TABLE 2-6 Smoking and Cancer Riska

Cancer

Population-Attributable Risk (%)b

Average Relative Risk

Men

Women

Lung

87

70

15.0–30.0

Urinary tract

46

27

3.0

Oral cavity

73

46

4.0–5.0

Oropharynx, hypopharynx

4.0–5.0c

Esophagus

72

56

1.5–5.0

Larynx

82

72

10.0c

Pancreas

21

23

2.0–4.0

Nasal cavity, sinuses, nasopharynx

1.5–2.5

Stomach

27

12

1.5–2.0

Liver

1.5–2.5

Kidney

38

5

1.5–2.0

Uterine cervix

12

1.5–2.5

Myeloid leukemia

22

11

1.5–2.0

a Adapted with permission from IARC (2004); Vineis et al. (2004).

bData from CDC (2008b).

cSynergistic interaction with alcohol use.

Cardiovascular Disease

About one-third of smoking-related deaths in the United States result from cardiovascular disease (CDC, 2008b). Smoking causes 20% of cardiovascular deaths in the United States; it increases the risk of coronary heart disease, including acute myocardial infarction; sudden death; stroke; and peripheral vascular disease, including abdominal aortic aneurysm (Burns, 2003). Smoking accelerates atherosclerosis, causes endothelial injury and dysfunction, and increases blood coagulation, thereby promoting acute ischemic events (US Surgeon General, 2004). Smoking delivers CO to the blood, which reduces the amount of oxygen carried by the hemoglobin and impairs the release of oxygen from hemoglobin to body tissues; this results in functional anemia. Concentrations of carboxyhemoglobin, which binds to red blood cells and competes with oxygen, are typically 5–10% in smokers and 1% in nonsmokers. Reduction in oxygen delivery secondary to CO exposure reduces the maximal exercise capacity in otherwise healthy smokers and the exercise capacity is reduced even further in people who have



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement