Addiction to cigarettes and cigars
Addiction to cigarettes and cigars primarily stems from nicotine, a highly addictive substance that affects the brain's pleasure centers, leading to both physical and psychological dependence. Cigarettes are thin cylinders of cured tobacco wrapped in paper, while cigars are larger and made with whole leaves. Both are legal for adults in most countries, although the legal age varies regionally. The history of tobacco use dates back to the sixteenth century, with commercial production beginning in the nineteenth century, which significantly increased smoking rates.
The health risks associated with smoking are severe; tobacco use is linked to multiple illnesses, including heart disease, stroke, and various cancers. Smokers often experience a range of negative physical effects, such as yellowed teeth, reduced senses of taste and smell, and premature aging. Additionally, the dangers of secondhand smoke pose significant health risks to non-smokers, exposing them to similar toxins and carcinogens.
While vaping has emerged as a popular alternative, it is not without its own health concerns, particularly regarding respiratory issues and the potential for increased nicotine use among adolescents. Understanding the complexities of nicotine addiction and its health implications is crucial for informed decision-making regarding tobacco use.
Subject Terms
Addiction to cigarettes and cigars
DEFINITION: A cigarette is a cylinder of cured, finely cut tobacco wrapped in paper. The paper is ignited, and the smoke is inhaled through the mouth and into the lungs. A cigar is a larger cylinder of dried and fermented tobacco wrapped in whole-leaf tobacco that is also ignited. Cigar smoke is drawn into the mouth, and nicotine is absorbed through the oral membranes; cigar smoke is not inhaled because its alkalinity highly irritates the inner mucous membranes.
STATUS: Legal in the United States (US) and most countries for adults (aged eighteen and older). In some Canadian provinces, the legal age is nineteen years. In Japan, the legal age is twenty years. In Kuwait, the legal age is twenty-one years. In many European countries, the legal age is sixteen years.
CLASSIFICATION: Regulated by the US Food and Drug Administration as a nicotine delivery system.
SOURCE: The US is the world's fourth-largest tobacco producing country after China, India, and Brazil. The majority of the American tobacco crop is grown in the states of Kentucky, North Carolina, and Tennessee.
TRANSMISSION ROUTE: The nicotine in cigarette smoke is absorbed in the lungs and rapidly acts on the brain to activate pleasure centers and stimulate an adrenaline rush. Small amounts of nicotine in the smoke may be absorbed through the mucous membranes of the nose and mouth. The nicotine in cigar smoke is absorbed slowly through the mucous membranes of the mouth because the smoke is too harsh to be inhaled.
History of Use
Smoking tobacco was introduced in Europe in the sixteenth century and the US in the seventeenth century. Matches and cigarettes were first commercially produced in the nineteenth century, facilitating the habit of smoking. By 1901, 80 percent of American men smoked at least one cigar a day; that same year, 6 million cigars and 3.5 million cigarettes were sold in the US.
In 1913, the R. J. Reynolds Tobacco Company introduced Camel cigarettes, and ten years later, Camels were smoked by 45 percent of American smokers. By 1940, the number of cigarette smokers had doubled from that of 1930. Tobacco company advertising and marketing in the twentieth century especially targeted military personnel and women.
In 1950, the first evidence linking lung cancer and tobacco smoking was published in a British medical journal. In 1965, a US federal law mandated that a warning from the US surgeon general be placed on all packages of cigarettes and all cigarette advertising, stating the risks of smoking tobacco. In 1971, cigarette advertising was banned from television. Still, smoking remained popular in the US. In 1972, Marlboro became the bestselling brand of cigarettes in the world, and it remained the bestselling brand in the mid-2020s. In 1988, the US Surgeon General determined that nicotine was an addictive substance. Nine years later, a US federal judge ruled that the US Food and Drug Administration could regulate tobacco as a drug.
Worldwide, nearly 8 million people die annually from tobacco-related illnesses, including heart disease, stroke, and cancer. For every person who dies of a smoking-related disease, thirty people are living with a serious smoking-related disease. Men and women who do not smoke live between ten and thirteen years longer than those who do smoke. Quitting smoking before the age of forty decreases one's chances of dying from a smoking-related illness by over 90 percent. In a poll conducted by the research group Gallup, findings indicated that by 2024, the incidence of adults who smoked in the US had fallen to 11 percent, an eighty-year low.
Effects and Potential Risks
The smoking of tobacco leads to nicotine addiction. Repeated introduction of nicotine into the body causes increased production of dopamine in the pleasure centers of the brain. As the dopamine level drops, the smoker feels depressed and lights the next cigarette or cigar to regain the heightened sense of pleasure and well-being.
Nicotine also stains the teeth and fingers yellow, sours the breath, diminishes the senses of smell and taste, and reduces one’s appetite. People who smoke experience hair loss and wrinkle formation at a younger age. Women who smoke have an increased risk of miscarriage, premature labor, and giving birth to an underweight baby.
Along with nicotine, tobacco smoke contains carbon monoxide, which reduces the blood’s ability to carry oxygen to cells. To ensure that adequate oxygen reaches vital organs, the body reduces the blood flow to the extremities. Smoking stresses the heart and thereby increases the risks of heart disease and stroke.
The toxicity of tobacco smoke damages the lips, tongue, gums, throat, larynx, esophagus, and lungs. This progressive damage leads to chronic bronchitis and emphysema and an increased likelihood of death from cancer of the mouth, lungs, kidneys, bladder, pancreas, and stomach.
Nonsmokers who breathe environmental, or secondhand, cigarette and cigar smoke are also exposed to the toxins and carcinogens contained in that smoke. Nonsmokers are thus exposed to the same health risks as smokers.
In the 2010s, e-cigarettes and vape pens, which provide users with nicotine in the form of a vaporized liquid without tobacco smoke, became popular as a less dangerous alternative to smoking. However, studies have suggested that vaping is still associated with respiratory problems, and nicotine itself has been linked to cardiovascular, respiratory, gastrointestinal, and reproductive disorders, and may be a carcinogen. One unfortunate effect of the proliferation of vapes and e-cigarettes has been an increase in nicotine use by adolescents. While anti-smoking campaigns of the early twenty-first century were popular and effective educational campaigns that led to a decrease in smoking in youth, vaping has complicated the message as many misunderstand their ability to cause harm.
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