Tobacco abuse and its treatment. Turning old and new issues into opportunities for the occupational health nurse.
1. Tobacco use is linked to excessive rates of cardiovascular disease, lung disease, and many fatal neoplasms. In the United States it is the number one cause of illness and premature death. Cigarettes and other combusted forms of tobacco generate environmental tobacco smoke, a major contributor to asthma attacks, heart attacks, and lung cancer among nonsmokers. 2. Cigarettes are the most prevalent and abused form of tobacco, but other forms, such as cigars and smokeless tobacco, also contain nicotine and may cause dependency in high risk groups that consume these products. 3. The addictiveness of tobacco products, especially cigarettes, is particularly detrimental to vulnerable groups such as youth, women, blue collar workers, and other high risk and economically disadvantaged populations. 4. Effective treatment programs (e.g., individual and group counseling, close monitoring, drug treatment) are available to treat nicotine dependency, but many health care providers have been reluctant to educate their patients and clients about these programs. 5. Workplace tobacco use treatment programs, along with policies to restrict tobacco use, have special merit for employers concerned with worker health and safety, productivity, and profitability. Even the more successful tobacco treatment programs perform better when combined with additional efforts to reduce worker health risks and promote well being.