Nicotine

Tobacco has been identified as the leading cause of preventable deaths by the World Health Organisation. It is responsible for over 7 million deaths per annum, 6 million of which are due to direct tobacco use and ~890000 resulting from second-hand smoke. Although nicotine is highly addictive, it does not contribute to the health risks listed below, and so smoke-free nicotine delivery methods are relatively safe when purchased from a reliable and safe retailer.

Addiction

Nicotine is extremely addictive, ranking as the 3rd most addictive drug after heroin & crack-cocaine. Almost 40% of people who start smoking become addicted, and there can be genetic vulnerabilities predisposing for nicotine dependence.^{4 5} Nicotine thus exposes smokers to the extremely harmful effects of tobacco smoking, which kills up to 50% of its users.⁹ Tobacco availability as well as the social context of smoking can contribute to high rates of exposure and fast transition to addiction. Alcohol has been shown to increase craving for tobacco in a dose-dependent way manner (i.e. nicotine cravings increase with the amount of alcohol consumed)¹³ and this can also speed up dependence.

Alarmingly, nicotine addiction causes permanent brain changes which are thought to increase the user’s sensitivity to the rewarding effects of other drugs, thus making them more vulnerable to addiction in general.

Withdrawal

Withdrawal is caused by your body craving nicotine and it can make it hard to quit because the symptoms can be unpleasant and hard to ignore. The effects of withdrawal aren’t life-threatening but it can take up to 3 months for your body to no longer crave nicotine.²⁵ Just remember that you’re making a vital change that will have an incredibly positive impact on your overall health.

The symptoms of withdrawal include: anxiety, headaches, depressed mood, difficulty concentrating, restlessness and irritability ²⁶. Withdrawal symptoms get worse with time until a normal balance is restored in the brain after abstinence. Slowly tapering down your nicotine requirements is an effective way to quit smoking because it can reduce withdrawal symptoms and reduce the likelihood of relapse.

Cancer

Since a causative link was first identified between smoking tobacco and lung cancer in the 1920s, extended research has universally confirmed that smoking tobacco significantly increases the risk of certain types of cancer⁹: It confers a **20-fold** increased risk of lung cancer and an increased risk of oral cancer. This is mainly due to the 69 carcinogens found in tobacco smoke (including arsenic, benzene and lead), but additives commonly found in packet cigarettes are thought to contribute to this as well.¹⁰ Now it’s accepted that tobacco use can cause at least 15 different cancers.

Other health risks

There are various severe and fatal health conditions which can result from first-hand or second-hand smoking, listed below:

• Increased risk of lung diseases (e.g. chronic bronchitis, emphysema, asthma)
• Risk of heart problems, CVD and stroke: Carbon monoxide, which is produced via combustion, can damage the heart and blood vessels leading to blood vessel constriction and acute hypertension
• Risk of diabetes
• Osteoporosis
• Foetal injury: this can happen if the mother smokes during pregnancy
• Sudden Infant Death Syndrome: can result from second-hand smoking

Nicotine, although not directly linked to health problems such as cancer, has associated side effects which can be harmful. Nicotine can cause the following:

• Atherosclerosis
• Peptic ulcers
• Increased risk of stroke
• During pregnancy, it could confer risk for obesity and type 2 diabetes for the foetus

Dangerous conditions

If you have or have had cardiovascular problems, high blood-pressure, asthma, lung problems, or cancer it is not recommended to smoke as this will increase the risk of these conditions becoming worse or reappearing.

Schizophrenia

People affected by schizophrenia are thought to be more susceptible to nicotine addiction, and smoking constitutes the main reason for premature death among this group. Thus, if you have a family history or experiences of psychosis it’s advised to never start smoking tobacco.

In the long-term...

Smoking severely compromises quality of life in the long term, as it greatly reduces physical fitness and can in many cases cause erectile dysfunction in men. Fertility rates are decreased as a result of smoking in both sexes. It can also produce changes in physical appearance such as premature ageing, yellowing or rotting teeth and fingernails and can give rise to a foul breath. Furthermore, smoking can be very expensive and long-term users end up spending a significant portion of income to keep up their habit.