Tobacco

Tobacco is a highly addictive substance, primarily due to its nicotine content, which stimulates the release of dopamine in the brain. The effects are almost immediate but short-lived, contributing to its addictive nature. Users often report feelings of relaxation and euphoria, although significant health risks outweigh these. Smoking tobacco is associated with a myriad of health issues, including various cancers, cardiovascular diseases, and respiratory conditions. It also poses risks to oral health and can have negative implications for mental health. Overdosing on nicotine can lead to severe consequences, including nausea, increased heart rate, and even seizures. In the UK, tobacco is subject to various regulations and public health campaigns to reduce its use and mitigate its public health impact. ^{1, 2}

Tobacco originated in the Americas, where indigenous peoples used it for ceremonial and medicinal purposes.⁶ Christopher Columbus was among the first Europeans to encounter tobacco during his voyages in the late 15th century. The plant was subsequently introduced to Europe, gaining popularity and being commercialised soon. Over time, the cultivation of tobacco spread to colonies around the world, becoming a significant cash crop.

During the 20th century, cigarettes became mass-produced, and tobacco companies launched extensive marketing campaigns. However, in the latter half of the century, health risks associated with tobacco started to emerge. Landmark research from the 1950s onwards established a link between tobacco use and a host of diseases, including cancer. ⁷

Appearance

In its raw form, tobacco consists of dried and cured leaves that are brown and fibrous. Once processed for consumption, the most common presentation is in cigarettes where finely shredded tobacco leaves are encased in a thin, white paper cylinder. The overall appearance can vary depending on the brand and type of product, such as cigars, pipes, or smokeless tobacco. ²

Tastе

The taste of tobacco is a complex medley of flavours. It is often described as robust with a certain earthiness. Tobacco can have slightly sweet, bitter, or even spicy undertones, depending on the variety and curing process. These taste profiles are more pronounced when the tobacco is smoked, but they can also be detected in smokeless forms like chewing tobacco.²

Smell

The smell of tobacco is distinct and easily recognisable. In its unburned form, it carries a somewhat sweet, woody aroma. Once ignited, the smell becomes more pungent, filling the air with a strong, earthy scent. The odour of tobacco smoke is quite persistent and tends to cling to fabrics, skin, and indoor environments. Different types of tobacco products may have subtle variations in scent, influenced by additional flavourings or the specific curing process.²

The amount of tobacco people consume can vary widely, depending on factors such as personal preference, level of addiction, and social circumstances. A common measure for tobacco use is often cited as the number of cigarettes smoked per day. In the UK, average cigarette consumption among daily smokers has been reported to be around 11 cigarettes per day. ⁵

Dosages of nicotine, the active compound in tobacco, can also differ based on the type of tobacco product used. For example, a single full-flavoured cigarette might contain around 10-12mg of nicotine, but actual absorption is much lower, around 1-2mg.² Smokeless tobacco products and e-cigarettes can also deliver varying amounts of nicotine.

It’s worth noting that even low consumption levels pose significant health risks. There’s no safe level of tobacco use, and even “light” or “occasional” smoking can lead to long-term health issues, such as cardiovascular diseases and various forms of cancer.⁶

Various factors such as the frequency of puffs, their volume and duration can also impact how much nicotine is absorbed and, subsequently, the health risks involved.¹  Given the serious health implications of any level of tobacco use, UK public health agencies actively encourage cessation through a range of strategies and interventions.⁷

• Minimum to Feel Something (mg): The minimal amount of nicotine needed to produce noticeable effects—like elevated mood and heightened alertness—varies among individuals but can be as low as 1 mg.
• Low Dose: A low dose typically refers to consuming one light cigarette, which may contain approximately 6-8 mg of tobacco. This can result in mild stimulation and relaxation.¹
• Common Dose: A common dose, as often reported, is around one regular cigarette, which may contain 10-14 mg of tobacco. Frequent smokers may consume around 20 cigarettes a day, which is considered a pack.
• High Dose: A high dose could involve the consumption of stronger cigarettes with a tobacco content of 15-20 mg per cigarette or more. High doses are often associated with chain smoking and may lead to nicotine toxicity, which can include symptoms such as vomiting, increased salivation, and even seizures.¹

Notes on What May Happen When Exceeding the High Dose

Exceeding a high dose of tobacco, particularly through chain smoking, can lead to nicotine poisoning, a serious medical condition. Symptoms may include nausea, vomiting, increased salivation, abdominal pain, and, in extreme cases, seizures or even death.¹ Elevated levels of nicotine can also lead to acute cardiovascular events, given that nicotine increases heart rate and blood pressure. This is particularly risky for individuals who already have heart-related health issues.⁷

Additionally, consuming an excessive amount of tobacco in a short period can intensify its harmful effects on the respiratory system. This can exacerbate symptoms in individuals who have pre-existing respiratory conditions like asthma or COPD.⁵ There is also the risk of mental health implications, such as heightened levels of anxiety or panic attacks, particularly in individuals with existing mental health conditions.⁴

Because the risks associated with high doses of tobacco are so severe, including both immediate and long-term health implications, public health organisations strongly advise against excessive tobacco use. ⁶

The sensation of smoking tobacco can vary from person to person, but many users report feelings of relaxation, stress relief, and a sense of euphoria shortly after smoking. This is largely due to the nicotine content in tobacco, which stimulates the release of dopamine in the brain.¹ However, these sensations are often short-lived, dissipating quickly and leading to the desire for another cigarette to maintain the pleasurable feelings, contributing to the cycle of addiction.²

For first-time smokers or those not accustomed to nicotine, the initial experience may include symptoms like dizziness, nausea, and increased salivation. The stimulating effects of nicotine can also lead to heightened alertness and improved concentration, which are other reasons people might be drawn to smoking.⁷

It’s important to note that while some users report positive sensations, these are counterbalanced by the numerous adverse health effects associated with tobacco use, both immediate and long-term.⁶ Public health campaigns in the UK and globally aim to educate the public about the fleeting nature of these positive sensations compared to the long-term health risk.⁵

The effects of smoking tobacco are almost immediate, with nicotine reaching the brain within seconds after inhalation. Peak levels of nicotine in the bloodstream are generally achieved within about 10 minutes after starting to smoke.¹ This rapid onset of effects is one of the reasons why tobacco is so addictive. The quick action of nicotine activates reward pathways in the brain, leading to the release of dopamine and creating sensations of pleasure and relaxation.²

Because the effects are so rapid and short-lived, often dissipating within 30 minutes to an hour, users may find themselves reaching for another cigarette soon after finishing one. This quick cycle contributes to the highly addictive nature of tobacco products.⁶ The speed with which nicotine acts also plays a role in the difficulties many people experience when trying to quit smoking, as cravings can emerge quickly when nicotine levels in the blood start to drop.⁵

The duration of the effects of tobacco smoking can vary depending on a multitude of factors, such as the type of tobacco product used, the method of consumption, and individual physiology. Generally speaking, the effects of smoking a cigarette can be felt within seconds to minutes, with nicotine reaching peak levels in the bloodstream within approximately 10 minutes.¹ However, the feeling of relaxation or stress relief that some users report tends to be short-lived, often dissipating within 30 minutes to an hour. This brief duration of effects is one of the factors that contribute to the addictive nature of tobacco, as users may find themselves reaching for another cigarette to maintain the sensation.²

The long-term physiological and psychological effects of nicotine can persist, contributing to its addictive quality and making it difficult for users to quit. As for the harmful health effects of tobacco use, they can last for years or even a lifetime, contributing to chronic diseases and conditions.⁶ This long-term impact forms the basis for ongoing public health campaigns aimed at reducing the prevalence of smoking and its associated health risks.⁵

The health risks associated with tobacco use are substantial and well-documented. Smoking tobacco is the leading cause of preventable deaths worldwide. It significantly raises the risk of developing a variety of serious illnesses, including various forms of cancer (especially lung cancer), cardiovascular diseases, and respiratory conditions such as chronic obstructive pulmonary disease (COPD).⁶ Beyond this, smoking also adversely impacts oral health, contributing to conditions like gum disease and tooth loss.⁴

Tobacco use is not only dangerous to the smoker but also poses risks to those exposed to second-hand smoke, including an increased risk of respiratory infections and sudden infant death syndrome (SIDS) in children.⁵ The risks extend even to unborn children, with maternal smoking being linked to premature birth and low birth weight.⁷ In addition to physical health risks, tobacco use can also have detrimental effects on mental health, contributing to conditions like depression and anxiety.⁴ Given these substantial risks, there are significant public health efforts aimed at reducing tobacco use and exposure.

Tobacco is widely recognised as a highly addictive substance, largely due to its nicotine content. Nicotine stimulates the release of dopamine in the brain, creating a pleasurable sensation that users often seek to replicate, leading to repeated use and, consequently, addiction.¹ Moreover, the addiction is not solely physiological but can also be psychological. Many users associate smoking with specific situations, emotions, or activities, making the habit difficult to break.² In the United Kingdom, the NHS offers support services to help individuals quit smoking, signifying the recognition of tobacco use as a public health concern that often leads to addiction.⁵ The risk of developing a tobacco addiction is also higher among individuals who start smoking at a younger age, making prevention efforts particularly focused on young people.⁴

In the United Kingdom, tobacco is a legal substance but is subject to several regulations and restrictions to reduce its harmful effects. The sale of tobacco products to individuals under 18 is strictly prohibited. Additionally, all tobacco products must be stored behind shutters in shops, preventing them from being openly displayed. This is part of the effort to make tobacco products less appealing, especially to young people. Smoking in enclosed public spaces, including pubs, restaurants, and workplaces, has been banned since 2007 in England, with similar bans in the rest of the UK. Various forms of advertising and promotion for tobacco products are also illegal. The aim is to limit the exposure and accessibility of these harmful substances to the general population, especially to vulnerable groups like children and young adults.⁴

Mixing tobacco with other drugs can have a range of interactions, some of which could be harmful. For instance, when tobacco is mixed with alcohol, it can lead to the metabolism of alcohol at a faster rate, potentially leading to increased consumption of both substances. This interaction can have serious health implications, including a higher risk of developing cancers, cardiovascular diseases, and respiratory conditions.⁵ Combining tobacco with stimulants like cocaine or amphetamines can increase the risk of heart problems, as both substances have cardiovascular effects. Moreover, the combination of tobacco with depressants, such as benzodiazepines or opiates, can put an additional strain on the respiratory system. This mixing may result in decreased effectiveness of medications or exacerbated side effects.⁷ Caution should be exercised when considering the use of tobacco in combination with other drugs, as the interactions could be unpredictable and potentially dangerous.⁶

1. FDA. (n.d.). Nicotine: Why Tobacco Products Are Addictive. Retrieved from https://www.fda.gov/tobacco-products/health-effects-tobacco-use/nicotine-why-tobacco-products-are-addictive
2. NIDA. (n.d.). Cigarettes and Other Tobacco Products. Retrieved from https://nida.nih.gov/publications/drugfacts/cigarettes-other-tobacco-products 
3. UK Government. (n.d.). Delivering Better Oral Health. Retrieved from https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-11-smoking-and-tobacco-use 
4. UK Government. (n.d.). Pathways to Problems. Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/119053/Pathwaystoproblems.pdf
5. Public Health England. (n.d.). Fingertips Profile for Tobacco Control. Retrieved from https://fingertips.phe.org.uk/profile/tobacco-control
6. WHO. (n.d.). Health Topics: Tobacco. Retrieved from https://www.who.int/health-topics/tobacco#tab=tab_1
7. BMC Public Health. (2016). Smoking prevalence and attributable disease burden in 195 countries and territories. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2962-8
8. Pathways to Problems. (n.d.). Pathways to Problems. Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/119053/Pathwaystoproblems.pdf