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Tobacco

Tobacco

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What is tobacco?

Tobacco is made from the dried leaves of the tobacco plant. The main chemical in tobacco is nicotine, which is highly addictive. Nicotine is a stimulant.

Tobacco can be smoked in cigarettes, pipes, cigars or hookah/shisha. Tobacco can also be used in 'smokeless' forms, including being snorted in the form of a powder (such as snuff or snus), obtained in blocks and chewed or dissolved in the mouth.

Tobacco use in Australia is legal; however, its supply and consumption are subject to strict regulations. Advertising tobacco has been prohibited and in recent years restrictions have expanded to ban advertising at the point of sale and include the introduction of plain packaging. Smoking is also banned inside restaurants, bars and clubs, and around many public places such as children’s play equipment, in cars with children, swimming pools, public transport and in and around public buildings (AIHW, 2019).

Electronic cigarettes

Electronic cigarettes (also known as e-cigarettes or vaporisers/vapes) are hand-held battery powered devices that deliver a liquid (which may or may not contain nicotine, along with other chemicals) which is heated and inhaled as an aerosol (or ‘vapour’).

What are the effects?

When tobacco is smoked nicotine dissolves instantly in the saliva and is absorbed quickly into the bloodstream. In a few seconds it reaches the brain.

Short term effects include:

  • A feeling of stimulation and alertness
  • Coughing
  • Increased heart rate and blood pressure
  • Acid in the stomach
  • Nausea
  • Weakened sense of taste and smell
  • Reduced appetite
  • Reduced muscle tension, leading to a feeling of relaxation

Passive smoking

Passive smoking is when someone breathes in smoke from other people smoking. Passive smoking can be secondary (exposure to the smoke of a nearby smoker) and tertiary (exposure to tobacco particles on surfaces and in dust). Passive smoking can cause many of the same health problems as smoking, so it’s important not to smoke near other people, particularly babies, children, pregnant and breastfeeding women, and people with chronic respiratory conditions (ADF, 2019).

What are the risks?

According to the Australian Institute of Health and Welfare, tobacco is the leading preventable cause of morbidity and mortality in Australia (AIHW, 2019).

Tobacco smoke contains many chemicals that are harmful to smokers and non-smokers. Breathing even small amounts of tobacco smoke can be harmful (ADOH, 2019).

A number of conditions and diseases can be caused by smoking tobacco, including:

  • Cancer
  • Breathing problems and chronic respiratory conditions
  • Heart disease, stroke and blood circulation problems
  • Diabetes
  • Infections
  • Dental problems
  • Hearing loss
  • Vision loss
  • Fertility problems
  • Osteoporosis and menopause (ADOH, 2019)

Dependence and withdrawal

Nicotine is highly addictive, and tolerance develops rapidly. Withdrawal symptoms usually start two to three hours after last use and may continue for a few days or weeks. Withdrawal symptoms can include:

  • Cravings
  • Irritability, anxiety and depression
  • Restless sleep
  • Eating more and putting on weight
  • Trouble concentrating
  • Headaches
  • Coughing and sore throat
  • Aches and pains
  • Upset stomach and bowels (ADF, 2019)

Tobacco and cancer

Tobacco is the leading cause of cancer in Australia, contributing 22 percent of cancer burden (AIHW, 2019).

Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia. Among the 250 known harmful chemicals in tobacco smoke, at least 69 can cause cancer. 

Smoking causes most lung cancers and can cause cancer almost anywhere in the body, including the lips, tongue, mouth, nose, oesophagus, throat, voice box, stomach, liver, kidney, pancreas, bladder, blood, cervix, vulva, penis and anus (ADOH, 2019).

Tobacco and pregnancy

Tobacco smoking is the most common preventable risk factor for pregnancy complications (AIHW, 2019).

During pregnancy the chemicals in tobacco pass through the placenta to the baby in the uterus, while carbon monoxide replaces some of the oxygen in both the mother’s and baby’s bloodstreams. This can affect the baby’s growth and development, increasing the risk of low birth weight, premature birth and perinatal death (Quick Guide to Drugs and Alcohol, 2017).

Tobacco and other drugs

The effects of using nicotine with other drugs – including over the counter or prescribed medications – can be unpredictable. It’s important to check with a medical professional about whether nicotine might affect any medications being taken (ADF, 2019).

Tobacco and COVID-19

Smokers are of greater risk of cardiorespiratory illness in general. Whilst the data are not clear on the relationship between smoking and COVID-19, it appears that those smokers who develop COVID-19 and have comorbidities, are more likely to have poorer outcomes associated with COVID-19. Smoking cessation remains a priority for any person who smokes, and the COVID-19 pandemic is likely to have been a trigger to quit for many.

Trends in tobacco use

According to the Australian Institute of Health and Welfare, daily smoking rates in Australia are around the lowest among Organisation for Economic Cooperation and Development (OECD) countries and there has been a long-term downward trend in tobacco smoking (AIHW, 2019). In 2019, 11 percent of people aged 14 and over smoked daily, declining from 12.2 percent in 2016 (AIHW, 2020).

Treatment

The addictive nature of nicotine means that successful cessation may take many attempts over several years (AIHW, 2019).

Research has shown that nicotine replacement therapies (such as transdermal patches, gum, lozenges, inhalers, nasal sprays and sublingual tablets) may be useful for people trying to give up smoking.

Prescription medications including varenicline, bupropion and some antidepressants can help some people cope with physical withdrawal symptoms. However, such medications are only of use during the period of withdrawal—up to two weeks— and in most cases psychological dependence must also be addressed (Quick Guide to Drugs and Alcohol, 2017).

There is some evidence that electronic cigarettes may assist people in quitting smoking, but the number of studies is currently low (Hartmann-Boyce, 2016).

The Australian Government Department of Health provides information about how to quit smoking and services that may assist. You can call Quitline on 137 848 between 8am and 8pm Monday to Friday, to talk to a counsellor.

Emergency info

If you, or someone around you, is experiencing undesired or distressing psychological or physical symptoms from the intake of alcohol or other drugs please seek immediate medical attention.

If you need urgent help from ambulance services call Triple Zero (000). If a person has been mixing drugs with alcohol or other drugs, tell the paramedic exactly what has been taken.

Services

For free and confidential advice about alcohol and other drugs, call the National Alcohol and Other Drug hotline on 1800 250 015.

The hotline will automatically direct you to the Alcohol and Drug Information Service in your state or territory.

More resources

The Illicit Drug Reporting System is an Australian monitoring system that identifies emerging trends of local and national interest in illicit drug markets.

The Ecstasy and Related Drugs Reporting System is an Australian monitoring system for ecstasy and related drugs that identifies emerging trends of local and national interest.

The Clinician’s Guide to Illicit Drugs and Health examines the health effects of each of the major illicit drugs.

The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.

The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.

Sources

A Quick Guide to Drugs and Alcohol (3rd ed.) (2017). Sydney, Australia: Drug Info.

Alcohol and Drug Foundation (2019). Nicotine. Retrieved from https://adf.org.au/drug-facts/nicotine/

Australian Government Department of Health (2019). Smoking and Tobacco. Retrieved from https://www.health.gov.au/health-topics/smoking-and-tobacco

Australian Institute of Health and Welfare (2019). Alcohol, tobacco & other drugs in

Australia. Cat. no. PHE 221. Canberra: AIHW. Retrieved from

https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia

Australian Institute of Health and Welfare (2020). National Drug Strategy Household Survey 2019. Retrieved from https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/table-of-contents

HartmannBoyce  J, McRobbie  H, Bullen  C, Begh  R, Stead  LF, Hajek  P. Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub3.