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Lung cancer takes more American lives annually than any other type of cancer. Some 80 percent of all lung cancer deaths, over 90,000 in a typical year, may be attributed to cigarette smoking. On average, 7 in 10 lung cancer patients die within a year of diagnosis The cigarette smoker’s risks are not confined to lung cancer. Such serious and sometimes fatal diseases as cancers of the mouth, pharynx, larynx, and esophagus may also be smoking-related. Of all cancer deaths, 30percent are related to smoking. Smoking leads to 10 times as many cancer deaths as all other reliable identified cancer causes combined. Where women accounted for one lung cancer death in six in 1968, one-fourth of all such deaths occurred among women in 1979. Those figures suggest what later statistics have borne out: that lung cancer would soon replace breast cancer as the leading cause of cancer death among women. Women were once thought to be less susceptible to smoking-related diseases than men. But later epidemiological studies have proved the opposite. When the earlier studies were conducted, women had simply not been smoking as long as men, or in such numbers. As the picture has changed, the statistics have changed. Like men, women smokers who experience other heart disease risk factors, including hypertension and high serum cholesterol levels, face a greatly increased risk of coronary heart disease. And heart disease caused by smoking cigarette takes more American lives than does cancer. But smoking is implicated in about 30 percent of all deaths resulting from coronary heart disease, the most common cause of American deaths. In 1982, about 170,000 US citizens died of heart disease resulting from smoking. In the mid-1980’s, statistics showed that one living American in every 10 would die prematurely as a result of smoking-related heart disease. The smoker who refused to give up smoking after a heart attack was inviting a second attack to a significant degree. But the person who quit smoking would after some 10 years face a heart-disease risk about equal to that of a nonsmoker. The number of cigarettes an individual smokes is one of the determinants of eventual damage even though individual susceptibility is also important. Thus a definite dose-response relationship exists between smoking and disease. If a person smokes one pack a day for one year he has smoked one pack-year; if he smokes one pack a day for two years or two packs a day for one year, he has smoked two pack-years, and so on. Calculating by pack-years, it appears that 40 pack-years is a crucial time period above which the incidence of cancer of the lung, emphysema, and other serious consequences rises rapidly. Smoking three packs a day, it takes only about 13 years to reach this critical level.
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