Marie Helweg-Larsen, Dickinson College

Smoking is really bad for you. Most people know that. Even smokers think smoking is bad for one’s health. But most people don’t know just how bad it is.

More people in the United States die every year from smoking than from alcohol, illegal drug use, car accidents, suicides and murders combined. Cigarette smoking costs an estimated US$240 billion annually in health care costs, which harm not only smokers but also nonsmokers, communities and the economy. Smoking is the top preventable cause of death and disease in the U.S. and worldwide.

The number of smokers in the U.S. has declined from 41% in 1944 to 11% in 2024. However, over 25 million Americans still smoke.

This drop is partly the result of many smoking laws enacted in the past 50 years. They include national bans on cigarette advertising on television and radio (1971), smoking on commercial flights (2000), sale of fruit- or candy-flavored cigarettes (2009), and sale of cigarettes to people ages 18 to 20 (2019). New policies might seem as strange or unfamiliar as these measures did at the time.

One potentially transformative idea – creating a tobacco-free generation – would build on these past laws. It would phase out smoking by banning it permanently for anyone born after a specific date. For example, a law could make it illegal for anyone under 21 to ever buy cigarettes, whereas people age 21 or older at the time would not be affected. The focus would be on tobacco sales, which already require age verification in the U.S., not on criminalizing tobacco use.

As a psychological scientist, I have studied for decades how people think about smoking. In my view, the key obstacle to creating future generations of nonsmokers is that people do not fully understand how dangerous smoking is and do not realize the formidable influence of the tobacco industry.

Creating a tobacco-free generation

The idea of creating a tobacco-free generation was first proposed by health researchers in 2010. In 2021 the town of Brookline, Massachusetts, became the first U.S. community to adopt it. Brookline’s ordinance prohibits tobacco and vape sales to anyone born on or after Jan. 1, 2000. It has survived a legal challenge and has been emulated in 22 more Massachusetts towns.

As of early 2026, Hawaii and Massachusetts are considering statewide tobacco-free generation bills. Abroad, the Maldives enacted the first countrywide ban in 2025.

Similar proposals have faced pushback elsewhere. In New Zealand, a ban was adopted in 2022 but repealed in 2024. The United Kingdom is considering a similar bill after an earlier version was scrapped due to a snap election.

Why people underestimate harm from cigarettes

It is hard to visualize what exactly it means that 480,000 people in the U.S. die from smoking every year or that each cigarette that you smoke shortens your life by 20 minutes. It is also easy to feel optimistically biased about one’s personal risk as a smoker and believe that others are more likely to become addicted or die prematurely.

Advertisement

Studies show that nonsmokers, former smokers and current smokers underestimate smoking risks. One likely reason is messaging by the tobacco industry, which claimed for decades that cigarettes were safe, even though tobacco industry scientists knew as early as 1953 that smoking caused lung cancer.

Another factor is glamorization of cigarettes in movies. Fully half of the top films released in 2024 showed tobacco imagery, typically of cigarettes. Research shows that adolescents and young adults who watch smoking in movies are more interested in taking up smoking.

Finally, smoking deaths may seem to be unremarkable because some of the illnesses that cigarette smoking causes, such as heart disease or cancer, are commonplace. And unlike deaths from drug overdoses, we do not always see the consequences of a lifetime of smoking. https://www.youtube.com/embed/2mKyosQbFNY?wmode=transparent&start=0 Smoking imagery is widespread in popular culture and may be one driver of tobacco use, especially among young Americans.

What about freedom of choice?

A common argument against laws that regulate personal choices, such as whether to smoke or wear seat belts, is that people prize their autonomy and don’t like governments telling them how to live. This isn’t a new challenge for public health policies, which often restrict private citizens’ freedom to do as they wish.

People can be persuaded that community action should trump individual choice if a behavior, such as smoking cigarettes or driving while drunk, harms others who don’t engage in it. Many public health laws are designed to protect people who are innocent or vulnerable. For example, current smoking laws have been enacted in part to protect nonsmokers who are exposed to secondhand smoke, especially children. And smoking increases health care costs for everyone, not just smokers.

By preventing people in the U.S. who cannot legally buy cigarettes now from ever doing so, generational smoking bans balance the rights of current adult smokers against the major public health benefits of a phased smoking ban that will eventually end the smoking epidemic.

Arguments against generational smoking laws

The tobacco industry’s attempts to undermine tobacco health policies are well documented and follow a predictable pattern. For example, when the U.K. government considered a generational smoking policy in 2023, tobacco companies and their supporters argued that smoking was a minor problem, that individuals should be responsible for their own choices, and that a nationwide ban would lead to illegal behavior or hurt business profits.

In a 2025 study assessing how Belgian politicians viewed generational smoking bans, researchers heard similar arguments. Respondents across the political spectrum valued personal freedom and informed individual choice more highly than protecting children. The politicians also believed that young people could understand how smoking affected their health, and that raising awareness was more important than bans. These arguments aligned with tobacco industry positions.

However, research shows that young people hold many optimistic beliefs about smoking, especially with respect to the addictiveness of nicotine and the likelihood that they will avoid becoming lifelong smokers. Studies have also found that adolescents don’t know enough to make an informed choice to smoke. These findings matter because the tobacco industry routinely targets young people in an effort to create lifelong smokers.

The tobacco industry’s harm reduction approach frames e-cigarettes, also known as vapes, as a way to create a smoke-free future by transitioning smokers to other nicotine products. But research shows that the tobacco industry actively markets nicotine products such as vapes to young people to create a new generation of nicotine users.

Advertisement

Not a silver bullet

Curbing the use of an addictive product is challenging, and there are ways for young people to obtain cigarettes illegally, as they do now in places where cigarette buyers must be at least 21. Tactics include shopping at stores that don’t check IDs, having older friends buy cigarettes and purchasing cigarettes illegally online.

Tobacco-free generation policies aren’t a silver bullet. They work most effectively in conjunction with other measures, such as plain packaging; high prices; bans on displays, advertising and flavored products; smoking cessation support; and public health messages making clear that cigarettes are unsafe at any age.

Still, health experts and groups including the American Heart Association and the American College of Cardiology argue that creating a tobacco-free generation could dramatically reduce preventable deaths and secure a healthier future for today’s children and future generations. In my view, understanding the obstacles to change is a critical step toward achieving this goal.

Marie Helweg-Larsen, Professor of Psychology, Dickinson College

This article is republished from The Conversation under a Creative Commons license. Read the original article.

STM Daily News is a vibrant news blog dedicated to sharing the brighter side of human experiences. Emphasizing positive, uplifting stories, the site focuses on delivering inspiring, informative, and well-researched content. With a commitment to accurate, fair, and responsible journalism, STM Daily News aims to foster a community of readers passionate about positive change and engaged in meaningful conversations. Join the movement and explore stories that celebrate the positive impacts shaping our world. 

https://stmdailynews.com/

Last Updated on April 20, 2026 by Daily News Staff

Amy Huebschmann, University of Colorado Anschutz Medical Campus and Judith Regensteiner, University of Colorado Anschutz Medical Campus

A simple difference in the genetic code – two X chromosomes versus one X chromosome and one Y chromosome – can lead to major differences in heart disease. It turns out that these genetic differences influence more than just sex organs and sex assigned at birth – they fundamentally alter the way cardiovascular disease develops and presents.

While sex influences the mechanisms behind how cardiovascular disease develops, gender plays a role in how healthcare providers recognize and manage it. Sex refers to biological characteristics such as genetics, hormones, anatomy and physiology, while gender refers to social, psychological, and cultural constructs. Women are more likely to die after a first heart attack or stroke than men. Women are also more likely to have additional or different heart attack symptoms that go beyond chest pain, such as nausea, jaw pain, dizziness and fatigue. It is often difficult to fully disentangle the influences of sex on cardiovascular disease outcomes versus the influences of gender.

While women who haven’t entered menopause have a lower risk of cardiovascular disease than men, their cardiovascular risk accelerates dramatically after menopause. In addition, if a woman has Type 2 diabetes, her risk of heart attack accelerates to be equivalent to that of men, even if the woman with diabetes has not yet gone through menopause. Further data is needed to better understand differences in cardiovascular disease risk among nonbinary and transgender patients.

Despite these differences, one key thing is the same: Heart attack, stroke and other forms of cardiovascular disease are the leading cause of death for all people, regardless of sex or gender.

We are researchers who study women’s health and the way cardiovascular disease develops and presents differently in women and men. Our work has identified a crucial need to update medical guidelines with more sex-specific approaches to diagnosis and treatment in order to improve health outcomes for all.

Gender differences in heart disease

The reasons behind sex and gender differences in cardiovascular disease are not completely known. Nor are the distinct biological effects of sex, such as hormonal and genetic factors, versus gender, such as social, cultural and psychological factors, clearly differentiated.

What researchers do know is that the accumulated evidence of what good heart care should look like for women compared with men has as many holes in it as Swiss cheese. Medical evidence for treating cardiovascular disease often comes from trials that excluded women, since women for the most part weren’t included in scientific research until the NIH Revitalization Act of 1993. For example, current guidelines to treat cardiovascular risk factors such as high blood pressure are based primarily on data from men. This is despite evidence that differences in the way that cardiovascular disease develops leads women to experience cardiovascular disease differently.

In addition to sex differences, implicit gender biases among providers and gendered social norms among patients lead clinicians to underestimate the risk of cardiac events in women compared with men. These biases play a role in why women are more likely than men to die from cardiac events. For example, for patients with symptoms that are borderline for cardiovascular disease, clinicians tend to be more aggressive in ordering artery imaging for men than for women. One study linked this tendency to order less aggressive tests for women partly to a gender bias that men are more open than women to taking risks.

In a study of about 3,000 patients with a recent heart attack, women were less likely than men to think that their heart attack symptoms were due to a heart condition. Additionally, most women do not know that cardiovascular disease is the No. 1 cause of death among women. Overall, women’s misperceptions of their own risk may hold them back from getting a doctor to check out possible symptoms of a heart attack or stroke.

These issues are further exacerbated for women of color. Lack of access to health care and additional challenges drive health disparities among underrepresented racial and ethnic minority populations.

Advertisement

Sex difference in heart disease

Cardiovascular disease physically looks different for women and men, specifically in the plaque buildup on artery walls that contributes to illness.

Women have fewer cholesterol crystals and fewer calcium deposits in their artery plaque than men do. Physiological differences in the smallest blood vessels feeding the heart also play a role in cardiovascular outcomes.

Women are more likely than men to have cardiovascular disease that presents as multiple narrowed arteries that are not fully “clogged,” resulting in chest pain because blood flow can’t ratchet up enough to meet higher oxygen demands with exercise, much like a low-flow showerhead. When chest pain presents in this way, doctors call this condition ischemia and no obstructive coronary arteries. In comparison, men are more likely to have a “clogged” artery in a concentrated area that can be opened up with a stent or with cardiac bypass surgery. Options for multiple narrowed arteries have lagged behind treatment options for typical “clogged” arteries, which puts women at a disadvantage.

In addition, in the early stages of a heart attack, the levels of blood markers that indicate damage to the heart are lower in women than in men. This can lead to more missed diagnoses of coronary artery disease in women compared with men.

The reasons for these differences are not fully clear. Some potential factors include differences in artery plaque composition that make men’s plaque more likely to rupture or burst and women’s plaque more likely to erode. Women also have lower heart mass and smaller arteries than men even after taking body size into consideration.

Reducing sex disparities

Too often, women with symptoms of cardiovascular disease are sent away from doctor’s offices because of gender biases that “women don’t get heart disease.”

Considering how symptoms of cardiovascular disease vary by sex and gender could help doctors better care for all patients.

One way that the rubber is meeting the road is with regard to better approaches to diagnosing heart attacks for women and men. Specifically, when diagnosing heart attacks, using sex-specific cutoffs for blood tests that measure heart damage – called high-sensitivity troponin tests – can improve their accuracy, decreasing missed diagnoses, or false negatives, in women while also decreasing overdiagnoses, or false positives, in men.

Our research laboratory’s leaders, collaborators and other internationally recognized research colleagues – some of whom partner with our Ludeman Family Center for Women’s Health Research on the University of Colorado Anschutz Medical Campus – will continue this important work to close this gap between the sexes in health care. Research in this field is critical to shine a light on ways clinicians can better address sex-specific symptoms and to bring forward more tailored treatments.

The Biden administration’s recent executive order to advance women’s health research is paving the way for research to go beyond just understanding what causes sex differences in cardiovascular disease. Developing and testing right-sized approaches to care for each patient can help achieve better health for all.

Advertisement

Amy Huebschmann, Professor of Medicine, University of Colorado Anschutz Medical Campus and Judith Regensteiner, Professor of Medicine, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.

(Feature Impact) Shingles isn’t just a painful rash and nerve pain. It’s also linked with a higher risk of serious cardiovascular events, including heart attack and stroke, especially in the weeks to months after infection. However, shingles is largely preventable with vaccination.

The world’s leading nonprofit organization focused on changing the future of health for all, the American Heart Association, reminds eligible adults to protect themselves by getting vaccinated and staying on top of their heart health.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 adults in the U.S. will get shingles in their lifetime. If you’ve had chickenpox, the virus that causes shingles, also known as herpes zoster, is already inside you. It can “wake up” years later, causing painful blisters and nerve pain that can last for months or longer.

After a shingles episode, one large study published in the “Journal of the American Heart Association” found the risk of heart attack and stroke was nearly 30% higher in the short term and may persist over time.

“Shingles can be very painful and knock you down for weeks,” said Eduardo Sanchez, M.D., FAHA, the American Heart Association’s chief medical officer for prevention. “It’s also associated with a higher chance of heart and stroke problems afterward. If you’re 50 or older, or have a weakened immune system, talk to your doctor or pharmacist about the shingles vaccine. It’s a simple step that can keep you healthier.”

Knowing your risk is the first step toward prevention. Age is the most important risk factor for developing shingles. As people age, their immune systems naturally weaken, making it easier for the virus to reactivate. People over 50, and especially those living with heart disease, diabetes or other chronic illnesses, are more likely to develop shingles.

The risk of serious complications from shingles increases:

• As you get older
• If you take drugs that keep your immune system from working properly, like steroids and drugs given after an organ transplant
• If you have medical conditions that keep your immune system from working properly such as certain cancers like leukemia and lymphoma, or HIV infection

Heart Health Made Simpler

In addition to ensuring you’re up to date on your vaccines, talk to your health care professional about ways you can improve your overall heart health. According to the American Heart Association, heart disease remains the leading cause of death, taking more lives in the United States than any other cause.

Following healthy lifestyle guidance like Life’s Essential 8 can make inroads toward preventing heart disease and stroke, and improving brain health. The set of four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (manage weight, control cholesterol, manage blood sugar and manage blood pressure) are key measures for improving and maintaining cardiovascular health.

How to Get the Shingles Vaccine

• Check eligibility: Recommended by the CDC for adults 50-plus and adults 19 and older with weakened immune systems.
• Find a location: Most national pharmacies, many primary care and specialty clinics and local health departments offer it. Search your pharmacy’s app or website, or call your clinician’s office.
• Book it: Make an appointment online or by phone. Same‑day or walk‑in options may be available at pharmacies.
• Bring what you need: Photo ID, insurance card and a list of medicines and allergies. Wear a short‑sleeve shirt, if you can.
• Plan for two doses, 2-6 months apart: When you schedule dose one, set a reminder or book dose two before you leave.
• Cost and coverage: Many health plans, including Medicare Part D, cover shingles vaccination at low or no cost. Check your benefits or ask the pharmacy to verify coverage.
• After your shot: A sore arm, fatigue, headache or mild fever are common and usually go away in 2-3 days. Call your clinician about severe or persistent symptoms.
• If you’ve had shingles before: You can still get vaccinated after you recover. Ask your health care provider about timing.

Learn more at heart.org/shingles.

Signs and Symptoms of Shingles

Symptoms to watch for: tingling, itching or burning on one side of the body or face; a stripe‑like rash that turns into fluid‑filled blisters; headache; fever; or chills.


Act fast: If you think you have shingles, contact your health care professional right away. Treatment works best within 72 hours of the rash appearing. If the rash is near your eye or you have eye pain or changes in vision, seek urgent care.

Lasting impact: The rash typically scabs over and clears within 2-4 weeks, but the pain in the rash area can last about a month. The duration of pain seems to increase with age.

Protect Yourself (and Others) from Shingles

If you have shingles, you can stop the spread by covering the rash and avoiding touching or scratching it. You should also wash your hands often, for at least 20 seconds, and avoid contact with people who may be at heightened risk until your rash scabs over, including:

Advertisement

• Pregnant women who never had chickenpox or the chickenpox vaccine
• Premature or low-birthweight infants
• People with weakened immune systems

Photos courtesy of Shutterstock

SOURCE:

American Heart Association 

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.