section_path: Health effects
section_name: Health effects
paragraph_text: Health effects
  
  Smoking is one of the leading preventable causes of deaths globally and is the cause of over 8 million deaths annually, 1.2 million of which are non-smokers who die due to second-hand smoke. In the United States, about 500,000 deaths per year are attributed to smoking-related diseases and a recent study estimated that as much as one-third of China's male population will have significantly shortened lifespans due to smoking. Male and female smokers lose an average of 13.2 and 14.5 years of life, respectively. At least half of all lifelong smokers die earlier as a result of smoking. The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female current smoker, in the absence of competing causes of death. The corresponding estimates for lifelong nonsmokers are a 1.1% probability of dying from lung cancer before age 85 for a man of European descent, and a 0.8% probability for a woman. Smoking just one cigarette a day results in a risk of coronary heart disease that is halfway between that of a heavy smoker and a non-smoker. The non-linear dose–response relationship may be explained by smoking's effect on platelet aggregation.
  
  Among the diseases that can be caused by smoking are vascular stenosis, lung cancer, heart attacks and chronic obstructive pulmonary disease (COPD). Smoking during pregnancy may cause ADHD to a fetus.
  
  Smoking is a risk factor strongly associated with periodontitis and tooth loss. The effects of smoking on periodontal tissues depend on the number of cigarettes smoked daily and the duration of the habit. A study showed that smokers had 2.7 times and former smokers 2.3 times greater probabilities to have established periodontal disease than non‐smokers, independent of age, sex and plaque index, however, the effect of tobacco on periodontal tissues seems to be more pronounced in men than in women. Studies have found that smokers had greater odds for more severe dental bone loss compared to non‐smokers; also, people who smoke and drink alcohol heavily have much higher risk of developing oral cancer (mouth and lip) compared with people who do neither. Smoking can also cause milanosis in the mouth.
  
  Smoking has been also associated with oral conditions including dental caries, dental implant failures, premalignant lesions, and cancer. Smoking can affect the immune-inflammatory processes which may increase susceptibility to infections; it can alter the oral mycobiota and facilitate colonization of the oral cavity with fungi and pathogenic molds.
  
  Many governments are trying to deter people from smoking with anti-smoking campaigns in mass media stressing the harmful long-term effects of smoking. Passive smoking, or secondhand smoking, which affects people in the immediate vicinity of smokers, is a major reason for the enforcement of smoking bans. These are laws enforced to stop individuals from smoking in indoor public places, such as bars, pubs and restaurants, thus reducing nonsmokers' exposure to secondhand smoke. A common concern among legislators is to discourage smoking among minors and many states have passed laws against selling tobacco products to underage customers (establishing a smoking age). Many developing countries have not adopted anti-smoking policies, leading some to call for anti-smoking campaigns and further education to explain the negative effects of ETS (Environmental Tobacco Smoke) in developing countries. Tobacco advertising is also sometimes regulated to make smoking less appealing.
  
  Despite the many bans, European countries still hold 18 of the top 20 spots, and according to the ERC, a market research company, the heaviest smokers are from Greece, averaging 3,000 cigarettes per person in 2007. Rates of smoking have leveled off or declined in the developed world but continue to rise in developing countries. Smoking rates in the United States have dropped by half from 1965 to 2006, falling from 42% to 20.8% in adults.
  
  The effects of addiction on society vary considerably between different substances that can be smoked and the indirect social problems that they cause, in great part because of the differences in legislation and the enforcement of narcotics legislation around the world. Though nicotine is a highly addictive drug, its effects on cognition are not as intense or noticeable as other drugs such as cocaine, amphetamines or any of the opiates (including heroin and morphine).
  
  Smoking is a risk factor in Alzheimer's disease. While smoking more than 15 cigarettes per day has been shown to worsen the symptoms of Crohn's disease, smoking has been shown to actually lower the prevalence of ulcerative colitis.
  
  Smokers are 30-40% more likely to develop type 2 diabetes than non-smokers, and the risk increases with the number of cigarettes smoked.