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| {{Smoking|expanded=tobacco}} | |||
| '''Tobacco smoking''' is the practice where ] is burned and the resulting smoke (consisting of particle and gaseous phases) is inhaled. The practice may have begun as early as 5000–3000 BC.<ref name="Gateley2004"/> Tobacco was introduced to ] in the late 16th century where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards, but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.<ref name="L&M"/><ref>{{Cite book|author=West, Robert and Shiffman, Saul|title=Fast Facts: Smoking Cessation|publisher=Health Press Ltd.|year=2007|isbn=978-1-903734-98-8|page=28}}</ref> | |||
| German scientists identified a link between smoking and lung cancer in the late 1920s, leading to the first ] in modern history, albeit one truncated by the collapse of the Third Reich at the end of the ].<ref name="NWC228"/> In 1950, British researchers demonstrated a clear relationship between smoking and cancer.<ref name="RichardHillyBMJ1954"/> Scientific evidence continued to mount in the 1980s, which prompted political action against the practice. Rates of consumption since 1965 in the ] have either peaked or declined.<ref name="RockEtAlCDC2006"/> However, they continue to climb in the ].<ref name="WHO2002FactSheet"/> | |||
| Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with additives<ref name ="WHOJeffreyWigand"/> and then ]. The resulting smoke is then inhaled and the active substances absorbed through the ] in the lungs.<ref name="GilmanXun2004p318"/> The active substances trigger chemical reactions in nerve endings, which heighten heart rate, alertness,<ref name="PMID2498936"/> and reaction time.<ref name="WesnessWarburton1997"/> ] and ]s are released, which are often associated with pleasure.<ref name="GilmanXun2004pp320-321"/> As of 2000, smoking is practiced by approximately 1.22 billion people. In most communities men are more likely to smoke than are women,<ref name="HNPGuindonBoisclair13-16" /> though the gender gap tends to be less pronounced in lower age groups.<ref name="WomenTobaccoChallenges5-6"/><ref name="2001SurgeonGeneralWomen47" /> | |||
| Many smokers begin during ] or ]. During the early stages, a combination of perceived pleasure acting as ] and desire to respond to social peer pressure may offset the unpleasant symptoms of initial use, which typically include nausea and interrupted sleep patterns. After an individual has smoked for some years, the avoidance of ] symptoms and ] become the key motivations to continue. | |||
| ==History== | |||
| {{Main|History of tobacco|History of smoking}} | |||
| ===Early years=== | |||
| ], 16th century.]] | |||
| Smoking's history dates back to as early as 5000–3000 BC when the agricultural product began to be cultivated in South America; consumption later evolved into burning the plant substance either by accident or with intent of exploring other means of consumption.<ref name="Gateley2004">{{Cite book|last=Gately|first=Iain|title=Tobacco: A Cultural History of How an Exotic Plant Seduced Civilization|url=http://books.google.com/?id=x41jVocj05EC&printsec=frontcover|accessdate=2009-03-22|origyear=2003|year=2004|publisher=Diane|isbn=0-80213-960-4|pages=3–7|ref=harv|postscript=<!--None-->}}</ref> The practice worked its way into shamanistic rituals<ref name="Wilbert1993">{{Cite journal|last=Wilbert|first=Johannes|title=Tobacco and Shamanism in South America|url=http://books.google.com/?id=qPCuo4LkrIwC&printsec=frontcover|accessdate=2009-03-22|date=1993-07-28|publisher=Yale University Press| isbn =0300057903|ref=harv|postscript=}}</ref>. Many ancient civilisations — such as the Babylonians, the Indians, and the Chinese — burnt incense during religious rituals. The practice was later adopted by the Catholic and the Orthodox churches. Smoking in the Americas probably had its origins in the incense-burning ceremonies of ] but was later adopted for pleasure or as a social tool<ref name="Robicsek1979">{{Cite journal|last=Robicsek|first= Francis|title=The Smoking Gods: Tobacco in Maya Art, History, and Religion|year=1979|month=January|publisher=University of Oklahoma Press|isbn=0806115114|page=30|ref=harv|postscript=}}</ref>. The smoking of tobacco and various hallucinogenic drugs was used to achieve trances and to come into contact with the spirit world. | |||
| Eastern North American tribes would carry large amounts of tobacco in pouches as a readily accepted trade item and would often smoke it in ]s, either in sacred ceremonies or to seal bargains.<ref>{{Cite journal|first1=John Gottlieb Ernestus|last1= Heckewelder | authorlink1 = John Heckewelder | first2=William Cornelius|last2=Reichel|authorlink2 = William Cornelius Reichel|title=History, manners, and customs of the Indian nations who once inhabited Pennsylvania and the neighbouring states|url=http://books.google.com/?id=qPCuo4LkrIwC&printsec=frontcover|format=PDF| accessdate=2009-03-22|origyear=1876 |year=1971| month=June|publisher=The Historical society of Pennsylvania|isbn=978-0405028533|page= 149|ref=harv|postscript=}}</ref> Adults as well as children enjoyed the practice.<ref>{{Cite journal|last1=Diéreville|first2=John Clarence|last2=Webster|first3=Alice de Kessler Lusk|last3=Webster| title = Relation of the voyage to Port Royal in Acadia or New France|year=1933|publisher=The Champlain Society|quote=They smoke with excessive eagerness men, women, girls and boys, all find their keenest pleasure in this way|ref=harv|postscript=}}</ref> It was believed that tobacco was a gift from the Creator and that the exhaled tobacco smoke was capable of carrying one's thoughts and prayers to heaven<ref>{{Cite journal|last=Gottsegen|first= Jack Jacob|title=Tobacco: A Study of Its Consumption in the United States|url=http://books.google.com/?id=1uNCAAAAIAAJ&q=Tobacco:+A+Study+of+Its+Consumption+in+the+United+States&dq=Tobacco:+A+Study+of+Its+Consumption+in+the+United+States|accessdate=2009-03-22 | year = 1940|publisher=Pitman Publishing Company|page=107|ref=harv|postscript=>}}</ref>. | |||
| Apart from smoking, tobacco had a number of uses as medicine. As a pain killer it was used for earache and toothache and occasionally as a ]. Smoking was said by the desert Indians to be a cure for colds, especially if the tobacco was mixed with the leaves of the small Desert Sage, ''Salvia Dorrii'', or the root of Indian Balsam or Cough Root, ''Leptotaenia multifida'', the addition of which was thought to be particularly good for asthma and tuberculosis<ref>{{Cite journal|last=Balls|first=Edward K.|title=Early Uses of California Plants|url=http://books.google.com/?id=F2RzddT6xAsC&printsec=frontcover&dq=Early+Uses+of+California+Plants|accessdate=2009-03-22|date=1962-10-01|publisher=University of California Press|isbn=978-0520000728|pages=81–85|ref=harv|postscript=}}</ref>. | |||
| ===Popularisation=== | |||
| {{For|more about the commercial development of tobacco|History of commercial tobacco in the United States}} | |||
| ], 1627.]] | |||
| In 1612, six years after the settlement of Jamestown, ] was credited as the first settler to successfully raise tobacco as a cash crop. The demand quickly grew as tobacco, referred to as "brown gold", reviving the Virginia joint stock company from its failed gold expeditions.<ref>{{Cite journal|last=Jordan, Jr.|first=Ervin L.|title=Jamestown, Virginia, 1607-1907: An Overview|url=http://curry.edschool.virginia.edu/socialstudies/projects/jvc/overview.html|accessdate=2009-02-22|publisher=University of Virginia|ref=harv|postscript=}}</ref> In order to meet demands from the Old World, tobacco was grown in succession, quickly depleting the soil. This became a motivator to settle west into the unknown continent, and likewise an expansion of tobacco production.<ref>{{Cite journal|last=Kulikoff|first=Allan|title=Tobacco and Slaves: The Development of Southern Cultures in the Chesapeake|url=http://books.google.com/?id=NCvU9_bj-1QC&printsec=frontcover&dq=Tobacco+%26+Slaves:+The+Development+of+Southern+Cultures+in+the+Chesapeake|accessdate=2009-03-22|date=1986-08-01|publisher=The University of North Carolina Press|isbn=978-0807842249|ref=harv|postscript=<!--None-->}}</ref> ] became the primary labor force up until ], from which the focus turned to slavery.<ref>{{Cite journal|last=Cooper|first=William James|title=Liberty and Slavery: Southern Politics to 1860|url=http://books.google.com/?id=AFS3Uu_EMQEC&printsec=frontcover#PPA9,M1|accessdate=2009-03-22|year=2000|month=October|publisher=Univ of South Carolina Press|isbn=978-1570033872|page=9|ref=harv|postscript=}}</ref> This trend abated following the ] as slavery became regarded as unprofitable. However, the practice was revived in 1794 with the invention of the cotton gin<ref>{{Cite journal|last=Trager|first=James|title=The People's Chronology: A Year-by-year Record of Human Events from Prehistory to the Present|year=1994|month=August|publisher=Holt|isbn=978-0805031348|ref=harv|postscript=}}</ref>. | |||
| Frenchman ] (from whose name the word nicotine is derived) introduced tobacco to France in 1560, and tobacco then spread to England. The first report of a smoking Englishman is of a sailor in Bristol in 1556, seen "emitting smoke from his nostrils"<ref name="L&M"/>. Like tea, coffee and opium, tobacco was just one of many intoxicants that was originally used as a form of medicine.<ref>{{Harvnb|Gilman|Xun|2004|p=38}}</ref> Tobacco was introduced around 1600 by French merchants in what today is modern-day ] and ]. At the same time caravans from ] brought tobacco to the areas around ] and the Portuguese brought the commodity (and the plant) to southern Africa, establishing the popularity of tobacco throughout all of Africa by the 1650s. | |||
| Soon after its introduction to the Old World, tobacco came under frequent criticism from state and religious leaders. ], sultan of the ] 1623-40 was among the first to attempt a smoking ban by claiming it was a threat to public moral and health. The Chinese emperor ] issued an edict banning smoking two years before his death and the overthrow of the ]. Later, the ] of the ], who were originally a tribe of nomadic horse warriors, would proclaim smoking "a more heinous crime than that even of neglecting archery". In ] Japan, some of the earliest tobacco plantations were scorned by the ] 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<ref name="Screech-Smoke">{{Harvnb|Gilman|Xun|2004|pp=92–99}}</ref>. | |||
| ] | |||
| Religious leaders have often been prominent among those who considered smoking immoral or outright blasphemous. In 1634 the ] forbade the sale of tobacco, and sentenced men and women who flouted the ban to have their nostrils slit and their backs flayed. The Western church leader ] likewise condemned smoking on holy places in a papal bull of 1624. Despite some concerted efforts, restrictions and bans were largely ignored. When ], a staunch anti-smoker and the author of a '']'', tried to curb the new trend by enforcing a 4000% tax increase on tobacco in 1604 it was unsuccessful, as suggested by the presence of around 7,000 tobacco outlets in London by the early 17th century. From this point on for some centuries, several administrations withdrew from efforts at discouragement and instead turned tobacco trade and cultivation into sometimes lucrative government monopolies<ref>{{Harvnb|Gilman|Xun|2004|pp=15–16}}</ref><ref>{{Cite journal|coauthor=King James I of England|title=A Counterblaste to Tobacco|url=http://www.laits.utexas.edu/poltheory/james/blaste/|accessdate=2009-03-22|date=2002-04-16|origyear=1604|publisher=University of Texas at Austin|ref=harv|postscript=}}</ref>. | |||
| By the mid-17th century most major civilisations had been introduced to tobacco smoking and in many cases had already assimilated it into the native culture, despite some continued attempts upon the parts of rulers to eliminate the practice with penalties or fines. Tobacco, both product and plant, followed the major trade routes to major ports and markets, and then on into the hinterlands. The English language term ''smoking'' appears to have entered currency in the late 18th century, before which less abbreviated descriptions of the practice such as ''drinking smoke'' were also in use<ref name="L&M">{{Cite journal|first1=John|last1=Lloyd|first2=John|last2=Mitchinson|title=The Book of General Ignorance|date=2008-07-25|publisher=Harmony Books|isbn=0307394913|ref=harv|postscript=}}</ref>. | |||
| Growth in the US remained stable until the American Civil War in 1860s, when the primary agricultural workforce shifted from ] to ]. This, along with a change in demand, accompanied the industrialisation of cigarette production as craftsman ] created a machine in 1881 to partially automate their manufacture<ref name="Burns134-135">{{Cite journal|last=Burns|first=Eric|title=The Smoke of the Gods: A Social History of Tobacco|url=http://books.google.com/?id=cZfqS7vi9vEC&printsec=frontcover&dq=The+Smoke+of+the+Gods:+A+Social+History+of+Tobacco|accessdate=2009-03-22|date=2006-09-28|publisher=Temple University Press|isbn=978-1592134809|pages=134–135|ref=harv|postscript=}}</ref>. | |||
| ===Social attitudes and public health=== | |||
| In Germany, anti-smoking groups, often associated with anti-liquor groups,<ref name="NWC178">{{Harvnb|Proctor|2000|p=178}}</ref> first published advocacy against the consumption of tobacco in the journal ''Der Tabakgegner'' (The Tobacco Opponent) in 1912 and 1932. In 1929, Fritz Lickint of Dresden, Germany, published a paper containing formal statistical evidence of a lung cancer–tobacco link. During the Great depression ] condemned his earlier smoking habit as a waste of money,<ref name="NWC219">{{Harvnb|Proctor|2000|p=219}}</ref> and later with stronger assertions. 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.<ref name="NWC187">{{Harvnb|Proctor|2000|p=187}}</ref> | |||
| The ] did not reach across enemy lines during the Second World War, as anti-smoking groups quickly lost popular support. By the end of the Second World War, American cigarette manufacturers quickly reentered the German black market. Illegal smuggling of tobacco became prevalent,<ref name="NWC245">{{Harvnb|Proctor|2000|p=245}}</ref> and leaders of the Nazi anti-smoking campaign were silenced.<ref name="ADLNMPHP">{{Cite journal|last=Proctor|first=Robert N.|title=Nazi Medicine and Public Health Policy|publisher=''Dimensions'', Anti-Defamation League|year=1996|url=http://www.adl.org/Braun/dim_14_1_nazi_med.asp|accessdate=2008-06-01|ref=harv|postscript=<!--None-->}}</ref> As part of the ], the United States shipped free tobacco to Germany; with 24,000 tons in 1948 and 69,000 tons in 1949.<ref name="NWC245"/> Per capita yearly cigarette consumption in ] steadily rose from 460 in 1950 to 1,523 in 1963.<ref name="NWC228">{{Harvnb|Proctor|2000|p=228}}</ref> 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 ] as "muted".<ref name="NWC228"/> | |||
| ] | |||
| In 1950, ] published research in the '']'' showing a close link between smoking and ].<ref>{{Cite pmid|14772469}}</ref> Beginning in December 1952, the magazine '']'' published "Cancer by the Carton", a series of articles that linked ] with ].<ref>{{Cite news|url=http://www.cnn.com/US/9705/tobacco/history/ |title=CNN Interactive |publisher=Cnn.com |date= |accessdate=2009-06-22}}</ref> | |||
| In 1954, the ], a study of some 40 thousand doctors over 20 years, confirmed the suggestion, based on which the government issued advice that smoking and lung cancer rates were related.<ref name="RichardHillyBMJ1954">{{Cite doi|10.1136/bmj.328.7455.1529}}</ref> In January 1964, the United States ]'s Report on Smoking and Health likewise began suggesting the relationship between smoking and cancer. | |||
| As scientific evidence mounted in the 1980s, tobacco companies claimed ] as the adverse health effects were previously unknown or lacked substantial credibility. Health authorities sided with these claims up until 1998, from which they reversed their position. The ], 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.<ref name="WallStreetJournalTobaccoMastersSettlement">{{Cite news|publisher=]|title=Forty-Six States Agree to Accept $206 Billion Tobacco Settlement|date=November 23, 1998|author=Milo Geyelin}}</ref> | |||
| From 1965 to 2006, rates of smoking in the United States declined from 42% to 20.8%.<ref name="RockEtAlCDC2006">{{Cite web|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a2.htm|title=Cigarette Smoking Among Adults --- United States, 2006|accessdate=2009-01-01|author=VJ Rock, MPH, A Malarcher, PhD, JW Kahende, PhD, K Asman, MSPH, C Husten, MD, R Caraballo, PhD|date=2007-11-09|publisher=United States Centers for Disease Control and Prevention|quote=In 2006, an estimated 20.8% (45.3 million) of U.S. adults}}</ref> The majority of those who quit were professional, affluent men. Although the per-capita number of smokers decreased, the average number of cigarettes consumed per person per day increased from 22 in 1954 to 30 in 1978. This paradoxical event suggests that those who quit smoked less, while those who continued to smoke moved to smoke more light cigarettes.<ref>{{Cite journal|last=Hilton|first=Matthew|title=Smoking in British Popular Culture, 1800-2000: Perfect Pleasures|url=http://books.google.com/?id=UjM8t6Ul73YC&printsec=frontcover&dq=Smoking+in+British+Popular+Culture#PPA229,M1|accessdate=2009-03-22|date=2000-05-04|publisher=Manchester University Press|isbn=978-0719052576|pages=229–241|ref=harv|postscript=<!--None-->}}</ref> The trend has been paralleled by many industrialized nations as rates have either leveled-off or declined. In the ], however, tobacco consumption continues to rise at 3.4% in 2002.<ref name="WHO2002FactSheet">{{Cite web|url=http://www.wpro.who.int/media_centre/fact_sheets/fs_20020528.htm|title=WHO/WPRO-Smoking Statistics|accessdate=2009-01-01|date=2002-05-28|publisher=World Health Organization Regional Office for the Western Pacific}}</ref> 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.<ref>{{Harvnb|Gilman|Xun|2004|pp=46–57}}</ref> Today Russia leads as the top consumer of tobacco followed by ], ], ], ], Greece, ], and China.<ref name="MPOWER 2008 pp=267–288">{{harvnb|MPOWER|2008|pp=267–288}}</ref> | |||
| ==Consumption== | |||
| ===Methods=== | |||
| {{Hatnote|For more about the production of the argicultural product, see ], ], ], and ]}} | |||
| ] is an agricultural product processed from the fresh leaves of plants in the genus '']''. The genus contains a number of species, however, '']'' is the most commonly grown. '']'' follows as second containing higher concentrations of nicotine. These leaves are harvested and cured to allow for the slow ] and degradation of ]s in tobacco leaf. This produces certain compounds in the tobacco leaves which can be attributed to sweet hay, tea, rose oil, or fruity aromatic flavors. Before packaging, the tobacco is often combined with other additives in order to: enhance the addictive potency, shift the products ], or improve the effects of smoke by making it more palatable. In the United States these additives are regulated to ].<ref name="WHOJeffreyWigand"/> The product is then processed, packaged, and shipped to consumer markets. Means of consumption has greatly expanded in scope as new methods of delivering the active substances with fewer by-products have encompassed or are beginning to encompass: | |||
| {{multiple image|align=right|direction=vertical|width=180|image1=Nicotiana Tobacco Plants 1909px.jpg|alt1=Field of tobacco organized in rows extending to the horizon.|caption1=Tobacco field in ].|image2=Basma-tobacco-drying.jpg|alt2=Powderly stripps hung vertically, slightly sun bleached.|caption2=] leaves curing in the sun at ] village of ], Thrace, Greece.|image3=DunhillLightFlake.jpg|alt3=Rectangular strips stacked in an open square box.|caption3=Processed tobacco pressed into long strips for shipping.}} | |||
| ;Beedi: ]s are thin South Asian cigarettes filled with tobacco flake and wrapped in a tendu leaf tied with a string at one end. They produce higher levels of carbon monoxide, nicotine, and tar than cigarettes typical in the United States.<ref>{{Cite web|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4836a2.htm|title=Bidi Use Among Urban Youth – Massachusetts, March–April 1999|accessdate=2009-02-14|date=1999-09-17|publisher=Centers for Disease Control and Prevention}}</ref><ref>{{Cite pmid|9862656}}</ref> | |||
| ;Cigars: ]s are tightly rolled bundles of dried and fermented tobacco which are ignited so that smoke may be drawn into the smoker's mouth. They are generally not inhaled because the high alkalinity of the smoke, which can quickly become irritating to the trachea and lungs. The prevalence of cigar smoking varies depending on location, historical period, and population surveyed, and prevalence estimates vary somewhat depending on the survey method. The United States is the top consuming country by far, followed by Germany and the United Kingdom; the US and Western Europe account for about 75% of cigar sales worldwide.<ref name="Rarick">{{Cite journal|ssrn=1127582|author=Rarick CA|title=Note on the premium cigar industry|date=2008-04-02|publisher=SSRN}}</ref> As of 2005 it is estimated that 4.3% of men and 0.3% of women smoke cigars in USA.<ref>{{Cite journal|journal=MMWR Morb Mortal Wkly Rep|year=2006|volume=55|issue=42|pages=1145–8|title=Tobacco use among adults—United States, 2005|author=Mariolis P, Rock VJ, Asman K ''et al.''|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5542a1.htm|pmid=17065979|ref=harv}}</ref> | |||
| ;Cigarettes: '']s'', French for "small cigar", are a product consumed through smoking and manufactured out of cured and finely cut tobacco leaves and reconstituted tobacco, often combined with other additives, which are then rolled or stuffed into a paper-wrapped cylinder.<ref name="WHOJeffreyWigand">{{Cite web|url=http://www.jeffreywigand.com/WHOFinal.pdf|title=ADDITIVES, CIGARETTE DESIGN and TOBACCO PRODUCT REGULATION|accessdate=2009-02-14|last=Wingand|first=Jeffrey S.|year=2006|month=July|format=PDF|publisher=Jeffrey Wigand|location=Mt. Pleasant, MI 48804}}<!-- RELIABLE ONLY FOR DEFINITION OF CIGARETTE --></ref> Cigarettes are ignited and inhaled, usually through a cellulose acetate filter, into the mouth and lungs. | |||
| ;Electronic cigarette: ]s are an alternative to tobacco smoking, although no tobacco is consumed. It is a battery-powered device that provides inhaled doses of nicotine by delivering a vaporized ]/] or ]/nicotine solution. Many legislation and public health investigations are currently pending in many countries due to its relatively recent emergence. Most electronic cigarettes are designed to resemble actual tobacco smoking implements, such as cigarettes, cigars, or pipes, but many take the form of ballpoint pens or screwdrivers since those designs are more practical to house the mechanisms involved. Most are also reusable, with replaceable and refillable parts, but some models are disposable. | |||
| ;French inhale: The French inhale is the action performed by smokers of expelling smoke from the mouth and inhaling it into the nostrils. | |||
| ;Hookah: '']'' are a single or multi-stemmed (often glass-based) water pipe for smoking. Originally from India. The hookah was a symbol of pride and honour for the landlords, kings and other such high class people. Now,the hookah has gained immense popularity, especially in the Middle East. A hookah operates by water filtration and indirect heat. It can be used for smoking herbal fruits, tobacco, or cannabis. | |||
| ;Kretek: '']'' are cigarettes made with a complex blend of tobacco, ]s and a flavoring "sauce". It was first introduced in the 1880s in Kudus, Java, to deliver the medicinal eugenol of cloves to the lungs. The quality and variety of tobacco play an important role in kretek production, from which kretek can contain more than 30 types of tobacco. Minced dried clove buds weighing about 1/3 of the tobacco blend are added to add flavoring. In 2004 the United States prohibited cigarettes from having a "characterizing flavor" of certain ingredients other than tobacco and menthol, thereby removing kretek from being classified as cigarettes.<ref>{{Cite press release|url=http://thomas.loc.gov/cgi-bin/bdquery/z?d108:SN02461:@@@D&summ2=m&|accessdate=2007-08-01|publisher=Library of Congress|title=A bill to protect the public health by providing the Food and Drug Administration with certain authority to regulate tobacco products. (Summary)|date=2004-05-20}}</ref> | |||
| ;Passive smoking: ] is the usually involuntary consumption of smoked tobacco. Second-hand smoke (SHS) is the consumption where the burning end is present, environmental tobacco smoke (ETS) or third-hand smoke is the consumption of the smoke that remains after the burning end has been extinguished. Because of its perceived negative implications, this form of consumption has played a central role in the regulation of tobacco products. | |||
| ;Pipe smoking: ] typically consists of a small chamber (the bowl) for the combustion of the tobacco to be smoked and a thin stem (shank) that ends in a mouthpiece (the bit). Shredded pieces of tobacco are placed into the chamber and ignited. Tobaccos for smoking in pipes are often carefully treated and blended to achieve flavour nuances not available in other tobacco products. | |||
| ;Roll-Your-Own: ] or hand-rolled cigarettes, often called 'rollies', are very popular particularly in European countries. These are prepared from loose tobacco, cigarette papers, and filters all bought separately. They are usually much cheaper than ready-made cigarettes. | |||
| ;Vaporizer: A ] is a device used to sublimate the active ingredients of plant material. Rather than burning the herb, which produces potentially irritating, toxic, or ]ic by-products; a vaporizer heats the material in a partial vacuum so that the active compounds contained in the plant boil off into a vapor. Medical administration of a smoke substance often prefer this method as to directly pyrolyzing the plant material. | |||
| ===Physiology=== | |||
| {{See also|Chain smoking}} | |||
| ] | |||
| The active substances in tobacco, especially cigarettes, are administered by burning the leaves and inhaling the vaporised gas that results. This quickly and effectively delivers substances into the bloodstream by absorption through the ] in the lungs. The lungs contain some 300 million alveoli, which amounts to a surface area of over 70 m<sup>2</sup> (about the size of a tennis court). This method is not completely efficient as not all of the smoke will be inhaled, and some amount of the active substances will be lost in the process of combustion, ].<ref name="GilmanXun2004p318">{{Harvnb|Gilman|Xun|2004|p=318}}</ref> Pipe and Cigar smoke are not inhaled because of its high ], which are irritating to the ] and lungs. However, because of its higher alkalinity (pH 8.5) compared to cigarette smoke (pH 5.3), non-ionised nicotine is more readily absorbed through the ] in the mouth.<ref>{{Cite pmid|589225}}</ref> Nicotine absorption from cigar and pipe, however, is much less than that from cigarette smoke.<ref>{{Cite doi|10.1038/2261231a0}}</ref> | |||
| The inhaled substances trigger chemical reactions in nerve endings. The ]s are often triggered by the naturally occurring ] ]. Acetylcholine and ] express chemical similarities, which allows Nicotine to trigger the receptor as well.<ref name="WonnacottPMID9023878">{{Cite doi|10.1016/S0166-2236(96)10073-4}}</ref> These ]s takes are located in the central nervous system and at the nerve-muscle junction of skeletal muscles; whose activity increases heart rate, alertness,<ref name="PMID2498936">{{Cite doi|10.1007/BF00442260}}</ref> and faster reaction times.<ref name="WesnessWarburton1997">{{Cite doi|10.1007/s002130050553}}</ref> Nicotine acetylcholine stimulation is not directly addictive. However, since dopamine-releasing neurons are abundant on nicotine receptors, dopamine is released.<ref>{{Cite doi|10.1038/382255a0}}</ref> This release of dopamine, which is associated with pleasure, is ] and may also increase ].<ref name="GilmanXun2004pp320-321">{{Harvnb|Gilman|Xun|2004|pp=320–321}}</ref><ref>{{Cite pmid|761168}}</ref> Nicotine and cocaine activate similar patterns of neurons, which supports the idea that common ] among these drugs.<ref>{{cite pmid|8974398}}</ref> | |||
| When tobacco is smoked, most of the nicotine is pyrolyzed. However, a dose sufficient to cause mild somatic dependency and mild to strong psychological dependency remains. There is also a formation of ] (a ]) from the acetaldehyde in tobacco smoke. This may play a role in nicotine addiction, by facilitating a dopamine release in the ] as a response to nicotine stimuli.<ref>{{Cite doi|10.1016/j.euroneuro.2007.02.013}}</ref> Using rat studies, withdrawal after repeated exposure to nicotine results in less responsive nucleus accumbens cells, which produce dopamine responsible for ].<ref>{{Cite doi|10.1016/j.neuroimage.2004.01.026}}</ref> | |||
| ===Demographics=== | |||
| {{Main|Prevalence of tobacco consumption}} | |||
| {{Multiple image|direction=vertical|align=right|image1=Female Smoking by Country.png|image2=Male Smoking by Country.png|width=200|caption1=Percentage of '''females''' smoking any tobacco product|caption2=Percentage of '''males''' smoking any tobacco product. Note that there is a difference between the scales used for females and the scales used for males.<ref name="MPOWER 2008 pp=267–288"/>}} | |||
| As of 2000, smoking was practised by around 1.22 billion people. At current rates of 'smoker replacement' and market growth, this may reach around 1.9 billion in 2025.<ref name="HNPGuindonBoisclair13-16">{{Cite journal|first1=G. Emmanuel|last1=Guindon|first2=David|last2=Boisclair|title=Past, current and future trends in tobacco use|url=http://www1.worldbank.org/tobacco/pdf/Guindon-Past,%20current-%20whole.pdf|format=PDF|accessdate=2009-03-22|year=2003|publisher=The International Bank for Reconstruction and Development / The World Bank|location=Washington DC|pages=13–16|ref=harv|postscript=<!--None-->}}</ref> | |||
| Smoking may be up to five times more prevalent amongst men than women in some communities,<ref name="HNPGuindonBoisclair13-16"/> although the gender gap usually declines with younger age.<ref name="WomenTobaccoChallenges5-6">{{Cite web|url=http://www.who.int/tobacco/media/en/WomenMonograph.pdf|format=PDF|title=Women and the Tobacco Epidemic: Challenges for the 21st Century|accessdate=2009-01-02|author=The World Health Organization, and the Institute for Global Tobacco Control, Johns Hopkins School of Public Health|year=2001|publisher=World Health Organization|pages=5–6}}</ref><ref name="2001SurgeonGeneralWomen47">{{Cite web|url=http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2001/sgr_women_chapters.htm|title=Surgeon General's Report—Women and Smoking|accessdate=2009-01-03|year=2001|publisher=Centers for Disease Control and Prevention|page=47}} {{Dead link|date=September 2010|bot=H3llBot}}</ref> In some developed countries smoking rates for men have peaked and begun to decline, while for women they continue to climb.<ref>{{Cite journal|first1=Richard|last1=Peto|first2=Alan D|last2=Lopez|first3=Jillian|last3=Boreham|first4=Michael|last4=Thun|title=Mortality from Smoking in Developed Countries 1950-2000: indirect estimates from national vital statistics|url=http://www.ctsu.ox.ac.uk/~tobacco/SMK_All_PAGES.pdf|format=PDF|accessdate=2009-03-22|year=2006|publisher=Oxford University Press|page=9|ref=harv|postscript=<!--None-->}}</ref> | |||
| As of 2002, about twenty percent of young teenagers (13–15) smoked worldwide. From which 80,000 to 100,000 children begin smoking every day, roughly half of whom live in Asia. Half of those who begin smoking in ] years are projected to go on to smoke for 15 to 20 years.<ref name="WHO2002FactSheet"/> | |||
| The ] (WHO) states that "Much of the disease burden and premature mortality attributable to tobacco use disproportionately affect the poor". Of the 1.22 billion smokers, 1 billion of them live in developing or transitional economies. Rates of smoking have leveled off or declined in the ].<ref>{{Cite pmid|19910909}}</ref> In the ], however, tobacco consumption is rising by 3.4% per year as of 2002.<ref name="WHO2002FactSheet"/> | |||
| The WHO in 2004 projected 58.8 million deaths to occur globally,<ref name="WHO2004GBD8">{{harvnb|GBD|2008|p=8}}</ref> from which 5.4 million are tobacco-attributed,<ref>{{harvnb|GBD|2008|p=23}}</ref> and 4.9 million as of 2007.<ref name="WHO2007FactSheet">{{Cite web|url=http://www.wpro.who.int/media_centre/fact_sheets/fs_20070529.htm|title=WHO/WPRO-Tobacco Fact sheet|accessdate=2009-01-01|date=2007-05-29|publisher=World Health Organization Regional Office for the Western Pacific}}</ref> As of 2002, 70% of the deaths are in developing countries.<ref name="WHO2007FactSheet"/> | |||
| ==Psychology== | |||
| ===Takeup=== | |||
| ], whose doctor assisted his ] because of ] caused by smoking<ref name=Gay>{{Cite book| last=Gay| first= Peter| year=1988| title=Freud: A Life for Our Time| location=New York |pages=650–651|isbn=0393328619|publisher= W. W. Norton & Company |authorlink=Peter Gay}}</ref>]] | |||
| Most smokers begin during adolescence or early adulthood. Smoking has elements of risk-taking and rebellion, which often appeal to young people. The presence of peers that smoke and media featuring high-status models smoking may also encourage smoking. 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 unsuccessful.<ref name="StantonSilva1992">{{Cite doi|10.1016/0193-3973(92)90010-F}}</ref><ref>{{Cite journal|last1=Harris|first1=Judith Rich|last2=Pinker|first2=Steven|title=The nurture assumption: why children turn out the way they do|url=http://books.google.com/?id=9GQlA_l-TQ0C&printsec=frontcover&dq=The+nurture+assumption:+Why+children+turn+out+the+way+they+do|accessdate=2009-03-22|date=1998-09-04|publisher=Simon and Schuster|isbn=978-0684844091|ref=harv|postscript=<!--None-->}}</ref> | |||
| Children of smoking parents are more likely to smoke than children with non-smoking parents. One study found that parental smoking cessation was associated with less adolescent smoking, except when the other parent currently smoked.<ref>{{Cite doi|10.1093/jpepsy/27.6.485}}</ref> A current study tested the relation of adolescent smoking to rules regulating where adults are allowed to smoke in the home. Results showed that restrictive home smoking policies were associated with lower likelihood of trying smoking for both middle and high school students.<ref>{{Cite doi|10.1080/713688125}}</ref> | |||
| Behavioural research generally indicates that teenagers begin their smoking habits due to peer pressure, and cultural influence portrayed by friends. However, one study found that direct pressure to smoke cigarettes played a less significant part in adolescent smoking, with ]s also reporting low levels of both ] and direct pressure to smoke cigarettes.<ref>{{Cite doi|10.1016/0306-4603(90)90067-8}}</ref> A similar study suggested that individuals may play a more active role in starting to smoke than has previously been thought and that social processes other than peer pressure also need to be taken into account.<ref>{{Cite journal|author=Michell L, West P|title=Peer pressure to smoke: the meaning depends on the method|volume=11|issue=1|pages=39–49|year=1996|url=http://www.oxfordjournals.org/our_journals/healed/online/Volume_11/Issue_01/110039.sgm.abs.html|ref=harv}}</ref> Another study's results indicated that ] was significantly associated with smoking behaviour across all age and gender cohorts, but that intrapersonal factors were significantly more important to the smoking behaviour of 12–13 year-old girls than same-age boys. Within the 14–15 year-old age group, one peer pressure variable emerged as a significantly more important predictor of girls' than boys' smoking.<ref>{{Cite doi|10.1300/J079v26n01_03}}</ref> It is debated whether peer pressure or ] is a greater cause of adolescent smoking. | |||
| Psychologists such as ] have developed a personality profile for the typical smoker. ] is the trait that is most associated with smoking, and smokers tend to be sociable, impulsive, risk taking, and excitement seeking individuals.<ref>{{Cite journal|first1=Hans J.|last1=Eysenck|first2=Stuart|last2=Brody|title=Smoking, health and personality|url=http://books.google.com/books?id=&printsec=frontcover&dq=Smoking,+health+and+personality|accessdate=2009-03-22|date=2000-11|publisher=Transaction|isbn=978-0765806390|ref=harv|postscript=<!--None-->}} {{Dead link|date=September 2010|bot=H3llBot}}</ref> Although personality and social factors may make people likely to smoke, the actual habit is a function of ]. During the early stages, smoking provides pleasurable sensations (because of its action on the ] system) and thus serves as a source of ]. | |||
| ===Persistence=== | |||
| The reasons given by some smokers for this activity have been categorised as ''addictive smoking'', ''pleasure from smoking'', ''tension reduction/relaxation'', ''social smoking'', ''stimulation'', ''habit/automatism'', and ''handling''. There are gender differences in how much each of these reasons contribute, with females more likely than males to cite ''tension reduction/relaxation'', ''stimulation'' and ''social smoking''.<ref>{{Cite doi|10.1046/j.1360-0443.2003.00523.x}}</ref> | |||
| Some smokers argue that the ] effect of smoking allows them to calm their nerves, often allowing for increased concentration. However, according to the ], "Nicotine seems to provide both a stimulant and a depressant effect, and it is likely that the effect it has at any time is determined by the mood of the user, the environment and the circumstances of use. Studies have suggested that low doses have a depressant effect, while higher doses have stimulant effect."<ref>{{Cite journal|title=Nicotine|url=http://www.ch.ic.ac.uk/rzepa/mim/drugs/html/nicotine_text.htm|accessdate=2009-03-22|publisher=Imperial College London|ref=harv|postscript=<!--None-->}}</ref> | |||
| ===Patterns=== | |||
| A number of studies have established that cigarette sales and smoking follow distinct time-related patterns. For example, cigarette sales in the United States of America have been shown to follow a strongly seasonal pattern, with the high months being the months of summer, and the low months being the winter months.<ref>{{Cite doi|10.1136/tc.12.1.105}}</ref> | |||
| Similarly, smoking has been shown to follow distinct circadian patterns during the waking day—with the high point usually occurring shortly after waking in the morning, and shortly before going to sleep at night.<ref>{{Cite doi|10.1037/1064-1297.15.1.67}}</ref> | |||
| ==Impact== | |||
| ===Economic=== | |||
| {{See also|Tobacco industry}} | |||
| In countries where there is a publicly-funded healthcare system, society covers the cost of medical care for smokers who become ill through smoking in the form of increased taxes. Two broad debating positions exist on this front, the "pro-smoking" argument suggesting that heavy smokers generally don't live long enough to develop the costly and chronic illnesses which affect the elderly, reducing society's healthcare burden, and the "anti-smoking" argument suggests that the healthcare burden is increased because smokers get chronic illnesses younger and at a higher rate than the general population. Data on both positions has been contested. The ] published research in 2002 claiming that the cost of each ] of cigarettes sold in the United States was more than $7 in medical care and lost productivity.<ref name="query.nytimes.com"></ref> The cost may be higher, with another study putting it as high as $41 per pack, most of which however is on the individual and his/her family.<ref name="Familycost"></ref> This is how one author of that study puts it when he explains the very low cost for others: "The reason the number is low is that for private pensions, Social Security, and Medicare — the biggest factors in calculating costs to society — smoking actually saves money. Smokers die at a younger age and don't draw on the funds they've paid into those systems."<ref name="Familycost"/> | |||
| By contrast, some non-scientific studies, including one conducted by ] in the Czech Republic<ref name="Czechonomics">{{Cite web|title=Public Finance Balance of Smoking in the Czech Republic|url=http://www.mindfully.org/Industry/Philip-Morris-Czech-Study.htm}}</ref> and another by the ],<ref>{{Cite web|title=Snuff the Facts|url=http://www.cato.org/dailys/1-16-98.html}}</ref> support the opposite position. Philip Morris has explicitly apologised for the former study, saying: "The funding and public release of this study which, among other things, detailed purported cost savings to the Czech Republic due to premature deaths of smokers, exhibited terrible judgment as well as a complete and unacceptable disregard of basic human values. For one of our tobacco companies to commission this study was not just a terrible mistake, it was wrong. All of us at Philip Morris, no matter where we work, are extremely sorry for this. No one benefits from the very real, serious and significant diseases caused by smoking."<ref name="Czechonomics"/> | |||
| Between 1970 and 1995, per-capita cigarette consumption in poorer developing countries increased by 67 percent, while it dropped by 10 percent in the richer developed world. Eighty percent of smokers now live in less developed countries. By 2030, the ] (WHO) forecasts that 10 million people a year will die of smoking-related illness, making it the single biggest cause of death worldwide, with the largest increase to be among women. WHO forecasts the 21st century's death rate from smoking to be ten times the 20th century's rate. ("Washingtonian" magazine, December 2007). | |||
| ===Health=== | |||
| {{Main|Health effects of tobacco}} | |||
| ] | |||
| Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for ], ]s, ] (COPD), ], and ] (particularly ], ], and ]). Cigarette smoking increases the risk of Crohn's disease as well as the severity of the course of the disease.<ref>Inflamm Bowel Dis. May 2009, P. Seksik, I Nion-Larmurier</ref> It is also the number one cause of bladder cancer. The smoke from tobacco elicits carcinogenic effects on the tissues of the body that are exposed to the smoke.<ref>Dreyer, L et al. (1997) Tobacco Smoking. APMIS Inc. </ref> | |||
| Tobacco smoke can combine with other carcinogens present within the environment in order to produce elevated degrees of lung cancer. | |||
| The ] estimate that tobacco caused 5.4 million deaths in 2004<ref name="WHO"></ref> and 100 million deaths over the course of the 20th century.<ref name=WHO2></ref> Similarly, the United States ] describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."<ref name="fn1">"." Centers for Disease Control and Prevention.</ref> | |||
| ] occurs at non-smokers in 3.4 cases per 100 000 ]. At people smoking 0.5 packs of cigarettes a day this figure rises to 51.4 per 100 000, 1-2 packs - up to 143.9 per 100 000 and if the intensity of smoking is over 2 packs a day - up to 217.3 per 100,000 population.{{citation needed|date=May 2011}} Tobacco smoke can combine with other carcinogens present within the environment in order to produce elevated degrees of lung cancer.<ref></ref> | |||
| Rates of smoking have generally levelled-off or declined in the developed world. Smoking rates in the United States have dropped by half from 1965 to 2006 falling from 42% to 20.8% in adults.<ref></ref> In the developing world, tobacco consumption is rising by 3.4% per year.<ref></ref> | |||
| ] presents a very real health risk, to which six hundred thousand deaths were attributed in 2004.<ref name="lancet-2nd-burden"> 2010-11-26</ref> Besides, ] is usually associated with lung cancer.<ref>Dreyer L., Winther J.F., Pukkala E. and Andersen A. (1997). Tobacco Smoking. APMIS Suppl.76, 105, 9-47.</ref> | |||
| ===Social=== | |||
| {{See also|Tobacco advertising|Religious views on smoking}} | |||
| Famous smokers of the past used cigarettes or pipes as part of their image, such as ]'s ]-brand cigarettes; ]'s, ]'s, ]'s, and Bing Crosby's pipes; or the news broadcaster ]'s cigarette. Writers in particular seem to be known for smoking, for example, Cornell Professor ]{{disambiguation needed|date=September 2011}}'s book ''Cigarettes are Sublime'' for the analysis, by this professor of French literature, of the role smoking plays in 19th and 20th century letters. The popular author ] addressed his addiction to cigarettes within his novels. British Prime Minister ] was well known for smoking a pipe in public as was ] for his cigars. ], the fictional detective created by ] smoked a pipe, cigarettes, and cigars. The ] ] comic book character, ], created by ], is synonymous with smoking, so much so that the first storyline by ] creator, ], centered around John Constantine contracting lung cancer. ] ], while in character as "The Sandman", is a chronic smoker in order to appear "tough". | |||
| The problem of smoking at home is particularly difficult for women in many cultures especially Arab cultures where it may not be acceptable for a woman to ask her husband not to smoke at home or in the presence of her children. Studies has shown that pollution levels in door places are higher than levels found on busy roadways, in closed motor garages, and during fire storms. Furthermore, smoke can spread from one room to another, even if doors to the smoking area are closed<ref>Mostafa RM. Dilemma of women's passive smoking. Ann Thorac Med 2011 ;6:55-6. Available from: http://www.thoracicmedicine.org/text.asp?2011/6/2/55/78410</ref>. | |||
| The ceremonial smoking of tobacco, and praying with a ], is a prominent part of the religious ceremonies of a number of ] Nations. ''Sema'', the ] word for tobacco, is grown for ceremonial use and considered the ultimate sacred plant since its smoke was believed to carry prayers to the heavens. In most major religions, however, tobacco smoking is not specifically prohibited, although it may be discouraged as an immoral habit. Before the health risks of smoking were identified through controlled study, smoking was considered an immoral habit by certain Christian preachers and social reformers. The founder of the ], ], recorded that on February 27, 1833, he received a ] which discouraged tobacco use. This "Word of Wisdom" was later accepted as a commandment, and faithful Latter-day Saints abstain completely from tobacco.<ref>{{Cite web| author = Church of Jesus Christ of Latter-day Saints|year = 2009| title = Obey the Word of Wisdom | url = http://www.mormon.org/mormonorg/eng/basic-beliefs/the-commandments/obey-the-word-of-wisdom | work = Basic Beliefs - The Commandments | accessdate = 2009-10-15 }} {{Dead link|date=September 2010|bot=H3llBot}}</ref> Jehovah's Witnesses base their stand against smoking on the Bible's command to "clean ourselves of every defilement of flesh" (2 Corinthians 7:1). The Jewish Rabbi ] (1838–1933) was one of the first Jewish authorities to speak out on smoking. In the ], smoking tobacco is discouraged though not forbidden<ref name="oneworld">{{Cite encyclopedia|last=Smith|first=Peter|encyclopedia=A concise encyclopedia of the Bahá'í Faith|title=smoking|year=2000|publisher=Oneworld Publications|location=Oxford|isbn=1-85168-184-1|pages=323}}</ref>. | |||
| ==Public policy== | |||
| {{See also|Tobacco politics}} | |||
| On February 27, 2005 the ], took effect. The FCTC is the world's first public health treaty. Countries that sign on as parties agree to a set of common goals, minimum standards for tobacco control policy, and to cooperate in dealing with cross-border challenges such as cigarette smuggling. Currently the WHO declares that 4 billion people will be covered by the treaty, which includes 168 signatories.<ref></ref> Among other steps, signatories are to put together legislation that will eliminate secondhand smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places. | |||
| ===Taxation=== | |||
| {{See also|Cigarette taxes in the United States}} | |||
| Many governments have introduced ]es on cigarettes in order to reduce the consumption of cigarettes. | |||
| In 2002, the ] said that each ] of cigarettes sold in the United States costs the nation more than $7 in medical care and lost productivity,<ref name="query.nytimes.com"/> around $3400 per year per smoker. Another study by a team of health economists finds the combined price paid by their families and society is about $41 per pack of cigarettes.<ref></ref> | |||
| Substantial scientific evidence shows that higher cigarette prices result in lower overall cigarette consumption. Most studies indicate that a 10% increase in price will reduce overall cigarette consumption by 3% to 5%. Youth, minorities, and low-income smokers are two to three times more likely to quit or smoke less than other smokers in response to price increases.<ref></ref><ref></ref> Smoking is often cited as an example of an ], however, i.e. a large rise in price will only result in a small decrease in consumption. | |||
| Many nations have implemented some form of tobacco taxation. As of 1997, Denmark had the highest cigarette tax burden of $4.02 per pack. Taiwan only had a tax burden of $0.62 per pack. The federal government of the United States charges $1.01 per pack.<ref>http://www.ttb.gov/tax_audit/atftaxes.shtml</ref> | |||
| Cigarette taxes vary widely from state to state in the United States. For example, ] has a cigarette tax of only 17 cents per pack, the nation's lowest, while ] has the highest cigarette tax in the U.S.: $4.35 per pack. In Alabama, Illinois, Missouri, New York City, Tennessee, and Virginia, counties and cities may impose an additional limited tax on the price of cigarettes.<ref></ref> Sales taxes are also levied on tobacco products in most jurisdictions. | |||
| In the United Kingdom, a packet of 20 cigarettes typically costs between £5.22 and £8.00 at 2007 prices, depending on the brand purchased and where the purchase was made.<ref></ref> The UK has a significant ] for tobacco, and it has been estimated by the tobacco industry that 27% of cigarette and 68% of handrolling tobacco consumption is non-UK duty paid (NUKDP).<ref></ref> | |||
| In Australia total taxes account for 62.5% of the final price of a packet of cigarettes (2011 figures). These taxes include federal excise or customs duty, and the more recently introduced Goods and Services Tax (GST).<ref>Scollo, Michelle (2008). . Tobacco in Australia. Cancer Council Victoria. Retrieved 2010-07-29.</ref>Many people are taxed 10 cents for every pack. | |||
| ===Restrictions=== | |||
| ] | |||
| {{Main|Tobacco advertising|Tobacco packaging warning messages|Smoking ban}} | |||
| In June 1967, the US ] ruled that programmes broadcast on a television station which discussed smoking and health were insufficient to offset the effects of paid advertisements that were broadcast for five to ten minutes each day. In April 1970, the US Congress passed the ] banning the advertising of cigarettes on ] and ] starting on January 2, 1971.<ref></ref> | |||
| The Tobacco Advertising Prohibition Act 1992 expressly prohibited almost all forms of Tobacco advertising in Australia, including the sponsorship of sporting or other cultural events by cigarette brands. | |||
| All tobacco advertising and sponsorship on television has been banned within the European Union since 1991 under the Television Without Frontiers Directive (1989)<ref></ref>. This ban was extended by the Tobacco Advertising Directive, which took effect in July 2005 to cover other forms of media such as the internet, print media, and radio. The directive does not include advertising in cinemas and on billboards or using merchandising – or tobacco sponsorship of cultural and sporting events which are purely local, with participants coming from only one Member State<ref></ref> as these fall outside the jurisdiction of the ]. However, most member states have transposed the directive with national laws that are wider in scope than the directive and cover local advertising. A 2008 European Commission report concluded that the directive had been successfully transposed into national law in all EU member states, and that these laws were well implemented.<ref></ref> | |||
| Some countries also impose legal requirements on the packaging of tobacco products. For example in the countries of the European Union, Turkey, Australia<ref name="auswarn"> Australian Government Department of Health and Ageing. Retrieved August 29, 2008</ref> and South Africa, cigarette packs must be prominently labeled with the health risks associated with smoking.<ref></ref> Canada, Australia, Thailand, Iceland and Brazil have also imposed labels upon cigarette packs warning smokers of the effects, and they include graphic images of the potential health effects of smoking. Cards are also inserted into cigarette packs in Canada. There are sixteen of them, and only one comes in a pack. They explain different methods of quitting smoking. Also, in the United Kingdom, there have been a number of graphic ] advertisements, one showing a cigarette filled with fatty deposits, as if the cigarette is symbolising the artery of a smoker. | |||
| Many countries have a ]. In many countries, including the United States, most European Union member states, New Zealand, Canada, South Africa, Israel, India, Brazil, Chile, Costa Rica and Australia, it is illegal to sell tobacco products to minors and in the Netherlands, Austria, Belgium, Denmark and South Africa it is illegal to sell tobacco products to people under the age of 16. On September 1, 2007 the minimum age to buy tobacco products in Germany rose from 16 to 18, as well as in the United Kingdom where on October 1, 2007 it rose from 16 to 18.<ref></ref> Underlying such laws is the belief that people should make an informed decision regarding the risks of tobacco use. These laws have a lax enforcement in some nations and states. In China, Turkey, and many other countries usually a child will have little problem buying tobacco products, because they are often told to go to the store to buy tobacco for their parents. | |||
| Several countries such as ], ], ], the Netherlands, France, Finland, Norway, Canada, Australia, Sweden, Portugal, ], Italy, ], India, ], ], Spain, ], United Kingdom, ], ] and ] have legislated against smoking in public places, often including bars and restaurants. Restaurateurs have been permitted in some jurisdictions to build designated smoking areas (or to prohibit smoking). In the United States, many states prohibit smoking in restaurants, and some also prohibit smoking in bars. In provinces of Canada, smoking is illegal in indoor workplaces and public places, including bars and restaurants. As of March 31, 2008 Canada has introduced a smoke-free law ban in all public places, as well as within 10 metres of an entrance to any public place. In Australia, smoke-free laws vary from state to state. Currently, Queensland has completely smoke-free indoor public places (including workplaces, bars, pubs and eateries) as well as patrolled beaches and some outdoor public areas. There are, however, exceptions for designated smoking areas. In ], smoking is restricted in railway stations, bus stops and tram stops as these are public locations where ] can affect non-smokers waiting for public transport, and since July 1, 2007 is now extended to all indoor public places. In New Zealand and ], smoking is restricted in enclosed public places including bars, restaurants and pubs. Hong Kong restricted smoking on January 1, 2007 in the workplace, public spaces such as restaurants, karaoke rooms, buildings, and public parks (bars which do not admit minors were exempt until 2009). In ] smoking is illegal in trains, metro stations, public institutions (except where designated, usually outside) and public transport. | |||
| ===Ignition safety=== | |||
| An indirect public health problem posed by cigarettes is that of accidental fires, usually linked with consumption of alcohol. Numerous cigarette designs have been proposed, some by tobacco companies themselves, which would extinguish a cigarette left unattended for more than a minute or two, thereby reducing the risk of fire. Among American tobacco companies, some have resisted this idea, while others have embraced it. ] was a leader in making prototypes of these cigarettes in 1983<ref></ref> and will make all of their U.S. market cigarettes to be fire-safe by 2010.<ref></ref> ] is not in active support of it.<ref name="letter_fire_safe_cigarettes"></ref> ], the US's third largest tobacco company, seems to be ambivalent.<ref name="letter_fire_safe_cigarettes"/> | |||
| ==Gateway drug theory== | |||
| {{Main|Tobacco and other drugs|Gateway drug theory}} | |||
| The relationship between tobacco and other drug use has been well-established, however the nature of this association remains unclear. The two main theories are the ] (gateway) model and the correlated liabilities model. The causation model argues that smoking is a primary influence on future drug use,<ref>{{Cite doi|10.1016/S0376-8716(99)00034-4}}</ref> while the correlated liabilities model argues that smoking and other drug use are predicated on genetic or environmental factors.<ref>{{Cite pmid|2136102}}</ref> | |||
| ==Cessation== | |||
| {{Main|Smoking cessation}} | |||
| Smoking cessation, referred to as "quitting", is the action leading towards abstinence of tobacco smoking. There are a number of methods such as ], ], ]s, ], self-help, and support groups. | |||
| ==See also== | |||
| *] | |||
| *] | |||
| *] | |||
| ==References== | |||
| {{Reflist|colwidth=30em}} | |||
| ==Bibliography== | |||
| {{Refbegin}} | |||
| * {{Cite journal|last=Gilman|first=Sander L.|last2=Xun|first2=Zhou|date=2004-08-15|title=Smoke: A Global History of Smoking|url=http://books.google.com/?id=mM5bYb_uVcwC&printsec=frontcover&dq=smoke|publisher=Reaktion Books|accessdate=2009-03-22|isbn=978-1861892003|ref=harv|postscript=<!--None-->}} | |||
| * {{Cite journal|last=Proctor|first=Robert N.|title=The Nazi War on Cancer|url=http://books.google.com/?id=02NGyKTwko0C&printsec=frontcover&dq=The+Nazi+War+on+Cancer|accessdate=2009-03-22|date=2000-11-15|publisher=Princeton University Press|isbn=978-0691070513|ref=harv|postscript=<!--None-->}} | |||
| * {{Cite book|last=World Health Organization|url=http://www.who.int/entity/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf|format=PDF|title=The Global Burden of Disease 2004 Update|accessdate=2008-01-01|year=2008|isbn=978-92-4-156371-0|ref=CITEREFGBD2008|publisher=]|postscript=<!--None-->}} | |||
| * {{Cite book|last=World Health Organization|url=http://www.who.int/entity/tobacco/mpower/mpower_report_full_2008.pdf|format=PDF|title=WHO Report on the Global Tobacco Epidemic, 2008: the MPOWER package|accessdate=2008-01-01|year=2008|isbn=978-92-4-159628-2|ref=CITEREFMPOWER2008|publisher=]|postscript=<!--None-->}} | |||
| {{Refend}} | |||
| ==External links== | |||
| {{Sister project links|wikt=Smoking|b=Smoking/Contents|q=Tobacco|s=Tobacco|commons=Category:Smoking|n=Smoking|v=Category:Smoking}} | |||
| {{Refbegin}} | |||
| * — repository from Tobacco.org | |||
| * | |||
| * | |||
| * | |||
| {{Refend}} | |||
| {{drug use}} | |||
| {{Cigarettes}} | |||
| {{DEFAULTSORT:Tobacco Smoking}} | |||
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| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||