History of Smoking - Smoking

History

The late-19th century invention of automated cigarette-making machinery in the American South made possible mass production of cigarettes at low cost, and cigarettes became elegant and fashionable among society men as the Victorian era gave way to the Edwardian. In 1912, American Dr. Isaac Adler was the first to strongly suggest that lung cancer is related to smoking. In 1929, Fritz Lickint of Dresden, Germany, published a formal statistical evidence of a lung cancer-tobacco link, based on a study showing that lung cancer sufferers were likely to be smokers. Lickint also argued that tobacco use was the best way to explain the fact that lung cancer struck men four or five times more often than women (since women smoked much less).

Prior to World War I, lung cancer was considered to be a rare disease, which most physicians would never see during their career. With the postwar rise in popularity of cigarette smoking, however, came an epidemic of lung cancer.

In 1950, Richard Doll published research in the British Medical Journal showing a close link between smoking and lung cancer. Four years later, in 1954, the British Doctors Study, a study of some 40,000 doctors over 20 years, confirmed the suggestion, based on which the government issued advice that smoking and lung cancer rates were related. The British Doctors Study lasted until 2001, with results published every ten years and final results published in 2004 by Doll and Richard Peto. Much early research was also done by Alton Ochsner. Reader's Digest magazine for many years published frequent anti-smoking articles. In 1964, the United States Surgeon General's Report on Smoking and Health, led millions of American smokers to quit, the banning of certain advertising, and the requirement of warning labels on tobacco products.

The Canadian province of British Columbia has the Tobacco Damages and Health Care Costs Recovery Act.

Particular forms of tobacco use - Smoking

Chewing tobacco

Chewing tobacco has been known to cause cancer, particularly of the mouth and throat. According to the International Agency for Research on Cancer, "Some health scientists have suggested that smokeless tobacco should be used in smoking cessation programmes and have made implicit or explicit claims that its use would partly reduce the exposure of smokers to carcinogens and the risk for cancer. These claims, however, are not supported by the available evidence. "Oral and spit tobacco increase the risk for leukoplakia a precursor to oral cancer.

Cigars

Like other forms of tobacco use, cigar smoking poses a significant health risk depending on dosage: risks are greater for those who inhale more when they smoke, smoke more cigars, or smoke them longer. The risk of dying from any cause is significantly greater for cigar smokers, with the risk particularly higher for smokers less than 65 years old, and with risk for moderate and deep inhalers reaching levels similar to cigarette smokers. Little cigars are commonly inhaled and likely pose the same health risks as cigarettes. The increased risk for those smoking 1–2 cigars per day is too small to be statistically significant, and the health risks of the 3/4 of cigar smokers who smoke less than daily are not known and are hard to measure; although it has been claimed that people who smoke few cigars have no increased risk, a more accurate statement is that their risks are proportionate to their exposure. Health risks are similar to cigarette smoking in nicotine addiction, periodontal health, tooth loss, and many types of cancer, including cancers of the mouth, throat, and esophagus. Cigar smoking also can cause cancers of the lung and larynx, where the increased risk is less than that of cigarettes. Many of these cancers have extremely low cure rates. Cigar smoking also increases the risk of lung and heart diseases such as chronic obstructive pulmonary disease.

Hookahs

A common belief among users is that the smoke is significantly less dangerous than that from cigarettes. The water moisture induced by the hookah makes the smoke less irritating and may give a false sense of security and reduce concerns about true health effects.[190] Doctors at institutions including the Mayo Clinic have stated that use of hookah can be as detrimental to a person's health as smoking cigarettes, and a study by the World Health Organization also confirmed these findings.

Each hookah session typically lasts more than 40 minutes, and consists of 50 to 200 inhalations that each range from 0.15 to 0.50 liters of smoke. In an hour-long smoking session of hookah, users consume about 100 to 200 times the smoke of a single cigarette; in a 45-minute smoking session a typical smoker would inhale 1.7 times the nicotine of a single cigarette. A study in the Journal of Periodontology found that water pipes smokers were five times more likely than non-smokers to show signs of gum disease. People who smoked water pipes had five times the risk of lung cancer of non-smokers.

A study on hookah smoking and cancer in Pakistan was published in 2008. Its objective was "to find serum CEA levels in ever/exclusive hookah smokers, i.e. those who smoked only hookah (no cigarettes, bidis, etc.), prepared between 1 and 4 times a day with a quantity of up to 120 g of a tobacco-molasses mixture each (i.e. the tobacco weight equivalent of up to 60 cigarettes of 1 g each) and consumed in 1 to 8 sessions". Carcinoembryonic antigen (CEA) is a marker found in several forms of cancer. Levels in exclusive hookah smokers were lower compared to cigarette smokers although the difference was not statistically significant between a hookah smoker and a non-smoker. Also the study concluded that heavy hookah smoking (2–4 daily preparations; 3–8 sessions a day ; >2 hrs to ≤ 6 hours) substantially raises CEA levels. A recent study published in the Asia Pacific Journal of Cancer Prevention (Koul PA et al. Hookah Smoking and Lung Cancer in the Kashmir Valley of the Indian SubcontinentAsian Pacific J Cancer Prev, 12, 519-524; doi.) documented that hookah smokers were nearly 6-times at risk for development of lung cancer as compared to healthy non-smokers in Kashmir (India). Hookah in Kashmir has some peculiar features in having a direct contact of the live embers with the burning tobbaco thus resulting in high temperatures that augments the production of carcinogenic products from tobacco burning. Additionally water in the hookah base is not changed after every session that renders the water contaminated to a greater degree and thus a possible source of dissolved carcinogens.

Snuff

Users of snuff are believed to face less cancer risk than smokers, but are still at greater risk than people who do not use any tobacco products. They also have an equal risk of other health problems directly linked to nicotine such as increased rate of atherosclerosis.

Health effects - Smoking

A person's increased risk of contracting disease is directly proportional to the length of time that a person continues to smoke as well as the amount smoked. However, if someone stops smoking, then these chances gradually decrease as the damage to their body is repaired. A year after quitting, the risk of contracting heart disease is half that of a continuing smoker. The health risks of smoking are not uniform across all smokers. Risks vary according to amount of tobacco smoked, with those who smoke more at greater risk. Light smoking is still a health risk. Likewise, smoking "light" cigarettes does not reduce the risks.

Tobacco use most commonly leads to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, Chronic Obstructive Pulmonary Disease (COPD), emphysema, and cancer, particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer. Overall life expectancy is also reduced in regular smokers, with estimates ranging from 10 to 17.9 years fewer than nonsmokers. About two thirds of male smokers will die of illness due to smoking. The association of smoking with lung cancer is strongest, both in the public perception and etiologically. People who have smoked tobacco at some point have about a one in ten chance of developing lung cancer during their lifetime. If one looks at men who continue to smoke tobacco, the risk increases to one in six. Historically, lung cancer was considered to be a rare disease prior to World War I and was perceived as something most physicians would never see during their career. With the postwar rise in popularity of cigarette smoking came a virtual epidemic of lung cancer.

Mortality

Male and female smokers lose an average of 13.4 to 14.3 years of life, respectively.

According to the results of a 14 year study of 34,486 male British doctors, at least half of all life-long smokers die earlier as a result of smoking.

Smokers are three times as likely to die before the age of 60 or 70 as non-smokers.

In the United States alone, cigarette smoking and exposure to tobacco smoke accounts for roughly one in five, or at at least 443,000 premature deaths annually.

"In the United States alone, tobacco kills the equivalent of three jumbo jets full of people crashing every day, with no survivors, 365 days of the year." -ABC's Peter Jennings On a worldwide basis, it's 1 jumbo jet per hour, 24 hours a day, 365 days of the year. -WHO

Cancer

The primary risks of tobacco usage include many forms of cancer, particularly lung cancer, kidney cancer, cancer of the larynx and head and neck, breast cancer, bladder cancer, cancer of the esophagus, cancer of the pancreas and stomach cancer.

There is some evidence suggesting an increased risk of myeloid leukaemia, squamous cell sinonasal cancer, liver cancer, cervical cancer, colorectal cancer, cancers of the gallbladder, the adrenal gland, the small intestine, and various childhood cancers.

The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female 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.

Pulmonary

In smoking, long term exposure to compounds found in the smoke such as carbon monoxide, cyanide, and so forth—, are believed to be responsible for pulmonary damage and for loss of elasticity in the alveoli, leading to emphysema and COPD. The carcinogen acrolein and its derivatives also contribute to the chronic inflammation present in COPD.

Secondhand smoke is a mixture of smoke from the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled, lingers in the air hours after cigarettes have been extinguished, and can cause a wide range of adverse health effects, including cancer, respiratory infections and asthma. Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%. Secondhand smoke has been estimated to cause 38,000 deaths per year, of which 3,400 are deaths from lung cancer in non-smokers.

Chronic obstructive pulmonary disease (COPD) caused by smoking, known as tobacco disease, is a permanent, incurable reduction of pulmonary capacity characterized by shortness of breath, wheezing, persistent cough with sputum, and damage to the lungs, including emphysema and chronic bronchitis.

Cardiovascular

Inhalation of tobacco smoke causes several immediate responses within the heart and blood vessels. Within one minute the heart rate begins to rise, increasing by as much as 30 percent during the first 10 minutes of smoking. Carbon monoxide in tobacco smoke exerts its negative effects by reducing the blood’s ability to carry oxygen.

Smoking also increases the chance of heart disease, stroke, atherosclerosis, and peripheral vascular disease. Several ingredients of tobacco lead to the narrowing of blood vessels, increasing the likelihood of a blockage, and thus a heart attack or stroke. According to a study by an international team of researchers, people under 40 are five times more likely to have a heart attack if they smoke.

Latest research of the American biologists have determined that cigarette smoke also influences the process of cell division in the cardiac muscle and changes the heart's shape.

The usage of tobacco has also been linked to Buerger's disease (thromboangiitis obliterans) the acute inflammation and thrombosis (clotting) of arteries and veins of the hands and feet.

The current Surgeon General’s Report concluded that there is no risk-free level of exposure to secondhand smoke. Even short exposures to secondhand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves, and reduce heart rate variability, potentially increasing the risk of heart attack. New research indicates that private research conducted by cigarette company Philip Morris in the 1980s showed that secondhand smoke was toxic, yet the company suppressed the finding during the next two decades.

Although cigarette smoking causes a greater increase of the risk of cancer than cigar smoking, cigar smokers still have an increased risk for many health problems, including cancer, when compared to non-smokers. As for Environmental Tobacco Smoke (ETS, or "Second-hand Smoking"), the NIH study points to the large amount of smoke generated by one cigar, saying "cigars can contribute substantial amounts of tobacco smoke to the indoor environment; and, when large numbers of cigar smokers congregate together in a cigar smoking event, the amount of ETS produced is sufficient to be a health concern for those regularly required to work in those environments."

Smoking tends to increase blood cholesterol levels. Furthermore, the ratio of high-density lipoprotein (the "good" cholesterol) to low-density lipoprotein (the "bad" cholesterol) tends to be lower in smokers compared to non-smokers. Smoking also raises the levels of fibrinogen and increases platelet production (both involved in blood clotting) which makes the blood viscous. Carbon monoxide binds to haemoglobin (the oxygen-carrying component in red blood cells), resulting in a much stabler complex than haemoglobin bound with oxygen or carbon dioxide—the result is permanent loss of blood cell functionality. Blood cells are naturally recycled after a certain period of time, allowing for the creation of new, functional erythrocytes. However, if carbon monoxide exposure reaches a certain point before they can be recycled, hypoxia (and later death) occurs. All these factors make smokers more at risk of developing various forms of arteriosclerosis. As the arteriosclerosis progresses, blood flows less easily through rigid and narrowed blood vessels, making the blood more likely to form a thrombosis (clot). Sudden blockage of a blood vessel may lead to an infarction (stroke). However, it is also worth noting that the effects of smoking on the heart may be more subtle. These conditions may develop gradually given the smoking-healing cycle (the human body heals itself between periods of smoking), and therefore a smoker may develop less significant disorders such as worsening or maintenance of unpleasant dermatological conditions, e.g. eczema, due to reduced blood supply. Smoking also increases blood pressure and weakens blood vessels.

Renal

In addition to increasing the risk of kidney cancer, smoking can also contribute to additional renal damage. Smokers are at a significantly increased risk for chronic kidney disease than non-smokers. A history of smoking encourages the progression of diabetic nephropathy.

Influenza

A study of an outbreak of A(H1N1) influenza in an Israeli military unit of 336 healthy young men to determine the relation of cigarette smoking to the incidence of clinically apparent influenza, revealed that, of 168 smokers, 68.5 percent had influenza, as compared with 47.2 percent of nonsmokers. Influenza was also more severe in the smokers; 50.6 percent of the smokers lost work days or required bed rest, or both, as compared with 30.1 percent of the nonsmokers.

According to a study of 1,900 male cadets after the 1968 Hong Kong A2 influenza epidemic at a South Carolina military academy, compared with nonsmokers heavy smokers (more than 20 cigarettes per day), had 21% more illnesses and 20% more bed rest, light smokers (less than 20 cigarettes per day) had 10% more illnesses and 7% more bed rest.

The effect of cigarette smoking upon epidemic influenza was studied prospectively among 1,811 male college students. Clinical influenza incidence among those who daily smoked 21 or more cigarettes was 21% higher than that of non-smokers. Influenza incidence among smokers of 1 to 20 cigarettes daily was intermediate between non-smokers and heavy cigarette smokers.

Surveillance of a 1979 influenza out-break at a military base for women in Israel revealed that, Influenza symptoms developed in 60.0% of the current smokers vs. 41.6% of the nonsmokers.

Smoking seems to cause a higher relative influenza-risk in older populations than in younger populations. In a prospective study of community-dwelling people 60–90 years of age, during 1993, of unimmunized people 23% of smokers had clinical influenza as compared with 6% of non-smokers.

Smoking may substantially contribute to the growth of influenza epidemics affecting the entire population. However the proportion of influenza cases in the general non-smoking population attributable to smokers has not yet been calculated.

Oral

Perhaps the most serious oral condition that can arise is that of oral cancer. However, smoking also increases the risk for various other oral diseases, some almost completely exclusive to tobacco users. The National Institutes of Health, through the National Cancer Institute, determined in 1998 that "cigar smoking causes a variety of cancers including cancers of the oral cavity (lip, tongue, mouth, throat), esophagus, larynx, and lung." Pipe smoking involves significant health risks, particularly oral cancer. Roughly half of periodontitis or inflammation around the teeth cases are attributed to current or former smoking. Smokeless tobacco causes gingival recession and white mucosal lesions. Up to 90% of periodontitis patients who are not helped by common modes of treatment are smokers. Smokers have significantly greater loss of bone height than nonsmokers, and the trend can be extended to pipe smokers to have more bone loss than nonsmokers. Smoking has been proven to be an important factor in the staining of teeth. Halitosis or bad breath is common among tobacco smokers. Tooth loss has been shown to be 2 to 3 times higher in smokers than in non-smokers. In addition, complications may further include leukoplakia, the adherent white plaques or patches on the mucous membranes of the oral cavity, including the tongue, and a loss of taste sensation or salivary changes.

Infection

Tobacco is also linked to susceptibility to infectious diseases, particularly in the lungs. Smoking more than 20 cigarettes a day increases the risk of tuberculosis by two to four times, and being a current smoker has been linked to a fourfold increase in the risk of invasive pneumococcal disease. It is believed that smoking increases the risk of these and other pulmonary and respiratory tract infections both through structural damage and through effects on the immune system. The effects on the immune system include an increase in CD4+ cell production attributable to nicotine, which has tentatively been linked to increased HIV susceptibility. The usage of tobacco also increases rates of infection: common cold and bronchitis, chronic obstructive pulmonary disease, emphysema and chronic bronchitis in particular.

Smoking reduces the risk of Kaposi's sarcoma in people without HIV infection. One study found this only with the male population and could not draw any conclusions for the female participants in the study.

Impotence

In a study of men aged 24 to 36 seeking treatment for infertility, Panayiotis Zavos, Ph.D., confirmed the results of earlier studies demonstrating that smoking harms sperm quality in every way, from longevity to motility. But Zavos also found that smoking affected sexual behavior. The smokers had sex an average of 5.7 times per month, while the nonsmokers reported an average of 11.6 encounters. And on a scale of 1 to 10, the smokers rated the quality of sex at a lackluster 5.2, compared to 8.7 for nonsmokers."

Female infertility

Smoking is harmful to the ovaries, potentially causing female infertility, and the degree of damage is dependent upon the amount and length of time a woman smokes. Nicotine and other harmful chemicals in cigarettes interfere with the body’s ability to create estrogen, a hormone that regulates folliculogenesis and ovulation. Also, cigarette smoking interferes with folliculogenesis, embryo transport, endometrial receptivity, endometrial angiogenesis, uterine blood flow and the uterine myometrium. Some damage is irreversible, but stopping smoking can prevent further damage. Smokers are 60% more likely to be infertile than non-smokers. Smoking reduces the chances of IVF producing a live birth by 34% and increases the risk of an IVF pregnancy miscarrying by 30%.

Psychological

"Smokers often report that cigarettes help relieve feelings of stress. However, the stress levels of adult smokers are slightly higher than those of nonsmokers, adolescent smokers report increasing levels of stress as they develop regular patterns of smoking, and smoking cessation leads to reduced stress. Far from acting as an aid for mood control, nicotine dependency seems to exacerbate stress. This is confirmed in the daily mood patterns described by smokers, with normal moods during smoking and worsening moods between cigarettes. Thus, the apparent relaxant effect of smoking only reflects the reversal of the tension and irritability that develop during nicotine depletion. Dependent smokers need nicotine to remain feeling normal."

Immediate effects

Users report feelings of relaxation, sharpness, calmness, and alertness. Those new to smoking may experience nausea, dizziness, and rapid heart beat. The unpleasant symptoms will eventually vanish over time, with repeated use, as the body builds a tolerance to the chemicals in the cigarettes, such as nicotine.

Stress

Smokers report higher levels of everyday stress. Several studies have monitored feelings of stress over time and found reduced stress after quitting.

The deleterious mood effects of abstinence explain why smokers suffer more daily stress than non-smokers, and become less stressed when they quit smoking. Deprivation reversal also explains much of the arousal data, with deprived smokers being less vigilant and less alert than non-deprived smokers or non-smokers.

Social and behavioral

Medical researchers have found that smoking is a predictor of divorce. Smokers have a 53% greater chance of divorce than nonsmokers.

Cognitive function

The usage of tobacco can also create cognitive dysfunction. There seems to be in increased risk of Alzheimer's disease, although "case–control and cohort studies produce conflicting results as to the direction of the association between smoking and AD". Smoking has been found to contribute to dementia and cognitive decline, reduced memory and cognitive abilities in adolescents, and brain shrinkage (cerebral atrophy).

In many respects, nicotine acts on the nervous system in a similar way to caffeine. Some writings have stated that smoking can also increase mental concentration; one study documents a significantly better performance on the normed Advanced Raven Progressive Matrices test after smoking.

Most smokers, when denied access to nicotine, exhibit symptoms such as irritability, jitteriness, dry mouth, and rapid heart beat. The onset of these symptoms is very fast, nicotine's half-life being only 2 hours. Withdrawal symptoms can appear even if the smoker's consumption is very limited or irregular, appearing after only 4–5 cigarettes in most adolescents. An ex-smoker's chemical dependence to nicotine will cease after approximately ten to twenty days, although the brain's number of nicotine receptors is permanently altered, and the psychological dependence may linger for months or even many years. Unlike some recreational drugs, nicotine does not measurably alter a smoker's motor skills, judgement, or language abilities while under the influence of the drug. Tobacco withdrawal has been shown to cause clinically significant distress.

Most notably, some studies have found that patients with Alzheimer's disease are more likely not to have smoked than the general population, which has been interpreted to suggest that smoking offers some protection against Alzheimer's. However, the research in this area is limited and the results are conflicting; some studies show that smoking increases the risk of Alzheimer's disease. A recent review of the available scientific literature concluded that the apparent decrease in Alzheimer risk may be simply because smokers tend to die before reaching the age at which Alzheimer normally occurs. "Differential mortality is always likely to be a problem where there is a need to investigate the effects of smoking in a disorder with very low incidence rates before age 75 years, which is the case of Alzheimer's disease," it stated, noting that smokers are only half as likely as non-smokers to survive to the age of 80.

Former and current smokers have a lower incidence of Parkinson's disease compared to people who have never smoked, although the authors stated that it was more likely that the movement disorders which are part of Parkinson's disease prevented people from being able to smoke than that smoking itself was protective. Another study considered a possible role of nicotine in reducing Parkinson's risk: nicotine stimulates the dopaminergic system of the brain, which is damaged in Parkinson's disease, while other compounds in tobacco smoke inhibit MAO-B, an enzyme which produces oxidative radicals by breaking down dopamine.

A very large percentage of schizophrenics smoke tobacco as a form of self medication. The high rate of tobacco use by the mentally ill is a major factor in their decreased life expectancy, which is about 25 years shorter than the general population. Following the observation that smoking improves condition of people with schizophrenia, in particular working memory deficit, nicotine patches had been proposed as a way to treat schizophrenia. Some studies suggest that a link exists between smoking and mental illness, citing the high incidence of smoking amongst those suffering from schizophrenia and the possibility that smoking may alleviate some of the symptoms of mental illness, but these have not been conclusive.

Recent studies have linked smoking to anxiety disorders, suggesting the correlation (and possibly mechanism) may be related to the broad class of anxiety disorders, and not limited to just depression. Current and ongoing research attempt to explore the addiction-anxiety relationship.

Data from multiple studies suggest that anxiety disorders and depression play a role in cigarette smoking. A history of regular smoking was observed more frequently among individuals who had experienced a major depressive disorder at some time in their lives than among individuals who had never experienced major depression or among individuals with no psychiatric diagnosis. People with major depression are also much less likely to quit due to the increased risk of experiencing mild to severe states of depression, including a major depressive episode. Depressed smokers appear to experience more withdrawal symptoms on quitting, are less likely to be successful at quitting, and are more likely to relapse.

Evidence suggests that non-smokers are up to twice as likely as smokers to develop Parkinson's disease or Alzheimer's disease. A plausible explanation for these cases may be the effect of nicotine, a cholinergic stimulant, decreasing the levels of acetylcholine in the smoker's brain; Parkinson's disease occurs when the effect of dopamine is less than that of acetylcholine. In addition, nicotine stimulates the mesolimbic dopamine pathway (as do other drugs of abuse), causing an effective increase in dopamine levels. Opponents counter by noting that consumption of pure nicotine may be as beneficial as smoking without the risks associated with smoking, although this is unlikely due to the importance of the MAO-B inhibitor compounds of tobacco in preventing neurodegenerative diseases.

In pregnancy

Further information: Effects of smoking during pregnancy and Smoking and pregnancy

A number of studies have shown that tobacco use is a significant factor in miscarriages among pregnant smokers, and that it contributes to a number of other threats to the health of the fetus. Second-hand smoke appears to present an equal danger to the fetus, as one study noted that "heavy paternal smoking increased the risk of early pregnancy loss."

Other harm

Studies suggest that smoking decreases appetite, but did not conclude that overweight people should smoke or that their health would improve by smoking. This is also a cause of heart diseases. However due to some new processes of treating tobacco, especially in the case of cigarette, heavy smokers tend to become overweight as the processing involves large quantities of starch. This effect is not seen in occasional smokers. Smoking also decreases weight by overexpressing the gene AZGP1 which stimulates lipolysis.

Smoking causes about 10% of the global burden of fire deaths, and smokers are placed at an increased risk of injury-related deaths in general, partly due to also experiencing an increased risk of dying in a motor vehicle crash.

Smoking increases the risk of symptoms associated with Crohn's disease (a dose-dependent effect with use of greater than 15 cigarettes per day). There is some evidence for decreased rates of endometriosis in infertile smoking women, although other studies have found that smoking increases the risk in infertile women. There is little or no evidence of a protective effect in fertile women. Some preliminary data from 1996 suggested a reduced incidence of uterine fibroids, but overall the evidence is unconvincing.

New research has found that women who smoke are at significantly increased risk of developing an abdominal aortic aneurysm, a condition in which a weak area of the abdominal aorta expands or bulges.

Benefits

Main article: Health benefits of smoking

The risk of symptoms associated with ulcerative colitis has been frequently shown to be reduced by smokers on a dose-dependent basis; the effect is eliminated if the individual stops smoking.

Preliminary reports suggest that smoking can decrease the incidence of acne prophylactically. This was seen by a decreased percentage ratio of patients needing acne medication versus the percentage of entire population of smokers. (A smaller percentage of patients who smoked needed medication than found in the population as a whole).

Several types of "Smoker’s Paradoxes", (cases where smoking appears to have specific beneficial effects), have been observed; often the actual mechanism remains undetermined.

Nicotine may help enhance memory, at least in adults.

Mechanism - Smoking

Chemical carcinogens

Smoke, or any partially burnt organic matter, contains carcinogens (cancer-causing agents). The potential effects of smoking, such as lung cancer, can take up to 20 years to manifest themselves. Historically, women began smoking en masse later than men, so an increased death rate caused by smoking amongst women did not appear until later. The male lung cancer death rate decreased in 1975 — roughly 20 years after the initial decline in cigarette consumption in men. A fall in consumption in women also began in 1975 but by 1991 had not manifested in a decrease in lung cancer related mortalities amongst women.

Smoke contains several carcinogenic pyrolytic products that bind to DNA and cause genetic mutations. Particularly potent carcinogens are polynuclear aromatic hydrocarbons (PAH), which are toxicated to mutagenic epoxides. The first PAH to be identified as a carcinogen in tobacco smoke was benzopyrene, which has been shown to toxicate into an epoxide that irreversibly attaches to a cell's nuclear DNA, which may either kill the cell or cause a genetic mutation. If the mutation inhibits programmed cell death, the cell can survive to become a cancer cell. Similarly, acrolein, which is abundant in tobacco smoke, also irreversibly binds to DNA, causes mutations and thus also cancer. However, it needs no activation to become carcinogenic.

There are over 19 known carcinogen in cigarette smoke. The following are some of the most potent carcinogens:

*Polynuclear aromatic hydrocarbons are tar components produced by pyrolysis in smoldering organic matter and emitted into smoke. Many of them are highly carcinogenic and mutagenic, because they are toxicated to mutagenic epoxides, which are electrophilic alkylating agents. The first PAH to be identified as a carcinogen in tobacco smoke was benzopyrene, which been shown to toxicate into a diol epoxide and then permanently attach to nuclear DNA, which may either kill the cell or cause a genetic mutation. The DNA contains the information on how the cell function; in practice, it contains the recipes for protein synthesis. If the mutation inhibits programmed cell death, the cell can survive to become a cancer cell, a cell that does not function like a normal cell. The carcinogenity is radiomimetic, i.e. similar to that produced by ionizing nuclear radiation. Tobacco manufacturers have experimented with combustionless vaporizer technology to allow cigarettes to be consumed without the formation of carcinogenic benzopyrenes. However, such products have become increasingly popular, with world wide markets claiming a safer smoke. No conclusive evidence has shown to prove or disprove health claims.

*Acrolein is a pyrolysis product that is abundant in cigarette smoke. It gives smoke an acrid smell and an irritating, lachromatory effect and is a major contributor to its carcinogenity. Like PAH metabolites, acrolein is also an electrophilic alkylating agent and permanently binds to the DNA base guanine, by a conjugate addition followed by cyclization into a hemiaminal. The acrolein-guanine adduct induces mutations during DNA copying and thus causes cancers in a manner similar to PAHs. However, acrolein is 1000 times more abundant than PAHs in cigarette smoke, and is able to react as is, without metabolic activation. Acrolein has been shown to be a mutagen and carcinogen in human cells. The carcinogenity of acrolein has been difficult to study by animal experimentation, because it has such a toxicity that it tends to kill the animals before they develop cancer. Generally, compounds able to react by conjugate addition as electrophiles (so-called Michael acceptors after Michael reaction) are toxic and carcinogenic, because they can permanently alkylate DNA, similarly to mustard gas or aflatoxin. Acrolein is only one of them present in cigarette smoke; for example, crotonaldehyde has been found in cigarette smoke. Michael acceptors also contribute to the chronic inflammation present in tobacco disease.

*Nitrosamines are a group of carcinogenic compounds found in cigarette smoke but not in uncured tobacco leaves. Nitrosamines form on flue-cured tobacco leaves during the curing process through a chemical reaction between nicotine and other compounds contained in the uncured leaf and various oxides of nitrogen found in all combustion gases. Switching to Indirect fire curing has been shown to reduce nitrosamine levels to less than 0.1 parts per million.

Radioactive carcinogens

In addition to chemical, nonradioactive carcinogens, tobacco and tobacco smoke contain small amounts of lead-210 (210Pb) and polonium-210 (210Po) both of which are radioactive carcinogens. The presence of polonium-210 in mainstream cigarette smoke has been experimentally measured at levels of 0.0263–0.036 pCi (0.97–1.33 mBq), which is equivalent to about 0.1 pCi per milligram of smoke (4 mBq/mg); or about 0.81 pCi of lead 210 per gram of dry condensed smoke (30 Bq/kg).

Research by NCAR radiochemist Ed Martell determined that radioactive compounds in cigarette smoke are deposited in "hot spots" where bronchial tubes branch. Since tar from cigarette smoke is resistant to dissolving in lung fluid, the radioactive compounds have a great deal of time to undergo radioactive decay before being cleared by natural processes. Indoors, these radioactive compounds linger in secondhand smoke, and therefore greater exposure occurs when these radioactive compounds are inhaled during normal breathing, which is deeper and longer than when inhaling cigarettes. Damage to the protective epithelial tissue from smoking only increases the prolonged retention of insoluble polonium 210 compounds produced from burning tobacco. Martell estimated that a carcinogenic radiation dose of 80–100 rads is delivered to the lung tissue of most smokers who die of lung cancer.

Smoking an average of 1.5 packs per day gives a radiation dose of 13-60 mSv/year, compared with living near a nuclear power station (0.0001 mSv/year) or the 3.0 mSv/year average dose for Americans

Nicotine

Nicotine that is contained in cigarettes and other smoked tobacco products is a stimulant and is one of the main factors leading to continued tobacco smoking. Although the amount of nicotine inhaled with tobacco smoke is quite small (most of the substance is destroyed by the heat) it is still sufficient to cause physical and/or psychological dependence. The amount of nicotine absorbed by the body from smoking depends on many factors, including the type of tobacco, whether the smoke is inhaled, and whether a filter is used. Despite the design of various cigarettes advertised and even tested on machines to deliver less of the toxic tar, studies show that when smoked by humans instead of machines, they deliver the same net amount of smoke. Ingesting a compound by smoking is one of the most rapid and efficient methods of introducing it into the bloodstream, second only to injection, which allows for the rapid feedback which supports the smokers' ability to titrate their dosage. On average it takes about ten seconds for the substance to reach the brain. As a result of the efficiency of this delivery system, many smokers feel as though they are unable to cease. Of those who attempt cessation and last three months without succumbing to nicotine, most are able to remain smoke free for the rest of their lives. There exists a possibility of depression in some who attempt cessation, as with other psychoactive substances. Depression is also common in teenage smokers; teens who smoke are four times as likely to develop depressive symptoms as their nonsmoking peers.

Although nicotine does play a role in acute episodes of some diseases (including stroke, impotence, and heart disease) by its stimulation of adrenaline release, which raises blood pressure, heart rate, and free fatty acids, the most serious longer term effects are more the result of the products of the smouldering combustion process. This has enabled development of various nicotine delivery systems, such as the nicotine patch or nicotine gum, that can satisfy the addictive craving by delivering nicotine without the harmful combustion by-products. This can help the heavily dependent smoker to quit gradually, while discontinuing further damage to health.

Nicotine is a highly addictive psychoactive chemical. When tobacco is smoked, most of the nicotine is pyrolyzed; a dose sufficient to cause mild somatic dependency and mild to strong psychological dependency remains. There is also a formation of harmane (a MAO inhibitor) from the acetaldehyde in cigarette smoke, which seems to play an important role in nicotine addiction probably by facilitating dopamine release in the nucleus accumbens in response to nicotine stimuli. According to studies by Henningfield and Benowitz, nicotine is more addictive than cannabis, caffeine, ethanol, cocaine, and heroin when considering both somatic and psychological dependence. However, due to the stronger withdrawal effects of ethanol, cocaine and heroin, nicotine may have a lower potential for somatic dependence than these substances. About half of Canadians who currently smoke have tried to quit. McGill University health professor Jennifer O'Loughlin stated that nicotine addiction can occur as soon as five months after the start of smoking.

Recent evidence has shown that smoking tobacco increases the release of dopamine in the brain, specifically in the mesolimbic pathway, the same neuro-reward circuit activated by drugs of abuse such as heroin and cocaine. This suggests nicotine use has a pleasurable effect that triggers positive reinforcement. One study found that smokers exhibit better reaction-time and memory performance compared to non-smokers, which is consistent with increased activation of dopamine receptors. Neurologically, rodent studies have found that nicotine self-administration causes lowering of reward thresholds—a finding opposite that of most other drugs of abuse (e.g. cocaine and heroin). This increase in reward circuit sensitivity persisted months after the self-administration ended, suggesting that nicotine's alteration of brain reward function is either long lasting or permanent.[citation needed] Furthermore, it has been found that nicotine can activate long term potentiation in vivo and in vitro.[citation needed] These studies suggest nicotine’s "trace memory" may contribute to difficulties in nicotine abstinence.[original research?]

The carcinogenity of tobacco smoke is not explained by nicotine per se, which is not carcinogenic or mutagenic. However, it inhibits apoptosis, therefore accelerating existing cancers. Also, NNK, a nicotine derivative converted from nicotine, can be carcinogenic.

It is worth noting that nicotine, although frequently implicated in producing tobacco addiction, is not significantly addictive when administered alone. The addictive potential manifests itself after co-administration of an MAOI, which specifically causes sensitization of the locomotor response in rats, a measure of addictive potential.

Genetic

Aespective of smoking status or quantity smoked.

Another study related to genetic changes in smokers was conducted by Wan L Lam and Stephen Lam from the BC Cancer Agency, in 2007. The study revealed that cigarette smoke can turn on or off some of the genes, which otherwise would remain inactive or active respectively. Some changes on genetic level could be reversed after the smoking was quit, yet others could not. Examples of reversible genes involved the so-called xenofobic functions, nucleotide metabolism and mucus secretion. Smoking turns off some DNA repair genes that cannot be reversed. It also switches off some genes responsible from protection from cancer growth in the body.

Prevalence - Smoking

Tobacco may be consumed by either smoking or other smokeless methods such as chewing, the World Health Organization (WHO) only collect data on smoked tobacco. Smoking has therefore been studied more extensively than any other form of consumption.

In 2000, smoking was practiced by 1.22 billion people, predicted to rise to 1.45 billion people in 2010 and 1.5 to 1.9 billion by 2025. If prevalence had decreased by 2% a year since 2000 this figure would have been 1.3 billion in 2010 and 2025. Despite dropping by 0.4 percent from 2009 to 2010, the United States still reports an average of 17.9 percent usage.

Smoking is generally five times more prevalent among males than females, however the gender gap declines with younger age. In developed countries smoking rates for men have peaked and have begun to decline, however for women they continue to climb.

As of 2002, about twenty percent of young teens (13–15) smoke worldwide, with 80,000 to 100,000 children taking up the habit every day—roughly half of whom live in Asia. Half of those who begin smoking in adolescent years are projected to go on to smoke for 15 to 20 years.

The WHO states that "Much of the disease burden and premature mortality attributable to tobacco use disproportionately affect the poor". Of the 1.22 billion smokers, 1 billion of them live in developing or transitional nations. Rates of smoking have leveled off or declined in the developed world.[21] In the developing world, however, tobacco consumption is rising by 3.4% per year as of 2002.

The WHO in 2004 projected 58.8 million deaths to occur globally, from which 5.4 million are tobacco-attributed, and 4.9 million as of 2007. As of 2002, 70% of the deaths are in developing countries.

The shift in prevalence of tobacco smoking to a younger demographic, mainly in the developing world, can be attributed to several factors. The tobacco industry spends up to $12.5 billion dollars annually on advertising, which is increasingly geared towards adolescents in the developing world because they are a very vulnerable audience for the marketing campaigns. Adolescents have more difficulty understanding the long term health risks that are associated with smoking and are also more easily influenced by “images of romance, success, sophistication, popularity, and adventure which advertising suggests they could achieve through the consumption of cigarettes”. This shift in marketing towards adolescents and even children in the tobacco industry is debilitating to organizations’ and countries’ efforts to improve child health and mortality in the developing world. It reverses or halts the effects of the work that has been done to improve health care in these countries, and although smoking is deemed as a “voluntary” health risk, the marketing of tobacco towards very impressionable adolescents in the developing world makes it less of a voluntary action and more of an inevitable shift.

Studies

In the 1930s German scientists showed that cigarette smoking caused lung cancer. In 1938 a study by a Johns Hopkins University scientist suggested a strongly negative correlation between smoking and lifespan. In 1950 five studies were published in which "smoking was powerfully implicated in the causation of lung cancer". These included the now classic paper "Smoking and Carcinoma of the Lung" which appeared in the British Medical Journal. This paper reported that "heavy smokers were fifty times as likely as non-smokers to contract lung cancer".

In 1953 scientists at the Sloan-Kettering Institute in New York City demonstrated that cigarette tar painted on the skin of mice caused fatal cancers. This work attracted much media attention; the New York Times and Life both covered the issue. The Reader's Digest published an article entitled "Cancer by the Carton".

A team of British scientists headed by Richard Doll carried out a longitudinal study of 34,439 medical specialists from 1951 to 2001, generally called the "British Doctors Study." The study demonstrated that about half of the persistent cigarette smokers born in 1900–1909 were eventually killed by their habit (calculated from the logarithms of the probabilities of surviving from 35–70, 70–80, and 80–90) and about two thirds of the persistent cigarette smokers born in the 1920s would eventually be killed by their habit. After a ban on smoking in all enclosed public places was introduced in Scotland in March 2006, there was a 17 percent reduction in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers.

The health effects of tobacco have been significant for the development of the science of epidemiology. As the mechanism of carcinogenicity is radiomimetic or radiological, the effects are stochastic. Definite statements can be made only on the relative increased or decreased probabilities of contracting a given disease; Philosophically and theoretically speaking, it is impossible to definitively prove a direct causative link between exposure to a radiomimetic poison such as tobacco smoke and the cancer that follows. Tobacco companies have capitalized on this philosophical objection and exploited the doubts of clinicians, who consider only individual cases, on the causal link in the stochastic expression of the toxicity as actual disease.

There have been multiple court cases on the issue that tobacco companies have researched the health effects of tobacco, but suppressed the findings or formatted them to imply lessened or no hazard.

A study published in the journal Pediatrics[33] refers to the danger posed by what the authors call "third-hand smoke" — toxic substances that remain in areas where smoking has recently occurred. The study was reviewed in an story broadcast by the Voice of America.

Occasional Smoking

The term "smoker" is used to mean a person who habitually smokes tobacco on a daily basis. This category has been the focus of the vast majority of tobacco studies. However, the health effects of less-than-daily smoking are far less well understood. Studies have often taken the data of "occasional smokers" (those who have never smoked daily) and grouped them with those who have never smoked.

A recent European study on occasional smoking published findings that the risk of the major smoking-related cancers for occasional smokers was 1.24 times that of those who have never smoked at all but the result was not statistically significant. (For a confidence interval of 95%, this data showed an incidence rate ratio of 0.80 to 1.94.) This compares to studies showing that habitual heavy smokers have greater than 50 times the incidence of smoking-related cancers.

Health effects of tobacco - Smoking

The health effects of tobacco are the circumstances, mechanisms, and factors of tobacco consumption on human health. Epidemiological research has been focused primarily on cigarette tobacco smoking, which has been studied more extensively than any other form of consumption.

Tobacco is the single greatest cause of preventable death in the United States and worldwide. Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis), and cancer (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer). It also causes peripheral vascular disease and hypertension. The effects depend on the number of years that a person smokes and on how much the person smokes. Starting smoking earlier in life and smoking cigarettes higher in tar increases the risk of these diseases. Cigarettes sold in underdeveloped countries tend to have higher tar content, and are less likely to be filtered, potentially increasing vulnerability to tobacco-related disease in these regions.

The World Health Organization (WHO) estimates that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."

Smoke contains several carcinogenic pyrolytic products that bind to DNA and cause many genetic mutations. There are over 19 known chemical carcinogens in cigarette smoke[citation needed]. Tobacco also contains nicotine, which is a highly addictive psychoactive chemical. When tobacco is smoked, nicotine causes physical and psychological dependency. Tobacco use is a significant factor in miscarriages among pregnant smokers, it contributes to a number of other threats to the health of the fetus such as premature births and low birth weight and increases by 1.4 to 3 times the chance for Sudden Infant Death Syndrome (SIDS). The result of scientific studies done in neonatal rats seems to indicate that exposure to cigarette smoke in the womb may reduce the fetal brain's ability to recognize hypoxic conditions, thus increasing the chance of accidental asphyxiation. Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers, and is a key factor causing erectile dysfunction (ED).

International Day of United Nations Peacekeepers

The "International Day of United Nations Peacekeepers", May 29, is "a day to pay tribute to all the men and women who have served and continue to serve in United Nations peacekeeping operations for their high level of professionalism, dedication, and courage and to honor the memory of those who have lost their lives in the cause of peace. "It was so designated by United Nations General Assembly Resolution 57/129, on December 11, 2002 and first celebrated in 2003. The date, May 29, marks the anniversary of the creation of the United Nations Truce Supervision Organization (UNTSO), in 1948 to monitor the ceasefire after the 1948 Arab-Israeli War, which was the first ever UN peacekeeping mission.

The day is marked at the United Nations Headquarters in New York City with the presentation of the Dag Hammarskjöld Medal, statements by the President of the General Assembly and the Secretary-General a press release regarding the state of UN Peacekeeping missions and the continued necessity of their work.

There are also observances around the world, often countries will honor their own peacekeepers abroad, but the UN also organizes festivals, discussion forums, and memorials in cooperation with local and national groups.

In 2009, the UN put a special focus on the role of and need for women in peacekeeping, both as role models and also to serve in a number of gender-specific capacities.

Biography of Henry Alfred Kissinger 1923 -

Secretary of State; statesman. Henry Kissinger was born as Heinz Alfred Kissinger on May 27, 1923, in Fürth, a city in the Bavaria region of Germany. Kissinger's mother, Paula Stern, came from a relatively wealthy and prominent family, and his father, Louis Kissinger, was a teacher. Kissinger grew up in an Orthodox Jewish household, and during his youth he spent two hours each day diligently studying the Bible and the Talmud. The interwar Germany of Kissinger's youth was still reeling from its defeat in World War I and the humiliating and debilitating terms of the 1919 Treaty of Versailles. Such national emasculation gave rise to the intense German nationalism of Nazism, in which many Germans increasingly treated Germany's Jewish population as outsiders and scapegoats for their misfortunes.

As a child, Kissinger encountered anti-Semitism daily. An avid soccer fan, he defied laws banning Jews from professional sporting events to attend matches, receiving several beatings at the hands of the stadium guards. He and his friends were also regularly abused by local gangs of Nazi youth. These experiences understandably made a lasting impression on Kissinger. One of his childhood friends said, "You can't grow up like we did and be untouched. Every day there were slurs in the streets, anti-Semitic remarks, calling you filthy names."

Kissinger was a shy, introverted and bookish child. "He withdrew," his mother remembered. "Sometimes he wasn't outgoing enough, because he was lost in his books." Kissinger excelled at the local Jewish school and dreamed of attending the Gymnasium, a prestigious state-run high school. However, by the time he was old enough to apply, the school had stopped accepting Jews. Sensing the impending tragedy of the Holocaust, his family decided to flee Germany for United States in 1938, when Kissinger was 15 years old.

On August 20, 1938, the Kissingers set sail for New York City by way of London. His family was extremely poor upon arrival in the United States, and Kissinger immediately went to work in a shaving brush factory to supplement his family's income. At the same time, Kissinger enrolled at New York's George Washington High School, where he learned English with remarkable speed and excelled in all of his classes. One of his teachers later recalled of Kissinger, "He was the most serious and mature of the German refugee students, and I think those students were more serious than our own." Kissinger graduated from high school in 1940 and continued on to the City College of New York, where he studied to become an accountant.

In 1943, Kissinger became a naturalized American citizen and, soon after, he was drafted into the army to fight in World War II. Thus, just five years after he left, Kissinger found himself back in his homeland of Germany, fighting the very Nazi regime from which he had once fled. He served first as a rifleman in France and then as a G-2 intelligence officer in Germany. Over the course of the war, Kissinger abandoned his plan to become an accountant and instead decided that he wanted to become an academic with a focus on political history. In 1947, upon his return to the United States, he was admitted to Harvard University to complete his undergraduate coursework. Kissinger's senior thesis, completed in 1950, was a 383-page tome that tackled a vast subject matter: the meaning of history. His daunting manuscript which, though unrefined, showed flashes of brilliance, inspired Harvard to impose "the Kissinger rule" limiting future theses to about one-third that length.

Upon graduating summa cum laude in 1950, Kissinger decided to remain at Harvard to pursue a Ph.D. in the Department of Government. His 1954 dissertation, A World Restored: Metternich, Castlereagh, and the Problems of Peace, 1812-1822, examined the efforts of Austrian diplomat Klemens von Metternich to reestablish a legitimate international order in Europe in the aftermath of the Napoleonic Wars. Metternich proved a profound influence on Kissinger's own later conduct of foreign policy, most notably in his firm belief that even a deeply flawed world order was preferable to revolution and chaos.

After receiving his doctorate in 1954, Kissinger accepted an offer to stay at Harvard as a member of the faculty in the Department of Government. Kissinger first achieved widespread fame in academic circles with his 1957 book Nuclear Weapons and Foreign Policy, opposing President Dwight Eisenhower's policy of holding out the threat of massive retaliation to ward off Soviet aggression. Instead, Kissinger proposed a "flexible" response model, arguing that a limited war fought with conventional forces and tactical nuclear weapons was, in fact, winnable. He served as a member of the Harvard faculty from 1954-69, earning tenure in 1959.

However, Kissinger always kept one eye outside academia on policymaking in Washington, D.C. From 1961-68, in addition to teaching at Harvard, he served as a special advisor to Presidents Kennedy and Johnson on matters of foreign policy. Then in 1969, Kissinger finally left Harvard when incoming President Richard Nixon appointed him to serve as his National Security Advisor. As National Security Advisor from 1969-75, and then as Secretary of State from 1973-77, Kissinger would prove one of the most dominant, influential and controversial statesmen in American history.

The great foreign policy trial of Kissinger's career was the Vietnam War. By the time Kissinger became National Security Advisor in 1969, the Vietnam War had become enormously costly, deadly and unpopular. Seeking to achieve "peace with honor," Kissinger combined diplomatic initiatives and troop withdrawals with devastating bombing campaigns on North Vietnam designed to improve the American bargaining position and maintain American credibility with its international allies and enemies.

On January 27, 1973, Kissinger and his North Vietnamese negotiating partner Le Duc Tho finally signed a ceasefire agreement to end direct American involvement in the conflict. Both men were honored with the 1973 Nobel Peace Prize, although Duc declined, leaving Kissinger the sole recipient of the award. Nevertheless, Kissinger's handling of the Vietnam War was highly controversial. His "peace with honor" strategy prolonged the war for four years, from 1969-73, during which 22,000 American troops and countless Vietnamese died. Furthermore, he initiated a secret bombing campaign in Cambodia that ravaged the country and helped the genocidal Khmer Rouge take power there.

In addition to ending the Vietnam War, Kissinger also accomplished a host of other foreign policy achievements. In 1971, Kissinger made two secret trips to the People's Republic of China, paving the way for President Nixon's historic visit in 1972 and the normalization of Chinese-American relations in 1979. Kissinger was also instrumental in bringing about the early 1970s détente between the United States and the Soviet Union. In 1972, he negotiated the Strategic Arms Limitation Treaty (SALT I) and the Anti-Ballistic Missile Treaty, helping to ease tensions between the two Cold War superpowers. When détente was threatened by the October 1973 Yom Kippur War between Israel, an American ally, and Egypt, a Soviet ally, Kissinger proved crucial in leading diplomatic efforts to prevent the war from escalating into a global confrontation. Kissinger stepped down as secretary of state at the conclusion of the Ford administration in 1977.

Since, then Kissinger has continued to play a major role in American foreign policy. In 1983, President Ronald Reagan appointed him to chair the National Bipartisan Commission on Central America, and from 1984-90, under Presidents Reagan and Bush, he served on the President's Foreign Intelligence Advisory Board. Kissinger founded the international consulting firm Kissinger Associates in 1982, and he serves as a board member and trustee to numerous companies and foundations. Kissinger has authored several books and countless articles on American foreign policy and diplomatic history.

Kissinger is married to Nancy Maginnes. He has two children with his former wife, Ann Fleicher, whom he divorced in 1964.

Henry Kissinger stands out as the dominant American statesman and foreign policymaker of the late 20th century. With his intellectual prowess and tough, skillful negotiating style, Kissinger ended the Vietnam War and greatly improved American relations with its two primary Cold War enemies, China and the Soviet Union. Nevertheless, Kissinger's ruthlessly pragmatic, sometimes Machiavellian tactics have earned him as many critics as admirers. The writer Christopher Hitchens, for example, has castigated Kissinger for bombing Cambodia, endorsing the Indonesian occupation of East Timor and orchestrating the overthrow of Chilean President Salvador Allende. Regardless of whether they praise or despise him, commentators agree that the current international order is the product of Kissinger's policies. As Kissinger himself put it, "Only rarely in history do statesmen find an environment in which all factors are so malleable; before us, I thought, was the chance to shape events, to build a new world, harnessing the energy and dreams of the American people and mankind's hopes."

Biography of Nicolas Copernicus 1473 – 1543

Born Feb. 19, 1473, Toru, Pol.—died May 24, 1543, Frauenburg, East Prussia [now Frombork, Pol.]) Polish astronomer who proposed that the planets have the Sun as the fixed point to which their motions are to be referred; that the Earth is a planet which, besides orbiting the Sun annually, also turns once daily on its own axis; and that very slow, long-term changes in the direction of this axis account for the precession of the equinoxes. This representation of the heavens is usually called the heliocentric, or “Sun-centred,” system—derived from the Greek helios, meaning “Sun.” Copernicus's theory had important consequences for later thinkers of the scientific revolution, including such major figures as Galileo, Kepler, Descartes, and Newton. Copernicus probably hit upon his main idea sometime between 1508 and 1514, and during those years he wrote a manuscript usually called the Commentariolus (“Little Commentary”). However, the book that contains the final version of his theory, De revolutionibus orbium coelestium libri vi (“Six Books Concerning the Revolutions of the Heavenly Orbs”), did not appear in print until 1543, the year of his death.

Early life and education

Certain facts about Copernicus's early life are well established, although a biography written by his ardent disciple Georg Joachim Rheticus (1514–74) is unfortunately lost. According to a later horoscope, Nicolaus Copernicus was born on February 19, 1473, in Toru, a city in north-central Poland on the Vistula River south of the major Baltic seaport of Gdask. His father, Nicolaus, was a well-to-do merchant, and his mother, Barbara Watzenrode, also came from a leading merchant family. Nicolaus was the youngest of four children. After his father's death, sometime between 1483 and 1485, his mother's brother Lucas Watzenrode (1447–1512) took his nephew under his protection. Watzenrode, soon to be bishop of the chapter of Varmia (Warmia), saw to young Nicolaus's education and his future career as a church canon.

Between 1491 and about 1494 Copernicus studied liberal arts—including astronomy and astrology—at the University of Cracow (Kraków). Like many students of his time, however, he left before completing his degree, resuming his studies in Italy at the University of Bologna, where his uncle had obtained a doctorate in canon law in 1473. The Bologna period (1496–1500) was short but significant. For a time Copernicus lived in the same house as the principal astronomer at the university, Domenico Maria de Novara (Latin: Domenicus Maria Novaria Ferrariensis; 1454–1504). Novara had the responsibility of issuing annual astrological prognostications for the city, forecasts that included all social groups but gave special attention to the fate of the Italian princes and their enemies. Copernicus, as is known from Rheticus, was “assistant and witness” to some of Novara's observations, and his involvement with the production of the annual forecasts means that he was intimately familiar with the practice of astrology. Novara also probably introduced Copernicus to two important books that framed his future problematic as a student of the heavens: Epitoma in Almagestum Ptolemaei (“Epitome of Ptolemy's Almagest”) by Johann Müller (also known as Regiomontanus, 1436–76) and Disputationes adversus astrologianm divinatricenm (“Disputations against Divinatory Astrology”) by Giovanni Pico della Mirandola (1463–94). The first provided a summary of the foundations of Ptolemy's astronomy, with Regiomontanus's corrections and critical expansions of certain important planetary models that might have been suggestive to Copernicus of directions leading to the heliocentric hypothesis. Pico's Disputationes offered a devastating skeptical attack on the foundations of astrology that reverberated into the 17th century. Among Pico's criticisms was the charge that, because astronomers disagreed about the order of the planets, astrologers could not be certain about the strengths of the powers issuing from the planets.

Only 27 recorded observations are known for Copernicus's entire life (he undoubtedly made more than that), most of them concerning eclipses, alignments, and conjunctions of planets and stars. The first such known observation occurred on March 9, 1497, at Bologna. In De revolutionibus, book 4, chapter 27, Copernicus reported that he had seen the Moon eclipse “the brightest star in the eye of the Bull,” Alpha Tauri (Aldebaran). By the time he published this observation in 1543, he had made it the basis of a theoretical claim: that it confirmed exactly the size of the apparent lunar diameter. But in 1497 he was probably using it to assist in checking the new- and full-moon tables derived from the commonly used Alfonsine Tables and employed in Novara's forecast for the year 1498.

In 1500 Copernicus spoke before an interested audience in Rome on mathematical subjects, but the exact content of his lectures is unknown. In 1501 he stayed briefly in Frauenburg but soon returned to Italy to continue his studies, this time at the University of Padua, where he pursued medical studies between 1501 and 1503. At this time medicine was closely allied with astrology, as the stars were thought to influence the body's dispositions. Thus, Copernicus's astrological experience at Bologna was better training for medicine than one might imagine today. Copernicus later painted a self-portrait; it is likely that he acquired the necessary artistic skills while in Padua, since there was a flourishing community of painters there and in nearby Venice. In May 1503 Copernicus finally received a doctorate—like his uncle, in canon law—but from an Italian university where he had not studied: the University of Ferrara. When he returned to Poland, Bishop Watzenrode arranged a sinecure for him: an in absentia teaching post, or scholastry, at Wrocaw. Copernicus's actual duties at the bishopric palace, however, were largely administrative and medical. As a church canon, he collected rents from church-owned lands; secured military defenses; oversaw chapter finances; managed the bakery, brewery, and mills; and cared for the medical needs of the other canons and his uncle. Copernicus's astronomical work took place in his spare time, apart from these other obligations. He used the knowledge of Greek that he had acquired during his Italian studies to prepare a Latin translation of the aphorisms of an obscure 7th-century Byzantine historian and poet, Theophylactus Simocattes. The work was published in Cracow in 1509 and dedicated to his uncle. It was during the last years of Watzenrode's life that Copernicus evidently came up with the idea on which his subsequent fame was to rest.

Copernicus's reputation outside local Polish circles as an astronomer of considerable ability is evident from the fact that in 1514 he was invited to offer his opinion at the church's Fifth Lateran Council on the critical problem of the reform of the calendar. The civil calendar then in use was still the one produced under the reign of Julius Caesar, and, over the centuries, it had fallen seriously out of alignment with the actual positions of the Sun. This rendered the dates of crucial feast days, such as Easter, highly problematic. Whether Copernicus ever offered any views on how to reform the calendar is not known; in any event, he never attended any of the council's sessions. The leading calendar reformer was Paul of Middelburg, bishop of Fossombrone. When Copernicus composed his dedication to De revolutionibus in 1542, he remarked that “mathematics is written for mathematicians.” Here he distinguished between those, like Paul, whose mathematical abilities were good enough to understand his work and others who had no such ability and for whom his work was not intended.


Copernicus's astronomical work

The contested state of planetary theory in the late 15th century and Pico's attack on astrology's foundations together constitute the principal historical considerations in constructing the background to Copernicus's achievement. In Copernicus's period, astrology and astronomy were considered subdivisions of a common subject called the “science of the stars,” whose main aim was to provide a description of the arrangement of the heavens as well as the theoretical tools and tables of motions that would permit accurate construction of horoscopes and annual prognostications. At this time the terms astrologer, astronomer, and mathematician were virtually interchangeable; they generally denoted anyone who studied the heavens using mathematical techniques. Pico claimed that astrology ought to be condemned because its practitioners were in disagreement about everything, from the divisions of the zodiac to the minutest observations to the order of the planets. A second long-standing disagreement, not mentioned by Pico, concerned the status of the planetary models. From antiquity, astronomical modeling was governed by the premise that the planets move with uniform angular motion on fixed radii at a constant distance from their centres of motion. Two types of models derived from this premise. The first, represented by that of Aristotle, held that the planets are carried around the centre of the universe embedded in unchangeable, material, invisible spheres at fixed distances. Since all planets have the same centre of motion, the universe is made of nested, concentric spheres with no gaps between them. As a predictive model, this account was of limited value. Among other things, it had the distinct disadvantage that it could not account for variations in the apparent brightness of the planets since the distances from the centre were always the same. A second tradition, deriving from Claudius Ptolemy, solved this problem by postulating three mechanisms: uniformly revolving, off-centre circles called eccentrics; epicycles, little circles whose centres moved uniformly on the circumference of circles of larger radius (deferents); and equants. The equant, however, broke with the main assumption of ancient astronomy because it separated the condition of uniform motion from that of constant distance from the centre. A planet viewed from the centre c of its orbit would appear to move sometimes faster, sometimes slower. As seen from the Earth, removed a distance e from c, the planet would also appear to move nonuniformly. Only from the equant, an imaginary point at distance 2 e from the Earth, would the planet appear to move uniformly. A planet-bearing sphere revolving around an equant point will wobble; situate one sphere within another, and the two will collide, disrupting the heavenly order. In the 13th century a group of Persian astronomers at Margheh discovered that, by combining two uniformly revolving epicycles to generate an oscillating point that would account for variations in distance, they could devise a model that produced the equalized motion without referring to an equant point.

The Margheh work was written in Arabic, which Copernicus did not read. However, he learned to do the Margheh “trick,” either independently or through a still-unknown intermediary link. This insight was the starting point for his attempt to resolve the conflict raised by wobbling physical spheres. Copernicus might have continued this work by considering each planet independently, as did Ptolemy in the Almagest, without any attempt to bring all the models together into a coordinated arrangement. However, he was also disturbed by Pico's charge that astronomers could not agree on the actual order of the planets. The difficulty focused on the locations of Venus and Mercury. There was general agreement that the Moon and Sun encircled the motionless Earth and that Mars, Jupiter, and Saturn were situated beyond the Sun in that order. However, Ptolemy placed Venus closest to the Sun and Mercury to the Moon, while others claimed that Mercury and Venus were beyond the Sun.

In the Commentariolus, Copernicus postulated that, if the Sun is assumed to be at rest and if the Earth is assumed to be in motion, then the remaining planets fall into an orderly relationship whereby their sidereal periods increase from the Sun as follows: Mercury (88 days), Venus (225 days), Earth (1 year), Mars (1.9 years), Jupiter (12 years), and Saturn (30 years). This theory did resolve the disagreement about the ordering of the planets but, in turn, raised new problems. To accept the theory's premises, one had to abandon much of Aristotelian natural philosophy and develop a new explanation for why heavy bodies fall to a moving Earth. It was also necessary to explain how a transient body like the Earth, filled with meteorological phenomena, pestilence, and wars, could be part of a perfect and imperishable heaven. In addition, Copernicus was working with many observations that he had inherited from antiquity and whose trustworthiness he could not verify. In constructing a theory for the precession of the equinoxes, for example, he was trying to build a model based upon very small, long-term effects. And his theory for Mercury was left with serious incoherencies.

Any of these considerations alone could account for Copernicus's delay in publishing his work. (He remarked in the preface to De revolutionibus that he had chosen to withhold publication not for merely the nine years recommended by the Roman poet Horace but for 36 years, four times that period.) And, when a description of the main elements of the heliocentric hypothesis was first published, in the Narratio prima (1540 and 1541, “First Narration”), it was not under Copernicus's own name but under that of the 25-year-old Georg Rheticus. Rheticus, a Lutheran from the University of Wittenberg, Germany, stayed with Copernicus at Frauenburg for about two and a half years, between 1539 and 1542. The Narratio prima was, in effect, a joint production of Copernicus and Rheticus, something of a “trial balloon” for the main work. It provided a summary of the theoretical principles contained in the manuscript of De revolutionibus, emphasized their value for computing new planetary tables, and presented Copernicus as following admiringly in the footsteps of Ptolemy even as he broke fundamentally with his ancient predecessor. It also provided what was missing from the Commentariolus: a basis for accepting the claims of the new theory.

Both Rheticus and Copernicus knew that they could not definitively rule out all possible alternatives to the heliocentric theory. But they could underline what Copernicus's theory provided that others could not: a singular method for ordering the planets and for calculating the relative distances of the planets from the Sun. Rheticus compared this new universe to a well-tuned musical instrument and to the interlocking wheel-mechanisms of a clock. In the preface to De revolutionibus, Copernicus used an image from Horace's Ars poetica (“Art of Poetry”). The theories of his predecessors, he wrote, were like a human figure in which the arms, legs, and head were put together in the form of a disorderly monster. His own representation of the universe, in contrast, was an orderly whole in which a displacement of any part would result in a disruption of the whole. In effect, a new criterion of scientific adequacy was advanced together with the new theory of the universe.

Publication of De revolutionibus

The presentation of Copernicus's theory in its final form is inseparable from the conflicted history of its publication. When Rheticus left Frauenburg to return to his teaching duties at Wittenberg, he took the manuscript with him in order to arrange for its publication at Nürnberg, the leading centre of printing in Germany. He chose the top printer in the city, Johann Petreius, who had published a number of ancient and modern astrological works during the 1530s. It was not uncommon for authors to participate directly in the printing of their manuscripts, sometimes even living in the printer's home. However, Rheticus was unable to remain and supervise. He turned the manuscript over to Andreas Osiander (1498–1552), a theologian experienced in shepherding mathematical books through production as well as a leading political figure in the city and an ardent follower of Luther (although he was eventually expelled from the Lutheran church). In earlier communication with Copernicus, Osiander had urged him to present his ideas as purely hypothetical, and he now introduced certain changes without the permission of either Rheticus or Copernicus. Osiander added an unsigned “letter to the reader” directly after the title page, which maintained that the hypotheses contained within made no pretense to truth and that, in any case, astronomy was incapable of finding the causes of heavenly phenomena. A casual reader would be confused about the relationship between this letter and the book's contents. Both Petreius and Rheticus, having trusted Osiander, now found themselves double-crossed. Rheticus's rage was so great that he crossed out the letter with a great red X in the copies sent to him. However, the city council of Nürnberg refused to punish Petreius, and no public revelation of Osiander's role was made until Kepler revealed it in his Astronomia Nova ( New Astronomy) in 1609. In addition, the title of the work was changed from the manuscript's “On the Revolutions of the Orbs of the World” to “Six Books Concerning the Revolutions of the Heavenly Orbs”—a change that appeared to mitigate the book's claim to describe the real universe.

Many of the details of these local publication struggles enjoyed an underground history among 16th-century astronomers long before Kepler published Osiander's identity. Ironically, Osiander's “letter” made it possible for the book to be read as a new method of calculation, rather than a work of natural philosophy, and in so doing may even have aided in its initially positive reception. It was not until Kepler that Copernicus's cluster of predictive mechanisms would be fully transformed into a new philosophy about the fundamental structure of the universe.

Legend has it that a copy of De revolutionibus was placed in Copernicus's hands a few days after he lost consciousness from a stroke. He awoke long enough to realize that he was holding his great book and then expired, publishing as he perished. The legend has some credibility, although it also has the beatific air of a saint's life.

Biography of Osama bin Laden 1957 – 2011

Jihadist leader. Born Osama bin Mohammed bin Awad bin Laden on March 10, 1957, in Riyadh, Saudi Arabia, to construction billionaire Mohammed Awad bin Laden and Mohammed's 10th wife, Syrian-born Alia Ghanem. Osama was the seventh of 50 children born to Muhammad bin Laden, but the only child from his father's marriage to Alia Ghanem.

Osama's father started his professional life in the 1930s in relative poverty, working as a porter in Jeddah, Saudi Arabia. During his time as a young laborer, Mohammed impressed the royal family with his work on their palaces, which he built at a much lower cost than any of his competitors could, and with a much greater attention to detail. By the 1960s, he had managed to land several large government contracts to build extensions on the Mecca, Medina and Al-Aqsa mosques. He became a highly influential figure in Jeddah; when the city fell on hard financial times, Mohammed used his wealth to pay all civil servants' wages for the entire kingdom for a six-month period. As a result, Mohammed bin Laden became well respected in his community.

As a father, he was very strict, insisting that all his children live under one roof and observe a rigid religious and moral code. He dealt with his children, especially his sons, as if they were adults, and demanded they become confident and self-sufficient at an early age.

Osama, however, barely came to know his father before his parents divorced. After his family split, Osama's mother took him to live with her new husband, Muhammad al-Attas. The couple had four children together, and Osama spent most of his childhood living with his step-siblings, and attending Al Thagher Model School at the time the most prestigious high school in Jedda. His biological father would go on to marry two more times, until his death in a charter plane crash in September 1967.

At the age of 14, Osama was recognized as an outstanding, if somewhat shy, student at Al Thagher. As a result, he received a personal invitation to join a small Islamic study group with the promise of earning extra credit. Osama, along with the sons of several prominent Jedda families, were told the group would memorize the entire Koran, a prestigious accomplishment, by the time they graduated from the institution. But the group soon lost its original focus, and during this time Osama received the beginnings of an education in some of the principles of violent jihad.

The teacher who educated the children, influenced in part by a sect of Islam called The Brotherhood, began instructing his pupils in the importance of instituting a pure, Islamic law around the Arab world. Using parables with often-violent endings, their teacher explained that the most loyal observers of Islam would institute the holy word even if it meant supporting death and destruction. By the second year of their studies, Osama and his friends had openly adopted the attitude and styles of teen Islamic activists. They preached the importance of instituting a pure Islamic law at Al Thagher; grew untrimmed beards; and wore shorter pants and wrinkled shirts in imitation of the Prophet's dress.

Osama was pushed to grow up rather quickly during his time at Al Thagher. At the age of 18 he married his first cousin, 14-year-old Najwa Ghanem, who had been promised to him. Osama graduated from Al Thager in 1976, the same year his first child, a son named Abdullah, was born. He then headed to King Abdul Aziz University in Jeddah, where some say he received a degree in public administration in 1981. Others claim he received a degree in civil engineering, in an effort to join the family business.

But Osama would have little chance to use his degree. When the Soviet Union invaded Afghanistan in 1979, Osama joined the Afghan resistance, believing it was his duty as a Muslim to fight the occupation. He relocated to Peshawar, Afghanistan, and using aid from the United States under the CIA program Operation Cyclone, he began training a mujahideen, a group of Islamic jihadists. After the Soviets withdrew from the country in 1989, Osama returned to Saudi Arabia as a hero, and the United States referred to him and his soldiers as "Freedom Fighters."

Yet Osama was quickly disappointed with what he believed was a corrupt Saudi government, and his frustration with the U.S. occupation of Saudi Arabia during the Persian Gulf War led to a growing rift between Osama and his country's leaders. Bin Laden spoke publicly against the Saudi government's reliance on American troops, believing their presence profaned sacred soil. After several attempts to silence Osama, the Saudis banished the former hero. He lived in exile in Sudan beginning in 1992.

By 1993, Osama had formed a secret network known as al-Qaeda (Arabic for "the Base"), comprised of militant Muslims he had met while serving in Afghanistan. Soldiers were recruited for their ability to listen, their good manners, obedience, and their pledge to follow their superiors. Their goal was to take up the jihadist cause around the world, righting perceived wrongs under the accordance of pure, Islamic law. Under Osama's leadership, the group funded and began organizing global attacks worldwide. By 1994, after continued advocacy of extremist jihad, the Saudi government forced Osama to relinquish his Saudi citizenship, and confiscated his passport. His family also disowned him, cutting off his $7 million yearly stipend.

Undeterred, Osama began executing his violent plans, with the goal of drawing the United States into war. His hope was that Muslims, unified by the battle, would create a single, true Islamic state. In 1996, to forward his goal, al Qaeda detonated truck bombs against U.S. occupied forces in Saudi Arabia. The next year, they claimed responsibility for killing tourists in Egypt, and in 1998 they bombed the U.S. embassies in Nairobi, Kenya, and Tanzania, killing nearly 300 people in the process.

Osama's actions abroad did not go unnoticed by the Sudanese government, and he was exiled from their country in 1996. Not able to return to Saudi Arabia, Osama took refuge in Afghanistan, where he received protection from the country's ruling Taliban militia. While under the protection of the Taliban, Osama issued a series of fatwas, religious statements, which declared a holy war against the United States. Among the accusations reared at the offending country were the pillaging of natural resources in the Muslim world, and assisting the enemies of Islam.

By 2001, Osama had attempted, and often successfully executed attacks on several countries using the help of Al Qaeda trained terrorists and his seemingly bottomless financial resources. On September 11, 2001, Osama would deliver his most devastating blow to the United States. A small group of Osama's Al Qaeda jihadists hijacked four commercial passenger aircraft in the United States, two of which collided into the World Trade Center towers. Another aircraft crashed into The Pentagon in Arlington, Virginia. A fourth plane was successfully retaken, and crashed in Pennsylvania. The intended target of the final aircraft was believed to be the United States Capitol. In all, the attack killed nearly 3,000 civilians.

Following the September 11 attacks on the United States, the government under President George W. Bush formed a coalition that sucecssfully overthrew the Taliban. Osama went into hiding and, for more than 10 years, he was hunted along the Afghanistan-Pakistan border. In 2004, shortly before President Bush's reelection, Osama bin Laden released a videotaped message claiming responsibility for the September 11 attacks.

Then, on May 1, 2011, President Barack Obama announced that Osama bin Laden had been killed in a terrorist compound in Abbottabad, Pakistan. In an 8-month plan enacted by the president, and led by CIA director Leon Panetta and American special forces, Osama was shot several times. His body was taken as evidence of his death, and DNA tests revealed that the body was, in fact, his. "For over two decades, bin Laden has been al Qaeda's leader and symbol and has continued to plot attacks against our country and our friends and our allies," President Obama said in a late-night address to the nation on the eve of Osama's death. "The death of bin Laden marks the most significant achievement to date in our nation's effort to defeat al Qaeda." He added that "his demise should be welcomed by all who believe in peace and human dignity."

31 May World No Tobacco Day

World No Tobacco Day is observed around the world every year on May 31. It is meant to encourage a 24-hour period of abstinence from all forms of tobacco consumption across the globe. The day is further intended to draw global attention to the widespread prevalence of tobacco use and to negative health effects, which currently lead to deaths worldwide annually. The member states of the World Health Organization (WHO) created World No Tobacco Day (WNTD) in 1987. In the past twenty years, the day has been met with both enthusiasm and resistance across the globe from governments, public health organizations, smokers, growers, and the tobacco industry.

WHO and World No Tobacco Day

World No Tobacco Day is one of many other world health awareness days throughout the year organized by the WHO, including World Mental Health Day, World AIDS Day, and World Blood Donor Day, among others.

Timeline

# In 1987, the World Health Assembly of the WHO passed Resolution WHA40.38, calling for April 7, 1988 to be "a world no-smoking day". April 7, 1988 was the 40th anniversary of the WHO. The objective of the day was to urge tobacco users worldwide to abstain from using tobacco products for 24 hours, an action they hoped would provide assistance for those trying to quit.

# In 1988, Resolution WHA42.19 was passed by the World Health Assembly, calling for the celebration of World No Tobacco Day, every year on May 31. Since then, the WHO has supported World No Tobacco Day every year, linking each year to a different tobacco-related theme.

# In 1998, the WHO established the Tobacco Free Initiative (TFI), an attempt to focus international resources and attention on the global health epidemic of tobacco. The initiative provides assistance for creating global public health policy, encourages mobilization across societies, and supports the World Health Organization Framework Convention on Tobacco Control (FCTC). The WHO FCTC is a global public health treaty adopted in 2003 by countries across the globe as an agreement to implement policies that work towards tobacco cessation.

# In 2008, on the eve of the World No Tobacco Day the WHO called for a worldwide ban on all tobacco advertising, promotion, and sponsorship. The theme of that year’s day was Tobacco-free youth; therefore, this initiative was especially meant to target advertising efforts aimed at youth. According to the WHO, the tobacco industry must replace older quitting or dying smokers with younger consumers. Because of this, marketing strategies are commonly observed in places that will attract youth such as movies, the Internet, billboards, and magazines. Studies have shown that the more youth are exposed to tobacco advertising, the more likely they are to smoke.

Discussion

Each year, the WHO selects a theme for the day in order to create a more unified global message for WNTD. This theme then becomes the central component of the WHO’s tobacco-related agenda for the following year. The WHO oversees the creation and distribution of publicity materials related to the theme, including brochures, fliers, posters, websites, and press releases. In 2008 for the theme Tobacco-free youth, Youtube videos were created as a part of the WNTD awareness campaign, and podcasts were first used in 2009.

In many of its WNTD themes and related publicity-materials, the WHO emphasizes the idea of “truth.” Theme titles such as “Tobacco kills, don’t be duped” (2000) and “Tobacco: deadly in any form or disguise” (2006) indicate a WHO belief that individuals may be misled or confused about the true nature of tobacco; the rationale for the 2000 and 2008 WNTD themes identify the marketing strategies and “illusions” created by the tobacco industry as a primary source of this confusion. The WHO’s WNTD materials present an alternate understanding of the “facts” as seen from a global public health perspective. WNTD publicity materials provide an “official” interpretation of the most up-to-date tobacco-related research and statistics and provide a common ground from which to formulate anti-tobacco arguments around the world.

Event coordination

The WHO serves as a central hub for coordinating WNTD events around the world. The WHO website provides a place for groups to register their planned WNTD events. The WHO publishes this information, by country, on its website. The registry helps foster communication and awareness between groups (locally, nationally, and globally) interested in the public health effects of tobacco, and it also serves as a way for interested individuals to quickly see if there is an event in their area.

Awards

Since 1988 the WHO has presented one or more Awards to organizations or individuals who have made exceptional contributions to reducing tobacco consumption. World No Tobacco Day Awards are given to individuals from six different world regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific), and Director-General Special Awards and Recognition Certificates are given to individuals from any region.

Global observance

Groups around the world—from local clubs to city councils to national governments—are encouraged by the WHO to organize events each year to help communities celebrate World No Tobacco Day in their own way at the local level. Past events have included letter writing campaigns to government officials and local newspapers, marches, public debates, local and national publicity campaigns, anti-tobacco activist meetings, educational programming, and public art.

In addition, many governments use WNTD as the start date for implementing new smoking bans and tobacco control efforts. For example, on May 31, 2008, a section of the Smoke Free Ontario Act came into effect banning tobacco "power walls" and displays at stores, and all hospitals and government offices in Australia will become smoke free on May 31, 2010.

The day has also been used as a springboard for discussing the current and future state of a country as it relates to tobacco. For example, in India, (which, with 120 million smokers, has one of the highest rates of tobacco consumption in the world), a special section of the Indian journal Current Science, together with the International Union Against Tuberculosis and Lung Disease, was published in time for WNTD, 2009. This section examined tobacco use and control in India in an attempt to spread awareness and build support for stricter tobacco control.

Resistance

For some, WNTD is nothing more than a “futile attempt to curb smoking” which has little to no visible effect in places like the former USSR, India, and China. For others, WNTD is seen as a challenge to individual freedom of choice or even a culturally acceptable form of discrimination. From ignoring WNTD, to participating in protests or acts of defiance, to bookending the day with extra rounds of pro-tobacco advertisements and events, smokers, tobacco growers, and the tobacco industry have found ways to make their opinions of the day heard.

Smoker response

There has been no sustained or wide-spread effort to organize counter-WNTD events on the part of smokers. There is, however, an active community of smokers’ rights advocates who see the WNTD as unfairly singling them out and challenging their rights. The WHO maintains a listing of these organizations on its website.

Some small groups have created local pro-smoking events. For example, the Oregon Commentator, an independent conservative journal of opinion published at the University of Oregon, hosted a “Great American Smoke-in” on campus as a counter to the locally more widespread Great American Smokeout: “In response to the ever-increasing vilification of smokers on campus, the Oregon Commentator presents the Great American Smoke-in as an opportunity for students to join together and enjoy the pleasures of fine tobacco products.”Similarly, “Americans for Freedom of Choice” a group in Honolulu, Hawaii organized “World Defiance Day” in response to WNTD and Hawaii’s statewide ban on smoking in restaurants.

Industry response

Historically, the tobacco industry has supported initiatives that provide resources to help smokers quit smoking. For example, Phillip Morris USA operates a “Quit Assist” website that acts as a guide for those who choose to quit smoking. Acknowledging the fact that quitting is possible puts the power back into the hands of the individual and therefore alleviates responsibility from the tobacco companies. Additionally, advocating for cessation of smoking can allow companies to still advocate for alternative forms of tobacco, while cessation of tobacco would eliminate business completely.

World No Tobacco Days have not induced a positive vocal response from the tobacco industry. For example, a memo made publicly available through www.tobaccoarchives.com was sent out to executives of R.J. Reynolds Tobacco Company in preparation for the 3rd annual World No Tobacco Day, which had the theme of “Childhood and Youth Without Tobacco.” The memo includes a warning about the upcoming day, a document that explains the arguments they anticipate the WHO making, and an explanation of how the company should respond to these claims. For example, in response to the anticipated argument that their advertisements target children, the company’s response includes arguments that claim their advertisements are targeted towards adults by using adult models, and that advertisements lack the power to influence what people will actually purchase. In Uganda, since the World No Tobacco Day is the one day that the media is obligated to publicize tobacco control issues, the British American Tobacco company uses the eve of the day to administer counter-publicity. In 2001, their strategy included events such as a visit with the President of the International Tobacco Growers Association.

Unlike the tobacco industry, some big pharmaceutical companies do publicly support WNTD. For example, Pfizer was a large sponsor for many WNTD events in the United Arab Emirates in 2008. At the time, Pfizer was preparing to release its drug Champix (Varenicline) into the Middle Eastern market. The drug was “designed to activate the nicotinic receptor to reduce both the severity of the smoker's craving and the withdrawal symptoms from nicotine.”

Grower response

Many tobacco growers feel that anti-tobacco efforts by organizations such as the WHO jeopardize their rights. For example, the International Tobacco Growers Association (ITGA) argues that poor farmers in Africa may suffer the consequences if WHO anti-tobacco movements succeed. They also argue that these efforts may gang up on manufacturers of tobacco and be an attack on the industry, therefore hurting the growers.