US Department of Health and Human Services
The 2010 Surgeon General's report on smoking is the 29th in a series of scientific documents released since the initial 1964 paper first summarized the adverse effects of tobacco use on health and its contribution to the onset of a variety of diseases. Despite the great strides that have been made since that original landmark survey, each year, more than 440 000 deaths occur due to smoking and exposure to secondhand smoke. The costs to society are staggering, particularly as they related to both public and private medical expenses and lost productivity. Even more important, the human suffering and loss is incalculable. There is no risk-free level of exposure to tobacco smoke. The complex mixture of combustible compounds in tobacco smoke cause a host of adverse health outcomes that affect both smokers and nonsmokers exposed to tobacco use alike.
Part 3 of the Surgeon General's report discusses 2 of the most important of these health outcomes: the relationship between smoking and pulmonary diseases and the reproductive/developmental effects induced by exposure to tobacco smoke. It describes how the oxidative stress induced by tobacco smoke contributes to the pathogenesis of chronic obstructive pulmonary disease (COPD), while the ensuing imbalance between protease and antiprotease plays a key role in the onset of emphysema. Moreover, the report amplifies how smoking in men leads to chromosomal changes that impairs fertility, pregnancy viability, and offspring anomalies, while maternal smoking is associated with a range of pregnancy complications, ranging from fetal cleft abnormalities to alternations in cardiovascular structure and function, dysfunctions in the immune system, a variety of reproductive endpoints, and most importantly, cognitive, neurological, and developmental impairment in the offspring of smokers. Finally, the research continues to demonstrate that smoking cessation is the only established method to reduce the pathological effects of smoking on both parents and their children.