Tobacco smoking

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Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America.^[1] Tobacco was introduced to Eurasia in the late 17th century by European colonists, 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.^[2][3]

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^[4] and then combusted. The resulting smoke, which contains various active substances the most significant of which is the addictive psychostimulant drug nicotine (a compound naturally found in tobacco), is absorbed through the alveoli in the lungs or the oral mucosa.^[5] Many substances in cigarette smoke, chiefly nicotine, trigger chemical reactions in nerve endings, which heighten heart rate, alertness^[6] and reaction time, among other things.^[7] Dopamine and endorphins are released, which are often associated with pleasure,^[8] leading to addiction.^[9]

German scientists identified a link between smoking and lung cancer in the late 1920s, leading to the first anti-smoking campaign in modern history, albeit one truncated by the collapse of Nazi Germany at the end of World War II.^[10] In 1950, British researchers demonstrated a clear relationship between smoking and cancer.^[11] Evidence continued to mount in the 1960s, which prompted political action against the practice. Rates of consumption since 1965 in the developed world have either peaked or declined.^[12] However, they continue to climb in the developing world.^[13] As of 2008 to 2010, tobacco is used by about 49% of men and 11% of women aged 15 or older in fourteen low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam), with about 80% of this usage in the form of smoking.^[14] The gender gap tends to be less pronounced in lower age groups.^[15][16] According to the World Health Organization, 8 million annual deaths are caused by tobacco smoking.^[17]

Many smokers begin during adolescence or early adulthood.^[18] A 2009 study of first smoking experiences of seventh-grade students found out that the most common factor leading students to smoke is cigarette advertisements. Smoking by parents, siblings and friends also encourages students to smoke.^[19] During the early stages, a combination of perceived pleasure acting as positive reinforcement and desire to respond to social peer pressure may offset the unpleasant symptoms of initial use, which typically include nausea and coughing. After an individual has smoked for some years, the avoidance of nicotine withdrawal symptoms and negative reinforcement become the key motivations to continue.