Overview and epidemiology:
Tobacco is a highly addictive plant that is processed and used in various ways. The end products may be smoked (in cigarettes, cigars, and pipes), applied to the gums (as dipping and chewing tobacco), or inhaled (as snuff). Tobacco smoke contains more than 7,000 chemicals. Nicotine is the main component of tobacco that causes addiction. Nicotine activates the production of adrenaline and dopamine, which induce a short-term pleasing effect on the brain and cause physical and psychological addiction.
The tobacco epidemic kills over 8 million people all over the world. About 90% of these deaths are the result of direct tobacco use, while others are exposed to second-hand smoke. In 2020, 22.3% of the world’s population used tobacco: 36.7% of men and 7.8% of women. Tobacco use is one of the leading preventable causes of premature death in the United States and one of the biggest public health problems that the world has ever faced. All forms of tobacco-containing products and all levels of consumption are harmful.
Symptoms:
Signs of tobacco abuse are:
- impossibility of stopping tobacco consumption,
- withdrawal symptoms after stopping, like mood and behavior changes: anxiety, irritability, restlessness, anger, insomnia, constipation or diarrhea, etc.
- inability to quit tobacco use despite health problems
- abandoning social activities, like avoiding smoke-free facilities and avoiding family gatherings due to inability to smoke in those settings
Complications:
Almost every organ system is affected by tobacco. Although nicotine itself is not carcinogenic, there are several compounds in tobacco smoke that cause cancer, and cigarette smoking accounts for at least 30 percent of all cancer deaths. Smoking increases the risk of lung cancer 5-10 fold, making lung cancer predominant among the cancers caused by tobacco use. Tobacco use is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, bladder and colorectal. Along with cancers, tobacco smoking is associated with chronic obstructive pulmonary disease, asthma exacerbations, heart diseases, diabetes, eye problems, impotence and infertility, pregnancy complications, etc.
Secondhand and “thirdhand” smoke:
Non-smokers are also exposed to environmental tobacco smoke and are at increased risk of many abovementioned diseases. It’s called passive or secondary smoke. The risk of lung cancer among these people has increased by about 20%. Exposure of children to tobacco smoke is a risk factor for asthma. Moreover, children are more vulnerable to “thirdhand smoke”: after tobacco smoking, chemical residue on surfaces and could be ingested after touching surfaces or crawling on floors.
Treatment:
Cessation of tobacco use shows instant health benefits, and many tobacco-related health issues could be reversible depending on the age of the smoker. Smokers should refer to a healthcare professional if any tobacco addiction symptom is noticed. Personalized treatment plans should be made for each patient. There are effective pharmacological and behavioral treatments of tobacco abuse. The main pharmacological treatments are certain medications and nicotine replacement therapy (nicotine-containing patches and nicotine gums, nicotine sprays or inhalers). Methods of psychological and behavioral management of nicotine addiction are hypnotherapy, cognitive-behavioral therapy, neuro-linguistic programming. The combination of both pharmacological and behavioral treatments enhance the level of success.
Source: European Lung Foundation
Prevention:
Systemic interventions are increased taxation of tobacco products, stricter laws regulating the purchase of tobacco products, restrictions on advertising and obligatory health warnings on packages.
Community-level prevention measures, like delaying smoking initiation, are also successful. The best way to keep children and youth away from tobacco is not to smoke.
