Practice ABC of chronic obstructive pulmonary disease

Smoking cessation

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7553.1324 (Published 01 June 2006) Cite this as: BMJ 2006;332:1324
  1. Prasima Srivastava, consultant,
  2. Graeme P Currie, specialist registrar,
  3. John Britton, professor of epidemiology
  1. Respiratory Unit, Aberdeen Royal Infirmary, Aberdeen.
  2. University of Nottingham, City Hospital, Nottingham.

    Smoking was first introduced into the United Kingdom in the late 16th century. Shortly afterwards, King James I of England implemented the first tax on tobacco use. He also published his famous A Counterblaste to Tobacco in 1604, where he reflected on his dislike of the “precious stink” and observed: “Smoking is a custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs, and in the black, stinking fume thereof nearest resembling the horrible Stygian smoke of the pit that is bottomless.”


    Embedded Image

    King James I of England, by John de Critz the Elder (c1552-1642). King James I implemented the first tax on tobacco

    Cigarette smoking delivers nicotine—a powerfully addictive drug—quickly and in high doses directly to the brain. Addiction to nicotine is usually established through experimentation with cigarettes during adolescence and often results in sustained or lifelong smoking. However, nicotine itself does not cause major health problems in most users; it is the accompanying tar that accounts for most of the harm caused by cigarettes.

    Warnings found on cigarette boxes are useful ways in which to remind individuals of the dangers of smoking

    Effects of cigarette smoking

    Apart from being the most common and important cause of chronic obstructive pulmonary disease (COPD), cigarette smoking causes a range of other chronic diseases and cancers affecting almost every bodily system. Cigarette smoking results in more than 100 000 deaths each year in the United Kingdom. Some diseases—including sarcoidosis, extrinsic allergic alveolitis, Parkinson's disease, and ulcerative colitis—are less common in smokers.

    Stopping smoking at any age has beneficial effects on the lung function of patients with COPD

    Primary prevention of COPD

    As long as cigarette smoking remains a normal and acceptable behaviour in adults, preventing children and adolescents from experimenting is difficult. However, measures to reduce children's access to cigarettes will probably help prevent …

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