If you're a smoker and you're pregnant - there's never been a more important time for you to quit your habit.



That's because a new Australian study has found women who smoke in pregnancy are putting their child at increased risk of heart attack or stroke later in life.

The study, published online in the European Heart Journal today, showed children born to smokers had a lower level of a certain type of cholesterol in their blood, which protects against heart disease.

The researchers estimate children born to women who smoked while pregnant face a 10-15% increased risk of developing heart disease later in life.

Quit Executive Director Fiona Sharkie said the study shows a woman's smoking habit during pregnancy doesn't only affect her baby when it's young - it continues to affect her child as it grows up into adulthood.

"Women who smoke and who are pregnant need to seriously think whether they want to pass on a lifetime of increased health risk to their unborn child. The best thing they can do for their own health, and that of their unborn child, is to quit smoking today."

This latest study showed only one of the risks caused by smoking during pregnancy.

Prior research has already shown that smoking during pregnancy increases the risk of sudden infant death syndrome, miscarriage, having a low-weight baby and a baby with weaker lungs.

But any positive changes you make to your smoking habits now can reduce these risks and give your baby the best chance of a healthy start in life.

Women who quit before or during their pregnancy reduce the risk of all complications, preterm delivery and low birth weight.

In Australia: Set your quit date today and ring the Quitline on 13 7848.

The first global study into the effects of passive smoking has found it causes 600,000 deaths every year.










One-third of those killed are children, often exposed to smoke at home, the World Health Organization (WHO) found.






The study, in 192 countries, found that passive smoking is particularly dangerous for children, said to be at higher risk of sudden infant death syndrome, pneumonia and asthma.


Passive smoking causes heart disease, respiratory illness and lung cancer.


"This helps us understand the real toll of tobacco," said Armando Peruga, of the WHO's Tobacco-Free Initiative, who led the study.


'Deadly combination'






The study used estimates of the incidence of specific diseases and of the number of people exposed to second-hand smoke in particular areas.


The global health body said it was particularly concerned about the estimated 165,000 children who die of smoke-related respiratory infections, mostly in South East Asia and in Africa.








It said that this group was more exposed to passive smoking than any other group, principally in their own homes.


"The mix of infectious diseases and second-hand smoke is a deadly combination," Mr Peruga said.



s well as being at increased risk of a series of respiratory conditions, the lungs of children who breathe in passive smoke may also develop more slowly than children who grow up in smoke-free homes.






Worldwide, as many as 40% of children, 33% of non-smoking men and 35% non-smoking women were exposed to second-hand smoke in 2004, researchers found.


This exposure was estimated to have caused 379,000 deaths from heart disease, 165,000 from lower respiratory infections, 36,900 from asthma and 21,400 from lung cancer.


According to the study, the highest numbers of people exposed to second-hand smoke are in Europe and Asia and the lowest rates of exposure were in the Americas, the Eastern Mediterranean and Africa.


The research also revealed that passive smoking had a large impact on women, killing about 281,000 worldwide. This is due to the fact that in many parts of the world, the study suggests, women are at least 50% more likely to be exposed to second-hand smoke than men.


However, the researchers said were limitations to the study, including uncertainties about the underlying health data and gaps in the data relating to exposure to second-hand smoke.


Writing in the Lancet, Dr Heather Wipfli of the University of Southern California and colleagues, said: "There are well acknowledged uncertainties in estimates of disease burden.


"However, there can be no question that the 1.2bn smokers in the world are exposing billions of non-smokers to second-hand smoke, a disease-causing indoor air pollutant."

• Lung cancer
• Nasal sinus cancer
• Heart disease mortality
• Acute and chronic coronary heart disease morbidity
• Fetal growth: low birthweight or small for gestational age
• Sudden Infant Death Syndrome
• Acute lower respiratory tract infections in children (e.g. bronchitis and pneumonia)
• Asthma induction and exacerbation in children
• Chronic respiratory symptoms in children
• Eye and nasal irritation in children
• Middle ear infections in children

• Spontaneous abortion
• Adverse impact on cognition and behavior
• Exacerbation of cystic fibrosis
• Decreased pulmonary function
• Cervical cancer

Fathers-to-be should stop smoking to protect their unborn child from the risk of stillbirth or birth defects, scientists say.





University of Nottingham researchers found that pregnant women exposed to smoke at work or home increased their risk of stillbirth by 23% and of having a baby with defects by 13%.

They looked at 19 previous studies from around the world.

A UK expert said it was "vital" women knew the risks of second-hand smoke.

The studies used to pull this research together were carried out in North America, South America, Asia and Europe.

All the studies focused on pregnant women who did not smoke themselves but were passive smokers due to their proximity to a partner who smoked or work colleagues who smoked.

The combined data from the studies suggests that being exposed to more than 10 cigarettes a day is enough for the risks to be increased.

However, the University of Nottingham study did not find an increased risk of miscarriage or newborn death from second-hand smoke - only an increased risk of still birth and birth defects.

The results did not point to a link with any specific congenital birth defect.

Impact on sperm development
The researchers say fathers who smoke should be more aware of the danger they pose to their unborn child.

Previous research has shown that women who smoke during their pregnancy create serious health risks for their unborn baby, including low birth weight, premature birth and a range of serious birth defects such as cleft palate, club foot and heart problems.

Dr Jo Leonardi-Bee, lead researcher of the study and associate professor in medical statistics at the University of Nottingham, said they still did not know when the effects of the second-hand smoke begin.

"What we still don't know is whether it is the effect of sidestream smoke that the woman inhales that increases these particular risks or whether it is the direct effect of mainstream smoke that the father inhales during smoking that affects sperm development, or possibly both.

"More research is needed into this issue although we already know that smoking does have an impact on sperm development, so it is very important that men quit smoking before trying for a baby."

Dr Leonardi-Bee added: "The risks are related to the amount of cigarettes that are smoked so it is therefore very important for men to cut down.

"Ultimately though, in the interests of their partner and their unborn child, the best option would be to give up completely."

Andrew Shennan, professor of obstetrics at St. Thomas' Hospital in London and spokesperson for baby charity Tommy's, said: "It is vital that women are made aware of the possible risks associated with second-hand smoke and alert those around them of the impact it could potentially have on the health of their unborn baby.

"The chemicals in cigarettes are known to significantly increase the risk of serious pregnancy complications."

There was also anecdotal evidence of some companies hiring non-smokers over smokers, workplace relations and safety lawyer Brad Petley said.

"There's a developing trend amongst some employers to hire a non-smoker over a smoker, if possible, because of a perception that a non-smoker is a more productive employee," he said.

His comments follow an American company's decision to hire only non-smokers from next month, while Lord Mayor Campbell Newman is moving to ban or restrict smoking in Brisbane's Queen Street Mall.

Cancer Council Queensland tobacco programs team leader Emma Dalglish said research showed smokers were 1.4 times more likely to be absent from work, costing businesses about $800 million a year.

Studies also showed the average smoker lost up to 30 minutes' productivity each day from lighting up during work hours, taking an average of six minutes to smoke each cigarette.

With laws forcing smokers more than 4m away from the entrance of non-residential buildings, Mr Petley said the amount of time needed for a "ciggie break" was adding up.

"Unfortunately at many workplaces, smoke breaks can turn into an unproductive social get-together where groups of employees take pre-arranged smoke breaks, favourite coffee mug in hand, and usually get involved in a gossip fest about the latest workplace goings-on," he said.

"Many non-smoking employees are likely to say 'Why should I work hard when the smokers can walk outside for a break any time they want?' "

Queensland general manager of Hamilton James Bruce recruitment, Steve Brown, agreed that smoking caused rifts between workers but said the same could be said for caffeine addicts.

He said employers need to take a commonsense approach and allow some flexibility.

"If you choose to go for a cigarette break outside of your regular break times, you need to make sure that time comes off your lunch hour," he said.

If you are serious about your health, fitness and general wellbeing, you simply can't afford to smoke. That isn't a new message, of course.

It has been known for 40 years or more that smoking causes lung cancer, heart disease and strokes. In fact, it is estimated that smoking is associated with more than 50 different diseases or disorders.

Recently, further scientific evidence has emerged to suggest that women may be at particular risk from smoking.

This year, a Norwegian study of almost 2000 women showed that women were at a higher risk of chronic obstructive pulmonary disease (COPD) at a younger age, and after smoking less heavily, than men.

COPD is an umbrella term that incorporates emphysema and chronic bronchitis. There are four stages of the condition, which are ranked in terms of their severity.

"We estimate that 2.1 million people in Australia have some form of COPD, and half of them don't know it," says Heather Allan, director of the COPD National Program at the Australian Lung Foundation.

COPD is characterised by shortness of breath and repetitive coughing with mucous, usually in the mornings. It gradually worsens if you don't do anything about it. "Simple daily activities become almost impossible," says Allan. "Eventually, you can't walk from the living room to the kitchen without stopping twice along the way to catch your breath."

"Many people believe that a few cigarettes a day represent a minimal risk," says one of the Norwegian researchers. "Our findings show that there is no safe level of exposure to cigarette smoke, and this is particularly true for female smokers."

The female factor

This isn't the first study that suggests that women may be more at risk from smoking than men. A 2005 Monash University found that women were more susceptible to exposure to smoke than men. Allan says researchers believe this could be because women have narrower and more sensitive airways than men.

A report by the British Lung Foundation in 2005 suggested it may be because women's lung capacity is smaller, and population studies have also suggested that there may be a genetic element involved.

This is why health campaigners are so concerned that more young women in their teens and 20s are starting and continuing to smoke than men.

COPD usually appears in people between the ages of 35 and 40, though Allan says increasingly, younger people are being diagnosed. "Before, it was an older person's disease.

Now we're seeing people in their early 30s with COPD." She says the incidence of COPD in Australia is starting to plateau in men, but it is rising in women.

"People don't take their lung health seriously," she says. "Women are very aware of their heart and their breasts, but not so much their lungs."

She says at a recent focus group she conducted in Melbourne with smokers and ex-smokers, all the participants said their health was fine, but none had climbed the flight of stairs to get to the meeting. "They had all started to adjust their lifestyles," she says. "COPD creeps up gradually without you even realising it."

The reasons for women's increased risk of lung disease have not yet been fully researched. According to NHS Direct in the UK, a gene that speeds up the growth of lung tumours is known to be more active in women.

The female hormone oestrogen is also known to affect the development of such tumours.

A conference on thoracic oncology in Switzerland earlier this year also found that women were more susceptible to tobacco carcinogens (cancer-causing substances), and a Spanish expert spoke of the growing awareness that smoking was, indeed, riskier for women.

It is sometimes said that more women have an "addictive" gene that makes it harder for them to give up smoking, and also that, while men tend to become physically addicted to nicotine, one of the most addictive substances, women tend to be more psychologically addicted.

Giving up

The good news is that though COPD is not curable, you can stop the progress of the condition if you catch it early, so it's important that it gets diagnosed. See your GP if you have any of the symptoms.

Allan says that simply by quitting smoking, at any age, and exercising, you can halt the decline of COPD. She says immunisation from disease and influenza is also important as any infection can easily spread to the lungs.

There is plenty of help out there for quitting smoking, from your local GP to Quit Now. There's always nicotine-replacement therapy too, which comes in the form of patches, tablets, gum or dummy cigarettes. Alternatively, you could try the complementary therapy approach with herbal cigarettes or hypnotherapy. 

Drugs such as Champix and Zyban are also available, but on authority prescription only - your doctor has to call for approval as there are various conditions which need to be met, such as ensuring the patient is enrolled in a support program.

Where to get help

For the cost of a local call from anywhere in Australia, the Quitline provides advice and assistance to smokers who want to quit.

The Quitline can help smokers plan their attempt and give advice on different techniques. You can also access a free copy of the Quit Pack and download the free self-help book, the Quit Booklet. Call 13 18 48 or 13 78 48 or visit www.quitnow.info.au

The Australian Lung Foundation has launched a free online Lung Health Checklist this month to encourage early diagnosis of lung disease. Visit
www.lungfoundation.com.au

Why non-smoking women are healthier
1 Women who don't smoke are far less likely to develop lung, mouth, throat, pancreatic, bladder or cervical cancer. 

2 Non-smokers' risk of coronary heart disease and strokes is much reduced.

3 Non-smokers' risk of these conditions when taking the contraceptive pill is also reduced. 

4 Non-smokers reach the menopause two years later than smokers.

5 Non-smokers have fewer fertility problems and a lower risk of miscarriage and pregnancy complications than smokers.

6 Non-smokers' babies are bigger and healthier at birth, with a lower risk of stillbirth or neonatal death (when a baby dies in the first 28 days of its life).

7 Non-smokers tend to store body fat around their hips rather than their waists, lessening their risk of diabetes
and heart disease.

8 Non-smokers have lower cholesterol than smokers.

9 Non-smokers are less likely to lose their teeth, have gum disease, become incontinent or suffer from eye damage.

10 Non-smokers have stronger bones and a lower risk of osteoporosis.

Source; The Sunday Telegraph by Jill Eckersley 

University of Sydney Professor in Public Health Simon Chapman points to recent Dutch research which identified 185 different industrial uses of a pig - including the use of its haemoglobin in cigarette filters.

Prof Chapman said the research offered an insight into the otherwise secretive world of cigarette manufacture, and it was likely to raise concerns for devout Muslims and Jews.

Religious texts at the core of both of these faiths specifically ban the consumption of pork.

"I think that there would be some particularly devout groups who would find the idea that there were pig products in cigarettes to be very offensive," Prof Chapman said today.

"The Jewish community certainly takes these matters extremely seriously and the Islamic community certainly do as well, as would many vegetarians.

"It just puts into hard relief the problem that the tobacco industry is not required to declare the ingredients of cigarettes ... they say 'that's our business' and a trade secret."

The Dutch research found pig haemoglobin - a blood protein - was being used to make cigarette filters more effective at trapping harmful chemicals before they could enter a smoker's lungs.

Prof Chapman said while tobacco companies had moved voluntarily list the contents of their products on their websites, they also noted undisclosed "processing aids ... that are not significantly present in, and do not functionally affect, the finished product".

This catch-all term hid from public view an array of chemicals and other substances used in the making of tobacco products, he said.

At least one cigarette brand sold in Greece was confirmed as using pig haemoglobin in its processes, Prof Chapman said, and the status of smokes sold was unknown.

"If you're a smoker and you're of Islamic or Jewish faith then you'd probably would want to know and there is no way of finding out," Prof Chapman said.

The Sydney office of British American Tobacco Australia was contacted by AAP.

A spokeswoman said a comment would be provided although it was not immediately available.

References: AAP

A recent study conducted by the University of Minnesota’s Transdisciplinary Tobacco Use Research Center concluded that nicotine-free cigarettes are effective in hindering prolonged cigarette use among smokers.

The study, which was funded by the National Institute on Drug Abuse, included 165 middle-aged men and women who had smoked for an average of 15 years. Researchers compared results among three groups that used nicotine-free cigarettes, low-nicotine cigarettes and nicotine lozenges.

According to a 2007 Boynton Health Service study, 25 percent of students reported tobacco use in the past 30 days. The study also stated that of those students, 38.9 percent reported making at least one attempt to quit over the past 12 months.

Participants in the study, which was published in the February edition of the journal Addiction, used the products for six weeks and were then administered lung and urine tests.

Of the 53 subjects given nicotine-free cigarettes, 19 remained smoke free, while only 7 of the 52 low-nicotine users were able to quit smoking following the trial period.

According to Dr. Dorothy Hatsukami, the study’s principal investigator, researchers discovered that nicotine-free cigarettes were as effective as nicotine lozenges at getting smokers to quit.

“What we found was the rates of cessation were pretty equivalent,” Hatsukami said.

Hatsukami noted that nicotine-free cigarettes are currently not available for sale in stores in the United States but can be found online.

While most cigarettes contain little more than a milligram of nicotine, nicotine-free cigarettes contain .05 milligrams and low-nicotine cigarettes contain .3 milligrams.

Hatsukami said the simple act of smoking seemed to be enough to suppress withdrawal symptoms among the subjects.

After a while, just inhaling smoke became rewarding, Hatsukami said, and low-nicotine cigarette users “had a tougher time.”

Bill Ryan, a sophomore physics major, said he has attempted to quit smoking several times.

“I’ve tried to use nicotine patches … but they didn’t really have an effect on me,” Ryan said.

After receiving federal stimulus funds, researchers will be conducting a similar experiment with the addition of a nicotine patch.

The experiment will include a group using both nicotine-free cigarettes with a patch versus two other groups using the products separately.

“We hypothesized that the patch and the nicotine-free cigarettes combined would be better for quitting smoking,” Hatsukami said.