Tobacco is a plant. Its leaves are smoked, chewed, or sniffed for a variety of effects. Tobacco that is not burned is called smokeless tobacco. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage.
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What’s in cigarettes
Cigarettes contain substances that you would never think about putting in your body. For example, cigarettes contain tar, carbon monoxide and chemicals like DDT, arsenic and formaldehyde (a gas used to preserve dead animals). The tobacco in cigarettes also contains nicotine - the drug that makes smoking addictive.
There are more than 5,000 chemical components found in cigarette smoke and hundreds of them are harmful to human health. Including nicotine, there are 29 chemicals in smokeless tobacco that are known to cause cancer.
Here are a few examples:
- 1,3-Butadiene is a chemical used to manufacture rubber. It is considered to be a carcinogenic chemical that can cause certain blood cancers.
- Arsenic is used to preserve wood. Some arsenic compounds have been linked to cancer of the lung, skin, liver, and bladder.
- Benzene is used to manufacture other chemicals. It can cause cancer, particularly leukemia, in humans.
- Cadmium is a metal used to make batteries. Cadmium and cadmium compounds can cause lung cancer and have been associated with kidney and prostate cancer.
- Chromium VI is used to make alloy metals, paint and dyes. Chromium VI compounds cause lung cancer and have been associated with cancer of the nose and nasal sinuses.
- Formaldehyde is used to make other chemicals and resins. It is also used as a preservative. Formaldehyde causes leukemia and cancer in respiratory tissues.
- Polonium-210 is a radioactive element that has been shown to cause cancer in animals.
- Tar is not one single chemical, instead it describes several chemicals that are in tobacco smoke. It leaves a sticky, brown residue on your lungs, teeth and fingernail
All of these things are bad for your body. Nicotine raises your risk of heart attack and stroke. Tar and carbon monoxide cause serious breathing problems. And you know tobacco smoke causes cancer.
Once you start smoking, it can be very hard to stop. The nicotine in cigarettes is poisonous and very addictive. Once you start using it, your body will feel like it cannot function without it.
Cigarettes and other forms of tobacco - including cigars, pipe tobacco, snuff, and chewing tobacco - contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked. A typical smoker will take 10 puffs on a cigarette over the period of about 5 minutes that the cigarette is lit. Thus, a person who smokes about 1 pack (25 cigarettes) daily gets 250 “hits” of nicotine each day.
Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate. Similar to other addictive drugs like cocaine and heroin, nicotine increases levels of the neurotransmitter dopamine, which affects the brain pathways that control reward and pleasure. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction - a condition of compulsive drug seeking and use, even in the face of negative consequences.
Nicotine use can have many different effects on the body. It can:
- Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking
- Boost mood, give people a sense of well-being, and possibly even relieve minor depression
- Increase activity in the intestines
- Create more saliva and phlegm
- Increase the heart rate by around 10 to 20 beats per minute
- Increase blood pressure by 5 to 10 mmHg
- Possibly cause sweating, nausea, and diarrhea
- Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well
Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include anxiety, irritability, drowsiness, attention difficulties, sleep disturbances, headaches, increased appetite, and powerful cravings for tobacco.
You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke.
Harmful effects of smoking
Cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. Smokeless tobacco (such as chewing tobacco and snuff) also increases the risk of cancer, especially oral cancers. In addition to cancer, smoking causes lung diseases such as chronic bronchitis and emphysema, and increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm. Smoking has also been linked to leukemia, cataracts, and pneumonia. On average, adults who smoke die 10 years earlier than nonsmokers.
Heart and blood vessel problems:
- Blood clots and weakness in the walls of blood vessels in the brain, which can lead to stroke
- Blood clots in the legs, which may travel to the lungs
- Coronary artery disease, including angina and heart attacks
- Temporarily increased blood pressure after smoking
- Poor blood supply to the legs
- Problems with erections because of decreased blood flow into the penis
Other health risks or problems:
- Cancer (more likely in the lung, mouth, larynx, nose and sinuses, throat, esophagus, stomach, bladder, kidney, pancreas, cervix, colon)
- People who have had cancer have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment.
- Poor wound healing after surgery
- Lung problems, such as COPD or asthma that is harder to control
- Problems during pregnancy, such as babies born at a low birth weight, early labor, losing your baby, and cleft lip
- Decreased ability to taste and smell
- Harm to sperm, which may lead to infertility
- Loss of sight due to an increased risk of macular degeneration
- Tooth and gum diseases
- Wrinkling of the skin
The nicotine in smokeless tobacco products is absorbed at the same rate as smoking tobacco and one chew contains 15 times the nicotine of a cigarette (meaning the risk of addiction is much higher). Smokers who switch to smokeless tobacco instead of quitting tobacco still have health risks:
- Increased risk of mouth or nasal cancer
- Gum problems, tooth wear, and cavities
- Worsening high blood pressure and angina
- Sores and white patches in the mouth
- Bad breath, discoloration of teeth and tooth loss.
Although nicotine is addictive and can be toxic if ingested in high doses, it does not cause cancer - other chemicals are responsible for most of the severe health consequences of tobacco use. Tobacco smoke is a complex mixture of chemicals such as carbon monoxide, tar, formaldehyde, cyanide, and ammonia - many of which are known carcinogens. Carbon monoxide increases the chance of cardiovascular diseases. Tar exposes the user to an increased risk of lung cancer, emphysema, and bronchial disorders.
Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birthweight. Maternal smoking may also be associated with learning and behavioral problems in children. Smoking more than one pack of cigarettes per day during pregnancy nearly doubles the risk that the affected child will become addicted to tobacco if that child starts smoking.
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While we often think of medical consequences that result from direct use of tobacco products, passive or secondary smoke also increases the risk for many diseases. Secondhand smoke, also known as environmental tobacco smoke, consists of exhaled smoke and smoke given off by the burning end of tobacco products. Those who are often around the smoke of others (secondhand smoke) have a higher risk of:
- Heart attack and heart disease
- Lung cancer
- Sudden and severe reactions, including of the eye, nose, throat, and lower respiratory tract
Infants and children who are often exposed to secondhand smoke are at risk of:
- Asthma flares (children with asthma who live with a smoker are much more likely to visit the emergency room)
- Infections of the mouth, throat, sinuses, ears, and lungs
- Lung damage (poor lung function)
- Sudden infant death syndrome (SIDS)
E-cigarettes are battery-operated devices that produce a flavored nicotine vapor that looks like tobacco smoke and is inhaled. Using an e-cigarette is called vaping. Although e-cigarette vapor does not contain the tar currently responsible for most lung cancer and other lung diseases, it has been shown to contain known carcinogens and toxic chemicals. Some people think that e-cigarettes are safer than cigarettes, and that they can be used to help people quit smoking. But not much is known about the health risks of using them, or whether they do help people quit smoking. However we do know about some dangers of e-cigarettes:
- They contain nicotine, which is addictive
- They contain other potentially harmful chemicals
- There is a link between e-cigarette use and tobacco cigarette use in teens
- The liquid in e-cigarettes can cause nicotine poisoning if someone drinks, sniffs, or touches it.
Because e-cigarettes contain nicotine derived from tobacco, they are now subject to government regulation as tobacco products, including the requirement that both in-store and online purchasers be at least 18 years of age.
Smoking is the most preventable cause of death in the United States. Almost one third of deaths from coronary heart disease are attributable to smoking and secondhand smoke. Smoking is linked to about 90% of lung cancer cases in the United States. About 20 percent of adult men and about 16 percent of adult women smoke. The highest percentage of people who smoke are between the ages of 21 and 34. About 54 percent of American children ages 3-11 are exposed to secondhand smoke. On average, smokers die more than 10 years earlier than nonsmokers.
Giving up a habit takes time to get used to, both physically and emotionally. There are many reasons to quit:
- Smoking weakens your lungs and heart
- Smoking gives you bad breath
- Smoking makes your clothes and hair smell bad
- Smoking turns your teeth and fingers yellow and makes your skin wrinkle more easily
- Smoking makes you get tired more quickly when you exercise
- Smoking raises your heartbeat and your blood pressure
- Smoking damages your immune system. You may get colds, the flu or even pneumonia more often if you smoke
- Smoking can affect your sexual performance by making it more difficult for blood to reach all of the body's organs
- Smoking weakens your tendons and ligaments, making it easier to get injured. It also makes it harder for injuries to heal
- Smoking is affecting people around you. Second-hand smoke is dangerous, too
- Smoking costs you money
- You’re setting a bad example for your children
Although quitting can be difficult, the health benefits of smoking cessation are immediate and substantial, including reduced risk for cancers, heart disease, and stroke. A 35-year-old man who quits smoking will, on average, increase his life expectancy by 5 years. Soon after you quit, your circulation begins to improve, and your blood pressure starts to return to normal. Your sense of smell and taste return, and it's easier for you to breathe. In the long term, giving up tobacco can help you live longer. Your risk of getting cancer decreases with each year you stay smoke-free.
How to quit
It is hard to stop smoking or using smokeless tobacco, but anyone can do it. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking.
Steps to make quitting easier:
- Pick a stop date. Choose a date 2 to 4 weeks from today so you can get ready to quit. If possible, choose a time when you don't expect any extra stress at school, work or home.
- Make a list of the reasons why you want to quit. Keep the list on hand so you can look at it when you have a nicotine craving.
- Keep track of where, when and why you smoke. You may want to make notes for a week or so to know ahead of time when and why you crave a cigarette. Plan what you'll do instead of smoking.
- Throw away all of your tobacco. Clean out your room if you have smoked there. Throw away your ashtrays and lighters - anything that you connect with your smoking habit.
- Tell your friends that you're quitting. Ask them not to pressure you about smoking. Find other things to do with them besides smoking.
- When your stop date arrives, STOP. Plan little rewards for yourself for each tobacco-free day, week or month.
Know what symptoms to expect when you stop smoking. These are called withdrawal symptoms. Common symptoms include:
- An intense craving for nicotine
- Anxiety, tension, restlessness, frustration, or impatience
- Difficulty concentrating
- Drowsiness or trouble sleeping
- Increased appetite and weight gain
- Irritability or depression
How bad your symptoms are depends on how long you smoked. The number of cigarettes you smoked each day also plays a role. Keep in mind that the worst symptoms will be over in a few days.
However, you may still have cravings for tobacco. Those cravings have less to do with nicotine addiction and more to do with the habit of smoking. A craving is a strong, distracting urge to smoke. Cravings are strongest when you first quit. Places and activities can trigger cravings. If you used to smoke after meals or when you talked on the phone, these things might make you crave a cigarette. You can expect to have cravings for a few weeks after you quit. The first 3 days will probably be the worst.
Thinking about how to resist cravings ahead of time can help you overcome them.
Make a list. Write down the reasons you are quitting. Post the list someplace visible so you can remind yourself of the good things about quitting.
Make rules. You might find yourself thinking you can just smoke one cigarette. Any cigarette you smoke will tempt you to smoke more. Rules provide structure to help you keep saying no. Your rules might include:
- When I have a craving, I will wait at least 10 minutes to see if it passes.
- When I have a craving, I will walk up and down the stairs five times.
- When I have a craving, I will eat a carrot or celery stick.
Set up rewards. Plan rewards for each stage of quitting you get through. The longer you go without smoking, the bigger the reward.
Avoid temptations. Think about all the situations that make you want to smoke. When possible, avoid these situations. For example, you might need to avoid spending time with friends who smoke, going to bars, or attending parties for a while. Spend time in public places where smoking is not allowed.
Distract yourself. Keep your hands and mouth busy as you get used to not handling cigarettes. You can hold a pen, stress ball, or rubber band, chop vegetables for snacking, knit or do a jigsaw puzzle, chew sugar-free gum, hold a straw or stir stick in your mouth, eat carrots, celery, or apple slices.
Practice new ways to relax. Many people use smoking to relieve stress. Try new relaxation techniques to help calm yourself:
- Take a deep breath in through your nose, hold it for five seconds, exhale slowly through your mouth. Try this a few times until you feel yourself relax.
- Listen to music.
- Read a book or listen to an audiobook.
- Try yoga, tai chi, or visualization.
Exercise. Moving your body may help reduce cravings. It can also give you a feeling of wellbeing and calm.
If you only have only a little time, take a short break and walk up and down the stairs, jog in place, or do squats. If you have more time, go to the gym, take a walk, bike ride, or do something else active for 30 minutes or more.
Tobacco addiction is a chronic disease that often requires multiple attempts to quit. Although some smokers are able to quit without help, many others need assistance. Both behavioral interventions (counseling) and medication can help smokers quit; but the combination of medication with counseling is more effective than either alone.
Behavioral treatments employ a variety of methods to help smokers quit, ranging from self-help materials to counseling. These interventions teach people to recognize high-risk situations and develop coping strategies to deal with them.
Nicotine replacement products are ways to take in nicotine without smoking. These products come in several forms: gum, patch, nasal spray, inhaler and lozenge. Nicotine replacement works by lessening your body’s craving for nicotine and reducing withdrawal symptoms. These products deliver a controlled dose of nicotine to a smoker in order to relieve withdrawal symptoms during the smoking cessation process. They are most successful when used in combination with behavioral treatments. It's very important that you don't smoke while using nicotine replacement products.
Nicotine replacement products can cause problems in some people, especially:
- Women who are pregnant or breast -feeding.
- People with any of the following medical problems:
Other medicines that do not have nicotine in them are used to help people quit smoking. They target nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people resume smoking. These include Bupropion (also called Zyban) and Varenicline (also called Chantix). It is important to know that bupropion and varenicline may cause serious psychiatric problems. Varenicline may also cause serious heart problems.
Some medications already in use might work better if they are used together. Scientists are looking for ways to target several relapse symptoms at the same time, such as withdrawal, craving and depression.
There are a couple of reasons why people gain weight when they give up cigarettes. Some have to do with the way nicotine affects your body.
- The nicotine in cigarettes speeds up your metabolism. Nicotine increases the amount of calories your body uses at rest by about 7 to 15%. Without cigarettes, your body may burn food more slowly.
- Cigarettes reduce appetite. When you quit smoking, you may feel hungrier.
- Smoking is a habit. After you quit, you may crave high-calorie foods to replace cigarettes.
As you get ready to quit smoking, here are some things you can do to keep your weight in check.
- Get active. Physical activity helps you burn calories. It can also help you ward off cravings for unhealthy foods or cigarettes. If you already exercise, you may need to exercise for longer or more often to burn the calories nicotine used to help remove.
- Shop for healthy groceries. Make a list of healthy foods like fruit, vegetables, and low-fat yogurt that you can indulge in without eating too many calories. Stock up on low-calorie "finger foods" that can keep your hands busy, such as sliced apples, baby carrots, or pre-portioned unsalted nuts.
- Stock up on sugar-free gum. It can keep your mouth busy without adding calories or exposing your teeth to sugar.
- Create healthy eating habits. Make a healthy meal plan ahead of time so you can combat cravings when they hit. It is easier to say "no" to fried chicken nuggets if you are looking ahead to a roast chicken with vegetables for dinner.
- Never let yourself get too hungry. A little hunger is a good thing, but if you are so hungry that you have to eat right away, you are more likely to reach for a diet-busting option.
- Sleep well. If you often do not get enough sleep, you are at greater risk of putting on extra weight.
- Control your drinking. Alcohol, sugary sodas, and sweetened juices may go down easy, but they add up, and can lead to weight gain. Try sparkling water with 100% fruit juice or herbal tea instead.
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