Introduction

There is an acknowledgment amongst health care professionals that working with tobacco and nicotine using patients to quit their addiction is one of the most difficult tasks they are asked to perform. The obligation and duty of a healthcare provider is to prevent disease, thus we ideally should be speaking to parents and their children about the dangers of tobacco use as early as is feasible as most smokers begin using cigarettes between the ages of 10-13.1 In addition, “Secondhand smoke exposure causes disease and premature death in children who do not smoke. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.”2,3

Despite our issuing these warnings, we still have 36.5 million adult smokers (15.1%) in the United States and 1 billion smokers worldwide.4 It is clear that far too many people are suffering. In order to try to make any inroads in reversing this national tragedy, there are many areas that need to be addressed. How did we get here? What products are causing this problem? How do they compromise our health and welfare? What can we do as a profession, and individual, to undo the damage done and prevent future generations from suffering a similar fate?