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Tobacco and Cardiovascular Disease

Physical Activity and Cardiovascular Disease

Diet and Cardiovascular Disease



  Tobacco and CVD

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Table of Interventions - Protection From Secondhand Smoke
Table of Interventions - Reduction of Tobacco Products Advertising
Table of Interventions - Prevention of Youth Access to Tobacco Products


MYTH: Cigar smoking is not as bad smoking.

FACT: Most studies of cigar and pipe smokers reveal lower lung cancer and cardiovascular risks compared with cigarette smokers. Former smokers of only pipes or cigars show an intermediate risk of lung cancer when compared to current smokers who show a higher risk. However, pipe and cigar smokers show a higher risk of lung cancer than those who have never smoked these products.

Many cigar and pipe smokers justify smoking a pipe or cigar by claiming they do not inhale. They may puff small amounts of smoke because pipes and cigars are much stronger in terms of nicotine than the average cigarette, and it is painful to the chest to inhale large amounts of pipe or cigar smoke. Pipe and cigar puffers do not need to inhale because these tobaccos have a much higher pH than cigarettes. Because of the higher pH, the user of these products needs to only hold the smoke in the mouth for absorption of nicotine to occur. Cigar and pipe smoking may be slightly safer than cigarette smoking but they are NOT safe.

MYTH: Smokeless tobacco is a safe alternative.

FACT: The smokeless tobacco (snuff and chewing tobacco) user is exposed to more nicotine than the typical cigarette smoker. The average cigarette contains approximately 8 to 11 milligrams of nicotine, but what the smoker ingests is 0.5 to 1.5 milligrams of nicotine (a cigarette averages one milligram). The average pinch of smokeless tobacco is 2.5 grams. That amount of Copenhagen contains approximately 13 to 23 milligrams of nicotine, resulting in roughly 35 milligrams of nicotine absorbed by the body.

Communities can play a leadership role in CVD prevention. Research shows us that one of the most effective ways to have measurable impact on our communities is to target all levels of social structure with behavioral and environmental change strategies. The purpose of this section is to help guide the choice of community changes that your group will seek in each relevant sector of the community. To address the mission of reducing risks for CVD, your group programs, policies, and practices within schools, health care settings, worksites, or the broader community.

  • Awareness strategies focus on informing the public about health issues, concerns, and/or solutions.
  • Knowledge and skill-based strategies educate the public about causes, symptoms, strategies, etc., of public health issues.
  • Providing opportunities and supportive environments promotes and encourages healthy behavior.
  • Policy and regulation means establishing mandates that promote healthy behaviors.

Schools are a key intervention channel for influencing healthier behaviors in a positive way. Elementary and secondary schools provide a structured opportunity to reach youth with interventions and health messages that can set the stage for a healthy lifestyle now and in the future.

Health care settings have the unique opportunity to promote positive lifestyle behaviors. Role modeling of positive lifestyle behaviors could perhaps be the most influential role a provider can have on clients.

The worksite channel is composed of those activities through which employers, unions, and insurers try to influence the health of workers in a positive fashion.

All these "channels" together are parts of the broader community. The community as an entity can, in turn, promote health for all its members. The above listed channels are only a few examples of channels for which interventions can take place.

Broader Community Efforts:
Expand the local tobacco coalition, with emphasis on recruiting members from the business community, law enforcement, elected officials, and opinion leaders;

  • Utilize the media to heighten awareness about the negative health and economic effects of tobacco use, and to increase support for tobacco control;
  • Increase taxes on sales of tobacco products, only at the state level;
  • Use tobacco excise taxes to fund tobacco prevention and cessation programs;
  • Review and modify policies on tobacco sales to minors and enforcement of these laws;
  • Enforce laws against merchants selling tobacco to minors;
  • Ban tobacco vending machines;
  • Require merchants to purchase a license to sell tobacco, only at state level;
  • Eliminate tobacco advertising in the community and near schools;
  • Implement a promotional plan to create a positive self-image for youth not to smoke;
  • Utilize or establish an easily accessible resource center on tobacco issues;
  • Create resource satellites in the community centers and housing authority;
  • Develop and implement educational programs for tobacco retailers about the legal, ethical and health issues related to selling tobacco to minors;
  • Develop and implement educational programs for the public on tobacco use and cessation.


  • Develop and implement an employer education program focused on tobacco avoidance;
  • Develop a tobacco prevention strategy for small to mid-sized businesses;
  • Make self-help materials designed for the workplace available to businesses in your community through organizations such as the Coalition for a Tobacco-Free West Virginia;
  • Promote smoking cessation programs;
  • Promote model policies for smoke-free workplaces;
  • Distribute economic and health data to employers to support smoking avoidance;
  • Promote enforcement of the Clean Indoor Air Act in the workplace;
  • Develop workplace programs targeted for women that include cessation, weight control, and stress management.


  • Survey West Virginia schools to determine levels of compliance with the federal Pro-Children’s Act, which prohibits smoking in any school which receives federal funds;
  • Ensure implementation of K-12 tobacco prevention curricula;
  • Integrate peer support (for not smoking) training into curricula and school clubs;
  • Collect and publicize information on the number of students who smoke or who are frequently exposed to secondhand smoke;
  • Ban tobacco vending machines within one mile of schools;
  • Ban tobacco advertising within 1,000 feet of schools;
  • Adopt and enforce a smoke-free policy in schools and at school-sponsored events;
  • Establish cessation and support services for parents, teachers, and students who smoke;
  • Develop and implement training workshops for teachers and youth workers (e.g. coaches, counselors, etc.)
  • Encourage youth participation in the Great American Smokeout;
  • Promote existing resource centers and current materials and handouts.

Health Care Systems:

  • Utilize nationally developed provider education programs and implement a statewide training strategy;
  • Have health care providers promote smoking cessation programs to their patients;
  • Conduct periodic smoke-free campaigns;
  • Provide continuing education for providers on tobacco use, prevention, and cessation;
  • Adopt and enforce a smoke-free workplace policy;
  • Prescribe smoking cessation for chronic, smoking-related conditions;
  • Provide incentives (e.g. reduced insurance rates) for patients who don’t smoke;
  • Establish affordable and accessible smoking cessation and support programs;
  • Strengthen alliances with the medical community, health insurance providers, and other health professional groups;
  • Participate in development of a unified national strategy for tobacco prevention and control, being spearheaded by the Association of State and Territorial Health Officers (ASTHO) Tobacco

Listing of tobacco resources

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Published July 1997
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