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  1. Public Health Education

Tobacco Use and Men’s Health

Tobacco Use and Men’s Health

man walking his dog outside

You probably know that tobacco use—particularly cigarette smoking—is harmful to health and can lead to premature death and disease, including, lung conditions, cardiovascular disease, and cancer nearly anywhere in the body.1 But you may not know that there are some differences in tobacco use between men and women. Also, since men use certain products more than women, they may be more at risk for certain tobacco-related conditions.

Combustible Tobacco Products and Men’s Health

While no tobacco product is considered “safe,” cigarettes contribute to 480,000 American deaths per year.1 Cigarette smoke contains a mix of over 7,000 chemicals, including nicotine.2  Nicotine is a highly addictive chemical present in the tobacco plant. While nicotine is a chemical in cigarettes, it is not responsible for the preventable harms caused by smoking cigarettes, such as cardiovascular disease, lung conditions, and cancer.

However, nicotine is the reason people continue to smoke even if they are aware of its dangers and want to quit.2  

Men who smoke are at risk for heart disease, cancer, lower respiratory diseases, stroke, and diabetes—the first, second, fourth, fifth and sixth leading causes of death among men in the United States in 2015.3 Nearly all lung cancer—the number one cancer killer of both men and women—is caused by smoking. Smokers are up to 20 times more likely to develop lung cancer than nonsmokers. And men with prostate cancer who smoke may be more likely to die from the disease than nonsmoking men with prostate cancer.4

man sitting on a couch

Cigarette smoking can also lead to other complications for men, specifically. Men who smoke may be at risk of erectile dysfunction. Additionally, because smoking can damage the DNA in sperm, it may lead to an increased risk of infertility.4

But it is not just cigarette use that can cause health problems for men. Another combustible tobacco product—cigars—can also cause serious health problems. Men overwhelmingly use cigars more than women do, with 6.8 percent of U.S. adult males reporting current use (defined of at least one day in the last 30 days) of cigars in 2017.  In contrast, only 1 percent of women were current cigar users.5  Cigars contain some of the same chemicals as cigarettes, and in fact, cigar tobacco contains increased levels of some cancer-causing chemicals as compared to cigarette tobacco.6,7,8 Cigar smoking can cause cancers of the mouth and throat, as users may inhale smoke even if they do not think they are doing so.9 Additionally, cigar smokers are at an increased risk of cardiovascular and respiratory conditions, such as coronary heart disease, aortic aneurysms, and chronic obstructive pulmonary disease.10 


Smokeless Tobacco: Smokeless Is Not Harmless

Smokeless tobacco, or chewing tobacco—also known as “dip, snuff, or chew”—may not be a product that produces smoke, but it can still cause health problems. Men overwhelmingly use smokeless tobacco more than women, with 4 percent of U.S. adult males reporting smokeless use, while only 0.2 percent of U.S. adult women use smokeless.5 Among U.S. high school students, 8.4 percent of male high school students reported current smokeless tobacco use.11

Smokeless tobacco use can lead to health problems, including cavities, gum disease and tooth loss,12 and more serious diseases like cancers of the mouth, esophagus, and pancreas.13 Each year, about 1,300 people in the U.S. are diagnosed with oral cancer because of smokeless tobacco use. Young, rural, white males ages 12-17 are particularly susceptible to smokeless tobacco use. Nearly 32 percent of these boys are either experimenting with or susceptible to smokeless tobacco.14,15 In the U.S. more than 950 male youths under age 18 try smokeless tobacco for the first time each day, and smokeless tobacco initiation among male youth has been shown to be influenced by their fathers, grandfathers, male cousins, and brothers.16 In an effort to prevent youth use of smokeless tobacco, FDA expanded its youth tobacco prevention campaign, “The Real Cost” to include a smokeless tobacco prevention campaign. The campaign’s key message, “smokeless doesn’t mean harmless,” is intended to motivate teens — particularly teen boys—to reconsider what they think they know about smokeless tobacco use and to educate them about its dangers, including preventable disease and addiction.  


E-cigarette Use Among Men 

Electronic Nicotine Delivery Systems (ENDS), or e-cigarettes, are another tobacco product that males use more than females—3.3 percent compared with 2.4 percent for adults.5,17,18 E-cigarettes are relatively new tobacco products, so their potential health risks—especially long-term risks—are still mostly unknown. Some e-cigarette aerosols have been shown to contain some of the same chemicals that are found in cigarette smoke, such as formaldehyde, acrolein, and acetaldehyde. E-cigarettes also can contain certain flavorings, which are considered safe when used in food, but could be harmful to the lungs when inhaled. Although the health effects of e-cigarettes are still being studied, there is some evidence that for addicted smokers, switching completely to e-cigarettes from combusted cigarettes without using any other tobacco product may be potentially less harmful for already addicted adult smokers.19-22 However, no youth should be initiating tobacco use with these products. Many e-cigarettes contain nicotine, the addictive substance in all tobacco products, which can be especially harmful to kids and teens, whose brains are still developing. 


Quitting: The Healthiest Option for All Men

The best way to protect a man’s health from damage caused by tobacco is for him to never start using any tobacco products. But for men who do use tobacco products, quitting is the best option. With smoking especially, the effects of quitting can be seen almost immediately.  Twenty minutes after your last cigarette, your heart rate drops, and 12 hours after quitting smoking, carbon monoxide levels—which displace oxygen in the blood and deprive the heart, brain, and other organs of air—in the blood drop to normal.23 Two to four years after quitting smoking, your risk of stroke becomes about the same as a lifetime nonsmoker.24

a group of friends having lunch at a table

Adult men who are looking to quit smoking may find nicotine replacement therapy (NRT) to be a viable option to help them through the hardest parts of quitting. FDA-approved NRTs help addicted smokers gradually withdraw from smoking by delivering nicotine incrementally without the toxic mix of chemicals found in cigarette smoke. NRTs, which can be found over the counter in the form of patches, gums, and lozenges may be used in combination with each other, as some addicted smokers may find they need more than one type of NRT to help them quit. When used properly, NRTs are safe and effective cessation methods and can double a smoker’s chance of quitting smoking successfully.25 

If you or a man in your life is trying to quit smoking, there are resources that can help. Smokefree.gov offers tips and strategies for quitting, as well as smartphone apps and a texting support program. FDA’s “Every Try Counts” campaign is aimed at encouraging smokers to quit through messages of support that underscore the health benefits of quitting. It may take several attempts to quit using tobacco products for good, but it is important to remember that every attempt is a learning experience and helps bring you closer to staying quit.


Additional Resources


1. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
2. U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
3. Office of Minority Health & Health Equity (OMHHE). Leading Causes of Death (LCOD) by Race/Ethnicity, All Males-United States, 2015. U.S. Department of Helth and Human Services, Centers for Disease Control and Prevention; 2018. https://www.cdc.gov/healthequity/lcod/men/2015/race-ethnicity/index.htm. Accessed June 4, 2019.
4. US Department of Health and Human Services (USDHHS). Let’s Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General’s Reporton Smoking and Health (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
5. Wang TW, Asman K, Gentzke AS, et al. Tobacco Product Use Among Adults – United States,-2017. MMWR Morb Mortal Wkly Rep 2018:67:1125–32.
6. Hoffmann D, Brunnemann KD, Prokopczyk B, Djordjevic MV. Tobacco specific N-nitrosamines and Areca-N-nitrosamines: chemistry, biochemistry, carcinogenicity and relevance to humans. Journal of Toxicology and Environmental Health. 1994; 41(1):1-52.
7. Hoffmann D, Adams JD, Brunnemann KD, Hecht SS. Assessment of tobacco specific nitrosamines in tobacco products. Cancer Research. 1979; 39(7 Pt 1):2505-2509.
8. McDonald LJ, Bhatia RS, Hollett PD. Deposition of cigar smoke particles in the lung: evaluation with ventilation scan using (99m)Tc-labeled sulfur colloid particles. Journal of Nuclear Medicine. 2002; 43 (12):1591–1595.
9. Food and Drug Administration (FDA). Rules and Regulations. Federal Register. 2016; 81(90):29061.
10. Chang CM, Corey CG, Rostron BL, Apelberg BJ. Systematic review of cigar smoking and all-cause and smoking-related mortality. Biomed Central Public Health. 2015; 15:390.
11. Gentzke AS, Creamer M, Cullen KA, et al. Vital Signs: Tobacco Product Use Among Middle and High School Students — United States, 2011–2018. MMWR Morb Mortal Wkly Rep. 2019;68:157–164.
12. U.S. Department of Health and Human Services (USDHHS). Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.
13. Secretan B, Straif K, Baan R, et al. A review of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. The Lancet Oncology. 2009; 10(11): 1033-1034.
14. National Institutes of Health (NIH), Food and Drug Administration (FDA). Population Assessment of Tobacco and Health (PATH) Study 2013-2016[United States] Restricted-Use Files. ICPSR36231-v3. Ann Arbor, MI: Inter-university Consortium for Political and Social Research. Updated April 18, 2016. http://doi.org/10.3886/ICPSR36231.v3. Accessed May 26, 2016.
15. U.S. Census Bureau. Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States: April 1, 2010 to July 1, 2014. Washington, D.C: U.S. Census Bureau, Population Division; 2015.
16. Hughes JR. Motivating and helping smokers to stop smoking. Journal of General Internal Medicine. 2003; 18(12):1053-1057.
17. Centers for Disease Control and Prevention (CDC). Tobacco product use among middle and high school students – United States, 2011-2015. Morbidity and Mortality Weekly Report. 2016; 65(14):361-367.
18. Schoenborn C, Gindi R. Electronic cigarette use among adults: United States, 2014. NCHS Data Brief. 2015; 217:1-7.
19. Goniewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23(2):133-139.
20. Bein K, Leikauf GD. Acrolein - a pulmonary hazard. Mol Nutr Food Res. 2011;55(9):1342 1360.
21. National Academies of Sciences, Engineering, and Medicine. 2018. Public Health Consequences of E Cigarettes. Washington, DC: The National Academies Press.
22. Allen JG, Flanigan SS, LeBlanc M, et al. Flavoring chemicals in e-cigarettes: diacetyl, 2,3 pentanedione, and acetoin in a sample of 51 products, including fruit-, candy-, and cocktail-flavored e cigarettes. Environ Health Perspect. 2016;124. https://ehp.niehs.nih.gov/15-10185/. Accessed March 27, 2018.
23. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
24. U.S. Department of Health and Human Services (USDHHS). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
25. Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews 2018, Issue 5.