What is tobacco?
Tobacco is a plant (Nicotiana tabacum and Nicotiana
rustica) that contains nicotine, an addictive drug with both stimulant
and depressant effects.
Tobacco is most commonly smoked in cigarettes. It
is also smoked in cigars or pipes, chewed as chewing tobacco, sniffed as
dry snuff or held inside the lip or cheek as wet snuff. Tobacco may
also be mixed with cannabis and smoked in “joints.” All methods of using tobacco deliver nicotine to the body.
Although tobacco is legal, federal, provincial and
municipal laws tightly control tobacco manufacture, marketing,
distribution and use. Second-hand tobacco smoke is now recognized as a
health danger, which has led to increasing restrictions on where people
can smoke. Violations of tobacco-related laws can result in fines and/or
Where does tobacco come from?
The tobacco plant’s large leaves are cured,
fermented and aged before they are manufactured into tobacco products.
Tobacco was cultivated and widely used by the peoples of the Americas
long before the arrival of Europeans. Today, most of the tobacco legally
produced in Canada is grown in Ontario, commercially packaged and sold
to retailers by one of three tobacco companies. Many of the cheaper
contraband cigarettes currently sold in Canada are smuggled in from the
Who uses tobacco?
Greater awareness of the negative health effects of
smoking, along with increased restrictions, has led to a steady decline
in rates of smoking in Canada. In 1965, almost half of the population
smoked. By 2008, this rate had dipped to 21 per cent of people aged 12
and over (24 per cent of males and 19 per cent of females). Despite the
decline, more than six million Canadians still smoke. An ongoing survey
of Ontario students in grades 7 to 12 indicates that cigarette smoking
in young people has fallen from more than 28 per cent in 1999 to less
than 12 per cent in 2009. While tobacco use is decreasing in Canada and
other developed countries, it is increasing in developing countries.
Tobacco use tends to be more common among people
with lower levels of education and income. Most people who smoke begin
between the ages of 11 and 15.
Studies show that genetic factors play a role in whether or not a person will become addicted to nicotine.
People with certain psychiatric disorders are more
likely to use tobacco. A U.S. survey of people who received psychiatric
outpatient services reported that rates of smoking were 88 per cent for
people with schizophrenia, 70 per cent for those with mania and 49 per
cent for those with depression. Another study found that 85 per cent of
people seeking treatment for alcohol dependence also smoked.
How does tobacco make you feel?
The nicotine in tobacco smoke travels quickly to
the brain, where it acts as a stimulant and increases heart rate and
breathing. Tobacco smoke also reduces the level of oxygen in the
bloodstream, causing a drop in skin temperature. People new to smoking
are likely to experience dizziness, nausea and coughing or gagging.
The mood-altering effects of nicotine are subtle,
complex and powerful. Some people feel that smoking helps them to be
alert and to concentrate, and also that it helps them to feel relaxed.
Research has shown that smoking raises levels of dopamine, a chemical in
the brain, increasing feelings of pleasure and reinforcing the desire
to continue to smoke.
Smoking and second-hand smoke can irritate the
eyes, nose and throat. Tobacco smoke may cause headaches, dizziness,
nausea, coughing and wheezing, and can aggravate allergies and asthma.
Smoking also weakens the sense of taste and smell, reduces hunger and
causes the stomach to produce acid.
How smoking affects you depends on:
- how much and how often you smoke
- how long you’ve been smoking
- your mood, expectations and the environment
- your age
- whether you have certain pre-existing medical or psychiatric conditions
- whether you’ve taken alcohol or other drugs (illicit, prescription, over-the-counter or herbal).
How long does the feeling last?
When a cigarette is smoked, the effects are felt in less than 10 seconds, and last only a few minutes.
Is tobacco dangerous?
Yes. Tobacco use is the primary cause of
preventable disease and death in Canada, and is considered our greatest
public health concern. One study estimated that more than 45,000
Canadians die each year of smoking-related causes. This includes people
who smoke, and people who are exposed to second-hand smoke.
When tobacco is burned, a dark sticky “tar” is
formed from a combination of hundreds of chemicals, including poisons
that cause cancers and bronchial disorders. Tar is released in tobacco
smoke in tiny particles that damage the lungs and airways and stain
teeth and fingers. Tar is the main cause of lung and throat cancers.
(Although nicotine is the main ingredient of tobacco that causes
addiction, it is not known to cause cancer.)
Burning tobacco also forms carbon monoxide (CO), a
poisonous gas you can’t see or smell. When smoke is inhaled, CO replaces
oxygen in red blood cells. While nicotine speeds up the heart, making
it work harder, CO deprives it of the extra oxygen this work demands.
This is one way that smoking contributes to heart disease.
When swallowed, nicotine is extremely toxic.
Ingesting about 40 milligrams of pure nicotine, or roughly the amount
contained in two cigarettes, is fatal. However, when a cigarette is
smoked, most of the nicotine is burned, and only one to four milligrams
is absorbed into the body. Similarly, the amount of nicotine absorbed
from the patch, and other methods of nicotine replacement therapy used
to help people quit smoking, is well below toxic levels.
Canadian laws require that levels of tar, nicotine
and carbon monoxide appear on cigarette packages. It was once thought
that cigarettes with less tar and nicotine might be less harmful.
However, research has shown that so-called “light” cigarettes are just
as likely to cause disease.
Is tobacco addictive?
Yes. Once a person begins to smoke, particularly at
a young age, the chances of becoming addicted are quite high. People
new to smoking quickly develop tolerance to the initial ill effects, and
if they enjoy the stimulant and pleasant effects, they may begin to
smoke regularly. Those who smoke regularly tend to have a consistent
number of cigarettes per day. Canadians who smoke have, on average,
about 15 cigarettes per day.
Nicotine addiction involves psychological and
physical factors. Psychological factors may include feelings of pleasure
and alertness. People who smoke regularly may learn to rely on the
effects of nicotine to bring about these feelings. They also develop
conditioned signals, or “triggers,” for cigarette use. For example, some
people always smoke after a meal, while working at a certain task or
while in certain emotional states, such as feeling depressed or anxious.
These triggers lead to behaviour patterns, or habits, which can be
difficult to change.
Signs of physical dependence include the urge to
smoke within minutes of waking, smoking at regular intervals throughout
the day, and ranking the first cigarette of the day as the most
People who are addicted to nicotine may become
tolerant to the desired effects. They may no longer experience pleasure
from smoking, but continue smoking due to cravings and to avoid nicotine
Symptoms of nicotine withdrawal include
irritability, restlessness, anxiety, insomnia and fatigue. These
symptoms vanish within a couple of weeks. Some people may be unable to
concentrate, and have strong cravings to smoke, for weeks or months
after quitting smoking.
What are the long-term effects of using tobacco?
The risk of long-term effects increases with the amount smoked, and the length of time a person smokes.
- is the main cause of lung cancer
- increases the risk of cancers of the colon, mouth, throat, pancreas, bladder and cervix
- causes most cases of chronic bronchitis and emphysema
- causes smoker’s cough
- is a major cause of heart disease and stroke
- increases the risk of medical problems for a woman during pregnancy
(e.g., miscarriage, bleeding, placenta previa and poor healing) and
increases the risk that her baby will be underweight or will die in
- causes osteoporosis (thinning of the bones)
- increases risk of digestive problems
- affects the immune system, making people who smoke more prone to colds, flu and pneumonia
- decreases the amount of vitamin C in the body, which may cause skin wounds to heal less quickly
- can cause the arteries in the legs to become clogged, resulting in poor circulation, leg pain, gangrene and loss of limb.
Many of the risks and dangers of smoking also
apply to people who are exposed to second-hand smoke. Long-term exposure
to second-hand smoke:
- has been linked to heart disease and cancer
- (in pregnant women) increases the risk of complications during
pregnancy and delivery, and of delivering babies with a low birth weight
- (in young children) has been linked to sudden infant death syndrome,
can lead to or worsen respiratory problems such as asthma; also causes
middle ear infections.
Use of tobacco products that are not smoked,
such as snuff and chewing tobacco, are linked to an increased risk of
oral cancers, gingivitis and tooth decay.
After a few years, people who quit smoking can
generally achieve the same health levels as those who have never smoked,
especially if they stop while they are young. Quitting smoking can take
several attempts, so it is important to keep trying. Stop-smoking aids
containing nicotine, such as the patch, gum, inhaler, lozenge or nasal
spray, can help to ease withdrawal symptoms and reduce cravings. Such
aids work best when the person is highly motivated to quit, and when the
person has other supports, such as family, friends, a stop-smoking
group or telephone support.
Certain medications that do not contain nicotine
can help people to quit smoking. These include bupropion (Zyban) and
varenicline (Champix). Both are available by prescription.
For some people, cutting down before quitting helps
to lessen the withdrawal symptoms, and allows them to change their
smoking behaviours gradually. Strategies for cutting down include
delaying cigarettes, smoking fewer cigarettes and smoking less of each
cigarette. Although cutting down may reduce some health risks, there is
no safe level of smoking; cutting down is not an alternative to
There are currently more former smokers than
smokers in Canada. In 2005, 39 per cent of the population, or more than
10 million Canadians aged 12 and over, reported they had quit smoking.
Copyright © 2003, 2010 Centre for Addiction and Mental Health
Where can I find help, treatment and support for using tobacco?
Treatment and support are available for people trying to quit smoking:
Treatment from CAMH
Help for Families from CAMH
Ontario Drug and Alcohol Helpline (open 24/7 for treatment anywhere in Ontario)
Kids Help Phone at 1 800 668-6868
Where can I find other CAMH resources related to tobacco and smoking?
Tips for Quitting Smoking (with video)
Dr. Mike Evans: Quitting Smoking is a Journey (video)
About tobacco: Information for youth
An early start: Lets talk about smoking
Smoking Treatment for Ontario Patients Study (STOP Study)
The Ontario Tobacco Research Unit