Harris C. Faigel, M.D. 
Associate Clinical Professor of Pediatrics 
Tufts University School of Medicine 
Boston, MA 02111 
Mailing address: 
55 Kensington Circle 
Chestnut Hill, MA 02467-2675 
617-943-5312 
617-232-1407 
Fax 617-738-7980 
e-mail: 
hfaigel@massmed.org 
  
  
TOBACCO'S HIDDEN TOLL: 
WHAT THE FUTURE HOLDS FOR ADOLESCENTS WHO 
SMOKE
Tobacco addiction begins in adolescence and the consequences are severe. One in four adults in the US smokes despite evidence that tobacco is the leading factor in preventable diseases and deaths in the nation. In 1998, there were 1.1 billion smokers worldwide according to World Health Organization data. More than 10,000 die and many thousands more become disabled by smoking-related disease each year. The risk of heart and lung disease and cancer are widely publicized in print and on the backs of cigarette packages. However, little similar attention is given to the deleterious effects of smoking on every system in the body. This report reviews the impact of smoking in biochemical and microvascular dysfunction that causes diseases in the skin, brain, pituitary, ears, eyes, nose, teeth, mouth, throat, airway, lungs, breasts, heart, blood pressure, stomach, intestines, liver, pancreas, kidneys, bladder, ovaries, uterus, testes, prostate, arteries, veins, nerves and bones. Smoking interferes with healing and accelerates aging. Physicians who care for adolescents play a crucial role in educating them about all of the effects of tobacco on every part of the body and reducing its use should be among their highest health and prevention priorities.