Health effects
According to the World Health Organization, tobacco kills more than 8 million people every year worldwide, including about 1.3 million non-smokers exposed to secondhand smoke.
Tobacco smoking harms health because of the toxic chemicals in tobacco smoke, including carbon monoxide, cyanide, and carcinogens, which have been proven to cause heart and lung diseases and cancer.
Thousands of different substances in cigarette smoke, including polycyclic aromatic hydrocarbons (such as benzopyrene), formaldehyde, cadmium, nickel, arsenic, tobacco-specific nitrosamines, and phenols contribute to the harmful effects of smoking.
According to the World Health Organization, tobacco is the single greatest cause of preventable death globally. WHO estimates that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. Similarly, the United States Centers for Disease Control and Prevention describe tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide." Due to these health consequences, it is estimated that a 10 hectare (approximately 24.7 acre) field of tobacco used for cigarettes causes 30 deaths per year – 10 from lung cancer and 20 from cigarette-induced diseases like cardiac arrest, gangrene, bladder cancer, mouth cancer, etc.
The harms caused by inhaling tobacco smoke include diseases of the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (emphysema), and cancer (particularly cancers of the lungs, larynx, mouth, and pancreas). Cancer is caused by inhaling carcinogenic substances in tobacco smoke.
Inhaling secondhand tobacco smoke (which has been exhaled by a smoker) can cause lung cancer in nonsmoking adults. In the United States, about 3,000 adults die each year due to lung cancer from secondhand smoke exposure. Heart disease caused by secondhand smoke kills around 46,000 nonsmokers every year.
In children, exposure to secondhand tobacco smoke is associated with a higher incidence and severity of respiratory illnesses, middle ear disease, and asthma attacks. Each year in the United States, secondhand smoke exposure causes 24,500 infants to be born with low birth weight, 71,900 preterm births, 202,300 episodes of asthma, and 790,000 health care visits for ear infections.
The addictive alkaloid nicotine is a stimulant, and popularly known as the most characteristic constituent of tobacco. In drug effect preference questionnaires, a rough indicator of addictive potential, nicotine scores almost as highly as opioids. Users typically develop tolerance and dependence. Nicotine is known to produce conditioned place preference, a sign of psychological enforcement value. In one medical study, tobacco's overall harm to user and self was determined at three percent below cocaine, and 13 percent above amphetamines, ranking sixth most harmful of the 20 drugs assessed.
Tobacco also contains 2,3,6-Trimethyl-1,4-naphthoquinone (sometimes called 2,3,6-TQ and TMN) which is a reversible monoamine oxidase inhibitor of type A and B with a binding affinity somewhat similar to that of clorgyline and deprenyl. It is a stronger dopamine releasing agent than nicotine and inhibits dopamine metabolism from its MAOI activity. Tobacco also contains Harmine and Norharmine which is a reversible MAO-A inhibitor. The MAO-A activity of tobacco alkaloids have been thought to play a role in the addictive qualities of tobacco.
As the plant grows, radon decay products (that come from decay of radium in fertilizer), like polonium-210 and lead-210, cling to the sticky hairs on the bottom of tobacco leaves.
Polonium-210 is a radioactive trace contaminant of tobacco, providing additional explanation for the link between smoking and bronchial cancer.
The radioactive particles build up over time in the lungs and a UCLA study has estimated that the radiation from 25 years of smoking would cause over 120 deaths per thousand smokers.
However, PAHs and nitrosamines are likely to play major roles in the development of lung cancer, rather than Po-210.
