effects of tobacco essay

Essay on Smoking

500 words essay on smoking.

One of the most common problems we are facing in today’s world which is killing people is smoking. A lot of people pick up this habit because of stress , personal issues and more. In fact, some even begin showing it off. When someone smokes a cigarette, they not only hurt themselves but everyone around them. It has many ill-effects on the human body which we will go through in the essay on smoking.

Ill-Effects of Smoking

Tobacco can have a disastrous impact on our health. Nonetheless, people consume it daily for a long period of time till it’s too late. Nearly one billion people in the whole world smoke. It is a shocking figure as that 1 billion puts millions of people at risk along with themselves.

Cigarettes have a major impact on the lungs. Around a third of all cancer cases happen due to smoking. For instance, it can affect breathing and causes shortness of breath and coughing. Further, it also increases the risk of respiratory tract infection which ultimately reduces the quality of life.

In addition to these serious health consequences, smoking impacts the well-being of a person as well. It alters the sense of smell and taste. Further, it also reduces the ability to perform physical exercises.

It also hampers your physical appearances like giving yellow teeth and aged skin. You also get a greater risk of depression or anxiety . Smoking also affects our relationship with our family, friends and colleagues.

Most importantly, it is also an expensive habit. In other words, it entails heavy financial costs. Even though some people don’t have money to get by, they waste it on cigarettes because of their addiction.

How to Quit Smoking?

There are many ways through which one can quit smoking. The first one is preparing for the day when you will quit. It is not easy to quit a habit abruptly, so set a date to give yourself time to prepare mentally.

Further, you can also use NRTs for your nicotine dependence. They can reduce your craving and withdrawal symptoms. NRTs like skin patches, chewing gums, lozenges, nasal spray and inhalers can help greatly.

Moreover, you can also consider non-nicotine medications. They require a prescription so it is essential to talk to your doctor to get access to it. Most importantly, seek behavioural support. To tackle your dependence on nicotine, it is essential to get counselling services, self-materials or more to get through this phase.

One can also try alternative therapies if they want to try them. There is no harm in trying as long as you are determined to quit smoking. For instance, filters, smoking deterrents, e-cigarettes, acupuncture, cold laser therapy, yoga and more can work for some people.

Always remember that you cannot quit smoking instantly as it will be bad for you as well. Try cutting down on it and then slowly and steadily give it up altogether.

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Conclusion of the Essay on Smoking

Thus, if anyone is a slave to cigarettes, it is essential for them to understand that it is never too late to stop smoking. With the help and a good action plan, anyone can quit it for good. Moreover, the benefits will be evident within a few days of quitting.

FAQ of Essay on Smoking

Question 1: What are the effects of smoking?

Answer 1: Smoking has major effects like cancer, heart disease, stroke, lung diseases, diabetes, and more. It also increases the risk for tuberculosis, certain eye diseases, and problems with the immune system .

Question 2: Why should we avoid smoking?

Answer 2: We must avoid smoking as it can lengthen your life expectancy. Moreover, by not smoking, you decrease your risk of disease which includes lung cancer, throat cancer, heart disease, high blood pressure, and more.

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Cause and Effects of Smoking Cigarettes, Essay Example

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Smoking cigarettes has historically been a leisurely and highly popular social activity that a litany of people turn to as a way to assuage daily stress, lose weight, and feel socially accepted in a constantly evolving social world. Tobacco, the main ingredient in cigarettes, has high levels of nicotine, which is a highly addictive ingredient that makes it hard for people to quit smoking if nicotine is ingested on a quotidian basis (Woolbright, 1994, p. 337). According to the CDC (2014), cigarette smoking causes over 480,000 deaths annually in the United States alone, which translates into one out of every five people extirpating due to the ingestion of tobacco. A preventable cause of death, cigarette smoking kills more persons than accidents caused due motor vehicle accidents, alcohol consumption, illegal drug use, deaths involving firearms, and the HIV/AIDS virus altogether (Center For Disease Control and Prevention, 2014). Women who smoke tobacco disproportionately suffer from even more health problems as it directly harms not only their reproductive health but also their mortality and morbidity rates of their progeny or future children (American Lung Association, n.d.). People should not smoke because it not only spawns negative health effects but also because it is not economically useful. If people stopped smoking, many lives would be both indirectly and directly saved from premature and preventative deaths as a result.

Doctors and other medical experts pinpoint the various health hazards caused by smoking, especially to the statistics pertaining to the nexus between smoking cigarettes and premature death, in order to convince people to quit smoking. In the past five decades, the risk of premature death in both female and male smokers has profoundly increased (Centers for Disease Control and Prevention, 2014). According to the CDC (2014), smoking cigarettes causes a handful of diseases because it adversely impacts almost all bodily organs and detracts from the general health of enthusiastic smokers. The risk of developing coronary heart disease (COPD), various cardiovascular maladies, and stroke–the leading cause of death in the United States alone–increases two to four times as much due to the damage it spawns to blood vessels because tobacco narrows and thickens them. These ramifications cause rapid heartbeat, which results in higher blood pressure levels which renders smokers vulnerable to blood clots. If blood clots prevent blood from reaching the heart, people put themselves at risk for heart attack due to the fact that the heart does not get enough oxygen and thus kills the heart muscle. In addition, blood clots can also cause a stroke because they can hinder blood flow to the brain. Shockingly, quitting smoking even after just one year drastically enhances an individual’s risk of incurring poor cardiovascular health. Moreover, smoking is directly connected to various respiratory diseases due to the fact that it harms both airways and alveoli, or the minute air vacs, that are in the lungs. Chronic Obstructive Pulmonary Disease (COPD), emphysema, and bronchitis are common forms of lung disease that chronic smokers often develop. In addition, medical experts correlate cigarette smoking with a litany of cancers, which have been pinpointed as the primary cause of lung cancer in individuals who smoke for a protracted period of time. Smoking cigarettes can also spawn various other types of cancer, including cancer in the stomach, liver, kidneys, bladders, pancreas, and oropharynx. Smoking not only puts smokers at risk for these often fatal types of cancer but also to those around smokes as a result of second-hand smoking. Second-hand smoke, according to the CDC (2014), causes an estimated 34,000 deaths per year in non-smokers because they too develop various cardiovascular diseases while an estimated 8,000 persons prematurely dying as a result of stroke (CDC, 2014). They also are put at risk for developing lung cancer by approximately thirty percent, and their risk for heart attack is also amplified. Physicians estimate that if nobody smoked cigarettes around the world, an estimated one out of every three deaths caused by cancer would not manifest (1).

More poignantly, smoking cigarettes negatively impacts women’s reproductive health, and children who are exposed to cigarette smoke suffer from often fatal effects. Many studies have analyzed and outlined the negative ramifications of maternal smoking on both the mother and the baby and/or infant ( Hofhuis, de Jongste, & Merkus, 2003 & Woolbright, 1994). Many states require documentation on birth certificates of maternal tobacco consumption (Woolbright, 1994). Despite the Surgeon General’s stern warning that maternal smoking has been linked to fetal injury, premature birth, and/or low birth rate, 15-37% of pregnant women still smoke cigarettes while pregnant (Hofhuis, de Jongste, & Merkus, 2003). Mothers who smoke also frequently participate in other high-risk behaviors that also negatively impacts the health of their progeny. Additionally, factors including marital and socio-economic status in addition education level affect the outcome of pregnancies due to increased vulnerability to cigarette smoking (Woolbright, 1994, p. 330). Low birth weight is the main impact of maternal smoking, although the existing literature pinpoints infant death and premature birth as major ramifications of it as well. Infant exposure to tobacco after they are born puts him or her at risk of premature death if they develop respiratory diseases in addition to Sudden Infant Death Syndrome (Woolbright, 1994). Hofhuis, de Jongste, and Merkus (2003) assessed how smoking cigarettes during pregnancy in addition to passive smoking thereafter affects both the mortality and morbidity rates in children. Statistics show that other obstetric complications directly linked to smoking, including spontaneous abortions, premature rupture of membranes, ectopic pregnancies, and complications related to the placenta. Smoking also stunts the lung growth that fetuses need in utero, which results in the child suffering from weakened lungs after birth while also exponentially increases the child’s chance of suffering from asthma and a vast array of other crippling respiratory diseases. In addition, it stunts brain development and detracts from the child’s mental acuity.

Health Effects of Cigarette Smoking. (2014, February 6). Centers for Disease Control and Prevention . Retrieved November 21, 2015 from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_ cig_smoking/

American Lung Association. (n.d.). Women and tobacco use. American Lung Association . Retrieved November 21, 2015 from http://www.lung.org/stop- smoking/about-smoking/facts- figures/women-and-tobacco-use.html

Ault, R. W., Jr., R. E., Jackson, J. D., Saba, R. S., & Saurman, D. S. (1991). Smoking and Absenteeism. Applied Economics , 23 , 743-754.

Hodgson TA. Cigarette Smoking and Lifetime Medical Expenditures. Millbank Q 1992, 70, 81-125.

Hofhuis, W., de Jongste, J. C., & Merkus, P. J. (2003). Adverse Health Effects of Prenatal and Postnatal Tobacco Smoke Exposure on Children. Arch Dis Child , 88 , 1086-1090.

Woolbright, L. A. (1994). The effects of maternal smoking on infant health. Population Research and Policy Review , 13 (3), 327-339.

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Essay on Harmful Effects of Smoking

Students are often asked to write an essay on Harmful Effects of Smoking in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

100 Words Essay on Harmful Effects of Smoking

Introduction.

Smoking is a dangerous habit that poses significant health risks. It’s not only harmful to smokers, but also to those around them.

Health Risks

Smoking can cause lung cancer, heart disease, and stroke. It damages nearly every organ in the body, leading to premature death.

Secondhand Smoke

Impact on environment.

Cigarette butts litter the environment and release toxic chemicals into the soil and water, harming wildlife.

250 Words Essay on Harmful Effects of Smoking

Smoking is a widespread habit, yet it is one of the most detrimental practices to human health. Despite the awareness campaigns and statutory warnings, many continue to smoke, oblivious of the damaging effects it has on their health and wellbeing.

Physical Health Risks

Primarily, smoking causes numerous fatal diseases. It is the leading cause of lung cancer, accounting for about 85% of all cases. It also significantly increases the risk of heart diseases and stroke. The harmful chemicals in cigarettes damage blood vessels, leading to atherosclerosis, which can result in heart attack or stroke.

Impact on Respiratory System

Effect on mental health.

Smoking also influences mental health. Nicotine addiction can lead to increased stress, anxiety, and depression. The temporary relief from stress that smoking provides is often mistaken for a stress reliever, while it is actually exacerbating the problem.

In conclusion, smoking is a harmful habit that poses significant threats to physical and mental health. The myriad diseases it causes, coupled with its addictive nature, make it a dangerous lifestyle choice. It is imperative to raise awareness about these harmful effects and encourage cessation to safeguard public health.

500 Words Essay on Harmful Effects of Smoking

The impact on physical health.

One of the most severe consequences of smoking is its impact on physical health. Smokers are at a higher risk of developing a plethora of diseases, including lung cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD). These conditions are often fatal, leading to premature death. The toxins in cigarette smoke damage the lining of the lungs, making smokers more susceptible to infections like pneumonia.

Detrimental Effects on Mental Health

Smoking doesn’t just harm the physical body; it also has a profound effect on mental health. Nicotine, the addictive substance in tobacco, alters the brain chemistry, leading to dependence. This dependence can exacerbate mental health conditions such as anxiety and depression. Furthermore, the stress of addiction and the struggle to quit smoking can also take a toll on mental well-being.

Smoking and Second-hand Smoke

Societal impact.

Smoking also has societal implications. The economic burden of smoking is substantial, with healthcare costs for smoking-related illnesses reaching astronomical levels. Additionally, the loss of productivity due to illness or premature death contributes to economic strain.

In conclusion, the harmful effects of smoking are far-reaching, affecting not only the smoker but also those around them and society at large. The physical and mental health implications, coupled with the economic burden, make it a significant public health issue. Despite the addictive nature of smoking, quitting is possible with the right support and resources, leading to improved health outcomes and quality of life. Understanding the full scope of smoking’s harmful effects is crucial in motivating smokers to quit and preventing non-smokers from starting.

Apart from these, you can look at all the essays by clicking here .

Cigarette smoke and adverse health effects: An overview of research trends and future needs

Sibu p saha.

1 Gill Heart Institute, University of Kentucky, Lexington, Kentucky

Deepak K Bhalla

2 Department of Pharmaceutical Sciences, Wayne State University, Detroit, Michigan

Thomas F Whayne, Jr

3 Graduate Center for Toxicology, University of Kentucky, Lexington, Kentucky, USA

A large volume of data has accumulated on the issues of tobacco and health worldwide. The relationship between tobacco use and health stems initially from clinical observations about lung cancer, the first disease definitively linked to tobacco use. Almost 35 years ago, the Office of the Surgeon General of the United States Health Service reviewed over 7000 research papers on the topic of smoking and health, and publicly recognized the role of smoking in various diseases, including lung cancer. Since then, numerous studies have been published that substantiate the strong association of tobacco use with a variety of adverse human health effects, most prominently with cancer and cardiovascular diseases. Cigarette smoking is regarded as a major risk factor in the development of lung cancer, which is the main cause of cancer deaths in men and women in the United States and the world. Major advances have been made by applying modern genetic technologies to examine the relationship between exposure to tobacco smoke and the development of diseases in human populations. The present review summarizes the major research areas of the past decade, important advances, future research needs and federal funding trends.

A repository for the collection, analysis, validation and dissemination of all smoking and health-related data was established by the World Health Organization. The data received from various member countries were compiled into a book entitled Tobacco or Health: A Global Status Report, 1997 ( 1 ). This report showed smoking prevalence and other tobacco use-related data from various countries and presented an analysis. It is estimated that there are approximately 1.1 billion smokers worldwide, of which 900 million are men and 200 million are women. The sex ratio of men to women is 2:1 for developed nations and 7:1 for developing nations. Smoking prevalence in men and women averages 42% and 24%, respectively, for developed countries, and 48% and 7%, respectively, for less developed countries. In comparison, approximately 47 million people smoke cigarettes in the United States ( 2 ), and smoking prevalence in the United States is estimated at 28% and 23% for men and women, respectively. The Surgeon General’s report in 2004 concluded that in the United States, cigarette smoking has caused 12 million deaths since 1964, at a cost to the nation of approximately US$157.7 billion each year ( 3 ). There has been a significant decline in the consumption of cigarettes in the United States since 1964. The production of cigarettes continues at a steady pace mainly to meet export demands, which continue to rise due to increasing tobacco use in the rest of the world, especially in far eastern and southeastern Asia. On the basis of consumption and disease incidence trends, it is predicted that there will be an epidemic of tobacco-related diseases in various countries of the world in the next 20 to 30 years.

EPIDEMIOLOGY OF TOBACCO-RELATED DISEASE

As part of the Global Burden of Disease Study carried out by the Harvard University School of Public Health in 1997 ( 4 ), it was projected that mortality and morbidity from tobacco use will increase by almost threefold worldwide in 20 to 25 years. Similar predictions have been made by the Oxford University Center headed by Sir Richard Doll, who was one of the first researchers to link cigarette smoking with lung cancer in the 1950s ( 5 , 6 ). Cancer, cardiovascular diseases and chronic obstructive pulmonary disease continue to be the main health problems associated with cigarette smoking. An extensive database has accumulated, which has consistently documented a relationship between smoking and these specific diseases. The strength of the association is further demonstrated by measuring the RR and the presence of a dose-response relationship (ie, direct relationship between the intensity of exposure to cigarette smoke and the risk of disease). According to a 2004 Centers for Disease Control and Prevention report ( 3 ), approximately 2600 people die of cardiovascular disease in the United States every day, which translates into one death every 33 s. Furthermore, the likelihood of dying from heart disease increases fourfold as a result of smoking. The cost of heart disease and stroke in terms of health care expenses and lost productivity was estimated at US$351 billion in the United States alone in 2003.

An analysis by European health experts ( 7 ) determined that in developed countries as a whole, tobacco is responsible for 24% of all male deaths and 7% of all female deaths; these figures rise to over 40% in men in some countries of central and eastern Europe and to 17% in women in the United States. The average decreased life span of smokers is approximately eight years. Among United Kingdom doctors followed for 40 years, overall death rates in middle age were approximately three times higher among physicians who smoked cigarettes than in nonsmokers. In those United Kingdom physicians who stopped smoking, even in middle age, a substantial improvement in life expectancy was noticed. These same experts found that worldwide, smoking kills three million people each year and this figure is increasing. They predict that in most countries, the worst is yet to come, because by the time the young smokers of today reach middle or old age, there will be approximately 10 million deaths per year from tobacco use. Approximately 500 million individuals alive today can expect to be killed by tobacco and 250 million of these deaths will occur in the middle age group. Tobacco is already the biggest cause of adult death in developed countries. Over the next few decades tobacco is expected to become the biggest cause of adult death in the world. For men in developed countries, the full effects of smoking can already be seen. Tobacco causes one-third of all male deaths in the middle age group (plus one-fifth in the old age group) and is the cause of approximately one-half of all male cancer deaths in the middle age group (plus one-third in the old age group). Of those who start smoking in their teenage years and continue smoking, approximately one-half will be killed by tobacco. One-half of these deaths will be in middle-aged individuals (35 to 69 years of age) and each will lose an average of 20 to 25 years of nonsmoker life expectancy. In contrast, the total mortality is decreasing rapidly and cancer mortality is decreasing slowly in nonsmokers in many countries. Throughout Europe in the 1990s, tobacco smoking caused three-quarters of a million deaths in the middle age group. In the Member States of the European Union in the 1990s, there were over one-quarter of a million deaths in the middle age group directly caused by tobacco smoking, which included 219,700 deaths in men and 31,900 in women. There were many more deaths caused by tobacco at older ages. In countries of central and eastern Europe, including the former Union of Soviet Socialist Republics, there were 441,200 deaths in middle-aged men and 42,100 deaths in women. Several epidemiological studies examining the factors responsible for the interindividual differences in the susceptibility to tobacco-related cancers and cardiovascular diseases are being performed in the United States, Europe and Japan. Although still not common practice, many of the newer studies are employing molecular genetic assays in conjunction with epidemiology to identify genotypes susceptible to disease development and select suitable biomarkers of tobacco smoke exposure.

The frequency of investigations in the area of cigarette smoke composition and chemistry decreased during the last decade. Nonetheless, there are ample data to suggest that cigarette smoke is a highly complex mixture that contains approximately 4800 different compounds ( 8 ). Approximately 100 of these compounds are known carcinogens, cocarcinogens and/or mutagens. The complex mixture also contains gases such as ozone, formaldehyde, ammonia, carbon monoxide, toluene and benzene, and about 10 10 particles of different sizes in each mL of mainstream smoke. In addition, a number of other toxic, mutagenic, tumour promoter and/or cocarcinogenic substances have been identified in both mainstream and sidestream cigarette smoke over the years. Many chemical and biological assays of smoke condensates have also documented the presence of potent inhibitors of carcinogenesis in smoke. Such a complex chemical composition of smoke has made it difficult to determine the active constituent(s) responsible for the tobacco-related health risks of smoking and has led to studies of individual constituents of smoke such as polycyclic aromatic hydrocarbons (PAH), nitrosamines and nicotine. Thus, over the years, various individual groups of smoke constituents have been the focus of research at different times. For example, studies of PAH were in vogue during the 1970s and 1980s, followed by nitrosamines in the 1990s. Tobacco alkaloids have long been studied because of their pharmacological activity and have attracted increased attention because of their suspected role in addiction, smoking behaviour and cessation. However, it is also being realized now that the health effects of this complex mixture are likely to result from a combined effect of these chemicals through multiple mechanisms rather than as result of the effects of a single smoke constituent. The mixture contains compounds belonging to almost every class of chemicals that are toxic and protective, agonist and antagonist, carcinogenic and anticarcinogenic, and exists in the gaseous as well as the particulate phase. Extensive studies on the chemical constituents of tobacco smoke and their relationship to disease were published by Hoffmann and Hoffmann of the American Health Foundation ( 8 ). Newer studies have largely focused on the comparative chemistry of mainstream and sidestream smoke. Interest in the free radical chemistry of smoke has resurfaced due to the realization that smoke-induced oxidative injury may play an important role in the etiology of a variety of tobacco-related diseases. Pioneering studies on the free radical chemistry of tobacco smoke, performed in the laboratory of William Pryor at the Louisiana State University ( 9 ), identified short- and long-lived radicals in mainstream and sidestream cigarette smoke, and implicated them in various smoking-associated disease etiologies.

TOBACCO-RELATED CARDIOVASCULAR DISEASE

Cardiovascular diseases, and atherosclerosis in particular, are the leading causes of death in industrial societies. The predominant underlying cause of coronary artery disease (CAD) is atherogenesis, which also causes atherosclerotic aortic and peripheral vascular diseases. Cigarette smoking, independently and synergistically with other risk factors such as hypertension and hypercholesterolemia, contributes to the development and promotion of the atherosclerotic process. Various studies have shown that the risk of developing CAD increases with the number of cigarettes smoked per day, total number of smoking years and the age of initiation, thus indicating a dose-related response. In contrast, cessation of smoking is reported to reduce mortality and morbidity from atherosclerotic vascular disease.

The mechanisms through which smoking influences the development and progression of atherosclerosis are poorly understood at present, but recent studies point to an adverse effect of smoking on endothelial and smooth muscle cell functions as well as thrombotic disturbances produced by tobacco smoke ( 10 , 11 ). With the use of modern ultrasonographic techniques, three independent studies performed in the United States, Europe and Australia have demonstrated that both active and passive smokers exhibit impaired endothelium-dependent vasoregulation ( 12 – 14 ). Some degree of recovery of endothelial function in ex-passive smokers who have stayed away from smoke-contaminated environments further supported a secondary role of smoke in endothelial dysfunction ( 15 ).

Evidence has been presented that tobacco-related impairment of endothelial function may be related to its adverse effects on endothelial nitric oxide (NO) synthase ( 16 , 17 ). An association between a genetic polymorphism of the endothelial NO synthase gene and the predisposition of smokers to CAD was reported ( 18 , 19 ). Additionally, studies report that smoke interferes with L-arginine and NO metabolism, resulting in reduced NO formation ( 20 ). Upregulation of the expression of endothelial cell adhesion molecules (CAMs) such as vascular CAM-1 and intercellular CAM-1 by smoke condensates, and stimulation of leukocyte and endothelium attachment by exposure to cigarette smoke was demonstrated ( 21 ). Cigarette smoke extract has been shown to induce expression of CAMs ( 22 ). However, the expression of a specific adhesion molecule is determined in vivo and the relationship between various events is poorly understood.

Exposure to tobacco smoke is known to increase oxidative stress in the body by various mechanisms, including depletion of plasma antioxidants such as vitamin C. At least two studies have been performed to determine the role of oxidative stress in increasing leukocyte-endothelial interactions that precede the development of atherosclerosis in smokers. One study showed that a high intake of vitamin C by smokers significantly reduced the adhesiveness of their monocytes to endothelial cells ( 23 ). However, in a second study, sera from young smokers was collected before and after a single oral supplementation with vitamin C and L-arginine (a substrate for NO production). The sera were tested for promotion of the adherence of human monocytes to human umbilical vein endothelial cell monolayers. It was shown that while oral L-arginine caused reduction in such leukocyte adherence, no reduction was seen with vitamin C supplementation ( 24 ). This suggested that the NO levels may be important in smoking-induced leukocyte-endothelial interactions, at least during the early stages. Neither NO nor any other markers of oxidative stress were measured in either of these studies.

The levels of 8-hydroxydeoxyguanosine, an oxidized DNA product, and F2-isoprostane, an oxidative arachidonic acid product, were found to be elevated in passive smokers ( 25 , 26 ). Oxidation of low-density lipoprotein (LDL), which is a gold standard risk factor of the atherosclerotic process, was also found to be elevated in smokers, as determined by the presence of increased levels of autoantibodies against oxidized LDL. It was further demonstrated that dietary supplementation with a lipid-soluble antioxidant, α-tocopherol, significantly reduced plasma levels of oxidized LDL autoantibodies ( 27 ). Similarly, intake of a mixture of antioxidants was found to increase the resistance of smoker LDL to oxidative modification ( 28 ) and reduce the plasma levels of 8-hydroxydeoxyguanosine in passive smokers ( 25 ). These studies have thus identified newer, more specific markers of oxidative stress that can be used as biomarkers of oxidant injury and used for the development of dietary and/or pharmacological interventions against disease development.

Relatively few studies related to cardiovascular effects of cigarette smoke have been performed in rodent models. Such animal studies are, however, needed to delineate the role of different mechanisms in promoting atherosclerotic disease and for developing appropriate interventions.

TOBACCO-RELATED CANCERS

Tobacco carcinogenesis has remained a focus of research during the past 10 years, and various epidemiological and experimental studies have not only confirmed the major role of tobacco smoke exposure in lung and bladder cancers, but have also reported on its association with cancers of various other sites, such as the oral cavity, esophagus, colon, pancreas, breast, larynx and kidney. It is also associated with leukemia, especially acute myeloid leukemia.

In addition to the highly recognized role of cigarette smoking in lung cancer, it has been implicated in many other chronic diseases, including chronic bronchitis and pulmonary emphysema. In the United States, the reduction in smoking has resulted in a decline in death due to lung cancer in men since the mid 1980s. However, the incidence of lung cancer in women has surpassed that of breast cancer and continues to rise; it will likely be the focus of future studies ( 29 , 30 ). Both active and passive smoking are implicated in this increase, and several studies of smoking behaviour and disease incidence in women suggest greater susceptibility of women to tobacco carcinogens ( 31 ). It is believed that 80% to 90% of all respiratory cancers are related to active smoking.

Because of the antiestrogenic protective effects of smoking, the role of smoking in breast cancer is controversial. However, recent studies suggest that both active and passive smoking may have a role in the occurrence of breast cancer. One example is a study that found an OR of 4.5 for breast cancer among women who were exposed to passive smoke before 12 years of age and an OR of 7.5 for active smokers. Women who were first exposed to passive smoke after 12 years of age had a lower, although still elevated, OR ( 32 ).

In both men and women, cancers of the head and neck are also on the rise, and this has been attributed to increased use of smokeless tobacco products. Also, a synergistic interaction between cigarette smoking and radon exposure was confirmed in a large study that showed that lung cancer incidence due to an interaction between smoking and radon exposure exceeded incidence accounted for by additive effects and, therefore, indicated multiplicative effects ( 33 ).

Comparative toxicity studies have shown that in comparison with standard cigarettes, the new experimental cigarettes that heat tobacco have a relatively low toxicity ( 34 ). In comparing lung cancer risk in smokers of different types of cigarettes, Lee ( 35 ) determined in 2001 that the risk was 36% lower in individuals smoking filtered cigarettes than in those smoking unfiltered cigarettes, and the risk was 23% lower for smokers of low-tar cigarettes than smokers of high-tar cigarettes. The risk increased by 42% in hand-rolled cigarette smokers and by 75% in smokers using black tobacco.

One interesting observation relates to the nature of lung cancer, which has changed over the years with respect to the location and the types of lung tumours observed in smokers. In the past, the primary tumours observed among smokers were the centrally located squamous cell carcinomas of the airways. Now, the predominant lung tumours in smokers are peripheral adenocarcinomas and other non-small-cell lung cancers. This shift in tumour types has been attributed to changes in the composition of cigarettes and its effect on the smoking patterns of tobacco users over the past 30 years ( 8 , 36 ). Significant reductions in cigarette tar and nicotine and increased levels of nitrates in cigarettes have markedly altered the manner in which cigarettes are smoked. The number and volume of puffs taken by smokers have increased from a single 35 mL puff/min with 1950s cigarettes to two to four 50 mL puffs/min of low-tar or low-nicotine cigarettes; the depth of inhalation has also increased. These changes in smoking patterns have promoted greater deposition of smoke constituents into the peripheral lungs, where adenocarcinomas develop.

Major advances are being made in the area of molecular epidemiology of tobacco-related cancers in human populations. Many recent epidemiological studies have focused on the differential susceptibility to tobacco-related cancers; they have employed polymerase chain reaction-based molecular assays that permit genotypic analysis of small human samples and supplement the information generated by enzymatic and immunological assays. These assays are increasingly being used in human and experimental studies to examine various gene-gene and gene-environment interactions. One area that has received considerable attention in recent years is the role of polymorphic enzymes in the development of diseases. It is now well recognized that genetic polymorphism strongly influences cancer susceptibility and incidence. The frequencies of mutated alleles of proto-oncogenes, tumour suppressor genes and xenobiotic bio-transformation genes vary significantly among different populations and impact substantially on their susceptibility to cancer. Nearly every enzyme in the carcinogen metabolism pathways has been found to exist in multiple forms, many of which vary in binding affinity and/or turnover efficiency. Some are even entirely absent in individuals, thereby influencing their susceptibility to disease development.

The chemical complexity of tobacco smoke and the metabolic activation requirements for many of its carcinogenic constituents have drawn particular attention to genetic polymorphisms of biotransformation enzymes that metabolize tobacco smoke carcinogens. Thus, genes for various activating enzymes such as cytochrome P450 (CYP) proteins, and deactivating enzymes such as glutathione S-transferase (GST), N-acetyl transferase (NAT) and uridine diphosphate-glucose transferase have been the main target of many recent studies in the context of tobacco carcinogenesis. Also, pre-existing inherited mutations and/or mutation susceptibility of tumour suppressor genes such as p53 , which are known to play a major role in determining cancer susceptibility, have been a subject of investigations in tobacco-related carcinogenesis ( 37 , 38 ).

Several human studies have suggested a strong interplay of various polymorphic CYP1A1, CYP1A2, CYP2E1, NAT1, NAT2, GSTM1 and GSTT1 enzymes in modulating the formation of DNA adducts, induction of mutations and chromosomal damage, and/or the incidence of cancers of various sites in different populations ( 39 – 47 ).

The CYP1A1 gene has been extensively studied in Japanese populations. Two polymorphic variants that interact with smoking to modify lung cancer risk have been identified ( 47 , 48 ). Thus, a homozygous minor allele combined with smoking was found to increase lung cancer risk. Studies of the same gene in Western populations have, however, yielded negative or conflicting results ( 49 ), although an interaction of CYP1A1 variants with the GST null genotype has been reported to significantly increase lung cancer risks in non-Japanese populations ( 50 , 51 ).

NATs are polymorphic conjugation enzymes (produced by the NAT1 and NAT2 genes) involved in the detoxification of aromatic amines by N-acetylation. Depending on the presence or absence of a particular variant, individuals can be categorized as slow or fast acetylators, which in turn can influence the incidence of bladder cancer. It was shown that slow acetylator NAT2 is an important modifier of the amount of aromatic amine-DNA adduct formation even at a low dose of tobacco smoke exposure ( 52 ). Slow acetylator NAT2 genotype was also a significant risk factor for bladder cancer in moderate and heavy smokers, but had no effect in nonsmokers ( 53 ).

GSTs are another group of metabolic detoxification enzymes that have attracted a great deal of interest in recent years because of their association with risks for different types of cancers. Based on their sequences, these enzymes are divided into five classes. Three of these classes – GSTM1, GSTT1 and GSTPi – are important in the context of tobacco-related cancers. Extensive studies on the relationship of these genes to cancer risks have shown that most populations studied have very high frequencies (20% to 50%) of homozygous GSTM1 and GSTT1 deletion carriers. GSTM1 and GSTT1 may be involved in the etiology of cancer at more than one site. Furthermore, the risk to individuals who carry homozygous deletions is generally small but increases significantly on interaction with cigarette smoking ( 54 ). Among all metabolic cancer susceptibility genes, the association of GSTM1 deficiency with cancer risk is the most consistent and unidirectional. Various experimental and epidemiological observations support the role of this gene in tobacco-related cancers. For example, it has been observed that the excretion of urinary mutagens and the number of lung tissue DNA adducts in GSTM1-deficient smokers is significantly greater than those carrying the wild-type allele ( 55 – 57 ). Various epidemiological studies also support the premise that deficiency of this enzyme predisposes for lung and bladder cancers ( 58 ). Furthermore, low activity alleles of GSTPi have been often found in association with different types of human cancers ( 59 , 60 ).

In addition to anomalies of biotransformation enzyme genes, inactivation of tumour suppressor genes such as p53 , and activation of the proto-oncogene K-ras are also involved in tobacco-related cancers. Various mutated forms of tumour suppressor gene p53 have been commonly detected in lung tumours and it has been found that these mutations are predominantly located in exons 5 to 8. The nature of point mutations in this gene has been extensively investigated and studies show that the most common mutant allele of the p53 gene possesses a G:C to A:C transversion ( 61 ), which is associated with tobacco use ( 62 , 63 ).

The above studies show that several genetically controlled polymorphic enzymes and enzyme systems are linked to tobacco carcinogen activation and deactivation. Some of these genes have been identified and characterized, but others remain undiscovered. Not only the independent effects of single gene polymorphisms, but an interplay of multiple gene interactions appear to be involved. The complexity of epidemiological studies, which have many uncontrollable variables, makes it difficult to study such interactions and their control in human studies. Additionally, many of the enzymes involved in tobacco carcinogen metabolism are also induced by other environmental factors such as alcohol use, dietary constituents, pesticide and xenobiotic exposure, hormonal status, etc, further complicating the interpretation of data. The interaction of many of these genes with each other and the effect of environmental factors are just beginning to be examined. Experimental studies in specifically constructed transgenic and knock-out animals will be important for a systematic evaluation of the contribution of specific cancer genes and/or cancer susceptibility genes to the tobacco carcinogenic process, and to help identify the mechanisms through which environmental agents, such as cigarette smoke, influence these processes.

SECONDHAND SMOKE

The adverse effects of cigarette smoke on human health are widely recognized. It is the main etiological agent in chronic obstructive pulmonary disease and lung cancer, and is a known human carcinogen. While the risks to human health from active smoking are accepted, evidence supporting the risk of involuntary exposure to environmental tobacco smoke (ETS) has accumulated in recent years. It is the main source of toxicant exposure by inhalation in nonsmokers. Despite recent regulations, smoking in public enterprises is not uncommon. However, despite an occasional report on the effect of secondhand smoke in nonsmokers, little attention was given to this aspect of smoking until about 1970. ETS is now regarded as a risk factor for development of lung cancer, cardiovascular disease and altered lung functions in passive smokers ( 64 ). In general, children exposed to ETS show deterioration of lung function, more days of restricted activity, more pulmonary infections, more days in bed, more absences from school and more hospitalization than children living in nonsmoking homes ( 65 ).

Passive smoking is also implicated in increasing atherosclerosis in individuals 15 to 65 years of age. Children exposed to ETS are at higher risk of developing cardiovascular disorders. Quantitative risk estimates were obtained by measuring the intimal-medial thickness of the carotid artery in a large longitudinal atherosclerosis risk study of 10,914 individuals. Increases of 50%, 25% and 20% were shown over nonsmokers in current, ex-and passive smokers, respectively, thus suggesting a role of all types of tobacco smoke exposure in the progression of atherosclerosis ( 66 ). A recent meta-analysis ( 67 ) of 18 epidemiological studies (10 cohort and eight case-control) further showed an increased RR of CAD in ETS-exposed individuals. These investigators also identified a significant dose-response relationship between the intensity of smoke exposure and risk of CAD in passive smokers. Cardiovascular health risks of smoke-exposed women are of particular concern. Although the exposure to ETS is a current topic of debate in tobacco-related cancers and other lung diseases, the limited research at the basic experimental level provides a strong argument for launching experimental studies to support human data and explore disease mechanisms.

Follow-up of news stories, and local and state ordinances, leads to the conclusion that more communities and states are restricting exposure to secondhand smoke.

NATIONAL INSTITUTES OF HEALTH RESEARCH FUNDING FOR STUDIES OF HEALTH EFFECTS OF CIGARETTE SMOKE

To determine the extent of federal support for experimental studies in the area of health effects of cigarette smoke, the National Institutes of Health (NIH) database of all R01 research grant awards was searched for titles and abstracts containing the words ‘cigarette smoke’ from 1985 to 1998. The results are summarized below. A total of 127 hits were obtained and a careful review of the abstracts provided the following distribution:

Grants involving experimental animal studies = 12 (9.4%)
Grants involving experimental animal studies in which whole tobacco smoke was used = 3 (2.3%)
Grants involving experimental animal studies using smoke components (nicotine, PAH, cadmium and quinones) = 8 (6.2%)
One grant involved aging

A similar search of the NIH database from 1999 to 2006 revealed 907 grants in all award categories. The grant distribution by category was as follows:

Total number of R01s = 383
Grants involving experimental animal studies = 77 (20.1%)
Grants involving experimental animal studies in which whole tobacco smoke was used = 29 (7.6%)
Grants involving experimental animal studies using smoke components (nicotine, PAH, cadmium and quinones) = 29 (7.6%)

All the remaining grants generally supported behavioural and epidemiological studies in humans or other systems. Although the number of grants supporting animal studies increased between 1999 and 2006 compared with 1985 to 1998, a significant portion of NIH funding still went to research projects in the area of tobacco use and smoking behaviour, tobacco use among youth and interventions, nicotine addiction and neurobiology of nicotine (areas not covered in this review), presumably in agreement with the NIH’s recent goal of finding effective smoking cessation programs to reduce tobacco usage in the general population. Thus, it is clear that the need for basic experimental research in the field of smoking-associated diseases and the mechanisms through which tobacco smoke causes various diseases remain as important as they ever were. The escalation of health care costs makes it even more necessary to find ways to protect the health of smokers and smoke-exposed individuals with any dietary or therapeutic interventions that hold promise.

DIRECTIONS FOR FUTURE RESEARCH

The most benefit is likely to result from detailed epidemiological studies complemented by specific molecular genotyping of various populations. Ideally, studies of this type will re-evaluate the prevalence of smoking and tobacco use and determine the exact nature of tobacco-related disease incidence, the role of contributory factors such as dietary habits, exposure to other substances and the genetic composition of subpopulations most at risk. Various biochemical and molecular assays will need to be applied to screen nonsmoker and smoker populations for a variety of health risks. Analysis of the results from such studies will help identify the main interacting factors for various health risks and define relationships among various epidemiological parameters. It would appear necessary to assemble teams of multidisciplinary investigators to perform these coordinated human studies in the field and in the laboratory. By nature, such studies are expensive and will involve commitment of resources, time and substantial amounts of funds to obtain meaningful results. Given the limited resources and competing priorities for research funding, it is not easy to undertake such human studies. Hence, the experimental studies in animal models using inhalation exposure to whole smoke, and not individual constituents of smoke, is probably the next best approach for smoking and health programs.

The human epidemiological studies described in the present review have identified a number of genes that appear to have a distinct role in various tobacco-related diseases, and cancers in particular. Inability to control all the different variables in human studies has made it difficult to clearly define the contribution of various suspect genes in tobacco carcinogenesis. With the recent commercial availability of a variety of transgenic and knock-out animals for research, it would be most desirable, as a first step, to use these animals to establish experimental models of various tobacco-related diseases which can then be used for determining the contribution of different genes to disease processes and for elucidation of the mechanism(s) of disease development. Furthermore, these animal models can be used to identify various agents possessing protective and therapeutic potential.

Research efforts in the area of smoking and health would benefit by focusing on studies of the in vivo effects of inhaled whole cigarette smoke in animal models of known specific genetic composition. Selection of the genetic composition would also require a thorough consideration of the information available from human molecular epidemiological studies. As indicated earlier, there are a number of genes that clearly influence the development of smoke-related diseases. In this context, many relevant transgenic and knock-out animals that can be effectively used for the study of tobacco-related diseases are now becoming available.

Tobacco abuse is a major public health problem and includes secondhand smoke exposure. Continued efforts to control and eliminate this abuse are a medical necessity.

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Published: 24 March 2022

Tobacco and nicotine use

Bernard Le Foll 1 , 2 ,
Megan E. Piper 3 , 4 ,
Christie D. Fowler 5 ,
Serena Tonstad 6 ,
Laura Bierut 7 ,
Lin Lu ORCID: orcid.org/0000-0003-0742-9072 8 , 9 ,
Prabhat Jha 10 &
Wayne D. Hall 11 , 12

Nature Reviews Disease Primers volume 8 , Article number: 19 ( 2022 ) Cite this article

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Disease genetics
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Preventive medicine

Tobacco smoking is a major determinant of preventable morbidity and mortality worldwide. More than a billion people smoke, and without major increases in cessation, at least half will die prematurely from tobacco-related complications. In addition, people who smoke have a significant reduction in their quality of life. Neurobiological findings have identified the mechanisms by which nicotine in tobacco affects the brain reward system and causes addiction. These brain changes contribute to the maintenance of nicotine or tobacco use despite knowledge of its negative consequences, a hallmark of addiction. Effective approaches to screen, prevent and treat tobacco use can be widely implemented to limit tobacco’s effect on individuals and society. The effectiveness of psychosocial and pharmacological interventions in helping people quit smoking has been demonstrated. As the majority of people who smoke ultimately relapse, it is important to enhance the reach of available interventions and to continue to develop novel interventions. These efforts associated with innovative policy regulations (aimed at reducing nicotine content or eliminating tobacco products) have the potential to reduce the prevalence of tobacco and nicotine use and their enormous adverse impact on population health.

Associations between classic psychedelics and nicotine dependence in a nationally representative sample

Nicotine dependence and incident psychiatric disorders: prospective evidence from us national study, use of electronic cigarettes and heated tobacco products during the covid-19 pandemic, introduction.

Tobacco is the second most commonly used psychoactive substance worldwide, with more than one billion smokers globally 1 . Although smoking prevalence has reduced in many high-income countries (HICs), tobacco use is still very prevalent in low-income and middle-income countries (LMICs). The majority of smokers are addicted to nicotine delivered by cigarettes (defined as tobacco dependence in the International Classification of Diseases, Tenth Revision (ICD-10) or tobacco use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)). As a result of the neuro-adaptations and psychological mechanisms caused by repeated exposure to nicotine delivered rapidly by cigarettes, cessation can also lead to a well-characterized withdrawal syndrome, typically manifesting as irritability, anxiety, low mood, difficulty concentrating, increased appetite, insomnia and restlessness, that contributes to the difficulty in quitting tobacco use 2 , 3 , 4 .

Historically, tobacco was used in some cultures as part of traditional ceremonies, but its use was infrequent and not widely disseminated in the population. However, since the early twentieth century, the use of commercial cigarettes has increased dramatically 5 because of automated manufacturing practices that enable large-scale production of inexpensive products that are heavily promoted by media and advertising. Tobacco use became highly prevalent in the past century and was followed by substantial increases in the prevalence of tobacco-induced diseases decades later 5 . It took decades to establish the relationship between tobacco use and associated health effects 6 , 7 and to discover the addictive role of nicotine in maintaining tobacco smoking 8 , 9 , and also to educate people about these effects. It should be noted that the tobacco industry disputed this evidence to allow continuing tobacco sales 10 . The expansion of public health campaigns to reduce smoking has gradually decreased the use of tobacco in HICs, with marked increases in adult cessation, but less progress has been achieved in LMICs 1 .

Nicotine is the addictive compound in tobacco and is responsible for continued use of tobacco despite harms and a desire to quit, but nicotine is not directly responsible for the harmful effects of using tobacco products (Box 1 ). Other components in tobacco may modulate the addictive potential of tobacco (for example, flavours and non-nicotine compounds) 11 . The major harms related to tobacco use, which are well covered elsewhere 5 , are linked to a multitude of compounds present in tobacco smoke (such as carcinogens, toxicants, particulate matter and carbon monoxide). In adults, adverse health outcomes of tobacco use include cancer in virtually all peripheral organs exposed to tobacco smoke and chronic diseases such as eye disease, periodontal disease, cardiovascular diseases, chronic obstructive pulmonary disease, stroke, diabetes mellitus, rheumatoid arthritis and disorders affecting immune function 5 . Moreover, smoking during pregnancy can increase the risk of adverse reproductive effects, such as ectopic pregnancy, low birthweight and preterm birth 5 . Exposure to secondhand cigarette smoke in children has been linked to sudden infant death syndrome, impaired lung function and respiratory illnesses, in addition to cognitive and behavioural impairments 5 . The long-term developmental effects of nicotine are probably due to structural and functional changes in the brain during this early developmental period 12 , 13 .

Nicotine administered alone in various nicotine replacement formulations (such as patches, gum and lozenges) is safe and effective as an evidence-based smoking cessation aid. Novel forms of nicotine delivery systems have also emerged (called electronic nicotine delivery systems (ENDS) or e-cigarettes), which can potentially reduce the harmful effects of tobacco smoking for those who switch completely from combustible to e-cigarettes 14 , 15 .

This Primer focuses on the determinants of nicotine and tobacco use, and reviews the neurobiology of nicotine effects on the brain reward circuitry and the functioning of brain networks in ways that contribute to the difficulty in stopping smoking. This Primer also discusses how to prevent tobacco use, screen for smoking, and offer people who smoke tobacco psychosocial and pharmacological interventions to assist in quitting. Moreover, this Primer presents emerging pharmacological and novel brain interventions that could improve rates of successful smoking cessation, in addition to public health approaches that could be beneficial.

Box 1 Tobacco products

Conventional tobacco products include combustible products that produce inhaled smoke (most commonly cigarettes, bidis (small domestically manufactured cigarettes used in South Asia) or cigars) and those that deliver nicotine without using combustion (chewing or dipping tobacco and snuff). Newer alternative products that do not involve combustion include nicotine-containing e-cigarettes and heat-not-burn tobacco devices. Although non-combustion and alternative products may constitute a lesser risk than burned ones 14 , 15 , 194 , no form of tobacco is entirely risk-free.

Epidemiology

Prevalence and burden of disease.

The Global Burden of Disease Project (GBDP) estimated that around 1.14 billion people smoked in 2019, worldwide, increasing from just under a billion in 1990 (ref. 1 ). Of note, the prevalence of smoking decreased significantly between 1990 and 2019, but increases in the adult population meant that the total number of global smokers increased. One smoking-associated death occurs for approximately every 0.8–1.1 million cigarettes smoked 16 , suggesting that the estimated worldwide consumption of about 7.4 trillion cigarettes in 2019 has led to around 7 million deaths 1 .

In most populations, smoking prevalence is much higher among groups with lower levels of education or income 17 and among those with mental health disorders and other co-addictions 18 , 19 . Smoking is also more frequent among men than women (Figs 1 – 3 ). Sexual and/or gender minority individuals have disproportionately high rates of smoking and other addictions 17 , 20 . In addition, the prevalence of smoking varies substantially between regions and ethnicities; smoking rates are high in some regions of Asia, such as China and India, but are lower in North America and Australia. Of note, the prevalence of mental health disorders and other co-addictions is higher in individuals who smoke compared with non-smokers 18 , 19 , 21 . For example, the odds of smoking in people with any substance use disorder is more than five times higher than the odds in people without a substance use disorder 19 . Similarly, the odds of smoking in people with any psychiatric disorder is more than three times higher than the odds of smoking in those without a psychiatric diagnosis 22 . In a study in the USA, compared with a population of smokers with no psychiatric diagnosis, subjects with anxiety, depression and phobia showed an approximately twofold higher prevalence of smoking, and subjects with agoraphobia, mania or hypomania, psychosis and antisocial personality or conduct disorders showed at least a threefold higher prevalence of smoking 22 . Comorbid disorders are also associated with higher rates of smoking 22 , 23 .

a | Number of current male smokers aged 15 years or older per country expressed in millions. b | Former male smokers aged 45–59 years per country expressed in millions. c | Former male smokers aged 45–59 years per country expressed as the percentage of smokers who stopped. The data shown are for male smokers for the period 2015–2019 from countries with direct smoking surveys. The prevalence of smoking among males is less variable than among females. Data from ref. 1 .

a | Number of current female smokers aged 15 years or older per country expressed in millions. b | Former female smokers aged 45–59 years per country expressed in millions. c | Former female smokers aged 45–59 years per country expressed as the percentage of smokers who stopped. The data shown are for female smokers for the period 2015–2019 from countries with direct smoking surveys. The prevalence of smoking among females is much lower in East and South Asia than in Latin America or Eastern Europe. Data from ref. 1 .

a | Number of current male and female smokers aged 15 years or older per country expressed in millions. b | Former male and female smokers aged 45–59 years per country expressed in millions. c | Former male and female smokers aged 45–59 years per country expressed as the percentage of smokers who stopped. The data shown are for the period 2015–2019 from countries with direct smoking surveys. Cessation rates are higher in high-income countries, but also notably high in Brazil. Cessation is far less common in South and East Asia and Russia and other Eastern European countries, and also low in South Africa. Data from ref. 1 .

Age at onset

Most smokers start smoking during adolescence, with almost 90% of smokers beginning between 15 and 25 years of age 24 . The prevalence of tobacco smoking among youths substantially declined in multiple HICs between 1990 and 2019 (ref. 25 ). More recently, the widespread uptake of ENDS in some regions such as Canada and the USA has raised concerns about the long-term effects of prolonged nicotine use among adolescents, including the possible notion that ENDS will increase the use of combustible smoking products 25 , 26 (although some studies have not found much aggregate effect at the population level) 27 .

Smoking that commences in early adolescence or young adulthood and persists throughout life has a more severe effect on health than smoking that starts later in life and/or that is not persistent 16 , 28 , 29 . Over 640 million adults under 30 years of age smoke in 22 jurisdictions alone (including 27 countries in the European Union where central efforts to reduce tobacco dependence might be possible) 30 . In those younger than 30 years of age, at least 320 million smoking-related deaths will occur unless they quit smoking 31 . The actual number of smoking-related deaths might be greater than one in two, and perhaps as high as two in three, long-term smokers 5 , 16 , 29 , 32 , 33 . At least half of these deaths are likely to occur in middle age (30–69 years) 16 , 29 , leading to a loss of two or more decades of life. People who smoke can expect to lose an average of at least a decade of life versus otherwise similar non-smokers 16 , 28 , 29 .

Direct epidemiological studies in several countries paired with model-based estimates have estimated that smoking tobacco accounted for 7.7 million deaths globally in 2020, of which 80% were in men and 87% were current smokers 1 . In HICs, the major causes of tobacco deaths are lung cancer, emphysema, heart attack, stroke, cancer of the upper aerodigestive areas and bladder cancer 28 , 29 . In some lower income countries, tuberculosis is an additional important cause of tobacco-related death 29 , 34 , which could be related to, for example, increased prevalence of infection, more severe tuberculosis/mortality and higher prevalence of treatment-resistant tuberculosis in smokers than in non-smokers in low-income countries 35 , 36 .

Despite substantial reductions in the prevalence of smoking, there were 34 million smokers in the USA, 7 million in the UK and 5 million in Canada in 2017 (ref. 16 ), and cigarette smoking remains the largest cause of premature death before 70 years of age in much of Europe and North America 1 , 16 , 28 , 29 . Smoking-associated diseases accounted for around 41 million deaths in the USA, UK and Canada from 1960 to 2020 (ref. 16 ). Moreover, as smoking-associated diseases are more prevalent among groups with lower levels of education and income, smoking accounts for at least half of the difference in overall mortality between these social groups 37 . Any reduction in smoking prevalence reduces the absolute mortality gap between these groups 38 .

Smoking cessation has become common in HICs with good tobacco control interventions. For example, in France, the number of ex-smokers is four times the number of current smokers among those aged 50 years or more 30 . By contrast, smoking cessation in LMICs remains uncommon before smokers develop tobacco-related diseases 39 . Smoking cessation greatly reduces the risks of smoking-related diseases. Indeed, smokers who quit smoking before 40 years of age avoid nearly all the increased mortality risks 31 , 33 . Moreover, individuals who quit smoking by 50 years of age reduce the risk of death from lung cancer by about two-thirds 40 . More modest hazards persist for deaths from lung cancer and emphysema 16 , 28 ; however, the risks among former smokers are an order of magnitude lower than among those who continue to smoke 33 .

Mechanisms/pathophysiology

Nicotine is the main psychoactive agent in tobacco and e-cigarettes. Nicotine acts as an agonist at nicotinic acetylcholine receptors (nAChRs), which are localized throughout the brain and peripheral nervous system 41 . nAChRs are pentameric ion channels that consist of varying combinations of α 2 –α 7 and β 2 –β 4 subunits, and for which acetylcholine (ACh) is the endogenous ligand 42 , 43 , 44 . When activated by nicotine binding, nAChR undergoes a conformational change that opens the internal pore, allowing an influx of sodium and calcium ions 45 . At postsynaptic membranes, nAChR activation can lead to action potential firing and downstream modulation of gene expression through calcium-mediated second messenger systems 46 . nAChRs are also localized to presynaptic membranes, where they modulate neurotransmitter release 47 . nAChRs become desensitized after activation, during which ligand binding will not open the channel 45 .

nAChRs with varying combinations of α-subunits and β-subunits have differences in nicotine binding affinity, efficacy and desensitization rate, and have differential expression depending on the brain region and cell type 48 , 49 , 50 . For instance, at nicotine concentrations found in human smokers, β 2 -containing nAChRs desensitize relatively quickly after activation, whereas α 7 -containing nAChRs have a slower desensitization profile 48 . Chronic nicotine exposure in experimental animal models or in humans induces an increase in cortical expression of α 4 β 2 -containing nAChRs 51 , 52 , 53 , 54 , 55 , but also increases the expression of β 3 and β 4 nAChR subunits in the medial habenula (MHb)–interpeduncular nucleus (IPN) pathway 56 , 57 . It is clear that both the brain localization and the type of nAChR are critical elements in mediating the various effects of nicotine, but other factors such as rate of nicotine delivery may also modulate addictive effects of nicotine 58 .

Neurocircuitry of nicotine addiction

Nicotine has both rewarding effects (such as a ‘buzz’ or ‘high’) and aversive effects (such as nausea and dizziness), with the net outcome dependent on dose and others factors such as interindividual sensitivity and presence of tolerance 59 . Thus, the addictive properties of nicotine involve integration of contrasting signals from multiple brain regions that process reward and aversion (Fig. 4 ).

During initial use, nicotine exerts both reinforcing and aversive effects, which together determine the likelihood of continued use. As the individual transitions to more frequent patterns of chronic use, nicotine induces pharmacodynamic changes in brain circuits, which is thought to lead to a reduction in sensitivity to the aversive properties of the drug. Nicotine is also a powerful reinforcer that leads to the conditioning of secondary cues associated with the drug-taking experience (such as cigarette pack, sensory properties of cigarette smoke and feel of the cigarette in the hand or mouth), which serves to enhance the incentive salience of these environmental factors and drive further drug intake. When the individual enters into states of abstinence (such as daily during sleep at night or during quit attempts), withdrawal symptomology is experienced, which may include irritability, restlessness, learning or memory deficits, difficulty concentrating, anxiety and hunger. These negative affective and cognitive symptoms lead to an intensification of the individual’s preoccupation to obtain and use the tobacco/nicotine product, and subsequently such intense craving can lead to relapse.

The rewarding actions of nicotine have largely been attributed to the mesolimbic pathway, which consists of dopaminergic neurons in the ventral tegmental area (VTA) that project to the nucleus accumbens and prefrontal cortex 60 , 61 , 62 (Fig. 5 ). VTA integrating circuits and projection regions express several nAChR subtypes on dopaminergic, GABAergic, and glutamatergic neurons 63 , 64 . Ultimately, administration of nicotine increases dopamine levels through increased dopaminergic neuron firing in striatal and extrastriatal areas (such as the ventral pallidum) 65 (Fig. 6 ). This effect is involved in reward and is believed to be primarily mediated by the action of nicotine on α 4 -containing and β 2 -containing nAChRs in the VTA 66 , 67 .

Multiple lines of research have demonstrated that nicotine reinforcement is mainly controlled by two brain pathways, which relay predominantly reward-related or aversion-related signals. The rewarding properties of nicotine that promote drug intake involve the mesolimbic dopamine projection from the ventral tegmental area (VTA) to the nucleus accumbens (NAc). By contrast, the aversive properties of nicotine that limit drug intake and mitigate withdrawal symptoms involve the fasciculus retroflexus projection from the medial habenula (MHb) to the interpeduncular nucleus (IPN). Additional brain regions have also been implicated in various aspects of nicotine dependence, such as the prefrontal cortex (PFC), ventral pallidum (VP), nucleus tractus solitarius (NTS) and insula (not shown here for clarity). All of these brain regions are directly or indirectly interconnected as integrative circuits to drive drug-seeking and drug-taking behaviours.

Smokers received brain PET scans with [ 11 C]PHNO, a dopamine D 2/3 PET tracer that has high sensitivity in detecting fluctuations of dopamine. PET scans were performed during abstinence or after smoking a cigarette. Reduced binding potential (BP ND ) was observed after smoking, indicating increased dopamine levels in the ventral striatum and in the area that corresponds to the ventral pallidum. The images show clusters with statistically significant decreases of [ 11 C]PHNO BP ND after smoking a cigarette versus abstinence condition. Those clusters have been superimposed on structural T1 MRI images of the brain. Reprinted from ref. 65 , Springer Nature Limited.

The aversive properties of nicotine are mediated by neurons in the MHb, which project to the IPN. Studies in rodents using genetic knockdown and knockout strategies demonstrated that the α 5 -containing, α 3 -containing and β 4 -containing nAChRs in the MHb–IPN pathway mediate the aversive properties of nicotine that limit drug intake, especially when animals are given the opportunity to consume higher nicotine doses 68 , 69 , 70 , 71 , 72 . In addition to nAChRs, other signalling factors acting on the MHb terminals in the IPN also regulate the actions of nicotine. For instance, under conditions of chronic nicotine exposure or with optogenetic activation of IPN neurons, a subtype of IPN neurons co-expressing Chrna5 (encoding the α 5 nAChR subunit) and Amigo1 (encoding adhesion molecule with immunoglobulin-like domain 1) release nitric oxide from the cell body that retrogradely inhibits MHb axon terminals 70 . In addition, nicotine activates α 5 -containing nAChR-expressing neurons that project from the nucleus tractus solitarius to the IPN, leading to release of glucagon-like peptide-1 that binds to GLP receptors on habenular axon terminals, which subsequently increases IPN neuron activation and decreases nicotine self-administration 73 . Taken together, these findings suggest a dynamic signalling process at MHb axonal terminals in the IPN, which regulates the addictive properties of nicotine and determines the amount of nicotine that is self-administered.

Nicotine withdrawal in animal models can be assessed by examining somatic signs (such as shaking, scratching, head nods and chewing) and affective signs (such as increased anxiety-related behaviours and conditioned place aversion). Interestingly, few nicotine withdrawal somatic signs are found in mice with genetic knockout of the α 2 , α 5 or β 4 nAChR subunits 74 , 75 . By contrast, β 2 nAChR-knockout mice have fewer anxiety-related behaviours during nicotine withdrawal, with no differences in somatic symptoms compared with wild-type mice 74 , 76 .

In addition to the VTA (mediating reward) and the MHb–IPN pathway (mediating aversion), other brain areas are involved in nicotine addiction (Fig. 5 ). In animals, the insular cortex controls nicotine taking and nicotine seeking 77 . Moreover, humans with lesions of the insular cortex can quit smoking easily without relapse 78 . This finding led to the development of a novel therapeutic intervention modulating insula function (see Management, below) 79 , 80 . Various brain areas (shell of nucleus accumbens, basolateral amygdala and prelimbic cortex) expressing cannabinoid CB 1 receptors are also critical in controlling rewarding effects and relapse 81 , 82 . The α 1 -adrenergic receptor expressed in the cortex also control these effects, probably through glutamatergic afferents to the nucleus accumbens 83 .

Individual differences in nicotine addiction risk

Vulnerability to nicotine dependence varies between individuals, and the reasons for these differences are multidimensional. Many social factors (such as education level and income) play a role 84 . Broad psychological and social factors also modulate this risk. For example, peer smoking status, knowledge on effect of tobacco, expectation on social acceptance, exposure to passive smoking modulate the risk of initiating tobacco use 85 , 86 .

Genetic factors have a role in smoking initiation, the development of nicotine addiction and the likelihood of smoking cessation. Indeed, heritability has been estimated to contribute to approximatively half of the variability in nicotine dependence 87 , 88 , 89 , 90 . Important advances in our understanding of such genetic contributions have evolved with large-scale genome-wide association studies of smokers and non-smokers. One of the most striking findings has been that allelic variation in the CHRNA5 – CHRNA3 – CHRNB4 gene cluster, which encodes α 5 , α 3 and β 4 nAChR subunits, correlates with an increased vulnerability for nicotine addiction, indicated by a higher likelihood of becoming dependent on nicotine and smoking a greater number of cigarettes per day 91 , 92 , 93 , 94 , 95 . The most significant effect has been found for a single-nucleotide polymorphism in CHRNA5 (rs16969968), which results in an amino acid change and reduced function of α 5 -containing nAChRs 92 .

Allelic variation in CYP2A6 (encoding the CYP2A6 enzyme, which metabolizes nicotine) has also been associated with differential vulnerability to nicotine dependence 96 , 97 , 98 . CYP2A6 is highly polymorphic, resulting in variable enzymatic activity 96 , 99 , 100 . Individuals with allelic variation that results in slow nicotine metabolism consume less nicotine per day, experience less-severe withdrawal symptoms and are more successful at quitting smoking than individuals with normal or fast metabolism 101 , 102 , 103 , 104 . Moreover, individuals with slow nicotine metabolism have lower dopaminergic receptor expression in the dopamine D2 regions of the associative striatum and sensorimotor striatum in PET studies 105 and take fewer puffs of nicotine-containing cigarettes (compared with de-nicotinized cigarettes) in a forced choice task 106 . Slower nicotine metabolism is thought to increase the duration of action of nicotine, allowing nicotine levels to accumulate over time, therefore enabling lower levels of intake to sustain activation of nAChRs 107 .

Large-scale genetic studies have identified hundreds of other genetic loci that influence smoking initiation, age of smoking initiation, cigarettes smoked per day and successful smoking cessation 108 . The strongest genetic contributions to smoking through the nicotinic receptors and nicotine metabolism are among the strongest genetic contributors to lung cancer 109 . Other genetic variations (such as those related to cannabinoid, dopamine receptors or other neurotransmitters) may affect certain phenotypes related to smoking (such as nicotine preference and cue-reactivity) 110 , 111 , 112 , 113 , 114 , 115 .

Diagnosis, screening and prevention

Screening for cigarette smoking.

Screening for cigarette smoking should happen at every doctor’s visit 116 . In this regard, a simple and direct question about a person’s tobacco use can provide an opportunity to offer information about its potential risks and treatments to assist in quitting. All smokers should be offered assistance in quitting because even low levels of smoking present a significant health risk 33 , 117 , 118 . Smoking status can be assessed by self-categorization or self-reported assessment of smoking behaviour (Table 1 ). In people who smoke, smoking frequency can be assessed 119 and a combined quantity frequency measure such as pack-year history (that is, average number of cigarettes smoked per day multiplied by the number of years, divided by 20), can be used to estimate cumulative risk of adverse health outcomes. The Association for the Treatment of Tobacco Use and Dependence recommends that all electronic health records should document smoking status using the self-report categories listed in Table 1 .

Owing to the advent of e-cigarettes and heat-not-burn products, and the popularity of little cigars in the US that mimic combustible cigarettes, people who use tobacco may use multiple products concurrently 120 , 121 . Thus, screening for other nicotine and tobacco product use is important in clinical practice. The self-categorization approach can also be used to describe the use of these other products.

Traditionally tobacco use has been classified according to whether the smoker meets criteria for nicotine dependence in one of the two main diagnostic classifications: the DSM 122 (tobacco use disorder) and the ICD (tobacco dependence) 123 . The diagnosis of tobacco use disorder according to DSM-5 criteria requires the presence of at least 2 of 11 symptoms that have produced marked clinical impairment or distress within a 12-month period (Box 2 ). Of note, these symptoms are similar for all substance use disorder diagnoses and may not all be relevant to tobacco use disorder (such as failure to complete life roles). In the ICD-10, codes allow the identification of specific tobacco products used (cigarettes, chewing tobacco and other tobacco products).

Dependence can also be assessed as a continuous construct associated with higher levels of use, greater withdrawal and reduced likelihood of quitting. The level of dependence can be assessed with the Fagerström Test for Nicotine Dependence, a short questionnaire comprising six questions 124 (Box 2 ). A score of ≥4 indicates moderate to high dependence. As very limited time may be available in clinical consultations, the Heaviness of Smoking Index (HSI) was developed, which comprises two questions on the number of cigarettes smoked per day and how soon after waking the first cigarette is smoked 125 . The HSI can guide dosing for nicotine replacement therapy (NRT).

Other measures of cigarette dependence have been developed but are not used in the clinical setting, such as the Cigarette Dependence Scale 126 , Hooked on Nicotine Checklist 127 , Nicotine Dependence Syndrome Scale 128 , the Wisconsin Inventory of Smoking Dependence Motives (Brief) 129 and the Penn State Cigarette Dependence Index 130 . However, in practice, these are not often used, as the most important aspect is to screen for smoking and encourage all smokers to quit smoking regardless of their dependence status.

Box 2 DSM-5 criteria for tobacco use disorder and items of the Fagerström Test for nicotine dependence

DSM-5 (ref. 122 )

Taxonomic and diagnostic tool for tobacco use disorder published by the American Psychiatric Association.

A problematic pattern of tobacco use leading to clinically significant impairment or distress as manifested by at least two of the following, occurring within a 12-month period.

Tobacco often used in larger amounts or over a longer period of time than intended

A persistent desire or unsuccessful efforts to reduce or control tobacco use

A great deal of time spent in activities necessary to obtain or use tobacco

Craving, or a strong desire or urge to use tobacco

Recurrent tobacco use resulting in a failure to fulfil major role obligations at work, school or home

Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco (for example, arguments with others about tobacco use)

Important social, occupational or recreational activities given up or reduced because of tobacco use

Recurrent tobacco use in hazardous situations (such as smoking in bed)

Tobacco use continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco use

Tolerance, defined by either of the following.

A need for markedly increased amounts of tobacco to achieve the desired effect

A markedly diminished effect with continued use of the same amount of tobacco

Withdrawal, manifesting as either of the following.

Withdrawal syndrome for tobacco

Tobacco (or a closely related substance, such as nicotine) taken to relieve or avoid withdrawal symptoms

Fagerström Test for Nicotine Dependence 124

A standard instrument for assessing the intensity of physical addiction to nicotine.

How soon after you wake up do you smoke your first cigarette?

Within 5 min (scores 3 points)

5 to 30 min (scores 2 points)

31 to 60 min (scores 1 point)

After 60 min (scores 0 points)

Do you find it difficult not to smoke in places where you should not, such as in church or school, in a movie, at the library, on a bus, in court or in a hospital?

Yes (scores 1 point)

No (scores 0 points)

Which cigarette would you most hate to give up; which cigarette do you treasure the most?

The first one in the morning (scores 1 point)

Any other one (scores 0 points)

How many cigarettes do you smoke each day?

10 or fewer (scores 0 points)

11 to 20 (scores 1 point)

21 to 30 (scores 2 points)

31 or more (scores 3 points)

Do you smoke more during the first few hours after waking up than during the rest of the day?

Do you still smoke if you are so sick that you are in bed most of the day or if you have a cold or the flu and have trouble breathing?

A score of 7–10 points is classified as highly dependent; 4–6 points is classified as moderately dependent; <4 points is classified as minimally dependent.

DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Young people who do not start smoking cigarettes between 15 and 25 years of age have a very low risk of ever smoking 24 , 131 , 132 . This age group provides a critical opportunity to prevent cigarette smoking using effective, evidence-based strategies to prevent smoking initiation and reduce escalation from experimentation to regular use 131 , 132 , 133 , 134 , 135 .

Effective prevention of cigarette uptake requires a comprehensive package of cost-effective policies 134 , 136 , 137 to synergistically reduce the population prevalence of cigarette smoking 131 , 135 . These policies include high rates of tobacco taxation 30 , 134 , 137 , 138 , widespread and rigorously enforced smoke-free policies 139 , bans on tobacco advertising and promotions 140 , use of plain packaging and graphic warnings about the health risks of smoking 135 , 141 , mass media and peer-based education programmes to discourage smoking, and enforcement of laws against the sale of cigarettes to young people below the minimum legal purchase age 131 , 135 . These policies make cigarettes less available and affordable to young people. Moreover, these policies make it more difficult for young people to purchase cigarettes and make smoking a much less socially acceptable practice. Of note, these policies are typically mostly enacted in HICs, which may be related to the declining prevalence of smoking in these countries, compared with the prevalence in LMICs.

Pharmacotherapy

Three evidence-based classes of pharmacotherapy are available for smoking cessation: NRT (using nicotine-based patches, gum, lozenges, mini-lozenges, nasal sprays and inhalers), varenicline (a nAChR partial agonist), and bupropion (a noradrenaline/dopamine reuptake inhibitor that also inhibits nAChR function and is also used as an antidepressant). These FDA-approved and EMA-approved pharmacotherapies are cost-effective smoking cessation treatments that double or triple successful abstinence rates compared with no treatment or placebo controls 116 , 142 .

Combinations of pharmacotherapies are also effective for smoking cessation 116 , 142 . For example, combining NRTs (such as the steady-state nicotine patch and as-needed NRT such as gum or mini-lozenge) is more effective than a single form of NRT 116 , 142 , 143 . Combining NRT and varenicline is the most effective smoking cessation pharmacotherapy 116 , 142 , 143 . Combining FDA-approved pharmacotherapy with behavioural counselling further increases the likelihood of successful cessation 142 . Second-line pharmacotherapies (for example, nortriptyline) have some potential for smoking cessation, but their use is limited due to their tolerability profile.

All smokers should receive pharmacotherapy to help them quit smoking, except those in whom pharmacotherapy has insufficient evidence of effectiveness (among adolescents, smokeless tobacco users, pregnant women or light smokers) or those in whom pharmacotherapy is medically contraindicated 144 . Table 2 provides specific information regarding dosing and duration for each FDA-approved pharmacotherapy. Extended use of pharmacotherapy beyond the standard 12-week regimen after cessation is effective and should be considered 116 . Moreover, preloading pharmacotherapy (that is, initiating cessation medication in advance of a quit attempt), especially with the nicotine patch, is a promising treatment, although further studies are required to confirm efficacy.

Cytisine has been used for smoking cessation in Eastern Europe for a long time and is available in some countries (such as Canada) without prescription 145 . Cytisine is a partial agonist of nAChRs and its structure was the precursor for the development of varenicline 145 . Cytisine is at least as effective as some approved pharmacotherapies for smoking cessation, such as NRT 146 , 147 , 148 , and the role of cytisine in smoking cessation is likely to expand in the future, notably owing to its much lower cost than traditional pharmacotherapies. E-cigarettes also have the potential to be useful as smoking cessation devices 149 , 150 . The 2020 US Surgeon General’s Report concluded that there was insufficient evidence to promote cytisine or e-cigarettes as effective smoking cessation treatments, but in the UK its use is recommended for smoking cessation (see ref. 15 for regularly updated review).

Counselling and behavioural treatments

Psychosocial counselling significantly increases the likelihood of successful cessation, especially when combined with pharmacotherapy. Even a counselling session lasting only 3 minutes can help smokers quit 116 , although the 2008 US Public Health Service guidelines and the Preventive Services Task Force 151 each concluded that more intensive counselling (≥20 min per session) is more effective than less intensive counselling (<20 min per session). Higher smoking cessation rates are obtained by using behavioural change techniques that target associative and self-regulatory processes 152 . In addition, behavioural change techniques that will favour commitment, social reward and identity associated with changed behaviour seems associated with higher success rates 152 . Evidence-based counselling focuses on providing social support during treatment, building skills to cope with withdrawal and cessation, and problem-solving in challenging situations 116 , 153 . Effective counselling can be delivered by diverse providers (such as physicians, nurses, pharmacists, social workers, psychologists and certified tobacco treatment specialists) 116 .

Counselling can be delivered in a variety of modalities. In-person individual and group counselling are effective, as is telephone counselling (quit lines) 142 . Internet and text-based intervention seem to be effective in smoking cessation, especially when they are interactive and tailored to a smoker’s specific circumstances 142 . Over the past several years, the number of smoking cessation smartphone apps has increased, but there the evidence that the use of these apps significantly increases smoking cessation rates is not sufficient.

Contingency management (providing financial incentives for abstinence or engagement in treatment) has shown promising results 154 , 155 but its effects are not sustained once the contingencies are removed 155 , 156 . Other treatments such as hypnosis, acupuncture and laser treatment have not been shown to improve smoking cessation rates compared with placebo treatments 116 . Moreover, no solid evidence supports the use of conventional transcranial magnetic stimulation (TMS) for long-term smoking cessation 157 , 158 .

Although a variety of empirically supported smoking cessation interventions are available, more than two-thirds of adult smokers who made quit attempts in the USA during the past year did not use an evidence-based treatment and the rate is likely to be lower in many other countries 142 . This speaks to the need to increase awareness of, and access to, effective cessation aids among all smokers.

Brain stimulation

The insula (part of the frontal cortex) is a critical brain structure involved in cigarette craving and relapse 78 , 79 . The activity of the insula can be modulated using an innovative approach called deep insula/prefrontal cortex TMS (deep TMS), which is effective in helping people quit smoking 80 , 159 . This approach has now been approved by the FDA as an effective smoking cessation intervention 80 . However, although this intervention was developed and is effective for smoking cessation, the number of people with access to it is limited owing to the limited number of sites equipped and with trained personnel, and the cost of this intervention.

Quality of life

Generic instruments (such as the Short-Form (SF-36) Health Survey) can be used to evaluate quality of life (QOL) in smokers. People who smoke rate their QOL lower than people who do not smoke both before and after they become smokers 160 , 161 . QOL improves when smokers quit 162 . Mental health may also improve on quitting smoking 163 . Moreover, QOL is much poorer in smokers with tobacco-related diseases, such as chronic respiratory diseases and cancers, than in individuals without tobacco-related diseases 161 , 164 . The dimensions of QOL that show the largest decrements in people who smoke are those related to physical health, day-to-day activities and mental health such as depression 160 . Smoking also increases the risk of diabetes mellitus 165 , 166 , which is a major determinant of poor QOL for a wide range of conditions.

The high toll of premature death from cigarette smoking can obscure the fact that many of the diseases that cause these deaths also produce substantial disability in the years before death 1 . Indeed, death in smokers is typically preceded by several years of living with the serious disability and impairment of everyday activities caused by chronic respiratory disease, heart disease and cancer 2 . Smokers’ QOL in these years may also be adversely affected by the adverse effects of the medical treatments that they receive for these smoking-related diseases (such as major surgery and radiotherapy).

Expanding cessation worldwide

The major global challenge is to consider individual and population-based strategies that could increase the substantially low rates of adult cessation in most LMICs and indeed strategies to ensure that even in HICs, cessation continues to increase. In general, the most effective tools recommended by WHO to expand cessation are the same tools that can prevent smoking initiation, notably higher tobacco taxes, bans on advertising and promotion, prominent warning labels or plain packaging, bans on public smoking, and mass media and educational efforts 29 , 167 . The effective use of these policies, particularly taxation, lags behind in most LMICs compared with most HICs, with important exceptions such as Brazil 167 . Access to effective pharmacotherapies and counselling as well as support for co-existing mental health conditions would also be required to accelerate cessation in LMICs. This is particularly important as smokers living in LMICs often have no access to the full range of effective treatment options.

Regulating access to e-cigarettes

How e-cigarettes should be used is debated within the tobacco control field. In some countries (for example, the UK), the use of e-cigarettes as a cigarette smoking cessation aid and as a harm reduction strategy is supported, based on the idea that e-cigarette use will lead to much less exposure to toxic compounds than tobacco use, therefore reducing global harm. In other countries (for example, the USA), there is more concern with preventing the increased use of e-cigarettes by youths that may subsequently lead to smoking 25 , 26 . Regulating e-cigarettes in nuanced ways that enable smokers to access those products whilst preventing their uptake among youths is critical.

Regulating nicotine content in tobacco products

Reducing the nicotine content of cigarettes could potentially produce less addictive products that would allow a gradual reduction in the population prevalence of smoking. Some clinical studies have found no compensatory increase in smoking whilst providing access to low nicotine tobacco 168 . Future regulation may be implemented to gradually decrease the nicotine content of combustible tobacco and other nicotine products 169 , 170 , 171 .

Tobacco end games

Some individuals have proposed getting rid of commercial tobacco products this century or using the major economic disruption arising from the COVID-19 pandemic to accelerate the demise of the tobacco industry 172 , 173 . Some tobacco producers have even proposed this strategy as an internal goal, with the idea of switching to nicotine delivery systems that are less harmful ( Philip Morris International ). Some countries are moving towards such an objective; for example, in New Zealand, the goal that fewer than 5% of New Zealanders will be smokers in 2025 has been set (ref. 174 ). The tobacco end-game approach would overall be the best approach to reduce the burden of tobacco use on society, but it would require coordination of multiple countries and strong public and private consensus on the strategy to avoid a major expansion of the existing illicit market in tobacco products in some countries.

Innovative interventions

The COVID-19 pandemic has shown that large-scale investment in research can lead to rapid development of successful therapeutic interventions. By contrast, smoking cessation has been underfunded compared with the contribution that it makes to the global burden of disease. In addition, there is limited coordination between research teams and most studies are small-scale and often underpowered 79 . It is time to fund an ambitious, coordinated programme of research to test the most promising therapies based on an increased understanding of the neurobiological basis of smoking and nicotine addiction (Table 3 ). Many of those ideas have not yet been tested properly and this could be carried out by a coordinated programme of research at the international level.

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Acknowledgements

B.Le F. is supported by a clinician-scientist award from the Department of Family and Community Medicine at the University of Toronto and the Addiction Psychiatry Chair from the University of Toronto. The funding bodies had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. The authors thank H. Fu (University of Toronto) for assistance with Figs 1–3.

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Bernard Le Foll

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Department of Medicine, University of Wisconsin, Madison, WI, USA

Megan E. Piper

University of Wisconsin Center for Tobacco Research and Intervention, Madison, WI, USA

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Christie D. Fowler

Section for Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway

Serena Tonstad

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Laura Bierut

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Introduction (B.Le F.); Epidemiology (P.J. and W.D.H.); Mechanisms/pathophysiology (C.D.F., L.B., L.L. and B.Le F.); Diagnosis, screening and prevention (P.J., M.E.P., S.T. and B.Le F.); Management (M.E.P., S.T., W.D.H., L.L. and B.Le F.); Quality of life (P.J. and W.D.H.); Outlook (all); Conclusions (all). All authors contributed substantially to the review and editing of the manuscript.

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Correspondence to Bernard Le Foll .

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B.Le F. has obtained funding from Pfizer (GRAND Awards, including salary support) for investigator-initiated projects. B.Le F. has received some in-kind donations of cannabis product from Aurora and medication donation from Pfizer and Bioprojet and was provided a coil for TMS study from Brainsway. B.Le F. has obtained industry funding from Canopy (through research grants handled by CAMH or the University of Toronto), Bioprojet, ACS, Indivior and Alkermes. B.Le F. has received in-kind donations of nabiximols from GW Pharma for past studies funded by CIHR and NIH. B.Le F. has been an advisor to Shinoghi. S.T. has received honoraria from Pfizer the manufacturer of varenicline for lectures and advice. All other authors declare no competing interests.

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Le Foll, B., Piper, M.E., Fowler, C.D. et al. Tobacco and nicotine use. Nat Rev Dis Primers 8 , 19 (2022). https://doi.org/10.1038/s41572-022-00346-w

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Youth and Tobacco Use

Smoking Cessation: Fast Facts
Economic Trends in Tobacco
State and Community Work
National and State Tobacco Control Program

What to know

Youth use of tobacco products in any form is unsafe.

Preventing tobacco product use among youth is critical to reducing tobacco use into adulthood.
Review the data about young tobacco use by product type.

Teacher speaking to high school students.

Preventing tobacco product use among youth is critical to reducing tobacco use among the nation's youth.

Tobacco product use is started and established primarily during adolescence. 1 2
Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18.
In 2021, 80.2% of high school students and 74.6% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. 5
In 2023, 90.3% of high school students and 87.1% of middle school students who used e-cigarettes in the past 30 days reported using a flavored e-cigarette during that time. 6

Estimates of current tobacco use among youth

Current Tobacco Use among U.S. High School Students. Any tobacco product 12.6%, E-cigarettes 10%, Cigarettes 1.9%, Cigars 1.8%, Nicotine pouches 1.7%, Smokeless tobacco 1.5%, Other oral nicotine products 1.2%, Hookah 1.1%, Heated tobacco products 1%, Pipes 0.6%

Electronic cigarettes (E-cigarettes)

E-cigarettes have been the most commonly used tobacco product among youth since 2014.
In 2023, about 1 out of every 22 middle school students (4.6%) reported that they had used electronic cigarettes in the past 30 days. 6
In 2023, 1 of every 10 high school students (10.0%) reported that they had used electronic cigarettes in the past 30 days. 6
In 2023, about 1 of every 100 middle school students (1.1%) reported that they had smoked cigarettes in the past 30 days. 6
In 2023, nearly 2 of every 100 high school students (1.9%) reported that they had smoked cigarettes in the past 30 days. 6
In 2023, nearly 1 of every 100 middle school students (1.1%) reported that they had smoked cigars in the past 30 days. 6
In 2023, nearly 2 of every 100 high school students (1.8%) reported that they had smoked cigars in the past 30 days. 6

Smokeless tobacco

In 2023, nearly 1 of every 100 middle school students (0.7%) reported that they had had used smokeless tobacco in the past 30 days. 6
In 2023, nearly 2 of every 100 high school students (1.5%) reported that they had had used smokeless tobacco in the past 30 days. 6
In 2023, less than 1 of every 100 middle school students (1.0%) reported that they had smoked hookah in the past 30 days. 6
In 2023, about 1 of every 100 high school students (1.1%) reported that they had smoked hookah in the past 30 days. 6

Heated tobacco products

In 2023, less than 1 of every 100 middle school students (0.8%) and about 1 of every 100 high school students (1.0%) reported using heated tobacco products in the past 30 days. 6
Heated tobacco products, also known as "heat-not-burn" products, deliver nicotine to the user by heating tobacco leaves rather than a nicotine-containing liquid like e-cigarettes.

Nicotine pouches

In 2023, about 1 of every 100 high school students (1.7%) reported using nicotine pouches in the past 30 days. 6
Nicotine pouches are microfiber pouches with flavored nicotine powder that users dissolve in the mouth without spitting. Sales of nicotine pouches have increased rapidly in the U.S. 7

All tobacco product use

In 2023, more than 6 of every 100 middle school students (6.6%) and about 1 of every 8 high school students (12.6%) reported current use of a tobacco product. 6
In 2023, nearly 15 of every 100 middle school students (14.7%) and nearly 28 of every 100 high school students (27.9%) said they had ever tried a tobacco product. 6

Many young people use multiple tobacco products.

In 2023, more than 2 of every 100 middle school students (2.5%) and about 1 of every 30 high school students (3.9%) reported current use of multiple tobacco products in the past 30 days. 6
In 2023, about 6 of every 100 middle school students (6.1%) and more than 12 of every 100 high school students (12.7%) reported they had ever tried multiple tobacco products. 6

Current Tobacco Product Use* Among High School Students in 2023 6

Tobacco Product	Overall	Girls	Boys
Any tobacco product	12.6%	14.1%	11.2%
Electronic cigarettes	10.0%	12.2%	8.0%
Cigarettes	1.9%	1.5%	2.3%
Cigars	1.8%	1.4%	2.3%
Smokeless tobacco	1.5%	—	2.1%
Hookah	1.1%	1.4%	0.9%
Nicotine Pouches	1.7%	—	2.6%
Heated tobacco products	1.0%	0.7%	1.4%
Pipe tobacco	0.6%	0.5%	0.7%

* "Current use" is determined by respondents indicating that they have used a tobacco product on at least 1 day during the past 30 days.

† In 2023, any tobacco product included e-cigarettes, cigarettes, cigars, smokeless tobacco (composite), pipe tobacco, bidis (small brown cigarettes wrapped in a leaf), hookahs, heated tobacco products, nicotine pouches, and other oral nicotine products.

Current Tobacco Product Use* Among Middle School Students in 2023 6

Tobacco Product	Overall	Girls	Boys
Any tobacco product	6.6%	7.5%	5.7%
Electronic cigarettes	4.6%	5.6%	3.5%
Cigarettes	1.1%	1.1%	—
Cigars	1.1%	1.2%	1.0%
Smokeless tobacco	0.7%	0.6%	—
Hookah	1.0%	—	0.8%
Nicotine Pouches	—	—	—
Heated tobacco products	0.8%	0.8%	—
Pipe tobacco	0.4%	—	—

Factors associated with youth tobacco product use

Factors associated with youth tobacco product use include the following:

The way mass media show tobacco product use as a normal activity can make young people want to try these products.
Youth are more likely to use tobacco products if they see people their age using these products.
High school athletes are more likely to use smokeless tobacco than those of the same age who are not athletes. 9
Young people may be more likely to use tobacco products if a parent uses these products.
There is evidence that youth may be sensitive to nicotine and that teens can feel dependent on nicotine sooner than adults.
Genetic factors may make quitting smoking harder for young people.
Smoking during pregnancy may increase the likelihood that the child will smoke cigarettes regularly in the future.
Mental health: There is a strong relationship between youth smoking and depression, anxiety, and stress. 2
Personal views: When young people expect positive things from smoking, such as coping with stress better or losing weight, they are more likely to smoke. 2 8
Lower socioeconomic status, including lower income or education
Not knowing how to say "no" to tobacco product use
Lack of support or involvement from parents
Accessibility, availability, and price of tobacco products
Doing poorly in school
Low self-image or self-esteem
Seeing tobacco product advertising in stores, on television, the Internet, in movies, or in magazines and newspapers

Reducing youth tobacco product use

National, state, and local program activities have been shown to reduce and prevent youth tobacco product use when implemented together. 2 10 11 These activities include:

Enacting higher costs for tobacco products (for example, through increased taxes) 2 11
Prohibiting smoking in indoor areas of workplaces and public places 2 11
Raising the minimum age of sale for tobacco products to 21 years 2 10
Using TV and radio commercials, posters, and other media messages aimed at kids and teens in order to counter tobacco product ads 2 11
Engaging community programs and school and college policies that encourage tobacco-free places and lifestyles 2 10
Developing community programs that lower tobacco advertising, promotions, and help make tobacco products less easily available 2 11

Some social and environmental factors are related to lower smoking levels among youth. Among these are: 2

Being part of a religious group or tradition
Racial/ethnic pride and strong racial identity
Higher academic achievement

It is important to keep working to prevent and reduce the use of all forms of tobacco product use among youth.

Corey CG, Ambrose BK, Apelberg BJ, King BA. Flavored tobacco product use among middle and high school students — United States, 2014 . MMWR Morb Mortal Wkly Rep 2015;64(38):1066–1070. / U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General . Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2014.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General . Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2012.
Corey CG, Ambrose BK, Apelberg BJ, King BA. Flavored tobacco product use among middle and high school students — United States, 2014 . MMWR Morb Mortal Wkly Rep 2015;64(38):1066–1070.
Wang TW, Gentzke AS, Neff LJ, et al. Characteristics of e-cigarette use behaviors among US Youth, 2020 . JAMA Netw Open . 2021;4(6):e2111336.
Gentzke AS, Wang TW, Cornelius M, et al. Tobacco product use and associated factors among middle and high school students — National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep. 2022; 71(No. SS-5):1–29.
Birdsey J, Cornelius M, Jamal A, et al. Tobacco product use among U.S. middle and high school students — National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep. 2023; 72(44);1173–1182.
Gentzke AS, Wang TW, Jamal A, et al. Tobacco product use among middle and high school students — United States, 2020 . MMWR Morb Mortal Wkly Rep. 2020;69(50);1881–1888.
U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General . Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2000.
Agaku IT, Singh T, Jones SE, et al. Combustible and smokeless tobacco use among high school athletes — United States, 2001–2013 . MMWR Morb Mortal Wkly Rep. 2015;64(34):935–939.
Gentzke AS, Glover-Kudon R, Tynan M, Jamal A. Adults' attitudes toward raising the minimum age of sale for tobacco products to 21 years, United States, 2014-2017 . Prev Med . 2020;133:106012. Epub ahead of print.
Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014 . U.S. Dept of Health and Human Services; 2014.
Substance Abuse and Mental Health Services Administration. 2018 National Survey on Drug Use and Health: Detailed Tables . Substance Abuse and Mental Health Data Archive. Accessed Dec 4, 2019. https://www.samhsa.gov/data/report/2018-nsduh-annual-national-report
Marynak KL, Wang X, Borowiecki M, et al. Nicotine pouch unit sales in the US, 2016-2020. JAMA . 2021;326(6):566–568.

Smoking and Tobacco Use

Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States.

For Everyone

Health care providers, public health.

Home — Essay Samples — Nursing & Health — Smoking — The Effects Of Smoking On Health

The Effects of Smoking on Health

Categories: Smoking Tobacco

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Published: Mar 1, 2019

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235 Smoking Essay Topics & Examples

Looking for smoking essay topics? Being one of the most serious psychological and social issues, smoking is definitely worth writing about.

🏆 Best Smoking Essay Examples & Topic Ideas

🥇 good titles for smoking essay, 👍 best titles for research paper about smoking, ⭐ simple & easy health essay titles, 💡 interesting topics to write about health, ❓ essay questions about smoking.

In your essay about smoking, you might want to focus on its causes and effects or discuss why smoking is a dangerous habit. Other options are to talk about smoking prevention or to concentrate on the reasons why it is so difficult to stop smoking. Here we’ve gathered a range of catchy titles for research papers about smoking together with smoking essay examples. Get inspired with us!

Smoking is a well-known source of harm yet popular regardless, and so smoking essays should cover various aspects of the topic to identify the reasons behind the trend.

You will want to discuss the causes and effects of smoking and how they contributed to the persistent refusal of large parts of the population to abandon the habit, even if they are aware of the dangers of cigarettes. You should provide examples of how one may become addicted to tobacco and give the rationales for smokers.

You should also discuss the various consequences of cigarette use, such as lung cancer, and identify their relationship with the habit. By discussing both sides of the issue, you will be able to write an excellent essay.

Reasons why one may begin smoking, are among the most prominent smoking essay topics. It is not easy to begin to enjoy the habit, as the act of smoke inhalation can be difficult to control due to a lack of experience and unfamiliarity with the concept.

As such, people have to be convinced that the habit deserves consideration by various ideas or influences. The notion that “smoking is cool” among teenagers can contribute to the adoption of the trait, as can peer pressure.

If you can find polls and statistics on the primary factors that lead people to tweet, they will be helpful to your point. Factual data will identify the importance of each cause clearly, although you should be careful about bias.

The harmful effects of tobacco have been researched considerably more, with a large body of medical studies investigating the issue available to anyone.

Lung cancer is the foremost issue in the public mind because of the general worry associated with the condition and its often incurable nature, but smoking can lead to other severe illnesses.

Heart conditions remain a prominent consideration due to their lethal effects, and strokes or asthma deserve significant consideration, as well. Overall, smoking has few to no beneficial health effects but puts the user at risk of a variety of concerns.

As such, people should eventually quit once their health declines, but their refusal to do so deserves a separate investigation and can provide many interesting smoking essay titles.

One of the most prominent reasons why a person would continue smoking despite all the evidence of its dangers and the informational campaigns carried out to inform consumers is nicotine addiction.

The substance is capable of causing dependency, a trait that has led to numerous discussions of the lawfulness of the current state of cigarettes.

It is also among the most dangerous aspects of smoking, a fact you should mention.

Lastly, you can discuss the topics of alternatives to smoking in your smoking essay bodies, such as e-cigarettes, hookahs, and vapes, all of which still contain nicotine and can, therefore, lead to considerable harm. You may also want to discuss safe cigarette avoidance options and their issues.

Here are some additional tips for your essay:

Dependency is not the sole factor in cigarette consumption, and many make the choice that you should respect consciously.
Cite the latest medical research titles, as some past claims have been debunked and are no longer valid.
Mortality is not the sole indicator of the issues associated with smoking, and you should take chronic conditions into consideration.

Find smoking essay samples and other useful paper samples on IvyPanda, where we have a collection of professionally written materials!

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Health Campaign: Smoking in the USA and How to Reduce It That is why, the government is oriented to complete such objectives associated with the tobacco use within the nation as the reduction of tobacco use by adults and adolescents, reduction of initiation of tobacco use […]
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Enforcement of Michigan’s Non-Smoking Law This paper is aimed at identifying a plan and strategy for the enforcement of the Michigan non-smoking law that has recently been signed by the governor of this state.
Smoking Cessation for Patients With Cardio Disorders It highlights the key role of nurses in the success of such programs and the importance of their awareness and initiative in determining prognosis.
Legalizing Electronic Vaping as the Means of Curbing the Rates of Smoking However, due to significantly less harmful effects that vaping produces on health and physical development, I can be considered a legitimate solution to reducing the levels of smoking, which is why it needs to be […]
Inequality and Discrimination: Impact on LGBTQ+ High School Students Consequently, the inequality and discrimination against LGBTQ + students in high school harm their mental, emotional, and physical health due to the high level of stress and abuse of various substances that it causes.
Self-Efficacy and Smoking Urges in Homeless Individuals Pinsker et al.point out that the levels of self-efficacy and the severity of smoking urges change significantly during the smoking cessation treatment.
“Cigarette Smoking: An Overview” by Ellen Bailey and Nancy Sprague The authors of the article mentioned above have presented a fair argument about the effects of cigarette smoking and debate on banning the production and use of tobacco in America.
“The Smoking Plant” Project: Artist Statement It is the case when the art is used to pass the important message to the observer. The live cigarette may symbolize the smokers while the plant is used to denote those who do not […]
Dangers of Smoking While Pregnant In this respect, T-test results show that mean birthweight of baby of the non-smoking mother is 3647 grams, while the birthweight of smoking mother is 3373 grams. Results show that gestation value and smoking habit […]
The Cultural Differences of the Tobacco Smoking The Middle East culture is connected to the hookah, the Native American cultures use pipes, and the Canadian culture is linked to cigarettes.
Ban on Smoking in Enclosed Public Places in Scotland The theory of externality explains the benefit or cost incurred by a third party who was not a party to the reasoning behind the benefit or cost. This will also lead to offer of a […]
How Smoking Cigarettes Effects Your Health Cigarette smoking largely aggravates the condition of the heart and the lung. In addition, the presence of nicotine makes the blood to be sticky and thick leading to damage to the lining of the blood […]
Alcohol and Smoking Abuse: Negative Physical and Mental Effects The following is a range of effects of heavy alcohol intake as shown by Lacoste, they include: Neuropsychiatric or neurological impairment, cardiovascular, disease, liver disease, and neoplasm that is malevolent.
Smoking Prohibition: Local Issues, Personal Views This is due to the weakening of blood vessels in the penis. For example, death rate due to smoking is higher in Kentucky than in other parts of the country.
Ban Smoking in Cars Out of this need, several regulations have been put in place to ensure children’s safety in vehicles is guaranteed; thus, protection from second-hand smoke is an obvious measure that is directed towards the overall safety […]
Smoking: Causes and Effects Considering the peculiarities of a habit and of a disease, smoking can be considered as a habit rather than a disease.
Smoking and Its Effect on the Brain Since the output of the brain is behavior and thoughts, dysfunction of the brain may result in highly complex behavioral symptoms. The work of neurons is to transmit information and coordinate messengers in the brain […]
Smoking Causes and Plausible Arguments In writing on the cause and effect of smoking we will examine the issue from the point of view of temporal precedence, covariation of the cause and effect and the explanations in regard to no […]
Summary of “Smokers Get a Raw Deal” by Stanley Scott Lafayette explains that people who make laws and influence other people to exercise these laws are obviously at the top of the ladder and should be able to understand the difference between the harm sugar […]
Smoking Qualitative Research: Critical Analysis Qualitative research allows researchers to explore a wide array of dimensions of the social world, including the texture and weave of everyday life, the understandings, experiences and imaginings of our research participants, the way that […]
Motivational Interviewing as a Smoking Cessation Intervention for Patients With Cancer The dependent variable is the cessation of smoking in 3 months of the interventions. The study is based on the author’s belief that cessation of smoking influences cancer-treated patients by improving the efficacy of treatment.
Factors Affecting the Success in Quitting Smoking of Smokers in West Perth, WA Australia Causing a wide array of diseases, health smoking is the second cause of death in the world. In Australia, the problem of smoking is extremely burning due to the high rates of diseases and deaths […]
Media Effects on Teen Smoking But that is not how an adult human brain works, let alone the young and impressionable minds of teenagers, usually the ads targeted at the youth always play upon elements that are familiar and appealing […]
Partnership in Working About Smoking and Tobacco Use The study related to smoking and tobacco use, which is one of the problematic areas in terms of the health of the population.
Causes and Effects of Smoking in Public The research has further indicated that the carcinogens are in higher concentrations in the second hand smoke rather than in the mainstream smoke which makes it more harmful for people to smoke publicly.
Quitting Smoking: Motivation and Brain As these are some of the observed motivations for smoking, quitting smoking is actually very easy in the sense that you just have to set your mind on quitting smoking.
Health Effects of Tobacco Smoking in Hispanic Men The Health Effects of Tobacco Smoking can be attributed to active tobacco smoking rather than inhalation of tobacco smoke from environment and passive smoking.
Smoking in Adolescents: A New Threat to the Society Of the newer concerns about the risks of smoking and the increase in its prevalence, the most disturbing is the increase in the incidences of smoking among the adolescents around the world.
Smoking and Youth Culture in Germany The report also assailed the Federal Government for siding the interest of the cigarette industry instead of the health of the citizens.
New Jersey Legislation on Smoking The advantages and disadvantages of the legislation were discussed in this case because of the complexity of the topic at hand as well as the potential effects of the solution on the sphere of public […]
Environmental Health: Tabaco Smoking and an Increased Concentration of Carbon Monoxide The small size of the town, which is around 225000 people, is one of the reasons for high statistics in diseases of heart rate.
Advanced Pharmacology: Birth Control for Smokers The rationale for IUD is the possibility to control birth without the partner’s participation and the necessity to visit a doctor just once for the device to be implanted.
Legislation Reform of Public Smoking Therefore, the benefit of the bill is that the health hazard will be decreased using banning smoking in public parks and beaches.
Smoking Bans: Protecting the Public and the Children of Smokers The purpose of the article is to show why smoking bans aim at protecting the public and the children of smokers.
Clinical Effects of Cigarette Smoking Smoking is a practice that should be avoided or controlled rigorously since it is a risk factor for diseases such as cancer, affects the health outcomes of direct and passive cigarette users, children, and pregnant […]
Public Health and Smoking Prevention Smoking among adults over 18 years old is a public health issue that requires intervention due to statistical evidence of its effects over the past decades.
Smoking Should Be Banned Internationally The questions refer to the knowledge concerning the consequences of smoking and the opinions on smoking bans. 80 % of respondents agree that smoking is among the leading causes of death and 63, 3 % […]
Microeconomics: Cigarette Taxes and Public Smoking Ban The problem of passive smoking will be minimized when the number of smokers decreases. It is agreeable that the meager incomes of such families will be used to purchase cigarettes.
Tobacco Debates in “Thank You for Smoking” The advantage of Nick’s strategy is that it offers the consumer a role model to follow: if smoking is considered to be ‘cool’, more people, especially young ones, will try to become ‘cool’ using cigarettes.
Alcohol and Smoking Impact on Cancer Risk The research question is to determine the quantity of the impact that different levels of alcohol ingestion combined with smoking behavioral patterns make on men and women in terms of the risks of cancer.
Indoor Smoking Restriction Effects at the Workplace Regrettably, they have neglected research on the effect of the legislation on the employees and employers. In this research, the target population will be the employees and employers of various companies.
Hypnotherapy Session for Smoking Cessation When I reached the age of sixty, I realized that I no longer wanted to be a smoker who was unable to take control of one’s lifestyle.
Smoking Experience and Hidden Dangers When my best college friend Jane started smoking, my eyes opened on the complex nature of the problem and on the multiple negative effects of smoking both on the smoker and on the surrounding society.
South Illinois University’s Smoking Ban Benefits The purpose of this letter is to assess the possible benefits of the plan and provide an analysis of the costs and consequences of the smoking ban introduction.
Smoking Cessation in Patients With COPD The strategy of assessing these papers to determine their usefulness in EBP should include these characteristics, the overall quality of the findings, and their applicability in a particular situation. The following article is a study […]
Smoking Bans: Preventive Measures There have been several public smoking bans that have proved to be promising since the issue of smoking prohibits smoking in all public places. This means it is a way of reducing the exposure to […]
Ban Smoking Near the Child: Issues of Morality The decision to ban smoking near the child on father’s request is one of the demonstrative examples. The father’s appeal to the Supreme Court of California with the requirement to prohibit his ex-wife from smoking […]
The Smoking Ban: Arguments Comparison The first argument against banning smoking employs the idea that smoking in specially designated areas cannot do harm to the health of non-smokers as the latter are supposed to avoid these areas.
Philip Morris Company’s Smoking Prevention Activity Philip Morris admits the existence of scientific proof that smoking leads to lung cancer in addition to other severe illnesses even after years of disputing such findings from health professionals.
Tobacco Smoking and Its Dangers Sufficient evidence also indicates that smoking is correlated with alcohol use and that it is capable of affecting one’s mental state to the point of heightening the risks of development of disorders.
Virginia Slims’ Impact on Female Smokers’ Number Considering this, through the investigation of Philip Morris’ mission which it pursued during the launch of the Virginia Slims campaign in 1968-1970 and the main regulatory actions undertaken by the Congress during this period, the […]
Tuberculosis Statistics Among Cigarette Smokers The proposal outlines the statistical applications of one-way ANOVA, the study participants, the variables, study methods, expected results and biases, and the practical significance of the expected results.
Smoking Habit, Its Causes and Effects Smoking is one of the factors that are considered the leading causes of several health problems in the current society. Smoking is a habit that may be easy to start, but getting out of this […]
Smoking Ban and UK’s Beer Industry However, there is an intricate type of relationship between the UK beer sector, the smoking ban, and the authorities that one can only understand by going through the study in detail The history of smoking […]
Smokers’ Campaign: Finding a Home for Ciggy Butts When carrying out the campaign, it is important to know what the situation on the ground is to be able to address the root cause of the problem facing the population.
Mobile Applications to Quit Smoking A critical insight that can be gleaned from the said report is that one of the major factors linked to failure is the fact that smokers were unable to quit the habit on their own […]
Behavior Modification Technique: Smoking Cessation Some of its advantages include: its mode of application is in a way similar to the act of smoking and it has very few side effects.
Effects of Thought Suppression on Smoking Behavior In the article under analysis called I suppress, Therefore I smoke: Effects of Thought Suppression on Smoking Behavior, the authors dedicate their study to the evaluation of human behavior as well as the influence of […]
Smoking Cessation Methods These methods are a part of NRT or nicotine replacement therapy, they work according to the principle of providing the smoker with small portions of nicotine to minimize the addiction gradually and at the same […]
Understanding Advertising: Second-Hand Smoking The image of the boy caught by the smoke is in the center of the picture, and it is in contrast with the deep black background.
People Should Quit Smoking Other counseling strategies such as telephone calls and social support also serves the ultimate goal of providing a modern approach in which counseling can be tailored to suit the counseling needs of an individual smoker. […]
Importance of Quitting Smoking As such, quitting smoking is important since it helps relief the worry and the fear associated with possibility of developing cancer among other smoking-related illnesses. It is therefore important to quit smoking if the problems […]
Cigarette Smoking in Public Places Those who argue against the idea of banning the smoking are of the opinion that some of them opt to smoke due to the stress that they acquire at their work places.
Anti-Smoking Campaign in Canada This is not the first attempt that the federal government of Canada intends to make in reducing the prevalence of smoking in the country.
Electronic Cigarettes: Could They Help University Students Give Smoking Up? Electronic Cigarettes An electronic cigarette is an electronic device that simulates the act of smoking by producing a mist which gives the physical sensation and often the flavor and the nicotine just as the analog […]
Psychosocial Smoking Rehabilitation According to Getsios and Marton most of the economic models that evaluate the effects of smoke quitting rehabilitation consider the influence of a single quit attempt.
Combating Smoking: Taxation Policies vs. Education Policies This is a considerable provision in the realms of health; hence, the efforts created by the government to curb this trend should be supported fully. In this regard, there is need to reduce the mentioned […]
The Program to Quit Smoking The second stage of the evaluation proves revealed the benefits of the program for the hospital in terms of discount rates for employees, age categories involved in the program. This process consists in selection of […]
Smoking Culture in Society Smoking culture refers to the practice of smoking tobacco by people in the society for the sheer satisfaction and delight it offers.
Possible Smoking Policies in Florida Majority also think that went it comes to workplaces hotels and bars it would be more appropriate to provide specific smoking zones as opposed to total bans The implications of the policy adopted therefore affect […]
Smoking Ban in the State of Florida These are the Total Ban Policy, the Partial Ban policy and the Liberated Smoking policy. The policy is authoritarian and ignores the interests of the smokers.
Core Functions of Public Health in the Context of Smoking and Heart Disease In the relation to our problem, heart attacks and smoking, it is important to gather the information devoted to the number of people who suffered from heart attacks and indicate the percentage rate of those […]
Putting Out the Fires: Will Higher Taxes Reduce the Onset of Youth Smoking? According to the article under consideration, increase in price of cigarettes can positively or negatively affect the rate of smoking among the youth.
Smoking Bans in US The issue of whether to ban smoking indoors by the governments of various countries is popular as they try to take a step towards curbing the harmful effects of smoking.
Smoking as Activity Enhancer: Schizophrenia and Gender Once learning the effects which nicotine has on people’s health and the relation between gender and schizophrenia, one can possibly find the ways to prevent the latter and to protect the people in the high-risk […]
Health Care Costs for Smokers Higher Tobacco taxes Some of the smokers have the same viewpoint that the current level of taxes imposed on the tobacco is high, 68%, and most of them, 59%, are in agreement for the increase […]
Medical Coverage for Smoking Related Diseases However, one of the most oblivious reasons is that it is a deterrent to this behavior, which is harmful to the life of the smoker.
The Realm of reality: Smoking In a nutshell, it can be argued that the definition of a man or a woman is different and not the same as in earlier days.
Ethical Problem of Smoking Since the job is urgent and therefore needed in a few days time, I would request her to work on the job with the promise that I will communicate her complaints to Frank and Alice […]
The Rate of Smoking Among HIV Positive Cases. To determine if use of group work among HIV positive smokers will be an effective strategy in reducing smoking habit among the target cases, then it is essential that this study establish if use of […]
Studying the Government’s Anti-Smoking Measures The methodology of study includes the review of the articles devoted to the anti-smoking measures of the Federal Government and application of economic theories to them.
Smoking Should Be Banned In the United States For numerous decades, smoking has remained the most disastrous problem in the universe in spite of the full awareness of the risk accompanied with its use.
Effectiveness of Cognitive Behavioral Theory on Smoking Cessation The study concluded that CBT intervention was effective for African American smoking cessation. As a result, the study concluded that CBT intervention was effectual for smoking cessation among African Americans.
Effectiveness of the Cognitive Behavioral Therapy for Smoking Cessation
Wayco Company’s Non-smoking Policy
Adverse Aspects of Smoking
Negative Impacts of Smoking on Individuals and Society
Smoking Ban in the United States of America
Dangers of Smoking Campaign
Smoking Ban in New York
Trends in Smoking Prevalence by Race/Ethnicity
Business Ethics: Smoking Issue
Should Smoking Tobacco Be Classified As an Illegal Drug?
Where Does the Path to Smoking Addiction Start?
Public Health Communication: Quit Smoking
Are Estimated Peer Effects on Smoking Robust?
Are There Safe Smoking and Tobacco Options?
What Are the Health Risks of Smoking?
Does Cigarette Smoking Affect Body Weight?
Does Cigarette Smuggling Prop Up Smoking Rates?
What Foods Help You Quit Smoking?
How Can People Relax Without Smoking?
Does Education Affect Smoking Behaviors?
Is Vaping Worse Than Smoking?
Do Movies Affect Teen Smoking?
What Is Worse: Drinking or Smoking?
Does Smoking Affect Breathing Capacity?
Does Smoking Cause Lung Cancer?
Does Having More Children Increase the Likelihood of Parental Smoking?
Does Smoking Cigarettes Relieve Stress?
Does Time Preference Affect Smoking Behavior?
How Does Smoking Affect Cardiovascular Endurance?
How Hypnosis Can Help You Quit Smoking?
How Does Smoking Affect Brain?
How Nicotine Affects Your Quit Smoking Victory?
How Does Secondhand Smoking Affect Us?
Why Is Smoking Addictive?
How Smoking Bans Are Bad for Business?
Why Smoking Should Not Be Permitted in Restaurants?
Why Public Smoking Should Be Banned?
Why Has Cigarette Smoking Become So Prominent Within the American Culture?
What Makes Smoking and Computers Similar?
Does Smoking Affect Schooling?
What Effects Can Cigarette Smoking Have on the Respiratory System?
What Are the Most Prevalent Dangers of Smoking and Drinking?
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Essay on Smoking in English for Students
Learn about the ill-effects of smoking on health, well-being and relationships, and how to quit smoking with various methods and tips. This 500-word essay on smoking is suitable for students in class 5 to 12.
Essay on Harmful Effects Of Tobacco
500 Words Essay on Harmful Effects Of Tobacco Introduction. Tobacco is a plant that is grown for its leaves. These leaves are dried and then used in many ways, including cigarettes, cigars, and chewing tobacco. While many people use tobacco, it can cause serious health problems. This essay will discuss the harmful effects of tobacco on the ...
Cause And Effect Of Smoking: [Essay Example], 788 words
Nicotine and other chemicals in tobacco smoke contribute to the buildup of plaque in arteries, leading to atherosclerosis. This increases the risk of heart attacks, strokes, and peripheral artery disease. Furthermore, smoking raises blood pressure and reduces the oxygen-carrying capacity of blood, straining the heart and circulatory system.
Tobacco Smoking and Its Dangers
For the essay, the article explains one of the few pro-tobacco arguments (that smoking has a calming effect) and proves that it is false and harmful. As a result, the article is an important contribution that provides some information on the opposite point of view, according to which there are benefits to smoking, and proves it wrong.
Essay on Effects of Smoking
Smoking, a widespread habit with serious health implications, is a topic of concern that merits significant attention. Despite the known dangers, millions globally continue to smoke, affecting not only their health but also those in their vicinity. This essay delves into the effects of smoking, focusing on health, environmental, and social impacts.
Smoking: Effects, Reasons and Solutions Essay
Smoking can result in stroke and heart attacks since it hinders blood flow, interrupting oxygen to various parts of the body, such as feet and hands. Introduction of cigarettes with low tar does not reduce these effects since smokers often prefer deeper puffs and hold the smoke in lungs for a long period. This smoking practice draws the tar ...
Cause and Effects of Smoking Cigarettes, Essay Example
This essay explains the negative health effects of smoking cigarettes on individuals and society, using facts and statistics from reliable sources. It also discusses the economic and social costs of smoking and the benefits of quitting.
Smoking and Its Effects on Human Body Essay
Smoking affects the lungs and respiratory organs causing such terrible diseases as cancer. Among the most wider spread diseases are peptic ulcers, cancer of the larynx, kidney, pancreas, and other major organs. The resins from the smoke enter the blood and ruin cells. This process is inevitable if a person smokes for years.
Essays About Smoking
Smoking Essay Smoking is a widespread habit that involves inhaling smoke from the burning of tobacco. It is a highly addictive habit that has numerous negative effects on the body, including lung cancer, heart disease, and respiratory issues. Writing an essay on smoking can be a challenging task, but it is an important topic to discuss.
Essay on Harmful Effects of Smoking
500 Words Essay on Harmful Effects of Smoking Introduction. Smoking is a prevalent habit, often started out of curiosity, peer pressure, or stress management. However, its harmful effects are well-documented, impacting nearly every organ in the human body. Despite the widespread knowledge of its adverse effects, smoking continues to be a ...
Argumentative Essay on Smoking Cigarettes
This essay argues for stricter regulations on smoking based on the health, economic, and social implications of this habit. It cites statistics, references, and examples to support its case and concludes that smoking is a harmful and preventable behavior that should be curbed.
Health effects of tobacco
Learn how tobacco products cause serious negative effects on human health, such as cancer, cardiovascular disease, and respiratory problems. Find out the history, mechanism, and prevention of tobacco use and its consequences.
Introduction, Summary, and Conclusions
Introduction. Tobacco use is a global epidemic among young people. As with adults, it poses a serious health threat to youth and young adults in the United States and has significant implications for this nation's public and economic health in the future (Perry et al. 1994; Kessler 1995).The impact of cigarette smoking and other tobacco use on chronic disease, which accounts for 75% of ...
Smoking: Causes and Effects
Get a custom essay on Smoking: Causes and Effects. 185 writers online. Learn More. Considering the first element, which one of the most important out of the three, willpower is a key to get rid of such a bad habit as smoking, which is very difficult to give up. If a person has a strong determination to quit smoking, he will have to endure ...
Tobacco smoking: Health impact, prevalence, correlates and
Health impact of smoking. Table Table1 1 lists the main causes of death from smoking. Tobacco smoking is estimated to lead to the premature death of approximately 6 million people worldwide and 96,000 in the UK each year (Action on Smoking and Health, 2016b; World Health Organization, 2013).A 'premature death from smoking' is defined as a death from a smoking-related disease in an ...
Health effects associated with smoking: a Burden of Proof study
As a leading behavioral risk factor for numerous health outcomes, smoking is a major ongoing public health challenge. Although evidence on the health effects of smoking has been widely reported ...
Cigarette smoke and adverse health effects: An overview of research
The mechanisms through which smoking influences the development and progression of atherosclerosis are poorly understood at present, but recent studies point to an adverse effect of smoking on endothelial and smooth muscle cell functions as well as thrombotic disturbances produced by tobacco smoke (10,11).
The Effects of Smoking on Your Body: [Essay Example], 454 words
Smoking increases the risk of mouth, throat, larynx, and esophagus cancer. Smokers also have higher rates of pancreatic cancer. Even people who "Smoke but don't inhale" face an increased risk of mouth cancer. Smoking also has an effect on insulin, making it more likely that you'll develop insulin resistance. That puts you at increased risk of ...
Smoking and Its Negative Effects on Human Beings Research Paper
From the above mentioned, it is easy to conclude that smoking has negative effects on people's health. Works Cited. Cox, Jack. " The Lesser Known Harmful Effects of Smoking." The Register. 2012. Orange Country Register News. Web. Pampel, Fred C. Tobacco Industry and Smoking. New York: Infobase Publishing, 2009. Print. Peate, Ian.
Tobacco and nicotine use
Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco (for example, arguments with others about tobacco use)
Youth and Tobacco Use
Preventing tobacco product use among youth is critical to reducing tobacco use among the nation's youth. Tobacco product use is started and established primarily during adolescence. 1 2. Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18. Flavorings in tobacco products can make them more appealing to youth. 3 4
The Effects Of Smoking On Health: [Essay Example], 491 words
I think smoking is bad for you because it can kill your cat, dog or pets. It can also kill your family. You can die from cancer by smoking. Every time you smoke you are exposing toxic chemicals to the air which somebody else is going to breath and possibly die from. For example, you are putting people at risk every time you smoke.
235 Smoking Essay Topics & Examples
Smoking is a well-known source of harm yet popular regardless, and so smoking essays should cover various aspects of the topic to identify the reasons behind the trend. You will want to discuss the causes and effects of smoking and how they contributed to the persistent refusal of large parts of the population to abandon the habit, even if they ...