, your chance of getting cancer of the mouth, throat, or voice box drops by half.
• Within 10 years of quitting, your chance of getting cancer of the bladder, esophagus, or kidney decreases.
• Within 10-15 years after you quit smoking, your risk of lung cancer drops by half.
• Within 20 years after you quit smoking, your risk of getting cancer of the mouth, throat, voice box, or pancreas drops to close of that of someone who does not smoke. Also, the risk of cervical cancer drops by about half.

Cancer Screening

Screening for Cervical and Colorectal Cancers

Research shows that screening for cervical and colorectal cancers, as recommended, helps prevent these diseases. Screening for cervical and colorectal cancers also helps find these diseases at an early stage when treatment is likely to work best. CDC offers free or low-cost cervical cancer screening nationwide. In addition, CDC’s Screen for Life: National Colorectal Cancer Action Campaign informs men and women aged 50 years and older about the importance of having regular colorectal cancer screening tests.

Screening for Lung Cancer

People who have smoked for many years may consider screening for lung cancer. The only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). In this test, an X-ray machine scans the body using low doses of radiation to make detailed pictures of the lungs.

The U.S. Preventive Services Task Force recommends yearly lung cancer screening with LDCT for people who:

• Have a 20 pack-year or more smoking history, and
• Smoke now or have quit within the past 15 years, and
• Are between 50 and 80 years old.

A pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

The task force recommends that yearly screening stop once a person has not smoked for 15 years, or develops a health problem that makes him or her unwilling or unable to have surgery if lung cancer is found.

Talk to your doctor about lung cancer screening and the possible benefits and risks. Lung cancer screening is not a substitute for quitting smoking. If lung cancer screening is right for you, your doctor can refer you to a high-quality screening facility.

How Is Cancer Treated?

The treatment for cancer depends on the type of cancer and the stage of the disease (how severe the cancer is and whether it has spread). Doctors may also consider the patient’s age and general health. Often, the goal of treatment is to cure the cancer. In other cases, the goal is to control the disease or to reduce symptoms for as long as possible. The treatment plan for a person may change over time.

Most treatment plans include surgery, radiation therapy, or chemotherapy. Other plans involve biological therapy (a treatment that helps your immune system fight cancer).

Some cancers respond best to a single type of treatment. Other cancers may respond best to a combination of treatments.

For patients who get very high doses of chemotherapy or radiation therapy, a stem cell transplant, also known as a bone marrow transplant, may be recommended by their doctor. This is because high-dose therapies destroy both cancer cells and normal blood cells. A stem cell transplant can help the body to make healthy blood cells to replace the ones lost due to the cancer treatment. It’s a complicated procedure with many side effects and risks.

Quitting smoking improves the outlook (the prognosis) for people with cancer. People who continue to smoke after diagnosis raise their risk for future cancers and death. They are more likely to die from cancer than nonsmokers and are more likely to develop a second (new) tobacco-related cancer.

Colorectal Cancer and Ostomies

An ostomy (or stoma) is a surgical opening made to the body that allows waste to be eliminated from the body. Ostomies are used in treatment or management of cancer or other diseases. Ostomies are needed when the body’s normal opening is closed or altered as part of cancer treatment. An ostomy pouch is located around the opening to collect waste for removal. Ostomies are usually done during the first stages of surgical treatment to remove cancer. For patients with colorectal cancer, a colostomy (surgical openings from the bowel or colon to the abdomen) can be a lifesaving surgery. An ostomy can be temporary or permanent. Temporary ostomies are used while the affected area of the body heals. Permanent ostomies are used when cancer has resulted in the removal of the entire colon or the end of it.

What Is COPD?

Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems. COPD includes emphysema and chronic bronchitis.

With COPD, less air flows through the airways—the tubes that carry air in and out of your lungs—because of one or more of the following:

• The airways and tiny air sacs in the lungs lose their ability to stretch and shrink back.
• The walls between many of the air sacs are destroyed.
• The walls of the airways become thick and inflamed (irritated and swollen).
• The airways make more mucus than usual, which can clog them and block airflow.

In the early stages of COPD, there may be no symptoms, or you may only have mild symptoms. As COPD worsens, the symptoms may become more severe. Symptoms of COPD include:

• A cough that lingers for a long time and doesn’t go away completely, or a cough that produces a lot of mucus
• Shortness of breath, especially with physical activity
• Wheezing (a whistling sound when you breathe)
• Tightness in the chest

Not everyone with these symptoms has COPD. A doctor can determine if you have COPD or another condition that has similar symptoms.

How severe your COPD symptoms are depends on how much lung damage you have. If you continue smoking, the damage will occur faster than if you stop smoking.

How Is Smoking Related to COPD?

COPD is usually caused by cigarette smoking, though long-term exposure to other lung irritants, like secondhand smoke, can also contribute to COPD. As many as 1 out of 4 Americans with COPD never smoked cigarettes. However, smoking accounts for as many as 8 out of 10 COPD-related deaths and 38% of the nearly 16 million U.S. adults diagnosed with COPD report current smoking.

Smoking and secondhand smoke exposure during childhood and teenage years can slow lung growth and development. This can increase the risk of developing COPD in adulthood.

How Can COPD Be Prevented?

The best way to prevent COPD is to never start smoking, and if you do smoke, to quit. Talk with your doctor or other health care professional about resources that can help you quit, like counseling and medication. Also, stay away from secondhand smoke, which is smoke from burning tobacco products, such as cigarettes, cigars, hookah, or pipes. Secondhand smoke also is smoke that has been exhaled, or breathed out, by a person smoking, or that comes from the end of a lit tobacco product.

How Is COPD Treated?

COPD treatment can alleviate symptoms, decrease the frequency and severity of exacerbations, and increase exercise tolerance. Treatment options that your physician may consider include:

• Quit smoking. For people who smoke, the most important part of treatment is smoking cessation.
• Avoid tobacco smoke and other air pollutants at home and at work.
• Ask your doctor about pulmonary rehabilitation, which is a personalized treatment program that teaches COPD management strategies to improve quality of life. Programs may include plans that teach people how to breathe better and conserve their energy, as well as provide advice on food and exercise.
• Take medication. Symptoms such as coughing or wheezing can be treated with medication.
• Avoid lung infections. Lung infections can cause serious problems in people with COPD. Certain vaccines, such as flu and pneumococcal vaccines, are especially important for people with COPD. Learn more about vaccination recommendations. Respiratory infections should be treated with antibiotics, if appropriate.
• Use supplemental oxygen. Some people may need to use a portable oxygen tank if their blood oxygen levels are low.

COVID-19 has many people feeling stressed, alone, or worried about their health. It’s a lot to deal with if you’re trying to stop smoking or stay smokefree if you've already quit. But not smoking (or using any tobacco products) is one of the best ways to protect and improve your health.

As a smoker, you or the people who care about you may be worried about a connection between COVID-19 and smoking. Scientists are still learning about the disease, but we know that:

• Being a current smoker increases your risk for severe illness from COVID-19.
• Smoking weakens the immune system, which makes it harder for your body to fight disease.
• If you continue to smoke, you have a greater risk for respiratory infections like pneumonia, colds, or flu.
• COVID-19 impacts many of the same organs of the body as smoking. For those with heart or lung disease caused by smoking, you are at increased risk for severe illness from COVID-19.

But there is good news: Soon after you stop smoking your body begins to heal. Within the first few weeks and months, your lungs start to work better and your risk for a heart attack goes down. The longer you go without smoking, the more time your body has to recover. No matter how old you are or how long you've been smoking, quitting smoking improves your health and can add years to your life.

It’s Always a Good Time to Quit

There has never been a better time to quit smoking. If you slipped or have returned to smoking, recommit to living without cigarettes. Quitting is not easy for most people, but there are things you can do to protect yourself and others during the COVID-19 pandemic:

• Learn about nicotine withdrawal. Common withdrawal symptoms include irritability, poor sleep, difficulty concentrating, or increased appetite. Sometimes people report that they feel like they have a cold or mild flu symptoms after they stop smoking. Call your doctor if you are concerned that you may have symptoms associated with COVID-19.
• Try a quit smoking medication. Consider using one or more of the seven FDA-approved prescription and over-the-counter medications that can more than double your chances of quitting smoking. Your doctor can talk to you about which ones might be right for you and how to combine medications.
• Manage your stress and be kind to yourself. The stress and anxiety caused by the COVID-19 pandemic can cause you to slip and start smoking after you quit. If you do slip, don’t be too hard on yourself.
• Look out for signs of depression. If you or someone you know is in distress or having suicidal thoughts, get help now. Call or text 988 or chat online for 24-hour, free and confidential support from trained counselors. Para obtener asistencia en español durante las 24 horas, llame al 988.
• Don’t give up. If you had a slip or started to smoke again because COVID-19 is stressing you out, set a new quit date and try again. It takes most people many tries to quit for good.
• Learn about secondhand smoke and make smokefree rules at home. Don’t smoke in your home or in your car and don’t allow others to smoke there either. Ask the smokers in your home to keep their cigarettes and lighters out of sight and to shower or change clothes after they smoke.
• Focus on the things you can control. COVID-19 has created a lot of uncertainty. Try to focus on what you can control right now instead of getting caught up in worrying about what’s next. Practicing mindfulness may help you stay focused or get through an urge to smoke.

What Is Depression?

Depression is more than just feeling down or having a bad day. When a sad mood lasts for a long time and interferes with normal, everyday functioning, you may be depressed. Symptoms of depression include:

• Feeling sad or anxious often or all the time
• Not wanting to do activities that used to be fun
• Feeling irritable‚ easily frustrated‚ or restless
• Having trouble falling asleep or staying asleep
• Waking up too early or sleeping too much
• Eating more or less than usual or having no appetite
• Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
• Having trouble concentrating, remembering details, or making decisions
• Feeling tired‚ even after sleeping well
• Feeling guilty, worthless, or helpless
• Thinking about suicide or hurting yourself

The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional. If you think you are depressed‚ talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities.

What Causes Depression?

The exact cause of depression is unknown. It may be caused by a combination of genetic, biological, environmental, and psychological factors. Everyone is different‚ but the following factors may increase a person’s chances of becoming depressed:

• Having blood relatives who have had depression
• Experiencing traumatic or stressful events, such as physical or sexual abuse, the death of a loved one, or financial problems
• Going through a major life change‚ even if it was planned
• Having a medical problem, such as cancer, stroke, or chronic pain
• Taking certain medications. Talk to your doctor if you have questions about whether your medications might be making you feel depressed.
• Using alcohol or drugs

Who Gets Depression?

In general‚ about 1 out of every 6 adults will have depression at some time in their life. Depression affects about 16 million American adults every year. Anyone can get depressed, and depression can happen at any age and in any type of person.

Many people who experience depression also have other mental health conditions. Anxiety disorders often go hand in hand with depression. People who have anxiety disorders struggle with intense and uncontrollable feelings of anxiety, fear, worry, and/or panic. These feelings can interfere with daily activities and may last for a long time.

What Is the Link Between Smoking and Mental Health Conditions?

Smoking is much more common among adults with mental health conditions, such as depression and anxiety, than in the general population. About 3 out of every 10 cigarettes smoked by adults in the United States are smoked by persons with mental health conditions. Why smokers are more likely than nonsmokers to experience depression, anxiety, and other mental health conditions is uncertain. More research is needed to determine this. No matter the cause‚ smoking is not a treatment for depression or anxiety. Getting help for your depression and anxiety and quitting smoking is the best way to feel better.

What Are the Treatments for Depression?

Many helpful treatments for depression are available. Treatment for depression can help reduce symptoms and shorten how long the depression lasts. Treatment can include getting therapy and/or taking medications. Your doctor or a qualified mental health professional can help you determine what treatment is best for you.

• Therapy. Many people benefit from psychotherapy—also called therapy or counseling. Most therapy lasts for a short time and focuses on thoughts‚ feelings‚ and issues that are happening in your life now. In some cases‚ understanding your past can help‚ but finding ways to address what is happening in your life now can help you cope and prepare you for challenges in the future.With therapy, you’ll work with your therapist to learn skills to help you cope with life, change behaviors that are causing problems‚ and find solutions. Do not feel shy or embarrassed about talking openly and honestly about your feelings and concerns. This is an important part of getting better.Some common goals of therapy include:
  • Getting healthier
  • Quitting smoking and stopping drug and alcohol use
  • Overcoming fears or insecurities
  • Coping with stress
  • Making sense of past painful events
  • Identifying things that worsen your depression
  • Having better relationships with family and friends
  • Understanding why something bothers you and creating a plan to deal with it
• Medication. Many people with depression find that taking prescribed medications called antidepressants can help improve their mood and coping skills. Talk to your doctor about whether they are right for you. If your doctor writes you a prescription for an antidepressant‚ ask exactly how you should take the medication. If you are already using nicotine replacement therapy or another medication to help you quit smoking, be sure to let your doctor know. Several antidepressant medications are available‚ so you and your doctor have options to choose from. Sometimes it takes several tries to find the best medication and the right dose for you, so be patient. Also be aware of the following important information:
  • When taking these medications‚ it is important to follow the instructions on how much to take. Some people start to feel better a few days after starting the medication‚ but it can take up to 4 weeks to feel the most benefit. Antidepressants work well and are safe for most people‚ but it is still important to talk with your doctor if you have side effects. Side effects usually do not get in the way of daily life‚ and they often go away as your body adjusts to the medication.
  • Don’t stop taking an antidepressant without first talking to your doctor. Stopping your medicine suddenly can cause symptoms or worsen depression. Work with your doctor to safely adjust how much you take.
  • Some antidepressants may cause risks during pregnancy. Talk with your doctor if you are pregnant or might be pregnant, or if you are planning to become pregnant.
  • Antidepressants cannot solve all of your problems. If you notice that your mood is getting worse or if you have thoughts about hurting yourself‚ it is important to call your doctor right away.

Quitting smoking will not interfere with your mental health treatment or make your depression worse. In fact, research shows that quitting smoking can actually improve your mental health in the long run.

Depression and Suicide: Getting Help in a Crisis

Some people who are depressed may think about hurting themselves or committing suicide (taking their own life). If you or someone you know is having thoughts about hurting themselves or committing suicide‚ please seek immediate help. The following resources can help:

• Call 1−800−273−TALK (8255) to reach a 24−hour crisis center or dial 911. 1−800−273−TALK is the National Suicide Prevention Lifeline, which provides free‚ confidential help to people in crisis. The Substance Abuse and Mental Health Services Administration runs this lifeline.
• Call your mental health provider.
• Get help from your primary doctor or other health care provider.
• Reach out to a close friend or loved one.
• Contact a minister, spiritual leader, or someone else in your faith community.

Some people try to cut back on smoking cigarettes or work toward quitting smoking completely by using electronic cigarettes (e-cigarettes), smokeless tobacco, or other tobacco products in addition to regular cigarettes. This is called “dual use.” Dual use is not an effective way to safeguard health.

Because smoking even a few cigarettes a day can be dangerous, quitting smoking completely is very important to protect your health. If you’ve never smoked or used other tobacco products, including e-cigarettes, don’t start.

Health Risks of Smoking

Smoking even a few cigarettes a day can be dangerous and can lead to serious health problems.

• People who smoke fewer than 5 cigarettes a day can have early signs of cardiovascular disease.
• Just cutting back on cigarettes may not protect someone from early death. People who smoke heavily and reduce their cigarette use by half still have a very high risk for early death. On average, people who smoke die 10 years earlier than people who don’t smoke.
• People who reported smoking in social situations rather than on a daily basis – a behavior referred to as “social smoking” – have similar blood pressure and cholesterol levels of people who smoke regularly.

Quitting Can Improve Your Health

Quitting smoking completely improves both your health and your quality of life. This is true regardless of your age or how long you have been smoking.

When you quit smoking completely:

• After 1-2 years, your risk of heart attack drops sharply and continues to drop over time.
• After 5-10 years, your risk of stroke decreases.
• After 5 years, your risk for cancers of the mouth, throat, and voice box drop by half.
• After 10-15 years, your risk of lung cancer drops by half.

People who quit smoking completely live longer than those who keep smoking. The earlier you quit, the lower your risk for early death. Even quitting at age 50 cuts your risk in half for early death from a smoking-related disease.

What Is Gum Disease?

Gum (periodontal) disease is an infection of the gums and can affect the bone structure that supports your teeth. In severe cases, it can make your teeth fall out. Smoking is an important cause of severe gum disease in the United States.

Gum disease starts with bacteria (germs) on your teeth that get under your gums. If the germs stay on your teeth for too long, layers of plaque (film) and tartar (hardened plaque) develop. This buildup leads to early gum disease, called gingivitis.

When gum disease gets worse, your gums can pull away from your teeth and form spaces that get infected. This is severe gum disease, also called periodontitis. The bone and tissue that hold your teeth in place can break down, and your teeth may loosen and need to be pulled out.

Warning Signs and Symptoms of Gum Disease

• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Gums that have pulled away from your teeth

How Is Smoking Related to Gum Disease?

• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Gums that have pulled away from your teeth

How Can Gum Disease Be Prevented?

You can help avoid gum disease with good dental habits.

• Brush your teeth twice a day.
• Floss often to remove plaque.
• See a dentist regularly for checkups and professional cleanings.
• Don’t smoke. If you smoke, quit.

How Is Gum Disease Treated?

Regular cleanings at your dentist’s office and daily brushing and flossing can help treat early gum disease (gingivitis).

More severe gum disease may require:

• Deep cleaning below the gum line.
• Prescription mouth rinse or medicine.
• Surgery to remove tartar deep under the gums.
• Surgery to help heal bone or gums lost to periodontitis. Your dentist may use small bits of bone to fill places where bone has been lost. Or your dentist may move tissue from one place in your mouth to cover exposed tooth roots.

If you smoke or use spit tobacco, quitting will help your gums heal after treatment.

Outlook for People Living With HIV

Smoking is a serious health threat for everyone, but it’s especially dangerous for people living with HIV. Smoking raises your risk for heart disease, cancer, serious lung diseases and infections such as pneumonia, and other illnesses. People with HIV are more likely to develop these harmful consequences of smoking than those without HIV.

Quitting smoking can help people with HIV have a better quality of life and fewer HIV-related symptoms. When you quit, your risk goes down for many serious illnesses, including heart attacks and pneumonia.

What Is HIV

HIV stands for human immunodeficiency virus. If HIV is not treated properly, it can lead to acquired immunodeficiency syndrome, or AIDS. In the United States, HIV is spread mainly by having unprotected sex or by sharing needles or other drug equipment (works) with someone who has HIV.

Once you have HIV, you have it for life. Your body cannot get rid of HIV.

HIV harms your body’s infection fighters—the cells of the immune system called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that your body can’t fight off infections and disease. When this happens, HIV leads to AIDS.

How Is Smoking Related to HIV?

Smoking causes one in every five deaths in the United States each year. About one in five Americans smokes cigarettes.

If you smoke and have HIV, you’re more likely to get HIV-related infections, including:

• Thrush (a mouth infection, also called oral candidiasis)
• Hairy leukoplakia (white mouth sores)
• Bacterial pneumonia
• Pneumocystis pneumonia, a dangerous lung infection

Smoking when you have HIV also makes you more likely to get other serious illnesses than nonsmokers with HIV. These illnesses can make you too sick to work (disabled) or even lead to an early death. They include:

• COPD (chronic obstructive pulmonary disease, a serious lung disease that causes severe breathing problems and includes emphysema and chronic bronchitis)
• Heart disease and stroke
• Lung cancer, head and neck cancer, cervical cancer, and anal cancer

How Can HIV Be Prevented?

Currently, there is no vaccine to prevent HIV infection and no cure for HIV infection. You can lower your risk of becoming infected with HIV or spreading the virus to other people with these steps:

• Get tested regularly for HIV.
• Practice abstinence (not having sex).
• Remain faithful to your spouse or partner.
• Consistently use male latex or female polyurethane condoms.
• Do not share needles or other drug injection equipment (works).
• Limit the use of alcohol, and don’t use drugs that affect your judgment.

How Is HIV Treated?

HIV is treated with a mix of drugs called antiretroviral therapy (ART). You take these medicines daily to prevent the virus from multiplying and destroying your body’s infection fighters—the CD4 cells. This, in turn, helps protect you from life-threatening illnesses, such as pneumonia and cancer.

ART can’t cure HIV, but it helps people with HIV live longer, healthier lives.

It’s very important to take your HIV medicines exactly as directed. If you don’t, your CD4 count may go down and your viral load may go up. Not taking your medicines as directed can also make the HIV virus resistant, which means the medicines won’t help you anymore. Smoking may limit how well HIV medicines work to fight the virus.

Tell your doctor if your medicines are making you sick. He or she may be able to help you deal with side effects and feel better. Don’t just stop taking your medicines.

The Benefits of Quitting Smoking

If you smoke, quit. Quitting smoking has major and immediate health benefits for all tobacco users, especially those living with HIV. Quitting reduces your chances of developing disease, helps you feel better, and improves your quality of life.

Also, stay away from secondhand smoke, which is smoke in the air from other people smoking. Secondhand smoke has immediate harmful effects on your blood and blood vessels, which can raise your risk for a heart attack. People who already have heart disease are at especially high risk for a heart attack. Secondhand smoke can also cause a stroke or lead to lung cancer.

Talk with your health care provider about programs and products that can help you quit.

What Are Heart Disease and Stroke?

Heart disease and stroke are cardiovascular (heart and blood vessel) diseases (CVDs).

Heart disease includes several types of heart conditions. The most common type in the United States is coronary heart disease (also known as coronary artery disease). Coronary heart disease occurs when the walls of arteries that carry blood to the heart are narrowed by plaque, a process known as atherosclerosis.This can cause:

• Chest pain
• Heart attack (when blood flow to the heart becomes blocked and a section of the heart muscle is damaged or dies)
• Heart failure (when the heart cannot pump enough blood and oxygen to support other organs)
• Arrhythmia (when the heart beats too fast, too slow, or irregularly)

A stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain bursts, causing parts of the brain to become damaged or die. Stroke can cause disability (such as paralysis, muscle weakness, trouble speaking, or memory loss) or death.

How Is Smoking Related to Heart Disease and Stroke?

Heart disease and stroke are cardiovascular (heart and blood vessel) diseases (CVDs).

Heart disease includes several types of heart conditions. The most common type in the United States is coronary heart disease (also known as coronary artery disease). Coronary heart disease occurs when the walls of arteries that carry blood to the heart are narrowed by plaque, a process known as atherosclerosis.This can cause:

• Chest pain
• Heart attack (when blood flow to the heart becomes blocked and a section of the heart muscle is damaged or dies)
• Heart failure (when the heart cannot pump enough blood and oxygen to support other organs)
• Arrhythmia (when the heart beats too fast, too slow, or irregularly)

A stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain bursts, causing parts of the brain to become damaged or die. Stroke can cause disability (such as paralysis, muscle weakness, trouble speaking, or memory loss) or death.

How Is Breathing Secondhand Smoke Related to Heart Disease and Stroke?

Breathing secondhand smoke also harms your health. Secondhand smoke is the smoke from burning tobacco products. Secondhand smoke also is smoke breathed out by a someone smoking.

Breathing secondhand smoke can cause coronary heart disease and stroke. Know the facts:

• Secondhand smoke causes nearly 34,000 early deaths from coronary heart disease each year in the United States among nonsmokers.
• Nonsmokers who breathe secondhand smoke at home or at work increase their risk of developing heart disease by 25–30%. Secondhand smoke increases the risk for stroke by 20−30%.
• Each year, secondhand smoke exposure causes more than 8,000 deaths from stroke.
• Breathing secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase your risk of having a heart attack.
• Even briefly breathing secondhand smoke can damage the lining of blood vessels and cause your blood to become stickier. These changes can lead to a heart attack.

How Can Heart Disease and Stroke Be Prevented?

Heart disease and stroke are major causes of death and disability in the United States. Many people are at high risk for these diseases and don’t know it. The good news is that many risk factors for heart disease and stroke can be prevented or controlled.

The federal government’s Million Hearts® initiative aims to prevent 1 million heart attacks and strokes within five years. It’s important to know your risk for heart disease and stroke and to take action to reduce that risk. A good place to start is with the ABCS of heart health:

• Aspirin: Aspirin may help reduce your risk for heart disease and stroke. But do not take aspirin if you think you are having a stroke. It can make some types of stroke worse. Before taking aspirin, talk to your doctor about whether aspirin is right for you.
• Blood pressure: Control your blood pressure.
• Cholesterol: Manage your cholesterol.
• Smoking: Quit smoking, or don’t start.

In addition to your ABCS, several lifestyle choices can help protect your heart and brain health. These include the following:

• Avoid breathing secondhand smoke.
• Eat fresh fruits and vegetables.
• Eat low-fat, low-salt foods most of the time.
• Maintain a healthy weight.
• Exercise regularly.
• Limit alcohol use.
• Control other health conditions (such as diabetes).

Cigarette smoking is the leading preventable cause of disease and death in the United States, killing more Americans per year than AIDS, alcohol, car accidents, homicide, suicide, illegal drugs, and fires combined. You may be aware that cigarettes increase a person’s risk of cancer, as well as diseases of the heart, lungs, and other organs. But you might not know that smoking is a risk factor for type 2 diabetes.

What is Type 2 Diabetes?

There are two primary types of diabetes:

Individuals with Type 1 diabetes do not produce insulin, which is a hormone produced by the pancreas for converting the glucose and carbohydrates that we eat into energy the body can use. Though it has been referred to in the past as “juvenile diabetes,” this type of diabetes can develop at any age, in any race, and is not related to body weight. Approximately 5 percent of diabetics have Type 1 diabetes; these individuals must use insulin therapy.

Individuals with Type 2 diabetes have an abnormality in the way their bodies use insulin that causes blood sugar—or blood glucose—to be too high. People with Type 2 diabetes may have adequate or even elevated levels of insulin, but their bodies cannot use it properly. Type 2 diabetes—which accounts for more than 90 percent of all diabetes cases—is a serious condition. In the past, Type 2 diabetes was thought to be a disease primarily seen in adults and acquired later in life. However, in the last 20 years, there has been an increase in the incidence of Type 2 diabetes in children and adolescents. The rise of Type 2 diabetes among youth has been linked to childhood obesity. In 2016, diabetes was the seventh leading cause of death in the United States.

How Does Smoking Affect Type 2 Diabetes?

There are several risk factors for type 2 diabetes, including age, ethnicity, obesity, family history, and cigarette smoking. According to the 2014 Surgeon General’s Report, there are several ways in which smoking may increase a person’s risk for developing type 2 diabetes. The chemicals in cigarettes cause harm to your body’s cells and can interfere with their normal function. This can cause inflammation throughout the body, which may decrease the effectiveness of insulin. Additionally, when chemicals from cigarette smoke meet oxygen in the body, this process can also cause cell damage, called oxidative stress. Both oxidative stress and inflammation may be related to an increased risk of diabetes.

Smokers are 30 to 40 percent more likely to develop type 2 diabetes than nonsmokers. Smoking can also make managing the disease and regulating insulin levels more difficult because high levels of nicotine can lessen the effectiveness of insulin, causing smokers to need more insulin to regulate blood sugar levels. Without proper management, diabetes can lead to health problems, including but not limited to:

• Heart disease;
• Blindness;
• Kidney failure; and
• Nerve and blood vessel damage to the feet and legs that can lead to amputation in severe cases.

Smokers are also at greater risk of these complications from diabetes.

Reducing your Diabetes Risk: Cessation

Quitting cigarettes before you develop serious diseases like diabetes helps to safeguard your health. But if you have type 2 diabetes and you smoke, it is not too late to quit smoking. By doing so, it may be easier to manage your diabetes.

Quitting smoking is difficult, but possible, and it is beneficial at any age. Whether you have type 2 diabetes or not, the sooner you quit, the sooner your body can start to heal. In fact, studies have found insulin to become more effective at lowering blood sugar levels just eight weeks after you quit smoking. If you are looking to get your diabetes under control, or are simply looking to quit for other health reasons, talk to your doctor about your options. Telephone quit lines can provide real-time help from an expert, and online resources are also available to support you as you try to quit cigarettes for good.

Overview of Smoking and Eyesight

Smoking is as bad for your eyes as it is for the rest of your body. If you smoke, you can develop serious eye conditions that can cause vision loss or blindness. Two of the greatest threats to your eyesight are:

• Macular degeneration
• Cataracts

Macular degeneration, also called age-related macular degeneration (AMD), is an eye disease that affects central vision. You need central vision to see objects clearly and for common tasks such as reading, recognizing faces, and driving.

There are two forms of AMD: dry AMD and wet AMD. Macular degeneration always begins in the dry form, and sometimes progresses to the more advanced wet form, where vision loss can be very rapid if untreated.

Cataracts cause blurry vision that worsens over time. Without surgery, cataracts can lead to serious vision loss. The best way to protect your sight from damage linked to smoking is to quit or never start smoking.

Symptoms of Eye Diseases Related to Smoking

You may think your eyes are fine, but the only way to know for sure is by getting a full eye exam. AMD often has no early symptoms, so an eye exam is the best way to spot this eye disease early. An eye specialist will place special drops in your eyes to widen your pupils. This offers a better view of the back of your eye, where a thin layer of tissue (the retina) changes light into signals that go to the brain. The macula is a small part of the retina that you need for sharp, central vision.

When symptoms of AMD do occur, they can include:

• Blurred vision or a blurry spot in your central vision
• The need for more light to read or do other tasks
• Straight lines that look wavy
• Trouble recognizing faces

Eye injections are often the preferred treatment for wet AMD. Your doctor can inject a drug to stop the growth of these blood vessels and stop further damage to your eyes. You may need injections on a regular basis to save your vision.

How Does Smoking Affect Your Eyes?

Smoking causes changes in the eyes that can lead to vision loss. If you smoke:

• You are twice as likely to develop AMD compared with a people who do not smoke.
• You are two to three times more likely to develop cataracts compared with a people who do not smoke.

How Can You Prevent Vision Loss Related to Smoking?

If you smoke, stop. Quitting may lower your risk for both AMD and cataracts.,

If you already have AMD, quitting smoking may slow the disease. AMD tends to get worse over time. Quitting smoking is something within your control that may help save your sight. Other healthy habits may also help protect your eyes from cataracts and AMD:

• Exercise regularly.
• Maintain normal blood pressure and cholesterol levels.
• Eat a healthy diet rich in green, leafy vegetables and fish.
• Wear sunglasses and a hat with a brim to protect your eyes from sunlight.