Smoking

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This article is about smoking of tobacco and other drugs. Smoking_sentence_0

For the method of food preparation, see Smoking (cooking). Smoking_sentence_1

For other uses, see Smoking (disambiguation). Smoking_sentence_2

Smoking is a practice in which a substance is burned and the resulting smoke is breathed in to be tasted and absorbed into the bloodstream. Smoking_sentence_3

Most commonly, the substance used is the dried leaves of the tobacco plant, which have been rolled into a small rectangle of rolling paper to create a small, round cylinder called a "cigarette". Smoking_sentence_4

Smoking is primarily practised as a route of administration for recreational drug use because the combustion of the dried plant leaves vaporizes and delivers active substances into the lungs where they are rapidly absorbed into the bloodstream and reach bodily tissue. Smoking_sentence_5

In the case of cigarette smoking these substances are contained in a mixture of aerosol particles and gases and include the pharmacologically active alkaloid nicotine; the vaporization creates heated aerosol and gas into a form that allows inhalation and deep penetration into the lungs where absorption into the bloodstream of the active substances occurs. Smoking_sentence_6

In some cultures, smoking is also carried out as a part of various rituals, where participants use it to help induce trance-like states that, they believe, can lead them to spiritual enlightenment. Smoking_sentence_7

Smoking is one of the most common forms of recreational drug use. Smoking_sentence_8

Tobacco smoking is the most popular form, being practised by over one billion people globally, of whom the majority are in the developing countries. Smoking_sentence_9

Less common drugs for smoking include cannabis and opium. Smoking_sentence_10

Some of the substances are classified as hard narcotics, like heroin, but the use of these is very limited as they are usually not commercially available. Smoking_sentence_11

Cigarettes are primarily industrially manufactured but also can be hand-rolled from loose tobacco and rolling paper. Smoking_sentence_12

Other smoking implements include pipes, cigars, bidis, hookahs, and bongs. Smoking_sentence_13

Smoking can be dated to as early as 5000 BCE, and has been recorded in many different cultures across the world. Smoking_sentence_14

Early smoking evolved in association with religious ceremonies; as offerings to deities, in cleansing rituals or to allow shamans and priests to alter their minds for purposes of divination or spiritual enlightenment. Smoking_sentence_15

After the European exploration and conquest of the Americas, the practice of smoking tobacco quickly spread to the rest of the world. Smoking_sentence_16

In regions like India and Sub-Saharan Africa, it merged with existing practices of smoking (mostly of cannabis). Smoking_sentence_17

In Europe, it introduced a new type of social activity and a form of drug intake which previously had been unknown. Smoking_sentence_18

Perception surrounding smoking has varied over time and from one place to another: holy and sinful, sophisticated and vulgar, a panacea and deadly health hazard. Smoking_sentence_19

In the last decade of the 20th century, smoking came to be viewed in a decidedly negative light, especially in Western countries. Smoking_sentence_20

Smoking generally has negative health effects, because smoke inhalation inherently poses challenges to various physiologic processes such as respiration. Smoking_sentence_21

Smoking tobacco is among the leading causes of many diseases such as lung cancer, heart attack, COPD, erectile dysfunction, and birth defects. Smoking_sentence_22

Diseases related to tobacco smoking have been shown to kill approximately half of long-term smokers when compared to average mortality rates faced by non-smokers. Smoking_sentence_23

Smoking caused over five million deaths a year from 1990 to 2015. Smoking_sentence_24

The health hazards of smoking have caused many countries to institute high taxes on tobacco products, run ads to discourage use, limit ads that promote use, and provide help with quitting for those who do smoke. Smoking_sentence_25

History Smoking_section_0

Main article: History of smoking Smoking_sentence_26

Early uses Smoking_section_1

The history of smoking dates back to as early as 5000 BCE in shamanistic rituals. Smoking_sentence_27

Many ancient civilizations, such as the Babylonians, Indians and Chinese, burnt incense as a part of religious rituals, as did the Israelites and the later Catholic and Orthodox Christian churches. Smoking_sentence_28

Smoking in the Americas probably had its origins in the incense-burning ceremonies of shamans but was later adopted for pleasure, or as a social tool. Smoking_sentence_29

The smoking of tobacco, as well as various hallucinogenic drugs, was used to achieve trances and to come into contact with the spirit world. Smoking_sentence_30

Substances such as cannabis, clarified butter (ghee), fish offal, dried snake skins and various pastes molded around incense sticks dates back at least 2000 years. Smoking_sentence_31

Fumigation (dhupa) and fire offerings (homa) are prescribed in the Ayurveda for medical purposes, and have been practiced for at least 3,000 years while smoking, dhumrapana (literally "drinking smoke"), has been practiced for at least 2,000 years. Smoking_sentence_32

Before modern times these substances have been consumed through pipes, with stems of various lengths or chillums. Smoking_sentence_33

Cannabis smoking was common in the Middle East before the arrival of tobacco, and was early on a common social activity that centered around the type of water pipe called a hookah. Smoking_sentence_34

Smoking, especially after the introduction of tobacco, was an essential component of Muslim society and culture and became integrated with important traditions such as weddings, funerals and was expressed in architecture, clothing, literature and poetry. Smoking_sentence_35

Cannabis smoking was introduced to Sub-Saharan Africa through Ethiopia and the east African coast by either Indian or Arab traders in the 13th century or earlier and spread on the same trade routes as those that carried coffee, which originated in the highlands of Ethiopia. Smoking_sentence_36

It was smoked in calabash water pipes with terracotta smoking bowls, apparently an Ethiopian invention which was later conveyed to eastern, southern and central Africa. Smoking_sentence_37

Reports from the first European explorers and conquistadors to reach the Americas tell of rituals where native priests smoked themselves into such high degrees of intoxication that it is unlikely that the rituals were limited to just tobacco. Smoking_sentence_38

Popularization Smoking_section_2

For more about the impact and development of tobacco, see History of tobacco. Smoking_sentence_39

For more about the commercial development of tobacco, see History of commercial tobacco in the United States. Smoking_sentence_40

In 1612, six years after the settlement of Jamestown, John Rolfe was credited as the first settler to successfully grow tobacco as a cash crop. Smoking_sentence_41

The demand quickly grew as tobacco, referred to as "golden weed", revived the Virginia Company from its failed expeditions in search for gold in the Americas. Smoking_sentence_42

In order to meet demands from the old world, tobacco was grown in succession, quickly depleting the land. Smoking_sentence_43

This became a motivator to settle west into the unknown continent, and likewise an expansion of tobacco production. Smoking_sentence_44

Indentured servants became the primary labor force up until Bacon's Rebellion, from which the focus turned to slavery. Smoking_sentence_45

This trend abated following the American Revolution as slavery became regarded as unprofitable. Smoking_sentence_46

However the practice was revived in 1794 with the invention of the cotton gin. Smoking_sentence_47

A Frenchman named Jean Nicot (from whose name the word nicotine is derived) introduced tobacco to France in 1560. Smoking_sentence_48

From France tobacco spread to England. Smoking_sentence_49

The first report documents an English sailor in Bristol in 1556, seen "emitting smoke from his nostrils". Smoking_sentence_50

Like tea, coffee and opium, tobacco was just one of many intoxicants that was originally used as a form of medicine. Smoking_sentence_51

Tobacco was introduced around 1600 by French merchants in what today is modern-day The Gambia and Senegal. Smoking_sentence_52

At the same time caravans from Morocco brought tobacco to the areas around Timbuktu and the Portuguese brought the commodity (and the plant) to southern Africa, establishing the popularity of tobacco throughout all of Africa by the 1650s. Smoking_sentence_53

Soon after its introduction to the Old World, tobacco came under frequent criticism from state and religious leaders. Smoking_sentence_54

Murad IV, sultan of the Ottoman Empire 1623–40 was among the first to attempt a smoking ban by claiming it was a threat to public morality and health. Smoking_sentence_55

The Chongzhen Emperor of China issued an edict banning smoking two years before his death and the overthrow of the Ming dynasty. Smoking_sentence_56

Later, the Manchu rulers of the Qing dynasty, would proclaim smoking "a more heinous crime than that even of neglecting archery". Smoking_sentence_57

In Edo period Japan, some of the earliest tobacco plantations were scorned by the shōgun as being a threat to the military economy by letting valuable farmland go to waste for the use of a recreational drug instead of being used to plant food crops. Smoking_sentence_58

Religious leaders have often been prominent among those who considered smoking immoral or outright blasphemous. Smoking_sentence_59

In 1634 the Patriarch of Moscow and all Rus' forbade the sale of tobacco and sentenced men and women who flouted the ban to have their nostrils slit and their backs whipped until skin came off their backs. Smoking_sentence_60

The Western church leader Pope Urban VII likewise condemned smoking in a papal bull of 1590. Smoking_sentence_61

Despite many concerted efforts, restrictions and bans were almost universally ignored. Smoking_sentence_62

When James VI and I, a staunch anti-smoker and the author of A Counterblaste to Tobacco, tried to curb the new trend by enforcing a whopping 4000% tax increase on tobacco in 1604, it proved a failure, as London had some 7,000 tobacco sellers by the early 17th century. Smoking_sentence_63

Later, scrupulous rulers would realise the futility of smoking bans and instead turned tobacco trade and cultivation into lucrative government monopolies. Smoking_sentence_64

By the mid-17th century every major civilization had been introduced to tobacco smoking and in many cases had already assimilated it into its culture, despite the attempts of many rulers to stamp the practice out with harsh penalties or fines. Smoking_sentence_65

Tobacco, both product, and plant followed the major trade routes to major ports and markets, and then on into the hinterlands. Smoking_sentence_66

The English language term smoking was coined in the late 18th century; before then the practice was referred to as drinking smoke. Smoking_sentence_67

Tobacco and cannabis were used in Sub-Saharan Africa, much like elsewhere in the world, to confirm social relations, but also created entirely new ones. Smoking_sentence_68

In what is today Congo, a society called Bena Diemba ("People of Cannabis") was organized in the late 19th century in Lubuko ("The Land of Friendship"). Smoking_sentence_69

The Bena Diemba were collectivist pacifists that rejected alcohol and herbal medicines in favor of cannabis. Smoking_sentence_70

The growth remained stable until the American Civil War in the 1860s, from which the primary labor force transition from slavery to sharecropping. Smoking_sentence_71

This compounded with a change in demand, lead to the industrialization of tobacco production with the cigarette. Smoking_sentence_72

James Albert Bonsack, a craftsman, in 1881 produced a machine to speed the production of cigarettes. Smoking_sentence_73

Opium Smoking_section_3

Main article: Opium Smoking_sentence_74

In the 19th century, the practise of smoking opium became widespread in China. Smoking_sentence_75

Previously, opium had only been ingested via consumption, and then only for it's medicinal properties (opium was an anaesthetic). Smoking_sentence_76

The narcotic was also outlawed in China sometime in the early 18th century due the societal issues it caused. Smoking_sentence_77

Due to a massive trade imbalance, however, foreign merchants started to smuggle opium into China via Canton, to the chagrin of the Chinese authorities. Smoking_sentence_78

Attempts by Chinese official Lin Zexu to eliminate the trade led to the outbreak of the First Opium War. Smoking_sentence_79

The Chinese defeat the First and Second Opium Wars resulted in the legalization of the importation of opium into China. Smoking_sentence_80

Opium smoking later spread with Chinese immigrants and spawned many infamous opium dens in Chinatowns around South and Southeast Asia, Europe and the Americas. Smoking_sentence_81

In the latter half of the 19th century, opium smoking became popular in the artistic community in Europe, especially Paris; artists' neighborhoods such as Montparnasse and Montmartre became virtual "opium capitals". Smoking_sentence_82

While opium dens that catered primarily to emigrant Chinese continued to exist in Chinatowns around the world, the trend among the European artists largely abated after the outbreak of World War I. Smoking_sentence_83

The consumption of Opium abated in China during the Cultural Revolution in the 1960s and 1970s. Smoking_sentence_84

Anti-tobacco movement Smoking_section_4

For more about the movement in the 1930s and 1940s, see Anti-tobacco movement in Nazi Germany. Smoking_sentence_85

For more about the modern movement, see Anti-smoking movement. Smoking_sentence_86

For more about the development of public policy, see Tobacco politics. Smoking_sentence_87

The anti-tobacco movement started long before most people today realize. Smoking_sentence_88

In 1798 Dr. Benjamin Rush (early American physician, signer of the Declaration of Independence, Surgeon General under George Washington, and anti-tobacco activist) was "against the habitual use of tobacco" because he believed it (a) "led to a desire for strong drink," (b) "was injurious both to health and morals," (c) "is generally offensive to" nonsmokers, (d) "produces a want of respect for" nonsmokers, and (e) "always disposes to unkind and unjust behavior towards them." Smoking_sentence_89

With the modernization of cigarette production compounded with the increased life expectancies during the 1920s, adverse health effects began to become more prevalent. Smoking_sentence_90

In Germany, anti-smoking groups, often associated with anti-liquor groups, first published advocacy against the consumption of tobacco in the journal Der Tabakgegner (The Tobacco Opponent) in 1912 and 1932. Smoking_sentence_91

In 1929, Fritz Lickint of Dresden, Germany, published a paper containing formal statistical evidence of a lung cancer–tobacco link. Smoking_sentence_92

During the Great Depression, Adolf Hitler condemned his earlier smoking habit as a waste of money, and later with stronger assertions. Smoking_sentence_93

This movement was further strengthened with Nazi reproductive policy as women who smoked were viewed as unsuitable to be wives and mothers in a German family. Smoking_sentence_94

The movement in Nazi Germany did reach across enemy lines during the Second World War, as anti-smoking groups quickly lost popular support. Smoking_sentence_95

By the end of the Second World War, American cigarette manufacturers quickly reentered the German black market. Smoking_sentence_96

Illegal smuggling of tobacco became prevalent, and leaders of the Nazi anti-smoking campaign were assassinated. Smoking_sentence_97

As part of the Marshall Plan, the United States shipped free tobacco to Germany; with 24,000 tons in 1948 and 69,000 tons in 1949. Smoking_sentence_98

Per capita yearly cigarette consumption in post-war Germany steadily rose from 460 in 1950 to 1,523 in 1963. Smoking_sentence_99

By the end of the 20th century, anti-smoking campaigns in Germany were unable to exceed the effectiveness of the Nazi-era climax in the years 1939–41 and German tobacco health research was described by Robert N. Proctor as "muted". Smoking_sentence_100

In the UK and the US, an increase in lung cancer rates, formerly "among the rarest forms of disease", was noted by the 1930s, but its cause remained unknown and even the credibility of this increase was sometimes disputed as late as 1950. Smoking_sentence_101

For example, in Connecticut, reported age-adjusted incidence rates of lung cancer among males increased 220% between 1935–39 and 1950–54. Smoking_sentence_102

In the UK, the share of lung cancer among all cancer deaths in men increased from 1.5% in 1920 to 19.7% in 1947. Smoking_sentence_103

Nevertheless, these increases were questioned as potentially caused by increased reporting and improved methods of diagnosis. Smoking_sentence_104

Although several carcinogens were already known at the time (for example, benzo[a]pyrene was isolated from coal tar and demonstrated to be a potent carcinogen in 1933), none were known to be contained in adequate quantities in tobacco smoke. Smoking_sentence_105

Richard Doll in 1950 published research in the British Medical Journal showing a close link between smoking and lung cancer. Smoking_sentence_106

Four years later, in 1954 the British Doctors Study, a study of some 40 thousand doctors over 20 years, confirmed the link, based on which the government issued advice that smoking and lung cancer rates were related. Smoking_sentence_107

In 1964 the United States Surgeon General's Report on Smoking and Health demonstrated the relationship between smoking and cancer. Smoking_sentence_108

Further reports confirmed this link in the 1980s and concluded in 1986 that passive smoking was also harmful. Smoking_sentence_109

As scientific evidence mounted in the 1980s, tobacco companies claimed contributory negligence as the adverse health effects were previously unknown or lacked substantial credibility. Smoking_sentence_110

Health authorities sided with these claims up until 1998, from which they reversed their position. Smoking_sentence_111

The Tobacco Master Settlement Agreement, originally between the four largest US tobacco companies and the Attorneys General of 46 states, restricted certain types of tobacco advertisement and required payments for health compensation; which later amounted to the largest civil settlement in United States history. Smoking_sentence_112

From 1965 to 2006, rates of smoking in the United States have declined from 42% to 20.8%. Smoking_sentence_113

A significant majority of those who quit were professional, affluent men. Smoking_sentence_114

Despite this decrease in the prevalence of consumption, the average number of cigarettes consumed per person per day increased from 22 in 1954 to 30 in 1978. Smoking_sentence_115

This paradoxical event suggests that those who quit smoked less, while those who continued to smoke moved to smoke more light cigarettes. Smoking_sentence_116

This trend has been paralleled by many industrialized nations as rates have either leveled-off or declined. Smoking_sentence_117

In the developing countries, however, tobacco consumption continues to rise at 3.4% in 2002. Smoking_sentence_118

In Africa, smoking is in most areas considered to be modern, and many of the strong adverse opinions that prevail in the West receive much less attention. Smoking_sentence_119

Today Russia leads as the top consumer of tobacco followed by Indonesia, Laos, Ukraine, Belarus, Greece, Jordan, and China. Smoking_sentence_120

At the global scale, initial ideas of an international convention towards the prevention of tobacco had been initiated in the World Health Assembly (WHA) in 1996. Smoking_sentence_121

In 1998, along with the successful election of Dr. Smoking_sentence_122 Gro Harlem Brundtland as the Director-General, the World Health Organization set tobacco control as its leading health concern and has begun a program known as the Tobacco Free Initiative (TFI) in order to reduce rates of consumption in the developing world. Smoking_sentence_123

However, it was not until 2003 that the Framework Convention on Tobacco Control (FCTC) was accepted in WHA and entered into force in 2005. Smoking_sentence_124

FCTC marked a milestone as the first international treaty concerning a global health issue that aims to combat tobacco in multiple aspects including tobacco taxes, advertisement, trading, environmental affects, health influences, etc. Smoking_sentence_125

The birth of this evidence-based and systematic approach has resulted in the reinforcement of tobacco taxes and the implementation of smoke-free laws in 128 countries that led to the decrease of smoking prevalence in developing nations. Smoking_sentence_126

Other substances Smoking_section_5

For more about the rise of crack cocaine, see Crack epidemic. Smoking_sentence_127

In the early 1980s, organized international trafficking of cocaine grew. Smoking_sentence_128

However, overproduction and tighter legal enforcement for the illegal product caused drug dealers to convert the powder to "crack" – a solid, smokable form of cocaine that could be sold in smaller quantities to more people. Smoking_sentence_129

This trend abated in the 1990s as increased police action coupled with a robust economy caused many potential consumers to give up or fail to take up the habit. Smoking_sentence_130

Recent years shows an increase in the consumption of vaporized heroin, methamphetamine and Phencyclidine (PCP). Smoking_sentence_131

Along with a smaller number of psychedelic drugs such as DMT, 5-Meo-DMT, and Salvia divinorum. Smoking_sentence_132

Substances and equipment Smoking_section_6

See also: List of drugs which can be smoked Smoking_sentence_133

The most popular type of substance that is smoked is tobacco. Smoking_sentence_134

There are many different tobacco cultivars which are made into a wide variety of mixtures and brands. Smoking_sentence_135

Tobacco is often sold flavored, often with various fruit aromas, something which is especially popular for use with water pipes, such as hookahs. Smoking_sentence_136

The second most common substance that is smoked is cannabis, made from the flowers or leaves of Cannabis sativa or Cannabis indica. Smoking_sentence_137

The substance is considered illegal in most countries in the world and in those countries that tolerate public consumption, it is usually only pseudo-legal. Smoking_sentence_138

Despite this, a considerable percentage of the adult population in many countries have tried it with smaller minorities doing it on a regular basis. Smoking_sentence_139

Since cannabis is illegal or only tolerated in most jurisdictions, there is no industrial mass-production of cigarettes, meaning that the most common form of smoking is with hand-rolled cigarettes (often called joints) or with pipes. Smoking_sentence_140

Water pipes are also fairly common, and when used for cannabis are called bongs. Smoking_sentence_141

A few other recreational drugs are smoked by smaller minorities. Smoking_sentence_142

Most of these substances are controlled, and some are considerably more intoxicating than either tobacco or cannabis. Smoking_sentence_143

These include crack cocaine, heroin, methamphetamine and PCP. Smoking_sentence_144

A small number of psychedelic drugs are also smoked, including DMT, 5-Meo-DMT, and Salvia divinorum. Smoking_sentence_145

Even the most primitive form of smoking requires tools of some sort to perform. Smoking_sentence_146

This has resulted in a staggering variety of smoking tools and paraphernalia from all over the world. Smoking_sentence_147

Whether tobacco, cannabis, opium or herbs, some form of receptacle is required along with a source of fire to light the mixture. Smoking_sentence_148

The most common today is by far the cigarette, consisting of a mild inhalant strain of tobacco in a tightly rolled tube of paper, usually manufactured industrially and including a filter, or hand-rolled with loose tobacco. Smoking_sentence_149

Other popular smoking tools are various pipes and cigars. Smoking_sentence_150

A less common but increasingly popular alternative to smoking is vaporizers, which use hot air convection to deliver the substance without combustion, which may reduce health risks. Smoking_sentence_151

A portable vaporization alternative appeared in 2003 with the introduction of electronic cigarettes, battery-operated, cigarette-shaped devices which produce an aerosol intended to mimic the smoke from burning tobacco, delivering nicotine to the user without some of the harmful substances released in tobacco smoke. Smoking_sentence_152

Other than actual smoking equipment, many other items are associated with smoking; cigarette cases, cigar boxes, lighters, matchboxes, cigarette holders, cigar holders, ashtrays, silent butlers, pipe cleaners, tobacco cutters, match stands, pipe tampers, cigarette companions and so on. Smoking_sentence_153

Some examples of these have become valuable collector items and particularly ornate and antique items can fetch high prices. Smoking_sentence_154

Health effects Smoking_section_7

Main article: Health effects of tobacco Smoking_sentence_155

Smoking is one of the leading causes of preventable death globally and is the cause of 15% of all deaths. Smoking_sentence_156

In the United States about 500,000 deaths per year are attributed to smoking-related diseases and a recent study estimated that as much as 1/3 of China's male population will have significantly shortened life-spans due to smoking. Smoking_sentence_157

Male and female smokers lose an average of 13.2 and 14.5 years of life, respectively. Smoking_sentence_158

At least half of all lifelong smokers die earlier as a result of smoking. Smoking_sentence_159

The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female current smoker, in the absence of competing causes of death. Smoking_sentence_160

The corresponding estimates for lifelong nonsmokers are a 1.1% probability of dying from lung cancer before age 85 for a man of European descent, and a 0.8% probability for a woman. Smoking_sentence_161

Smoking just one cigarette a day results in a risk of coronary heart disease that is halfway between that of a heavy smoker and a non-smoker. Smoking_sentence_162

The non-linear dose–response relationship may be explained by smoking's effect on platelet aggregation. Smoking_sentence_163

Among the diseases that can be caused by smoking are vascular stenosis, lung cancer, heart attacks and chronic obstructive pulmonary disease. Smoking_sentence_164

Smoking during pregnancy may cause ADHD to a fetus. Smoking_sentence_165

Smoking is a risk factor strongly associated with periodontitis and tooth loss. Smoking_sentence_166

The effects of smoking on periodontal tissues depend on the number of cigarettes smoked daily and the duration of the habit . Smoking_sentence_167

A study showed that smokers had 2.7 times and former smokers 2.3 times greater probabilities to have established periodontal disease than non‐smokers, independent of age, sex and plaque index, however, the effect of tobacco on periodontal tissues seems to be more pronounced in men than in women. Smoking_sentence_168

Studies have found that smokers had greater odds for more severe dental bone loss compared to non‐smokers , also, people who smoke and drink alcohol heavily have much higher risk of developing oral cancer (mouth and lip) compared with people who do neither. Smoking_sentence_169

Smoking can also cause milanosis in the mouth. Smoking_sentence_170

Smoking has been also associated with oral conditions including dental caries, dental implant failures, premalignant lesions, and cancer. Smoking_sentence_171

Smoking can affect the immune-inflammatory processes which may increase the susceptibility to infections; it can alter the oral mycobiota and facilitate colonization of the oral cavity with fungi and pathogenic molds. Smoking_sentence_172

Many governments are trying to deter people from smoking with anti-smoking campaigns in mass media stressing the harmful long-term effects of smoking. Smoking_sentence_173

Passive smoking, or secondhand smoking, which affects people in the immediate vicinity of smokers, is a major reason for the enforcement of smoking bans. Smoking_sentence_174

These are laws enforced to stop individuals from smoking in indoor public places, such as bars, pubs and restaurants, thus reducing nonsmokers’ exposure to secondhand smoke. Smoking_sentence_175

A common concern among legislators is to discourage smoking among minors and many states have passed laws against selling tobacco products to underage customers (establishing a smoking age). Smoking_sentence_176

Many developing countries have not adopted anti-smoking policies, leading some to call for anti-smoking campaigns and further education to explain the negative effects of ETS (Environmental Tobacco Smoke) in developing countries. Smoking_sentence_177

Tobacco advertising is also sometimes regulated to make smoking less appealing. Smoking_sentence_178

In May 2016 the state of California passed legislation raising the smoking age from 18 to 21. Smoking_sentence_179

This law also includes the sale of electronic cigarettes. Smoking_sentence_180

Despite the many bans, European countries still hold 18 of the top 20 spots, and according to the ERC, a market research company, the heaviest smokers are from Greece, averaging 3,000 cigarettes per person in 2007. Smoking_sentence_181

Rates of smoking have leveled off or declined in the developed world but continue to rise in developing countries. Smoking_sentence_182

Smoking rates in the United States have dropped by half from 1965 to 2006, falling from 42% to 20.8% in adults. Smoking_sentence_183

The effects of addiction on society vary considerably between different substances that can be smoked and the indirect social problems that they cause, in great part because of the differences in legislation and the enforcement of narcotics legislation around the world. Smoking_sentence_184

Though nicotine is a highly addictive drug, its effects on cognition are not as intense or noticeable as other drugs such as cocaine, amphetamines or any of the opiates (including heroin and morphine). Smoking_sentence_185

Smoking is a risk factor in Alzheimer's disease. Smoking_sentence_186

While smoking more than 15 cigarettes per day has been shown to worsen the symptoms of Crohn's disease, smoking has been shown to actually lower the prevalence of ulcerative colitis. Smoking_sentence_187

Smokers are 30-40% more likely to develop type 2 diabetes than non-smokers, and the risk increases with the number of cigarettes smoked. Smoking_sentence_188

Smoking_unordered_list_0

  • Smoking_item_0_0
  • Smoking_item_0_1

Physiology Smoking_section_8

Inhaling the vaporized gas form of substances into the lungs is a quick and very effective way of delivering drugs into the bloodstream (as the gas diffuses directly into the pulmonary vein, then into the heart and from there to the brain) and affects the user within less than a second of the first inhalation. Smoking_sentence_189

The lungs consist of several million tiny bulbs called alveoli that altogether have an area of over 70 m² (about the area of a tennis court). Smoking_sentence_190

This can be used to administer useful medical as well as recreational drugs such as aerosols, consisting of tiny droplets of a medication, or as gas produced by burning plant material with a psychoactive substance or pure forms of the substance itself. Smoking_sentence_191

Not all drugs can be smoked, for example the sulphate derivative that is most commonly inhaled through the nose, though purer free base forms of substances can, but often require considerable skill in administering the drug properly. Smoking_sentence_192

The method is also somewhat inefficient since not all of the smoke will be inhaled. Smoking_sentence_193

The inhaled substances trigger chemical reactions in nerve endings in the brain due to being similar to naturally occurring substances such as endorphins and dopamine, which are associated with sensations of pleasure. Smoking_sentence_194

The result is what is usually referred to as a "high" that ranges between the mild stimulus caused by nicotine to the intense euphoria caused by heroin, cocaine and methamphetamines. Smoking_sentence_195

Inhaling smoke into the lungs, no matter the substance, has adverse effects on one's health. Smoking_sentence_196

The incomplete combustion produced by burning plant material, like tobacco or cannabis, produces carbon monoxide, which impairs the ability of blood to carry oxygen when inhaled into the lungs. Smoking_sentence_197

There are several other toxic compounds in tobacco that constitute serious health hazards to long-term smokers from a whole range of causes; vascular abnormalities such as stenosis, lung cancer, heart attacks, strokes, impotence, low birth weight of infants born by smoking mothers. Smoking_sentence_198

8% of long-term smokers develop the characteristic set of facial changes known to doctors as smoker's face. Smoking_sentence_199

Tobacco smoke is a complex mixture of over 5,000 identified chemicals, of which 98 are known to have specific toxicological properties. Smoking_sentence_200

The most important chemicals causing cancer are those that produce DNA damage since such damage appears to be the primary underlying cause of cancer. Smoking_sentence_201

Cunningham et al. Smoking_sentence_202

combined the microgram weight of the compound in the smoke of one cigarette with the known genotoxic effect per microgram to identify the most carcinogenic compounds in cigarette smoke. Smoking_sentence_203

The seven most important carcinogens in tobacco smoke are shown in the table, along with DNA alterations they cause. Smoking_sentence_204

Smoking_table_general_0

The most genotoxic cancer causing chemicals in cigarette smokeSmoking_table_caption_0
CompoundSmoking_header_cell_0_0_0 Micrograms per cigaretteSmoking_header_cell_0_0_1 Effect on DNASmoking_header_cell_0_0_2 Ref.Smoking_header_cell_0_0_3
AcroleinSmoking_cell_0_1_0 122.4Smoking_cell_0_1_1 Reacts with deoxyguanine and forms DNA crosslinks, DNA-protein crosslinks and DNA adductsSmoking_cell_0_1_2 Smoking_cell_0_1_3
FormaldehydeSmoking_cell_0_2_0 60.5Smoking_cell_0_2_1 DNA-protein crosslinks causing chromosome deletions and re-arrangementsSmoking_cell_0_2_2 Smoking_cell_0_2_3
AcrylonitrileSmoking_cell_0_3_0 29.3Smoking_cell_0_3_1 Oxidative stress causing increased 8-oxo-2'-deoxyguanosineSmoking_cell_0_3_2 Smoking_cell_0_3_3
1,3-butadieneSmoking_cell_0_4_0 105.0Smoking_cell_0_4_1 Global loss of DNA methylation (an epigenetic effect) as well as DNA adductsSmoking_cell_0_4_2 Smoking_cell_0_4_3
AcetaldehydeSmoking_cell_0_5_0 1448.0Smoking_cell_0_5_1 Reacts with deoxyguanine to form DNA adductsSmoking_cell_0_5_2 Smoking_cell_0_5_3
Ethylene oxideSmoking_cell_0_6_0 7.0Smoking_cell_0_6_1 Hydroxyethyl DNA adducts with adenine and guanineSmoking_cell_0_6_2 Smoking_cell_0_6_3
IsopreneSmoking_cell_0_7_0 952.0Smoking_cell_0_7_1 Single and double strand breaks in DNASmoking_cell_0_7_2 Smoking_cell_0_7_3

Psychology Smoking_section_9

Most tobacco smokers begin during adolescence or early adulthood. Smoking_sentence_205

Smoking has elements of risk-taking and rebellion, which often appeal to young people. Smoking_sentence_206

The presence of high-status models and peers may also encourage smoking. Smoking_sentence_207

Because teenagers are influenced more by their peers than by adults, attempts by parents, schools, and health professionals at preventing people from trying cigarettes are not always successful. Smoking_sentence_208

Smokers often report that cigarettes help relieve feelings of stress. Smoking_sentence_209

However, the stress levels of adult smokers are slightly higher than those of nonsmokers. Smoking_sentence_210

Adolescent smokers report increasing levels of stress as they develop regular patterns of smoking, and smoking cessation leads to reduced stress. Smoking_sentence_211

Far from acting as an aid for mood control, nicotine dependency seems to exacerbate stress. Smoking_sentence_212

This is confirmed in the daily mood patterns described by smokers, with normal moods during smoking and worsening moods between cigarettes. Smoking_sentence_213

Thus, the apparent relaxant effect of smoking only reflects the reversal of the tension and irritability that develop during nicotine depletion. Smoking_sentence_214

Dependent smokers need nicotine to remain feeling normal. Smoking_sentence_215

In the mid-20th century psychologists such as Hans Eysenck developed a personality profile for the typical smoker of that period; extraversion was associated with smoking, and smokers tended to be sociable, impulsive, risk taking, and excitement-seeking individuals. Smoking_sentence_216

Although personality and social factors may make people likely to smoke, the actual habit is a function of operant conditioning. Smoking_sentence_217

During the early stages, smoking provides pleasurable sensations (because of its action on the dopamine system) and thus serves as a source of positive reinforcement. Smoking_sentence_218

After an individual has smoked for many years, the avoidance of withdrawal symptoms and negative reinforcement become the key motivations. Smoking_sentence_219

Like all addictive substances, the amount of exposure required to become dependent on nicotine can vary from person to person. Smoking_sentence_220

In terms of the Big Five personality traits, research has found smoking to be correlated with lower levels of agreeableness and conscientiousness, as well as higher levels of extraversion and neuroticism. Smoking_sentence_221

Prevention Smoking_section_10

Education and counselling by physicians of children and adolescents has been found to be effective in decreasing the risk of tobacco use. Smoking_sentence_222

Systematic reviews show that psychosocial interventions can help women stop smoking in late pregnancy, reducing low birthweight and preterm births. Smoking_sentence_223

A 2016 Cochrane review showed that the combination of medication and behavioural support was more effective than minimal interventions or usual care. Smoking_sentence_224

Another Cochrane review "suggests that neither reducing smoking to quit nor quitting abruptly results in superior quit rates; people could therefore be given a choice of how to quit, and support provided to people who would specifically like to reduce their smoking before quitting." Smoking_sentence_225

Smoking_unordered_list_1

  • Smoking_item_1_2
  • Smoking_item_1_3
  • Smoking_item_1_4
  • Smoking_item_1_5

Prevalence Smoking_section_11

Further information: Prevalence of tobacco consumption Smoking_sentence_226

Smoking, primarily of tobacco, is an activity that is practiced by some 1.1 billion people, and up to 1/3 of the adult population. Smoking_sentence_227

The image of the smoker can vary considerably, but is very often associated, especially in fiction, with individuality and aloofness. Smoking_sentence_228

Even so, smoking of both tobacco and cannabis can be a social activity which serves as a reinforcement of social structures and is part of the cultural rituals of many and diverse social and ethnic groups. Smoking_sentence_229

Many smokers begin smoking in social settings and the offering and sharing of a cigarette is often an important rite of initiation or simply a good excuse to start a conversation with strangers in many settings; in bars, night clubs, at work or on the street. Smoking_sentence_230

Lighting a cigarette is often seen as an effective way of avoiding the appearance of idleness or mere loitering. Smoking_sentence_231

For adolescents, it can function as a first step out of childhood or as an act of rebellion against the adult world. Smoking_sentence_232

Also, smoking can be seen as a sort of camaraderie. Smoking_sentence_233

It has been shown that even opening a packet of cigarettes, or offering a cigarette to other people, can increase the level of dopamine (the "happy feeling") in the brain, and it is doubtless that people who smoke form relationships with fellow smokers, in a way that only proliferates the habit, particularly in countries where smoking inside public places has been made illegal. Smoking_sentence_234

Other than recreational drug use, it can be used to construct identity and a development of self-image by associating it with personal experiences connected with smoking. Smoking_sentence_235

The rise of the modern anti-smoking movement in the late 19th century did more than create awareness of the hazards of smoking; it provoked reactions of smokers against what was, and often still is, perceived as an assault on personal freedom and has created an identity among smokers as rebels or outcasts, apart from non-smokers: Smoking_sentence_236

The importance of tobacco to soldiers was early on recognized as something that could not be ignored by commanders. Smoking_sentence_237

By the 17th century allowances of tobacco were a standard part of the naval rations of many nations and by World War I cigarette manufacturers and governments collaborated in securing tobacco and cigarette allowances to soldiers in the field. Smoking_sentence_238

It was asserted that regular use of tobacco while under duress would not only calm the soldiers but allow them to withstand greater hardship. Smoking_sentence_239

Until the mid-20th century, the majority of the adult population in many Western nations were smokers and the claims of anti-smoking activists were met with much skepticism, if not outright contempt. Smoking_sentence_240

Today the movement has considerably more weight and evidence of its claims, but a considerable proportion of the population remains steadfast smokers. Smoking_sentence_241

Society and culture Smoking_section_12

Smoking has been accepted into culture, in various art forms, and has developed many distinct, and often conflicting or mutually exclusive, meanings depending on time, place and the practitioners of smoking. Smoking_sentence_242

Pipe smoking, until recently one of the most common forms of smoking, is today often associated with solemn contemplation, old age and is often considered quaint and archaic. Smoking_sentence_243

Cigarette smoking, which did not begin to become widespread until the late 19th century, has more associations of modernity and the faster pace of the industrialized world. Smoking_sentence_244

Cigars have been, and still are, associated with masculinity, power and is an iconic image associated with the stereotypical capitalist. Smoking_sentence_245

In fact, some evidence suggests that men with higher than average testosterone levels are more likely to smoke. Smoking_sentence_246

Smoking in public has for a long time been something reserved for men and when done by women has been associated with promiscuity. Smoking_sentence_247

In Japan during the Edo period, prostitutes and their clients would often approach one another under the guise of offering a smoke; the same was true for 19th-century Europe. Smoking_sentence_248

Art Smoking_section_13

The earliest depictions of smoking can be found on Classical Mayan pottery from around the 9th century. Smoking_sentence_249

The art was primarily religious in nature and depicted deities or rulers smoking early forms of cigarettes. Smoking_sentence_250

Soon after smoking was introduced outside of the Americas it began appearing in painting in Europe and Asia. Smoking_sentence_251

The painters of the Dutch Golden Age were among the first to paint portraits of people smoking and still lifes of pipes and tobacco. Smoking_sentence_252

For southern European painters of the 17th century, a pipe was much too modern to include in the preferred motifs inspired by mythology from Greek and Roman antiquity. Smoking_sentence_253

At first smoking was considered lowly and was associated with peasants. Smoking_sentence_254

Many early paintings were of scenes set in taverns or brothels. Smoking_sentence_255

Later, as the Dutch Republic rose to considerable power and wealth, smoking became more common amongst the affluent and portraits of elegant gentlemen tastefully raising a pipe appeared. Smoking_sentence_256

Smoking represented pleasure, transience and the briefness of earthly life as it, quite literally, went up in smoke. Smoking_sentence_257

Smoking was also associated with representations of both the sense of smell and that of taste. Smoking_sentence_258

In the 18th century smoking became far more sparse in painting as the elegant practice of taking snuff became popular. Smoking_sentence_259

Smoking a pipe was again relegated to portraits of lowly commoners and country folk and the refined sniffing of shredded tobacco followed by sneezing was rare in art. Smoking_sentence_260

When smoking appeared it was often in the exotic portraits influenced by Orientalism. Smoking_sentence_261

Many proponents of postcolonialism controversially believe this portrayal was a means of projecting an image of European superiority over its colonies and a perception of the male dominance of a feminized Orient. Smoking_sentence_262

Proponents believe the theme of the exotic and alien "Other" escalated in the 19th century, fueled by the rise in the popularity of ethnology during the Enlightenment. Smoking_sentence_263

In the 19th century smoking was common as a symbol of simple pleasures; the pipe smoking "noble savage", solemn contemplation by Classical Roman ruins, scenes of an artists becoming one with nature while slowly toking a pipe. Smoking_sentence_264

The newly empowered middle class also found a new dimension of smoking as a harmless pleasure enjoyed in smoking saloons and libraries. Smoking_sentence_265

Smoking a cigarette or a cigar would also become associated with the Bohemian, someone who shunned the conservative middle class values and displayed his contempt for conservatism. Smoking_sentence_266

But this was a pleasure that was to be confined to a male world; women smokers were associated with prostitution and smoking was not considered an activity fit for proper ladies. Smoking_sentence_267

It was not until the start of the 20th century that smoking women would appear in paintings and photos, giving a chic and charming impression. Smoking_sentence_268

Impressionists like Vincent van Gogh, who was a pipe smoker himself, would also begin to associate smoking with gloom and fin-du-siècle fatalism. Smoking_sentence_269

While the symbolism of the cigarette, pipe and cigar respectively were consolidated in the late 19th century, it was not until the 20th century that artists began to use it fully; a pipe would stand for thoughtfulness and calm; the cigarette symbolized modernity, strength and youth, but also nervous anxiety; the cigar was a sign of authority, wealth and power. Smoking_sentence_270

The decades following World War II, during the apex of smoking when the practice had still not come under fire by the growing anti-smoking movement, a cigarette casually tucked between the lips represented the young rebel, epitomized in actors like Marlon Brando and James Dean or mainstays of advertising like the Marlboro Man. Smoking_sentence_271

It was not until the 1970s when the negative aspects of smoking began to appear, yielding the image of the unhealthy lower-class individual, reeking of cigarette smoke and lack of motivation and drive, which was especially prominent in art inspired or commissioned by anti-smoking campaigns. Smoking_sentence_272

In his painting "Holy Smokes", artist Brian Whelan pokes fun at the smoking debate and its newly found focus on morality and guilt. Smoking_sentence_273

Film and TV Smoking_section_14

Ever since the era of silent films, smoking has had a major part in film symbolism. Smoking_sentence_274

In the hard-boiled film noir crime thrillers, cigarette smoke often frames characters and is frequently used to add an aura of mystique or nihilism. Smoking_sentence_275

One of the forerunners of this symbolism can be seen in Fritz Lang's Weimar era Dr Mabuse, der Spieler, 1922 (Dr Mabuse, the Gambler), where men mesmerized by card playing smoke cigarettes while gambling. Smoking_sentence_276

Female smokers in film were also early on associated with a type of sensuous and seductive sexuality, most notably personified by German film star Marlene Dietrich. Smoking_sentence_277

Similarly, actors like Humphrey Bogart and Audrey Hepburn have been closely identified with their smoker persona, and some of their most famous portraits and roles have involved them being haloed by a mist of cigarette smoke. Smoking_sentence_278

Hepburn often enhanced the glamor with a cigarette holder, most notably in the film Breakfast at Tiffany's. Smoking_sentence_279

Smoking could also be used as a means to subvert censorship, as two cigarettes burning unattended in an ashtray were often used to suggest sexual activity. Smoking_sentence_280

Since World War II, smoking has gradually become less frequent on screen as the obvious health hazards of smoking have become more widely known. Smoking_sentence_281

With the anti-smoking movement gaining greater respect and influence, conscious attempts not to show smoking on screen are now undertaken in order to avoid encouraging smoking or giving it positive associations, particularly for family films. Smoking_sentence_282

Smoking on screen is more common today among characters who are portrayed as anti-social or even criminal. Smoking_sentence_283

According to a 2019 study, the introduction of television in the United States led to a substantial increase in smoking, in particular among 16–21-year-olds. Smoking_sentence_284

The study suggested "that television increased the share of smokers in the population by 5–15 percentage points, generating roughly 11 million additional smokers between 1946 and 1970." Smoking_sentence_285

Literature Smoking_section_15

Just as in other types of fiction, smoking has had an important place in literature and smokers are often portrayed as characters with great individuality, or outright eccentrics, something typically personified in one of the most iconic smoking literary figures of all, Sherlock Holmes. Smoking_sentence_286

Other than being a frequent part of short stories and novels, smoking has spawned endless eulogies, praising its qualities and affirming the author's identity as a devoted smoker. Smoking_sentence_287

Especially during the late 19th century and early 20th century, a panoply of books with titles like Tobacco: Its History and associations (1876), Cigarettes in Fact and Fancy (1906) and Pipe and Pouch: The Smokers Own Book of Poetry (1905) were written in the UK and the US. Smoking_sentence_288

The titles were written by men for other men and contained general tidbits and poetic musings about the love for tobacco and all things related to it, and frequently praised the refined bachelor's life. Smoking_sentence_289

The Fragrant Weed: Some of the Good Things Which Have been Said or Sung about Tobacco, published in 1907, contained, among many others, the following lines from the poem A Bachelor's Views by Tom Hall that were typical of the attitude of many of the books: Smoking_sentence_290

These works were all published in an era before the cigarette had become the dominant form of tobacco consumption and pipes, cigars, and chewing tobacco were still commonplace. Smoking_sentence_291

Many of the books were published in novel packaging that would attract the learned smoking gentleman. Smoking_sentence_292

Pipe and Pouch came in a leather bag resembling a tobacco pouch and Cigarettes in Fact and Fancy (1901) came bound in leather, packaged in an imitation cardboard cigar box. Smoking_sentence_293

By the late 1920s, the publication of this type of literature largely abated and was only sporadically revived in the later 20th century. Smoking_sentence_294

Music Smoking_section_16

There have been few examples of tobacco in music in early modern times, though there are occasional signs of influence in pieces such as Johann Sebastian Bach's Enlightening Thoughts of a Tobacco-Smoker. Smoking_sentence_295

However, from the early 20th century and onwards smoking has been closely associated with popular music. Smoking_sentence_296

Jazz was from early on closely intertwined with the smoking that was practiced in the venues where it was played, such as bars, dance halls, jazz clubs and even brothels. Smoking_sentence_297

The rise of jazz coincided with the expansion of the modern tobacco industry, and in the United States also contributed to the spread of cannabis. Smoking_sentence_298

The latter went under names like "tea", "muggles" and "reefer" in the jazz community and was so influential in the 1920s and 30s that it found its way into songs composed at the time such as Louis Armstrong's Muggles Larry Adler's Smoking Reefers and Don Redman's Chant of The Weed. Smoking_sentence_299

The popularity of marijuana among jazz musicians remained high until the 1940s and 50s, when it was partially replaced by the use of heroin. Smoking_sentence_300

Another form of modern popular music that has been closely associated with cannabis smoking is reggae, a style of music that originated in Jamaica in the late 1950s and early 60s. Smoking_sentence_301

Cannabis, or ganja, is believed to have been introduced to Jamaica in the mid-19th century by Indian immigrant labor and was primarily associated with Indian workers until it was appropriated by the Rastafari movement in the middle of the 20th century. Smoking_sentence_302

The Rastafari considered cannabis smoking to be a way to come closer to God, or Jah, an association that was greatly popularized by reggae icons such as Bob Marley and Peter Tosh in the 1960s and 70s. Smoking_sentence_303

Economics Smoking_section_17

Estimates claim that smokers cost the U.S. economy $97.6 billion a year in lost productivity and that an additional $96.7 billion is spent on public and private health care combined. Smoking_sentence_304

This is over 1% of the gross domestic product. Smoking_sentence_305

A male smoker in the United States that smokes more than one pack a day can expect an average increase of $19,000 just in medical expenses over the course of his lifetime. Smoking_sentence_306

A U.S. female smoker that also smokes more than a pack a day can expect an average of $25,800 additional healthcare costs over her lifetime. Smoking_sentence_307

See also Smoking_section_18

Smoking_unordered_list_2


Credits to the contents of this page go to the authors of the corresponding Wikipedia page: en.wikipedia.org/wiki/Smoking.