Citation, DOI, disclosures and article data
At the time the article was created Daniel J Bell had no recorded disclosures.View Daniel J Bell's current disclosures
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.View Henry Knipe's current disclosures
Tobacco use, most commonly by smoking cigarettes, is a drug habit of many throughout the world. It is a significant risk factor for many malignancies, and respiratory and cardiovascular diseases and is a major cause of premature mortality throughout the world.
The World Health Organization (WHO) estimates that ~7 million people die per year due to personal tobacco use, with a further 1.2 million dying from exposure to second-hand smoke 1. Smoking was estimated in 2015 to be directly responsible for 11.5% of global mortality 10.
In 2015, a large systematic review found that ~25% of men and ~5% of women in the world smoked tobacco daily 10.
Tobacco smoking markedly increases the risk of developing many diseases 2-7. It is a major risk factor for malignancy with a good correlation with an individual's pack-year history 1.
malignancy: commonest histological type is adenocarcinoma
cardiovascular disease 5
Diseases for which smoking decreases risk
The chemical analysis of tobacco smoke has been intensively studied for more than a century, over which time more than 7,000 different substances have been found in the fumes. The International Agency for Research on Cancer (IARC), of the World Health Organization (WHO), has designated over fifty of these compounds as carcinogens. Toxic compounds found in the smoke include carbon monoxide, benzene, formaldehyde, polycyclic aromatic hydrocarbons, hydrogen cyanide, elemental lead and nitrosamines 1.
However, it is nicotine, an alkaloid compound found in tobacco, which forms almost 95% of the chemical composition of the smoke, that is the primary driver for the addictive nature of tobacco usage 1. Interestingly there is no conclusive evidence that nicotine itself is a carcinogen 14.
Methods of tobacco administration
Although the smoking of cigarettes is far and away the most prevalent form, tobacco is self-administered via a broad range of other methods including:
predominantly cigarettes, including bidis, krekets, water pipes
electronic cigarettes (a.k.a. e-cigarettes/vaping)
chewing loose leaf
- 1. Omare MO, Kibet JK, Cherutoi JK, Kengara FO. A review of tobacco abuse and its epidemiological consequences. (2021) Zeitschrift fur Gesundheitswissenschaften = Journal of public health. doi:10.1007/s10389-020-01443-4 - Pubmed
- 2. Carlicchi E, Caminati A, Fughelli P, Pelosi G, Harari S, Zompatori M. High-resolution CT in smoking-related interstitial lung diseases. (2021) The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 25 (2): 106-112. doi:10.5588/ijtld.20.0622 - Pubmed
- 3. Hidalgo A, Franquet T, Giménez A, Bordes R, Pineda R, Madrid M. Smoking-related interstitial lung diseases: radiologic-pathologic correlation. (2006) European radiology. 16 (11): 2463-70. doi:10.1007/s00330-006-0340-0 - Pubmed
- 4. Polosa R, Thomson NC. Smoking and asthma: dangerous liaisons. (2013) The European respiratory journal. 41 (3): 716-26. doi:10.1183/09031936.00073312 - Pubmed
- 5. Banks E, Joshy G, Korda RJ, Stavreski B, Soga K, Egger S, Day C, Clarke NE, Lewington S, Lopez AD. Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study. (2019) BMC medicine. 17 (1): 128. doi:10.1186/s12916-019-1351-4 - Pubmed
- 6. Pirie K, Peto R, Reeves GK, Green J, Beral V. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. (2013) Lancet (London, England). 381 (9861): 133-41. doi:10.1016/S0140-6736(12)61720-6 - Pubmed
- 7. Guslandi M. Nicotine treatment for ulcerative colitis. (1999) British journal of clinical pharmacology. 48 (4): 481-4. doi:10.1046/j.1365-2125.1999.00039.x - Pubmed
- 8. Mappin-Kasirer B, Pan H, Lewington S, Kizza J, Gray R, Clarke R, Peto R. Tobacco smoking and the risk of Parkinson disease: A 65-year follow-up of 30,000 male British doctors. (2020) Neurology. 94 (20): e2132-e2138. doi:10.1212/WNL.0000000000009437 - Pubmed
- 9. Felix AS, Yang HP, Gierach GL, Park Y, Brinton LA. Cigarette smoking and endometrial carcinoma risk: the role of effect modification and tumor heterogeneity. (2014) Cancer causes & control : CCC. 25 (4): 479-89. doi:10.1007/s10552-014-0350-1 - Pubmed
- 10. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015. (2017) Lancet (London, England). 389 (10082): 1885-1906. doi:10.1016/S0140-6736(17)30819-X - Pubmed
- 11. Law M & Hackshaw A. A Meta-Analysis of Cigarette Smoking, Bone Mineral Density and Risk of Hip Fracture: Recognition of a Major Effect. BMJ. 1997;315(7112):841-6. doi:10.1136/bmj.315.7112.841 - Pubmed
- 12. Vestergaard P & Mosekilde L. Fracture Risk Associated with Smoking: A Meta-Analysis. J Intern Med. 2003;254(6):572-83. doi:10.1111/j.1365-2796.2003.01232.x - Pubmed
- 13. Wikström A, Stephansson O, Cnattingius S. Tobacco Use During Pregnancy and Preeclampsia Risk. Hypertension. 2010;55(5):1254-9. doi:10.1161/hypertensionaha.109.147082
- 14. Wilson N, Peace J, Edwards R, Weerasekera D. Smokers Commonly Misperceive That Nicotine is a Major Carcinogen: National Survey Data. Thorax. 2011;66(4):353-4. doi:10.1136/thx.2010.141762 - Pubmed