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Tobacco

​Tobacco is a plant used to make products that deliver nicotine to the body. Nicotine is the addictive drug in tobacco products, but they also contain many other chemicals that cause serious health problems.

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Official Name

​Tobacco

Street Name

Tobacco, cigarettes, cigs, smokes, darts, chew, spit, snuff, dip, shisha, hookah

What is it?

Tobacco is a plant (Nicotiana tabacum and Nicotiana rustica) that contains nicotine, an addictive drug with both stimulant and depressant effects.

Tobacco leaves are used to make products that can be consumed in different ways:

  • smoked in cigarettes, cigars or pipes
  • smoked in loose form in hookahs (water pipe)
  • chewed
  • sniffed as dry snuff
  • held inside the lip or cheek as wet snuff
  • mixed with cannabis and smoked in “joints.”

Tobacco is legal, but federal, provincial and municipal laws tightly control tobacco manufacturing, marketing, distribution and use.

Where does it come from?

Tobacco products are made from the leaves of the tobacco plant. The leaves are cured, fermented and aged before they are manufactured into tobacco products.

Tobacco was cultivated and used as a sacred and healing herb by Indigenous peoples in North America long before the arrival of Europeans.

Today, most of the tobacco legally produced in Canada is grown in Ontario, and is commercially packaged and sold to retailers by one of three tobacco companies. Many of the cheaper contraband cigarettes sold in Canada are smuggled in from the United States.

What does it look like?

Tobacco is prepared differently depending on how it will be consumed:

  • Cigarettes use finely cut tobacco leaves that are rolled in thin paper.
  • Cigars use whole tobacco leaves.
  • Snuff is a finely ground powder of tobacco leaves that often comes in teabag-like pouches.
  • Chewing tobacco uses shredded or twisted tobacco leaves.
  • Hookah uses flavoured and sweetened tobacco that is heated, and the smoke filters through water into a mouthpiece.

Who uses it?

More than five million Canadians smoke. Most people begin between the ages of 11 and 15.

Canada has experienced a steady decline in smoking over the past 50 years:

  • In 1965, almost half of the population smoked. By 2014, the rate of daily and occasional smoking had dipped to 17 per cent of people aged 12 and over.
  • Among Ontario students in grades 7 to 12, cigarette smoking has fallen from more than 28 per cent in 1999 to less than 7 per cent in 2017.

Tobacco use is more common among certain groups:

  • people with lower levels of education and income
  • Aboriginal people: the smoking rate for this population was reported to be 33 per cent in 2014.
  • people who use cannabis: a 2015 Canadian survey found that 48 per cent of people age 15 and over who use cannabis regularly smoke tobacco compared with 10 per cent of people who do not use cannabis.
  • people with substance use problems: a study found that 85 per cent of people seeking treatment for alcohol problems also smoked.
  • people with mental health problems: studies have found that up to 90 per cent of people with schizophrenia, 70 per cent with mania and 49 per cent with depression smoke.

How does it 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 often 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. Smoking raises levels of a brain chemical called dopamine, which increases feelings of pleasure and reinforces 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 medical or psychiatric conditions
  • whether you’ve taken alcohol or other drugs (illegal, prescription, over-the-counter, 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 it addictive?

Tobacco itself is not addictive, but the nicotine in tobacco is very addictive. 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. 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. On average, Canadians who smoke have 15 cigarettes per day.

Nicotine dependence involves psychological and physical factors. Psychological factors 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 or when they feel depressed or anxious. These triggers lead to behaviour patterns, or habits, that can be difficult to change.  

Signs of physical dependence on nicotine include:

  • the urge to smoke within minutes of waking
  • ranking the first cigarette of the day as the most important
  • smoking at regular intervals throughout the day.

People who are addicted to nicotine may become tolerant to the desired effects. They may no longer experience pleasure from smoking, but continue smoking because they have cravings and want to avoid nicotine withdrawal.

Symptoms of nicotine withdrawal include irritability, restlessness, anxiety, insomnia and fatigue. These symptoms usually vanish within a couple of weeks. Some people are unable to concentrate and still have strong cravings to smoke weeks or months after quitting.

Studies show that genetic factors play a role in whether a person will become addicted to nicotine.

Is it dangerous?

Yes. Tobacco use is the primary cause of preventable disease and death in Canada. About 17 per cent of deaths are attributable to smoking. 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 forms 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 are less harmful. However, research has shown that so-called “light” cigarettes are just as likely to cause disease.

Second-hand tobacco smoke is recognized as a health danger, which has led to restrictions on where people can smoke. Violations of tobacco-related laws can result in fines and prison terms.

What are the long-term effects of using it?

All forms of tobacco have long-term health risks. The risk is highest for people who used tobacco that is smoked, particularly cigarettes. The risk of long-term effects increases with the amount smoked, and the length of time a person smokes.

Smoking:

  • 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
  • is a major cause of heart disease and stroke
  • increases the risk of medical problems during pregnancy (e.g., miscarriage, bleeding, placenta previa and poor healing) and increases the risk that the baby will be underweight or will die in infancy
  • causes osteoporosis (thinning of the bones)
  • increases the 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:

  • is linked to heart disease and cancer
  • 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, respiratory problems such as asthma and middle ear infections.

Smokeless tobacco products, such as snuff and chewing tobacco, increase the risk of oral cancers, gingivitis and tooth decay.

Where can I find help, treatment and support?

After a few years, people who quit smoking can generally achieve the same health levels as people 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 called nicotine replacement therapy (NRT), can ease withdrawal symptoms and reduce cravings. These products, such as the patch, gum, inhaler, lozenge and nasal spray, contain nicotine, but none of the toxins that smoked tobacco products contain.

Certain medications that do not contain nicotine can help people quit smoking. These include bupropion (Zyban) and varenicline (Champix). Both are available by prescription.

In Canada, cytisine, a naturally occurring chemical found in plants of the legume family, was approved in 2017 for use as an over-the-counter natural health product to aid in smoking cessation. It is less expensive than NRT or prescription medication.

Cutting down before quitting eases withdrawal symptoms for some people, 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. Cutting down may reduce some health risks, but there is no safe level of smoking; cutting down is not an alternative to quitting.

All approaches to quitting tobacco use work best when the person is highly motivated to quit and has other supports, such as family, friends, a stop-smoking group or telephone support.

 

Copyright © 2003, 2010 Centre for Addiction and Mental Health

  • Treatment at CAMH: Access CAMH
  • INTREPID Lab (formerly Nicotine Dependence Service)
  • Ontario Tobacco Research Unit
  • Help for families from CAMH 
  • ConnexOntario
  • Kids Help Phone at 1 800 668-6868

Where can I find more information?

  • Nicotine dependence
  • Dr. Mike Evans: Quitting Smoking is a Journey (video)
  • Do you know...Tobacco (PDF)
  • Disease Interrupted (CAMH Store)
  • Managing alcohol, tobacco and other drugs: A Pocket Guide for Physicians and Nurses  (CAMH Store)
  • What parents need to know about teen risk-taking: Strategies for Reducing the Risks of Alcohol, Tobacco, Other Drugs and Gambling  (PDF)
  • Vaping: What you and your friends should know
  • Vaping: What elementary school educators need to know
  • Vaping: What secondary school educators need to know

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