Female

Smoking and lung cancer

This graph shows that male and female smokers are, respectively, over 20 and 10 times more likely to develop lung cancer than those who have never smoked. Ex-smokers have a much lower risk than current smokers; 15 years after giving up, they will have reduced their lung cancer risk by more than half.

Mouth and tongue cancers may be caused by irritants in smoke

The risk of cardiovascular disease is increased by smoking

Giving up smoking

You can help to prevent heart or lung disease by not smoking or by giving up before you begin to develop the diseases. No matter how long you have been smoking, you can prevent further damage to your health by giving up. If you need help in giving up, consult your doctor for advice. If you want to try on your own, list the reasons why you want to stop smoking, then work out the reasons why you smoke. Plan ways to cope with temptation and ask your family and friends for support. Telephone helplines staffed by ex-smokers can be helpful. Choose a fairly stress-free day on which to stop smoking completely and throw away cigarettes, lighters, and ashtrays. You may have withdrawal symptoms, such as irritability, and crave nicotine. Aids such as nicotine patches or gum can help to stop cravings. If you relapse, work out why it has happened, refer to your reasons for giving up, and try again.

Nicotine patch in place

Using a nicotine patch

Nicotine patches deliver a constant supply of nicotine through the skin, helping to stop cravings for cigarettes.

Drugs

A drug is any chemical that alters the function of an organ or a biochemical process in the body. Drugs that are used to improve body functions or to treat diseases and disorders are known as medicines. Certain drugs, such as the sleeping drug temazepam, may be both used as medicines and abused for recreation. Other drugs, such as ecstasy, have no medicinal value and are used only for recreational purposes. Drug abuse can cause serious physical and mental problems, particularly if the abuser becomes dependent on a drug or takes an overdose, and may even cause death. In addition, the use of recreational drugs is illegal.

Effects of drug use on the body

People use recreational drugs to alter their mood. The main types of drug are classified according to the usual mood change that they cause, but often they have a mixture of effects. Stimulants, such as cocaine, increase mental and physical activity; relaxants, such as marijuana and heroin, produce a feeling of calm; intoxicants, such as glue, make users feel giggly and dreamy; and hallucinogens, such as lysergic acid diethylamine (LSD), alter perception and cause hallucinations (seeing or hearing things that do not exist).

Extreme reactions and risks of drugs

Drugs pose serious health risks. Overdoses of drugs such as heroin and cocaine can be fatal; other drugs, such as ecstasy, can also cause death. Some drugs affect vital functions; for example, heroin can slow breathing and heart rate. In addition, extreme reactions or adverse interactions with substances such as alcohol may occur. Another common effect is dependence, a condition in which users experience physical and mental cravings when they do not take a drug. Some problems may arise soon after taking a drug (even for the first time); others are associated with long-term abuse. Injected drugs carry additional risks associated with the use of nonsterile needles, such as HIV infection, hepatitis B or C, or blood poisoning. If you or someone close to you abuses drugs, ask your doctor for information on health risks and advice on counselling and treatment.

Sex and health

Puberty, when the body makes the change from childhood to adulthood, prepares you physically for sexual activity and reproduction. The development of emotional maturity often takes much longer, and involves both learning about yourself and gaining experience in dealing with other people.

Sex can be an intensely pleasurable experience that boosts the feeling of wellbeing. In addition, regular sex can improve cardiovascular fitness and help prolong life. However, you should be aware of the health risks of sex, such as unwanted pregnancy and diseases, called sexually transmitted infections (STIs), that are spread only or mainly by sexual intercourse.

Sexual relationships

Sexual fulfilment depends on a blend of physical and psychological factors, and what is right for one person or couple may not suit another. You and your partner should be happy with the frequency of sexual activity, and should be able to discuss which activities you enjoy or find unappealing. Anyone in a sexual relationship should be aware of transmitted infections (STIs) and understand how to minimize the risk of exposure to such conditions by practising safe sex (below). In addition, to avoid an unwanted pregnancy, you should be familiar with the options for contraception (see Contraception choices for men, p.254, and Contraception choices for women, p.276).

It is common to experience a temporary lack of sexual desire or inability to perform sexually (see Low sex drive in men, p.250, and Low sex drive in women, p.272). Such problems are often due to stress or emotional difficulties, or to the use of alcohol, recreational drugs, or certain medications. Disorders such as diabetes mellitus can cause longer-term sexual problems. It is important to discuss concerns with your partner. Talk to your doctor if the problem is persistent.

Practising safe sex

Sexually transmitted infections (STIs) are usually spread by contact with infected skin or body fluids such as semen, blood, and vaginal secretions. Many STIs are uncomfortable but fairly minor problems, but some, such as HIV infection, are life-threatening. You can take simple steps to protect yourself. If you have sex with someone whom you do not know to be free of infection, use a condom, which gives protection against most STIs (apart from genital warts and pubic lice, which can affect body areas that are not covered by a condom). If you develop an STI, you should avoid sexual activity until you have been treated and are free of infection.

Physical and emotional benefits

Good sexual relationships fulfil both partners' needs for comfort and closeness as well as satisfying their physical desires.

Physical and emotional benefits

Good sexual relationships fulfil both partners' needs for comfort and closeness as well as satisfying their physical desires.

Stress

Stress is a physical or mental demand that provokes certain responses in us, allowing us to meet challenges or escape from danger. A moderate amount of stress can improve your performance in situations such as sports and work, but excessive stress can harm your health. You can minimize harmful stress by identifying situations that you find stressful and developing ways to cope with them.

f \ Stress ratings of different life events

Very high

High

Death of a spouse Divorce or marital separation Personal injury or illness Loss of job Moving house

Retirement

Serious illness of family member

Pregnancy

Change of job

Death of close friend

Moderate

Low

Big mortgage Legal action over debt Trouble with in-laws Spouse begins or stops work Trouble with boss

Change in work conditions Change in schools Small mortgage or loan Change in eating habits Christmas or other holidays j

Sources of stress

Stress may result from external events or circumstances, your personal reactions to pressure, or a combination of these factors. Major external sources of stress include long-term problems, such as an unhappy relationship, debilitating illness, or unemployment; major changes, even desirable ones, such as marriage or moving house; and a build-up of everyday stresses, such as being late for work or getting caught in a traffic jam. Behaviour patterns that cause or aggravate stress include impatience and aggression, lack of confidence, and suppressing feelings of tension or anxiety.

Recognizing signs of stress

If signs of stress are recognized early, action can be taken to prevent health problems. These signs may include having less energy than usual, a reduced appetite, or eating more than you do normally. You may have headaches, mouth ulcers, or be unusually susceptible to minor infections, such as colds. If you feel very stressed, you may be anxious, tearful, irritable, or low in spirits. Sleep may be disrupted, and relationships may suffer. To distract yourself, you may rely on alcohol, tobacco, or drugs. If stress is causing any of these problems, seek help from your family, friends, or doctor.

Making lifestyle changes

If your lifestyle is stressful, try to minimize the harmful effects that stress may cause. Find time to keep up with your family and friends, and take up leisure activities. Exercising regularly can help to relieve physical tension, as may learning to relax your body consciously (see Relaxation exercises, below). Break stressful tasks down into small, easy parts. Concentrate on important tasks and limit the number of less urgent ones to conserve your time and energy. If people make heavy demands on you, try to set limits on these demands.

Relaxation exercises

If you are under stress, your muscles tighten, the heart beats more rapidly, and breathing becomes fast and shallow. Relax both your mind and body by learning simple relaxation routines that slow down your body's stress responses. The breathing technique shown here may help to reduce stress. For more information, ask your doctor if he or she can recommend any relaxation classes.

Breathing to relax

Breathe slowly and deeply, using your diaphragm and abdominal muscles. Rest one hand on your chest and one on your abdomen: the lower hand should move more than the upper one.

Safety and health

Your environment, like your personal habits, can affect your health but can be modified to some extent. Accidents are a major cause of death and serious injury, particularly in elderly people and small children. Other health hazards include factors such as certain weather conditions and features of your environment at home or work. However, you can easily avoid many risks to health and safety, whether at home, at work, or when travelling, by identifying potential hazards and taking steps to avoid them.

Home safety and health

Accidents are a major hazard to health. Almost half of all serious accidents happen in the home, with elderly people and young children having the highest rates of injury. Elderly people are particularly vulnerable to falling, while children are at significant risk from poisoning by toxic household substances. Fire is another hazard. A significant risk to health is posed by poor kitchen hygiene, which can lead to food poisoning.

To prevent falls, install bright lighting, make rugs and mats secure, and keep floors tidy. If you have a small child, fit stair gates to stop the child from falling down the stairs.

Poisonous substances include drugs, cleaning fluids, carbon monoxide (a gas that is released by burning fuels), and lead. You

Fitting smoke detectors

Fit smoke detectors on every storey of your home. Take care to keep them free of dust and test the batteries once a month.

Fitting smoke detectors

Fit smoke detectors on every storey of your home. Take care to keep them free of dust and test the batteries once a month.

should keep toxic substances out of reach of children. To prevent the build-up of carbon monoxide, have chimneys, heating systems, and gas appliances inspected yearly, and never run machines with petrol engines in a closed garage. To prevent lead poisoning, have lead pipes replaced and lead-based paint removed professionally.

Use fire or hot items with care; for example, if you are a smoker, be sure to put out cigarettes and matches once you have finished with them. To prevent electrical fires, do not overload electrical sockets. Store flammable materials, such as paints, in a shed or a garage. In addition, keep a fire blanket or extinguisher in the kitchen, and fit smoke detectors throughout your home, in case a fire breaks out.

To avoid food poisoning, keep your kitchen clean, cook food thoroughly, and store perishable foods in a refrigerator. Keep food in airtight containers, and use it by the recommended expiry date.

_ These ividth adjusters alloiv the gate to fit any size of stainvay

_ Vertical bars help to prevent a child from climbing over the gate

Using a stair gate

If you have young children, fit gates at both the top and the bottom of staircases to help prevent falls. Check that the gates are too l)igl> for your children to climb over.

_ These ividth adjusters alloiv the gate to fit any size of stainvay

_ Vertical bars help to prevent a child from climbing over the gate

Using a stair gate

If you have young children, fit gates at both the top and the bottom of staircases to help prevent falls. Check that the gates are too l)igl> for your children to climb over.

Safety in the garden

The greatest risks associated with gardens are from ponds or pools, poisonous plants and chemicals, garden tools, barbecues, and play equipment. Ponds can pose a risk to small children, who can drown even in shallow water. Take care to supervise children when they are playing around these areas. Toxic plants may cause symptoms such as skin irritation and, if swallowed, internal irritation and vomiting. A few plants may be lethal. Teach children that touching or eating plants may be dangerous. If a child does eat anything poisonous, call your doctor immediately, or take the child to hospital together with a sample of the plant. If you use poisonous garden chemicals, store them in a locked shed or cabinet. Consider safe alternatives, such as removing weeds by hand or applying chemical-free pesticides. Never leave dangerous machines or sharp tools where children can find them. When using such equipment yourself, wear the necessary protective clothing.

Insects such as bees, wasps, and mosquitoes can bite or sting. The venom may cause an allergic reaction. An extreme allergic reaction (anaphylaxis) can be life-threatening. To protect yourself, keep your arms and legs covered, and apply insect repellent to your skin.

Goggles Ear protectors

Thick gloves

Protective gear

Wear protective gear when using machinery such as a hedge cutter. For example, wear thick gloves, sl)ield your eyes from flying debris with goggles, and use ear protectors to block out noise.

Pets and safety

Animals can cause allergies, and some infections and infestations may spread to people. Cat and dog faeces may contain dangerous organisms such as the eggs of the toxocara worm. If ingested, these eggs may cause toxocariasis, a disease that may lead to blindness. Cat faeces may also contain toxoplasma protozoa, which may cause serious harm to fetuses in pregnant women. Worm your pets regularly and dispose of their faeces hygienically. Teach children to wash their hands after touching animals. Because pets such as dogs can bite, they should never be left alone with young children.

Goggles Ear protectors

Handling dogs safely

Teach children how to approach and stroke dogs correctly. Even a normally friendly dog may bite if provoked.

Handling dogs safely

Teach children how to approach and stroke dogs correctly. Even a normally friendly dog may bite if provoked.

with stressful situations, try to resolve these problems, or seek help if necessary, before they start to affect your health.

Many types of manual work are dangerous. Working with machinery or heavy objects may put you at risk of injury. Many chemicals are toxic or have other harmful effects such as burning the skin. Some forms of dust, such as silica (found in sand and some rocks) and asbestos, can damage the lungs if inhaled. Other hazards include loud noise and extreme temperatures. Your employer should inform you of any risks and supply protective equipment. If you are self-employed, find out about possible risks to protect yourself and ensure that you conform to safety regulations for your work.

Using equipment safely

When using tools such as a drill, you need clothing and equipment that protect you from noise, vibration, and flying debris.

Safety in the sun

Overexposure to the sun may lead to sunburn, heatstroke, and, in the long term, serious problems such as skin cancer. You are at especially high risk if you have red or blond hair and green or blue eyes because your skin contains a low level of melanin, a pigment that absorbs ultraviolet light. To minimize the risk of sun damage, everyone should stay out of the sun in the middle of the day. If you are outdoors, make sure to protect your skin and eyes. Wear a wide-brimmed hat, a long-sleeved shirt, and long trousers or skirt. Use a sunscreen with a suitable sun protection factor (SPF); the higher the factor, the greater the protection it gives you. m Apply it 15-30 minutes before you go outside l| ^ and re-apply it every 2 hours. Sunglasses should have British Standard mark BS2724 and give maximum protection from ultraviolet light.

Apply sunscreen to uncovered areas

Protecting children's skin

Babies and children are at l)igl> risk of sunburn because of their delicate skin. Keep babies out of the sun, and ensure that young children wear protective clothing and sunscreens.

Safety at work

Both office work and manual jobs can involve certain risks to health. It is wise to find out about any potential risks associated with your work and take action to prevent them. If necessary, ask your employer for help in minimizing these hazards.

Office work rarely poses risks to your physical safety, but it can give rise to various health problems. Two of the most common physical conditions are lower back pain, due to poor posture while sitting at a desk, and repetitive strain injury (RSI), a type of muscle strain caused by repetitive movements such as typing. Another common problem is psychological stress (p.32), which may be due to factors such as demanding situations or poor relationships with colleagues. To avoid physical problems, you should make sure that your work space is well ventilated and is well lit. Sit with your back straight and feet on the floor. If you do a lot of typing, make sure that your wrists are supported while you work. If you are faced

Open ivindoiu provides ventilation

Computer monitor is level ivith line of sight

Shoulders relaxed and not hunched

Foam-rubber rest supports the ivrists for typing

on the floor

Upright seat back aids posture

Shoulders relaxed and not hunched

Foam-rubber rest supports the ivrists for typing

Open ivindoiu provides ventilation

Computer monitor is level ivith line of sight

Your work station

Arrange your desk and equipment so that they are positioned correctly for you. Sit in a position that maintains good posture and enables you to use the keyboard comfortably.

on the floor

Helmet shields head from debris

Ear protectors cut out loud noise

Using equipment safely

When using tools such as a drill, you need clothing and equipment that protect you from noise, vibration, and flying debris.

Helmet shields head from debris

Ear protectors cut out loud noise

Gloves help to reduce °f vibration young children should ensure that they learn about road safety.

Cycle helmet protects head from impacts

Bright clothing makes cyclists clearly visible to other road users

Tyres should be inflated to the right pressure

Brakes must be checked regularly for wear and tear

Child seats

A car seat for a child should cushion the child from possible injury and should allow the seat belt to fit correctly across his or her body.

Brakes must be checked regularly for wear and tear

Safety on the road

In the UK, road traffic accidents result in thousands of deaths and injuries each year. Nearly all accidents are due to human error rather than mechanical faults. A major cause of errors in drivers is alcohol abuse; other causes include lack of experience, use of medications, and tiredness. These factors can delay reactions and impair drivers' judgment. Drivers should ensure that they are not tired or under the influence of alcohol, and check that any medications they are taking will not cause them to feel drowsy. Every occupant of a car should wear a seat belt. Young children should have car seats that are appropriate for their size and weight.

Motorcyclists and cyclists need helmets and clothing that will protect them from adverse weather conditions and injury. They should ensure that their lights work properly, and wear reflectors or bright clothing to make them visible to other road users.

Pedestrians should use pavements or footpaths, and should cross roads at pedestrian crossings. If there is no path, they should walk on the same side of the road as oncoming traffic. Anyone who has

Child seats

A car seat for a child should cushion the child from possible injury and should allow the seat belt to fit correctly across his or her body.

young children should ensure that they learn about road safety.

Cycle helmet protects head from impacts

Bright clothing makes cyclists clearly visible to other road users

Cycling safety

Cyclists should wear helmets to protect the skull and fluorescent or bright clothes to make them easily visible. Lights must be used at night. Always maintain your bicycle in good working order.

Tyres should be inflated to the right pressure

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