To
Jeffrey M. Drazen
Editor-in-chief
New England Journal of Medicine
10 Shattuck Street,
Boston, MA 02115
Dear Mr. Drazen,
The number of smoking women is considerably high in the USA at18%(1,2).Nearly 174,000 women die each year due to smoking related disease(2,7).These diseases are preventable but the true awareness of themin women is still deficient. Smoking is a big problem, especially in pregnancy.
Smoking tobacco accounts for 1 in 3 cancer deaths(2,3,6). Besides lung cancer and COPD, it is also a cause for mouth, larynx, pharynx, nose, lips, esophagus, bladder, pancreas, stomach and colorectal cancer(2,3,5,6,10). In women it is also a cause for cervical and ovarian cancer(2,3,4,6,10).It leads to a high risk for heart disease, stroke and infertility(3,4,5,).Nearly 10% of women smoke during pregnancy(6).In addition, if a woman smokes in pregnancy, there are higher chances for adverse obstetrical outcomes such as placenta previa, placental abruption, miscarriage, and intrauterine fetal demise(3,4,6,10).Babies born to smokers have slightly higher risk of low birth weight, heart disease, cleft lip/palate and other birth defects(4,8,9,10). The baby of a woman who smoked during gestation is more likely to die due to sudden infant death syndrome.Furthermore,nicotine and other substances in tobacco pass through breast milk and the baby is also exposed via second hand smoke (4,8,9,10).
Five percent of infant deaths could be prevented if pregnant women did not smoke (6). Smoking pregnant women should be encouraged to quit.Nicotine replacement therapy and other medications like bupropion and vareniclineare used to assist cessation(9).In pregnancy these drugs can affect the baby,so phone-based quitting programs and support groups should be encouraged (9). There are laws banning smoking in public but is not always followed. More strict law should be made and followed. Health providers should more focus on this matter and motivate women to quit smoking.
A Concerned Citizen,
References:
1) World Health Organization. “Female Smoking”
