Editor's Note: More than a half million African Americans have died from smoking-related diseases over the past decade. That’s enough people to fill the cities of Atlanta, New Orleans, Kansas City, Mo., or Cleveland, Ohio. Yet, “cigarette smoking is the single most preventable cause of premature death in the United States”, according to the Centers for Disease Control. Then why are so many Black people dying from cigarettes and why is it so difficult to quit? This eight-part series - ''Nicotine Addiction'' - seeks to explore these questions by featuring real people, real circumstances, and real answers.

WASHINGTON (NNPA) - Awakened by her biological clock at 10:30 a.m., 22-year-old Toya Tonpea rolls over to grab the remote control. She turns on the television as she begins to mentally plan her day.

Tonpea flips through the cable to watch her line-up of reality TV and talk shows. Two hours pass and it is now 12:30.

She is interrupted by her mother, which turns into an argument and the stress begins. Tonpea picks up a cigarette.

“Majority of the time, it's an extreme case of my emotions like when I got into that argument with my mother and realized that I still live with my mother. I had to go smoke,” says Tonpea of Atlanta, Ga.

Tonpea is one of the 3.6 million African American women who smoke, according to the 2004 National Health Interview Survey, conducted by the Centers for Disease Control. Inhaling and exhaling - the very action that maintains human life destroys it when cigarette smoke is added.

The United States Department of Health and Human Services says in its most recent smoking mortality report in 1995 that there are 45,000 tobacco-related deaths among African Americans annually. Moreover, the department later reported in 2006 that African American women are more susceptible than any other group to the health risks attributed to smoking.

John Wills, a family physician for 11 years, describes those risks.

“Tobacco smoking is the leading cause of lung cancer, primary respiratory illnesses, increased risk of hypertension, and of cardiovascular diseases,” Wills says.

Hypertension is the medical term for high blood pressure. Every puff of nicotine, the dominant toxin in tobacco, temporarily increases blood pressure and heart rate, according to the American Cancer Association.

For steady smokers, blood pressure is continuously elevated, leading to blood pressure above the normal levels.

Additionally, heavy smoking can cause permanent damage to the lining of the lungs called the pleura. Wills explained that the pleura prevents the accumulation of mucus in the lungs.

“It's like the hairs in your nostrils that collect dirt that you breathe. Well, your lungs are the same and smoking destroys that lining,” Wills says. “If you have a lot of mucus in your lungs but don't have the pleura to help you cough that stuff up, then you get an infection like bronchitis or pneumonia.”

There is also the possibility of heart attack and stroke.

Smoking causes the blood vessel, arteries, and veins in the body to get thicker and harder according to Wills. The longer a person smokes, the harder their vessels become.

“If they (blood vessels, arteries, and veins) don't have the elasticity and can't stretch, then blood doesn't circulate,” he says. He added that the lack of circulation causes plaque build up, which can lead to a heart attack.

Many people find it very difficult to stop smoking.

Tonpea has been a regular smoker since her senior year of high school in 2002. Now an adult and ready to live alone in an apartment, smoking is a part of her lifestyle.

“I don't necessarily want to stop because if I don't stop then there (will) always be something in my purse or my car that I can fall back on in case something ridiculous happens,” Tonpea told.

Statistics show Tonpea’s lifestyle is like a Russian roulette.

According to the most recent in depth “Surgeon General’s report on Women and Smoking”, lung cancer incidence rates among women younger than age 65 years were higher among Blacks than among Whites and was predicted to increase.
The study, released 2001 by then Surgeon General Tommy G. Thompson, reports that between the years, 1989 and 1996, the five-year lung cancer survival rates for Black women and White women were 13.5 percent survival for Black women and 16.6 percent survival for White women, 3 percent higher for Whites.

African American women are 60 percent more likely to die of coronary heart disease than White women.

According the surgeon general’s report, the death rate for chronic obstructive pulmonary disease, (bronchitis and emphysema) was 44 percent among White women and 78 percent – nearly twice the rate - among African American women.

Smoking exacerbates conditions that lead to heart disease and stroke, however some Black women may also die because they do not receive appropriate medical care, states a 2000 report from the New England Journal of Medicine, as attributed by the Agency for Healthcare Research at the U. S. Department of Health and Human Services: “Most of the 1 million U.S. patients who suffer a heart attack each year are candidates for reperfusion therapy, either thrombolytic (clot-busting) drugs or primary angioplasty,” the agency attributes to the Journal. “In a study of nearly 27,000 Medicare beneficiaries who met the strict criteria for reperfusion therapy between February 1994 and July 1995, only 44 percent of eligible Black women received the treatment, compared with 59 percent of White men, 50 percent of Black men, and 56 percent of White women.”

The surgeon general also suggested that Black women may also have more difficulty quitting smoking.

“Black women may be more sensitive than White women to the dependence-producing properties of nicotine. Researchers have hypothesized that Black women may smoke cigarettes with a higher nicotine content or inhale more deeply than do White women,” the report states.

But Tonpea’s resistance to quitting may go against the majority. The CDC’s 1993 National Health Interview Survey reported that 75 percent of African American women who smoke would like to stop.

Virginia Ross, 66, was a smoker for 44 years and quit just last year.

“My husband kept asking me `why don't you stop smoking, why don't you stop smoking,' and so I just decided to stop,” Ross says.

Quitting can be just as difficult as weaning an addict off heroin or cocaine. The surgeon general reported in a “You Can Quit Smoking” consumer guide that it usually takes two tries or more before a person successfully quits smoking.

Wills recommends three options for people trying to quit smoking:

• Stop smoking all together, what some call, “cold turkey”;
• Try “smoking cessation pills”, which are only available through prescription;
• Buy over the counter medications such as nicotine gum, nicotine patches, or nicotine lozenges similar to Halls.

According to Ross, she tried twice but when she had a successful quit, she gained weight.

There’s a reason for the weight gain, says Wills.

“It happens because they reach for food instead of a cigarette. It's a lifestyle modification. Instead of reaching for a cigarette you have to figure out what else you can do,” he says.

Ross is approaching three years of being smoke-free. She offered advice for anyone trying to quit: “Bottom line, you have to be ready. It's a mind thing and it takes a strong commitment to stop.”