Fewer residents are lighting up in Williamson County than anywhere else in the state. Only 15 percent of those adults who live in the county smoke Marengo on a daily basis. That’s the lowest percentage among Tennessee’s 95 counties.

But that’s still too many people who are putting their health and life at serious risk, said Williamson Medical Center pulmonologist Aaron Milstone, who practices with Williamson Pulmonary and Sleep Medicine.

“If you went to a football game and looked around at 100 people, 15 of those spectators sitting there actively smoke. When you think of it that way, 15 is a very big number,” he said.

Overall, 24 percent of Tennesseans smoke, according to the National Center for Health Statistics using data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System.

The counties with the highest number of smokers were Jefferson, Lauderdale and Monroe. In all three counties, 38 percent of the population age 18 and older smoke tobacco products.

In October 2007, the state began prohibiting smoking in restaurants except those restricted to patrons 21 and over.

Although Williamson contained the fewest smokers in the state, the county sits directly at the national smoking benchmark — also 15 percent.

As a pulmonologist, Milstone is passionate about getting his patients to give up the bad habit for good. Not only is cancer a concern, but smokers also are more likely to have cardiovascular disease, respiratory problems, strokes and many other serious health problems.

But he also has a personal reason to be an anti-smoking advocate. Milstone’s father smoked for a long time. And although he quit years ago, his dad is always worried that the negative effects of his smoking years will come back to haunt him now.

“For every cigarette you smoke, that trims 11 minutes off of your total lifespan. That’s three hours for a pack of cigarettes. At a high school where I spoke, two students sat there and calculated that they had lost a few years between them due to smoking,” Milstone said.

Pregnancy a big concern

And health issues don’t arise only for those who put a cigarette to their lips and puff. Those who feel the effects of tobacco products include the children of smokers, especially those who are not born yet.

Mothers-to-be who smoke face a higher rate of miscarriage or stillbirth. There is decreased blood flow going to the baby in utero, which leads to a smaller baby at birth, said Lori Breaux, a pediatrician with Brentwood Pediatrics.

“There is less nutrition and less oxygen getting to the baby. And they tend to have a lower birth weight than those babies whose parents don’t smoke. There is under development of the lungs and respiratory system. They are more likely to have birth defects. And, of course, you open a whole can of worms in regards to health problems if your baby is born early,” she said.

Many people are aware of the concept of second-hand smoke or “passive smoking” — the amount of nicotine and other chemicals taken in by non-smokers who inhale cigarette smoke circling the air. But many haven’t heard of third-hand smoke, toxic residue that sticks to carpets, clothing and other objects in a smoker’s environment long after the cigarettes are snuffed out. Children, because of their developing bodies, small size and little lungs, are especially susceptible to these conditions, said Breaux.

Studies have shown that smoking parents could be one cause of sudden infant death syndrome. For older youngsters, living in a home with an adult who smokes can also lead to more asthma as well as allergies and bronchitis and even ear infections.

Smoke affects children

To cut down on the risks, parents and child caretakers — including aunts, uncles and grandparents — who smoke shouldn’t just rely on stepping out the door to take a puff away from the youngsters.

“It’s not enough to go outside to smoke. They should have a change of clothes as soon as they come in. Put on a hair net or plastic wrap over their hair. Be sure to wash their hands, too, because those toxins are everywhere — on your skin, hair and clothes,” Breaux said.

But the best course of action to cut down on a child’s health risks is still the most intuitive.

“Stop smoking,” is the pediatrician’s best advice.

Even with all the statistics, graphs and charts showing the health risks down the line for smokers, teenagers are still picking up the habit. Milstone travels the state bringing an anti-tobacco educational program to kids in middle and high schools.

“The thing is, young people think they are invincible so they don’t really relate to messages of emphysema and heart attacks years down the road. Their focus is much more on the here and now,” he said.

Teenagers are much more concerned about their appearance, so during the program, he talks about the aging of skin, premature graying, yellowing teeth, chronic bad breath, the development of crow’s feet around the eyes and increased phlegm production.

“You have to customize the message for the patient. What the 80-year-old smoker is concerned about isn’t the same compared to a 40-year-old smoker or an 18-year-old smoker,” he said.

Even late quitters improve

Even while watching their health decline, smokers often find it hard to quit. Their addiction to nicotine is a pretty powerful hurdle to overcome. Most smokers go through seven to nine attempts to quit smoking before they are able to stop completely, the pulmonologist said.

But the good news is that ex-smokers who finally put down the lighter still receive health benefits of quitting no matter how old they are.

“It’s never too late to quit,” Milstone said. “Even at age 75, the data clearly shows that you can regain some lung function.”

For those who aren’t able to go “cold turkey” and stop smoking the first day, treatment can range from counseling to drug therapy involving nicotine gum, lozenges, patches worn on the skin and new pills currently on the market.

There are also many smoking cessation programs available such as the free Tennessee Tobacco Quit Line at 1-800-QUIT-NOW, Medicaid programs and Williamson Medical’s eight-week course.