Tobacco smoking

A woman smoking a cigarette, the most common method of tobacco smoking
Aztec women are handed flowers and smoking tubes before eating at a banquet, Florentine Codex, 16th century.
Gentlemen Smoking and Playing Backgammon in an Interior by Dirck Hals, 1627
Bonsack's cigarette rolling machine, as shown on U.S. patent 238,640
A lengthy study conducted in order to establish the strong association necessary for legislative action (US cigarette consumption per person blue, male lung cancer rate brown)
Tendu Patta (Leaf) collection for Beedi industries
A graph that shows the efficiency of smoking as a way to absorb nicotine compared to other forms of intake.
Sigmund Freud, whose doctor assisted his suicide because of oral cancer caused by smoking
Common adverse effects of tobacco smoking. The more common effects are in bold face.
Skull with a burning cigarette, by Vincent van Gogh.
An enclosed smoking area in a Japanese train station. Notice the air vent on the roof.

Practice of burning tobacco and ingesting the smoke that is produced.

- Tobacco smoking
A woman smoking a cigarette, the most common method of tobacco smoking

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A filtered cigarette

Cigarette

Narrow cylinder containing burnable material, typically tobacco, that is rolled into thin paper for smoking.

Narrow cylinder containing burnable material, typically tobacco, that is rolled into thin paper for smoking.

A filtered cigarette
An electronic cigarette
A reproduction of a carving from the temple at Palenque, Mexico, depicting a Maya deity using a smoking tube
Francisco Goya's La Cometa, depicting a (foreground left) man smoking an early quasicigarette
A 1942 ad encourages women to smoke Camel brand cigarettes.
Diagram of a cigarette
Leones Africanos brand cigarettes from the mid-20th century, part of the permanent collection of the Museo del Objeto del Objeto
A discarded cigarette butt, lying on dirty snow
Various types of electronic cigarettes.
Artistas brand cigarette package of Mexico from the Museo del Objeto del Objeto collection
Tabak-Trafik in Vienna: Since January 1, 2007, all cigarette machines in Austria must attempt to verify a customer's age by requiring the insertion of a debit card or mobile phone verification.
Simple molecular representation of cellulose acetate with one of the acetate groups on the cellulose backbone shown by the red circle
Discarded Newport cigarettes packs found in Olneyville, Rhode Island - 2008
Chemical hydrolysis of cellulose acetate
The chemical structure change of cellulose into glucose
A cigarette disposal canister, encouraging the public to dispose of their cigarettes properly
A Woolworths supermarket cigarette counter in New South Wales, Australia: In January 2011, Australia prohibited the display of cigarettes in retail outlets countrywide.
Cigarette salespeople in Jakarta, Indonesia

An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco.

A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

Cancer

Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Symptoms of cancer metastasis depend on the location of the tumor.
The GHS Hazard pictogram for carcinogenic substances
Share of cancer deaths attributed to tobacco in 2016.
The incidence of lung cancer is highly correlated with smoking.
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Chest X-ray showing lung cancer in the left lung
Three measures of global cancer mortality from 1990 to 2017
Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
University of Florida Cancer Hospital
CancerTreeMammal
An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
An invasive colorectal carcinoma (top center) in a colectomy specimen
A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
A large invasive ductal carcinoma in a mastectomy specimen

Tobacco use is the cause of about 22% of cancer deaths.

A 21mg dose nicotine patch applied to the left arm

Smoking cessation

A 21mg dose nicotine patch applied to the left arm
Some health organizations manage text messaging services to help people avoid smoking
Percent increase of success for six months over unaided attempts for each type of quitting (chart from West & Shiffman based on Cochrane review data
Individuals who sustained damage to the insula were able to more easily abstain from smoking.
Survival from age 35 of non-smokers, cigarette smokers and ex-smokers who stopped smoking between 25 and 34 years old. The ex-smokers line follows closely the non-smokers line.
Smokers as a percentage of the population for the United States, the Netherlands, Norway, Japan, and Finland

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking.

Tobacco smoke in an Irish pub before a smoking ban came into effect on March 29, 2004

Tobacco smoke

Tobacco smoke in an Irish pub before a smoking ban came into effect on March 29, 2004

Tobacco smoke is a sooty aerosol produced by the incomplete combustion of tobacco during the smoking of cigarettes and other tobacco products.

A chest X-ray showing a tumor in the lung (marked by arrow)

Lung cancer

Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

A chest X-ray showing a tumor in the lung (marked by arrow)
Relationship between cigarette consumption per person (blue) and male lung cancer rates (dark yellow) in the US over the century
Risk of death from lung cancer is strongly correlated with smoking.
CT scan showing a cancerous tumor in the left lung
Primary pulmonary sarcoma in an asymptomatic 72-year-old male
Pie chart showing incidences of NSCLCs as compared to SCLCs shown at right, with fractions of smokers versus nonsmokers shown for each type
Cross section of a human lung: The white area in the upper lobe is cancer; the black areas are discoloration due to smoking.
Pneumonectomy specimen containing a squamous-cell carcinoma, seen as a white area near the bronchi
Brachytherapy (internal radiotherapy) for lung cancer given via the airway
Monoclonal antibodies used in the treatment of NSCLC and their mechanism of action https://doi.org/10.3390/ph13110373
The main treatment arms of phase 3 clinical trials providing immunotherapy in the first line for patients with NSCLC https://doi.org/10.3390/ph13110373
Overall survival in NSCLC patients treated with protocols incorporating immunotherapy in the first line for advanced or metastatic disease. Nasser NJ, Gorenberg M, Agbarya A. Pharmaceuticals 2020, 13(11), 373;
Lung cancer, incidence, mortality, and survival, England 1971–2011
Stage IA and IB lung cancer
Stage IIA lung cancer
Stage IIB lung cancer
One option for stage IIB lung cancer, with T2b; but if tumor is within 2 cm of the carina, this is stage 3
Stage IIIA lung cancer
Stage IIIA lung cancer, if there is one feature from the list on each side
Stage IIIA lung cancer
Stage IIIB lung cancer
Stage IIIB lung cancer
Stage IV lung cancer

The vast majority (85%) of cases of lung cancer are due to long-term tobacco smoking.

Tobacco flakes, sliced from pressed plugs

Tobacco

Common name of several plants in the genus Nicotiana of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants.

Common name of several plants in the genus Nicotiana of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants.

Tobacco flakes, sliced from pressed plugs
Tobacco drying kiln in Myrtleford, Victoria, Australia, 2018. This kiln was built in 1957, and moved to Rotary Park in 2000. Kilns of this structure were made from the early 1930s through to the late 1960s.
Basma tobacco leaves drying in the sun at Pomak village in Xanthi, Greece
William Michael Harnett (American, 1848–1892), Still Life with Three Castles Tobacco, 1880, Brooklyn Museum.
The earliest depiction of a European man smoking, from Tobacco by Anthony Chute, 1595.
An Indian man smoking tobacco on hookah, Rajasthan, India.
An illustration from Frederick William Fairholt's Tobacco, its History and Association, 1859
Tobacco plant and tobacco leaf from the Deli plantations in Sumatra, 1905
Nicotine is the compound responsible for the addictive nature of tobacco use.
Tobacco (Nicotiana rustica) flower, leaves, and buds
Illustration with photographs of tobacco leaves infested by Lasioderma serricorne (tobacco beetles), from Runner, G. A., The tobacco beetle (1919), Bulletin of the U.S. Department of Agriculture, Biodiversity Heritage Library
Tobacco plants growing in a field in Intercourse, Pennsylvania.
Tobacco barn in Simsbury, Connecticut used for air curing of shade tobacco
Sun-cured tobacco, Bastam, Iran
Tobacco production, 2018
Tobacco production in Portuguese Timor in the 1930s
Tobacco plantation, Pinar del Río, Cuba
Tobacco harvesting, Viñales Valley, Cuba

Dried tobacco leaves are mainly used for smoking in cigarettes and cigars, as well as pipes and shishas.

A diagram of the human body showing cancers and chronic diseases caused by smoking

Health effects of tobacco

Tobacco use has predominantly negative effects on human health and concern about health effects of tobacco has a long history.

Tobacco use has predominantly negative effects on human health and concern about health effects of tobacco has a long history.

A diagram of the human body showing cancers and chronic diseases caused by smoking
Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Tobacco was ranked 3rd in dependence, 14th in physical harm, and 12th in social harm.
Share of cancer deaths attributed to tobacco in 2016
Since establishing causation through experimental trials was not possible due to ethical restrictions, a lengthy study was conducted in order to establish the strong association necessary to allow for legislative action against tobacco consumption.
Smoking can cause atherosclerosis, leading to coronary artery disease and peripheral arterial disease.
Tobacco stains on primarily the second and third fingers of a heavy smoker
Dental radiograph showing bone loss in a 32 year old heavy smoker
Protein AZGP1
Nicotine molecule
Posted sign to avoid passive smoking in York University, Toronto, Ontario, Canada
A sign forbidding the use of cigarettes, e-cigarettes and hookah in Tbilisi, Georgia
Share of deaths from smoking, 2017<ref>{{cite web |title=Share of deaths from smoking |url=https://ourworldindata.org/grapher/share-deaths-smoking |website=Our World in Data |access-date=5 March 2020}}</ref>
The number of deaths attributed to smoking per 100,000 people in 2017<ref>{{cite web |title=Death rate from smoking |url=https://ourworldindata.org/grapher/death-rate-smoking?tab=map |website=Our World in Data |access-date=5 March 2020}}</ref>
Average price of a pack of 20 cigarettes, measured in international dollars in 2014.<ref>{{cite web |title=Average price of a pack of cigarettes |url=https://ourworldindata.org/grapher/average-price-of-a-pack-of-cigarettes |website=Our World in Data |access-date=5 March 2020}}</ref>
Taxes as a share of cigarette price, 2014<ref>{{cite web |title=Taxes as a share of cigarette price |url=https://ourworldindata.org/grapher/taxes-as-share-of-cigarette-price |website=Our World in Data |access-date=5 March 2020}}</ref>
Types of bans on tobacco advertising, 2014<ref>{{cite web |title=Enforcement of bans on tobacco advertising |url=https://ourworldindata.org/grapher/enforcement-of-bans-on-tobacco-advertising |website=Our World in Data |access-date=5 March 2020}}</ref>
Support to help quit tobacco use, 2014<ref>{{cite web |title=Support to help quit tobacco use |url=https://ourworldindata.org/grapher/support-to-help-to-quit-tobacco-use |website=Our World in Data |access-date=5 March 2020}}</ref>

Tobacco taxes that increase the price of tobacco products have also been enacted.

A first-generation e-cigarette that resembles a tobacco cigarette. The battery portion of the e-cigarette can be disconnected and recharged using the USB power charger.

Electronic cigarette

A first-generation e-cigarette that resembles a tobacco cigarette. The battery portion of the e-cigarette can be disconnected and recharged using the USB power charger.
Various types of e-cigarettes, including a disposable e-cigarette, a rechargeable e-cigarette, a medium-size tank device, large-size tank devices, an e-cigar, and an e-pipe.
Exploded view of an e-cigarette with transparent clearomizer and changeable dual-coil head. This model allows for a wide range of settings.
Estimated trends in the global number of vapers
Reasons for initiating e-cigarette use in the European Union according to a Eurobarometer poll (2018).
Effects of vaping, compared to tobacco smoking.
Possible side effects of nicotine
The reinforcing effects of addictive drugs, such as nicotine, are associated with its ability to excite the mesolimbic and dopaminergic systems. How does the nicotine in e-cigarettes affect the brain? Until about age 25, the brain is still growing. Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. Young people's brains build synapses faster than adult brains. Because addiction is a form of learning, adolescents can get addicted more easily than adults. The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine.
The Ruyan e-cigar was first launched in China in 2004.
E-cigarette user blowing a cloud of aerosol (vapor). The activity is known as cloud-chasing.
From 2011 to 2014, e-cigarette use among youth was rising as e-cigarette advertising increased.
Tobacco product waste.
Philip Morris International's IQOS device with charger and tobacco stick.

An electronic cigarette is an electronic device that simulates tobacco smoking.

A cigar with a semi-airtight storage tube and a double guillotine-style cutter

Cigar

A cigar with a semi-airtight storage tube and a double guillotine-style cutter
Harry Nelson Pillsbury smoking a cigar
Indigenous tobacco pipe on display at the regional museum in San Andrés Tuxtla
Inside an Ybor City cigar factory c. 1920
Hand rolling cigars and relevant artifacts, Ybor City Museum State Park display, Tampa, Florida
An aged tobacco leaf being examined
Cigar makers in Puerto Rico, c. 1942
Vendor rolling cigars at the Eyipantla Falls in San Andrés Tuxtla, Mexico
Cigars (top to bottom) by H. Upmann, Montecristo, Macanudo, Romeo y Julieta
A Tuscan cigar
Cigar cases from the Te Amo and Sihuapan manufacturers in Mexico
Arturo Fuente cigar boxes at 2005 Tampa Cigar Heritage Festival. The Montesino cigars are also produced by Tabacalera A. Fuente y Cia.
Darker wrappers reflect tobacco type, age, and greater fermentation
Long-leaf filler as used in a hand-rolled cigar (slightly crumbled during cutting)
Short or chopped filler
World's largest cigar at the Tobacco and Matchstick Museum in Skansen, Stockholm, Sweden
The parejo is the easiest and least expensive common cigar shape to produce
Cohiba Mini and Dannemann Moods cigarillos
A double guillotine-style cutter, used for cutting the tip of a cigar, next a hand-rolled H. Upmann Coronas Major cigar. The "Made in Cuba" label (see Cuban cigar) is visible on the lower tube
Illustration with photographs of tobacco leaves infested by Lasioderma serricorne (tobacco beetles), from Runner, G. A., The tobacco beetle (1919), Bulletin of the U.S. Department of Agriculture, Biodiversity Heritage Library
A cigar case made of crocodile skin with sterling silver appointments bearing a Birmingham hallmark for 1904
A cigar holder stood on end
Display of various cigar cases with prices in a cigar store in Amsterdam, Netherlands

A cigar is a rolled bundle of dried and fermented tobacco leaves made to be smoked.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet and excessive alcohol intake.