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What's addictive?.

Tobacco

Tobacco smoke components

Tobacco smoke is made up of thousands of components, the main ones being nicotine, tar and carbon monoxide. Nicotine is the addictive agent in tobacco, tar can cause cancers and bronchial disorders, and carbon monoxide contributes to heart disease.

Nicotine is a powerful mood-altering substance which reaches the brain quickly when you smoke a cigarette.

Nicotine is also extremely toxic. A dose of about 30 mg can be fatal. Although an average cigarette contains 15-20 mg of nicotine, only a fraction is absorbed by the smoker.

Smokers can control the intake of nicotine considerably by adjusting their smoking technique. Long, deep inhalations, more puffs per cigarette, smoking down to the butt, or blocking the filter airflow of an ultra-low-tar brand can increase the nicotine yield.

Tar is not a single ingredient; it is a dark sticky combination of hundreds of chemicals including poisons and cancer-causing substances. As with nicotine, the tar yield of a cigarette can be higher depending on how a cigarette is smoked.

Carbon Monoxide (CO) the poisonous emission from automobile engines is also formed when tobacco is burned. CO in smoke replaces the oxygen in red blood cells, forming carboxyhemoglobin (COHb). While nicotine causes the heart to work harder, COHb deprives it of the extra oxygen this work demands. Among the chemicals in cigarette smoke are acids, glycerol, glycol, alcohols, aldehydes, ketones, aliphatic and aromatic hydrocarbons, phenols, and such corrosive gases as hydrogen cyanide and nitrogen oxide, as well as a heavy dose of carbon monoxide. Heart and circulatory disease, lung and other cancers, and emphysema and chronic bronchitis have been linked to some of these substances

Effects of smoking

Short-term effects of smoking include a significant increase in heart rate and a drop in skin temperature. Respiration rate is also increased. In novice smokers, diarrhea and vomiting may occur. Although the central nervous system is, in fact, stimulated by smoking, smokers usually feel it relaxes them.

Long-term effects are mainly on the bronchopulmonary and cardiovascular systems. Smoking is the main cause of lung cancer (related to 90% of all lung cancer cases). Other factors - notably industrial carcinogens (e.g. asbestos) - may be involved, especially among smokers. An average smoker is 10 times more likely to get lung cancer than a non-smoker.

Smoking is estimated to be responsible for 30% of all cancer deaths. It is also associated with cancers of the mouth, throat, colon, pancreas, bladder, kidneys, stomach, and cervix, and related to 75% of chronic bronchitis cases and 80% of emphysema cases.

Tobacco also affects the digestive system - gastric and duodenal ulcers are twice as common and twice as likely to cause death in smokers as in non-smokers. Skin wounds may heal less quickly in smokers, partly because smoking depletes the body of vitamin C. Smokers may also have less effective immune systems than non-smokers.

Tobacco use is associated with 25% to 30% of all cardiovascular disease. Smokers have a 70% higher rate of coronary heart disease than non-smokers (it is the major smoking-related cause of death), nearly twice the risk of heart attack, and five times the risk of stroke.

The damaging effects of smoking are often increased by other factors: for example, the heavy use of such other drugs as alcohol with tobacco increases the risk of both tobacco-related cancer and other diseases of the heart and blood vessels.

Women and tobacco

Tobacco use during pregnancy increases the risk of such complications as stillbirths, low birth weights, premature delivery, miscarriage, and sudden infant death syndrome. Women who smoke may also experience reduced fertility, increased menstrual disorders, earlier onset of menopause, and an increased risk of cervical cancer.

Women who smoke and use birth control pills are especially vulnerable, particularly after age 30. They are 39 times more likely to suffer from stroke than non-smokers who do not use the pill, and are at higher risk of contacting other circulatory diseases. as well.

Nicotine Addiction

Tobacco use can lead to physical and psychological dependence on nicotine, particularly in cigarette smokers. The United States Surgeon General's 1988 report states that "cigarettes and other forms of tobacco are just as addicting as heroin and cocaine...."

People who are physically dependent on tobacco suffer a withdrawal reaction when they stop using it. Some signs of withdrawal are: irritability, anxiety, headaches, sleep disturbances (insomnia or drowsiness), difficulty concentrating, decreased heart rate and increased appetite, and a craving for nicotine. These symptoms can last from several days to several weeks. However, desire for a cigarette and relapse to smoking can occur months after quitting, indicating that, as with other drug use, factors in addition to physical dependence play a role in nicotine addiction. Environmental events or emotional states may become conditioned signals for cigarette use.

Quitting smoking

Although the majority of smokers want to reduce or stop smoking, attempts to do so often fail. The U.S. Surgeon General's 1988 report states that "...at least 60% of tobacco smokers have tried to quit at some time in their lives." Quitting is possible, however: the majority of people who have ever smoked give up cigarettes later in life. Although about 20% of would-be quitters stop on their first attempt, most people "give up" several times before finally stopping for good.

People who quit generally achieve the same health levels as nonsmokers after a few years, especially if they stop while they are young. Risk of heart disease drops immediately; risk of lung cancer declines more gradually. Some lung disease may not be completely reversible, but even older lifetime smokers can benefit significantly from quitting.

There is no simple "cure" for smoking. It helps to find a personal reason. Cutting down or switching to ultra-low-yield brands instead of quitting may reduce exposure to smoke products, but many people just change the way they smoke - they take more or longer puffs - to get the same effect. Withdrawal symptoms subside more quickly for smokers who quit all at once than for those who gradually cut down.

Most quitters stop on their own - sometimes with the help of books, pamphlets, guides, or videos. Some prefer group support or professional counselling from a doctor, a smoking clinic, or a local health agency. No single method works for everyone; several different approaches may have to be tried.

Nicorette, a prescription gum containing nicotine, has helped some people deal with withdrawal symptoms, particularly those who are very dependent on nicotine. Other non-prescription anti-smoking products have not been shown scientifically to be effective.

Many smokers worry about weight gain if they stop smoking. Studies show that many of those who quit gain weight, but the gain is usually only a few kilograms, and can be minimized by exercising and eating low-fat foods.

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Copyright (c) 1976 Revised January 1991 Alcoholism and Drug Addiction Research Foundation, Toronto Canada
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