Tobacco

Tobacco is classified as a stimulant drug. [1] It is produced by drying the leaves of plants belonging to the Nicotiana genus. The most common tobacco product is smoked tobacco, used in cigarettes, cigars, pipes, or waterpipes. Smokeless tobacco products used orally include snus and chewing tobacco. [2]

Legal status: Tobacco is a legal intoxicant in Finland. Possession is prohibited for individuals under the age of 18. It is also illegal to sell or provide tobacco to minors. [3]

How does it work?

The intoxicating effect of tobacco is caused by nicotine. The substance acts on the brain’s nicotinic receptors, producing stimulating and pleasurable effects. [1][4] Nicotine increases the release of dopamine, among other things. [5] It is rapidly absorbed from the lungs into the bloodstream and reaches the brain within seconds. [1] When tobacco is smoked, the half-life of nicotine in the body is approximately two hours. [1] Nicotine is a relatively short-acting substance: individuals addicted to nicotine must smoke regularly to maintain consistent nicotine levels in the blood. [1]

The strength of nicotine’s effects varies between individuals. Genetic factors, for example, influence how nicotine affects neurotransmitters in the nervous system. [6]

Psychological effects: Nicotine typically produces feelings of well-being in users. Depending on the situation, it can either stimulate or calm the user. Nicotine may improve concentration, relieve stress, and reduce appetite. [1][7]

Physical effects: Smoking raises blood pressure and heart rate, dries out the mucous membranes of the mouth, increases saliva production, and dilates the bronchial tubes. Tremors may also occur. [1][7] It is common for those unaccustomed to tobacco products to feel unwell after smoking a cigarette. In contrast, experienced users may smoke large amounts without experiencing nausea or headaches during smoking. [8]

Key risks

Risks of heavy use: Smoking carries a significant risk of long-term health harms, including addiction, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), cancers, gastrointestinal inflammation, oral diseases, skin disorders and symptoms, pancreatic diseases, and harm to the fetus. [9] The adverse effects of smoking impact nearly all parts of the body. [10]

Smoking increases the risk of developing several types of cancer, the most significant being lung cancer: approximately 90% of lung cancer cases are caused by smoking. [10] Tobacco smoke contains over 7,000 chemical compounds, of which more than 200 are toxic and about 70 are carcinogenic. [11] Repeated exposure to secondhand smoke is also hazardous: passive smoking increases the risk of lung cancer by 20–30% compared to individuals not exposed to tobacco smoke. [12]

Chronic obstructive pulmonary diseases are caused almost exclusively by tobacco use. [10] In the long term, smoking also increases the risk of other lung diseases, coronary artery disease, type 2 diabetes, and stroke. Smoking also negatively affects reproductive health as well as oral and dental health. [7][10][11][13] It is estimated that smokers have, on average, a life expectancy ten years shorter than that of non-smokers. [10]

Acute Risks: Nicotine poisoning is possible if large amounts of the substance enter the body. Symptoms may include nausea, headache, tremors, and vomiting. In extreme cases, poisoning can cause shock, unconsciousness, and respiratory depression. [13] Smoking increases heart rate and blood pressure, making it particularly risky for individuals with cardiovascular conditions. However, sudden deaths directly caused by smoking are rare. [13] Even a single instance of smoking delivers tar, carbon monoxide, and numerous other toxic substances into the body. [18][19]

Addiction: Tobacco is one of the most highly addictive substances. [14] Addiction can be both psychological and physical. Psychological nicotine addiction is characterized by intense cravings and a compulsive urge to smoke, even when the user is aware of the health risks. [14] Physical addiction, on the other hand, refers to the body’s dependence on nicotine to function normally. [8][15] In this case, quitting use leads to withdrawal symptoms, which are likely to include irritability, nausea, and difficulty concentrating. [15] Withdrawal symptoms begin within a few hours and peak after a few days. [15] Physical symptoms typically last for an average of 3–4 weeks, while psychological dependence may persist for longer. [16]

With repeated use, the body develops a tolerance to the effects of tobacco: it becomes less responsive to nicotine in an effort to minimize its effects. [17] At the same time, the body may also become sensitized to nicotine, which can intensify its pleasurable effects. This dual mechanism increases the risk of addiction. [8][17]

Use during pregnancy: Smoking should be avoided during pregnancy. Substances in tobacco can cross the placenta and enter the fetal bloodstream. Smoking affects fetal brain development and increases the risk of miscarriage and premature birth. Babies born to mothers who smoke are, on average, smaller in size. [20] Passive smoking also harms fetal development. [20] Smoking during pregnancy increases the risk of health problems even after birth. [21]

How can risks be reduced?

There is exceptionally strong consensus regarding the harmful health effects of smoking. The best way to avoid smoking-related risks is to refrain from smoking altogether. Support and counseling for quitting smoking are available, for example, through local health centers.

Nicotine replacement products—such as lozenges, patches, and chewing gum—can be used to aid in quitting. However, these products still contain nicotine, which sustains dependence and contributes to many of the health risks associated with smoking. It is recommended that nicotine replacement therapies also be discontinued eventually.