In 1965, the United States Surgeon General issued the first warning that cigarettes are harmful, yet almost 54 years later smoking still causes nearly a half a million American deaths each year and is the most preventable cause of death. It is responsible for increasing death from COPD (like emphysema and chronic bronchitis), cardiovascular disease, and cancer. Over half a century of knowledge, of targeted campaigns to inform consumers of the dangers of smoking, and it remains a deadly and costly part of our culture. The effects of smoking have triggered billions of dollars in healthcare costs each year in the United States.

Kristin Romesburg is a native of Arizona and has been a nurse for more than 10 years.

It is also accountable for more than 40,000 yearly deaths in nonsmokers, from cancer or heart disease, which are believed to be attributed to secondhand smoke. The effects of secondhand smoke on children is especially worrisome as it is commonly responsible for ear infections, respiratory issues including severe and frequent asthma attacks, shortness of breath, coughing, bronchitis and pneumonia affecting the overall health of children, including the missed school days and a detrimental impact on learning.  Maybe it’s not those germs from the other kids at school—maybe it’s secondhand smoke causing keeping our children from feeling their best.  And even scarier, infants are even at a higher risk for sudden infant death syndrome.

Older children are not immune to the effects of cigarettes.  Any amount of nicotine exposure to young adolescents is concerning as their brain is developing and nicotine affects emotional and cognitive function as well as the portion of the brain that is associated with reward and motivation. These changes can also lead to other substance abuse problems. Parents who smoke can have a strong connection with smoking in adolescents.

Vaping is increasingly popular among teenagers as they are easy to access and are believed to be safer than cigarettes. Contrary to that myth, The Centers for Disease Control and Prevention report that smokeless tobacco is hazardous as it causes cancer of the mouth and esophagus as well as deterioration of the gums and teeth.  According to the National Institute on Drug Abuse, students who used smokeless tobacco were seven times more likely to smoke cigarettes within the next six months.  In fact, so great is the concern over teenage vaping that the FDA declared it “an epidemic proportion” and have sent warning letters to manufacturers and sellers that they have 60 days to prove they can keep devices out of the hands of minors.

No doubt, many people have a desire to quit smoking but have not felt motivated or sufficiently supported to accomplish what is a difficult addiction to overcome. Health care providers can initiate the process by starting the conversation with options for support.  This dialogue can lead the patient and provider to develop a quit plan. Frequently, smoking cessation requires several attempts, experiencing withdrawal symptoms such as irritability, weight gain and cravings are common causes for failure. But, there are many proven techniques and strategies that provide the support necessary to be successful!

Many smokers want to quit – they understand the physical and financial cost but can feel overwhelmed or unsure of where to start or don’t know how to deal with withdrawal symptoms.  A relationship with a primary care provider, with conversations and counseling can be a positive strategy as it provides motivational support.  Smoking cessation resources can be printed out for patients to use as additional tools during this hopeful process.  There are a variety of medications that may be prescribed to ease the transition of smoking cessation. We’ve come a long way since 1965 when all we had was the warning – now there is help. 

If you, or someone you care about, want to quit smoking – contact your primary care provider or call the Arizona Smoker’s Helpline at 1-800-55-66-222 (24 hours a day, 7 days a week) or go to for free resources and counseling.


Kristin Romesburg is a native of Arizona and has been a nurse for more than 10 years. She is a wife and mother of two children in middle school and high school. She worked as a bedside ICU nurse while attending school to obtain her Master’s degree in Nursing and has loved working as a Family Nurse Practitioner in an underserved community for the last two years. Smoking cessation has been a prominent focus for Kristin as she was exposed to second-hand smoke for most of her adolescent years.  She also has concern for youth in social situations who may attempt smoking as it has been found to have a strong connection in nicotine dependence as adults.