Q: I know that smoking is bad for a person's health. Just how bad is it?
A: About as bad as it could get. Smoking is one of the most important causes of disease and is responsible for at least one out of every five deaths in the United States. Compared to nonsmokers, smokers have 10 times the risk of getting lung cancer -- and twice the risk of dying from heart disease. Smoking also causes chronic lung disease -- chronic bronchitis and emphysema -- which can be fatal. But that's not all. As research continues, the list of diseases associated with smoking keeps growing longer. That list now includes stroke, peptic ulcer, osteoporosis, and cataracts, as well as cancer of the mouth, throat, esophagus, pancreas, kidney, bladder, uterus, cervix -- and possibly also leukemia and cancer of the breast, prostate, and colon. In addition, diabetics who smoke increase their risk of kidney disease. Smoking can interfere with the healing of wounds and fractures. And it increases facial wrinkling, making a person look older than he or she really is.

Q: Isn't cigar smoking less of a risk to health than cigarette smoking? After all, most cigar smokers don't inhale.
A: This is largely a myth, and a dangerous one. Medical research has shown that cigar smoking increases a person's risk of heart disease and cancer -- especially mouth, throat, and lung cancer. That's not really surprising once you know that cigar smoke contains the same toxic and cancer-causing chemicals as cigarette smoke (and is just as addictive), that smoking four or more cigars in a day is the equivalent of smoking at least 10 cigarettes, and that a single large cigar contains as much tobacco as a pack of cigarettes. What's more, "mainstream" cigar smoke (the smoke drawn into the mouth) contains more of many toxic and cancer-causing chemicals than cigarette smoke does. Even cigar smokers who don't inhale are exposed to their own environmental or passive smoke -- which has been proved to be a risk factor for heart and lung disease -- and just holding an unlit cigar in your mouth can cause nicotine to be absorbed into your body.

Q: What about chewing tobacco? Is it safe?
A: No. Holding chewing tobacco in your mouth can cause toxic chemicals to be absorbed into your body. In addition, people who chew tobacco have an increased risk of developing mouth cancer.

Q: What is "passive" or "secondhand" smoking?
A: These terms refer to the smoke you breathe in from other people's cigarettes, cigars, or pipes -- or your own smoke, such as when you're holding a lit cigarette and inhaling the smoke indirectly. When you breathe other people's smoke, even if you're not smoking yourself, in a way you might as well be -- because the smoke is going into your lungs, too.

Q: I know that cigarette and cigar smoke can cause disease in smokers. How harmful is passive smoke?
A: Recent studies have shown small but significant increases in risk of coronary heart disease, lung disease, and cancer among nonsmokers exposed to cigarette and cigar smoke -- a risk that increases with higher levels and longer duration of smoke exposure. Passive smoke has also been linked with development of lung cancer, heart attack, low birth weight, sudden infant death syndrome (SIDS), bronchitis, pneumonia, asthma, chronic respiratory problems, eye and nasal irritation, and middle ear infection. Children are particularly at risk for the effects of passive smoke.

Q: I just got pregnant, and I smoke. Is it true that smoking can hurt the baby? Should I stop?
A: You're probably aware that smoking can hurt you, mainly by greatly increasing your risk of developing lung cancer and heart disease. So you should stop smoking to protect your own health as well as your baby's. When a pregnant woman smokes, she exposes her baby to the toxic chemicals in cigarette smoke, including more than 40 cancer-causing agents. In addition, medical research studies have shown that pregnant women who smoke increase their risk of such serious problems as miscarriage, stillbirth, premature birth, low-birth-weight babies, and lower intelligence in the children they are carrying. There are even studies showing that male children of mothers who smoke during pregnancy are more likely to become criminals when they grow up! Tell your obstetrician you smoke, and follow his or her advice on what you can safely do to stop -- and improve your chances of having a healthy pregnancy and a healthy baby.

Q: What's so wrong with a teen-ager experimenting with smoking?
A: What's wrong is that cigarette smoking isn't just bad for your health, it's also addictive. Most teen-agers underestimate their risk of becoming "hooked" on cigarettes -- until it's too late. The truth is, among high school seniors who smoke for 1 to 5 cigarettes a day, a full 70% will still be smoking -- and risking their health -- 5 years later. Even people who have smoked as few as 100 cigarettes report that they can't quit smoking. So why take the risk of starting? Remember, the happy, carefree young people you see in cigarette advertisements more closely resemble people who don't smoke.

Q: What's being done to stop teen-age smoking?
A: A number of different approaches are being taken. First, there are legal restrictions -- it is illegal to sell cigarettes or other tobacco products to minors under age 18. Store clerks are required by law to ask young adults for proof of age -- and enforcement has sometimes included "compliance checks" in which government-employed minors (under adult supervision) attempt to buy tobacco products. Second, more and more states and communities are putting programs into action to persuade young people not to smoke. These often include school-based education, media campaigns, and youth community action. Third, it's important to realize that reducing adult smoking can also help reduce teen-age smoking. A recent study showed that teen-agers who live in smoke-free homes -- and/or have jobs in smoke-free workplaces -- are significantly less likely to smoke than those whose home or work environments have no smoking restrictions. These findings suggest that one of the most important things parents can do to prevent their teen-agers from smoking is to keep their home smoke-free.