Different Forms of Tobacco Use

Tobacco products are made from leaf tobacco. The products are used to smoke, suck, chew or snuff. All the products contain nicotine- a highly addictive substance.

Forms of tobacco
There are different forms of tobacco: smokeless and smoked

Smokeless tobacco includes snuff, moist snuff and chewing tobacco. The latter two are also known as oral tobacco. Moist snuff is also called snus, which has been banned in the EU since 1992, except for Sweden.

Smoked tobacco includes pipes, cigars, and cigarettes. The pH of tobacco in pipes and cigars is high, i.e. more alkaline, therefore nicotine is absorbed in the oral cavity. Cigarette tobacco is more acidic which means that in order to absorbed the nicotine is must be inhaled into the lungs.

Tobacco and health
According to the WHO, smoking kills up to half of its users. It kills almost 6 million people every year- 5 million smokers and ex-smokers and over 600,000 nonsmokers who are exposed to second-hand smoke.

Smoking causes:


 * 20-25% of cardiovascular diseases. The mechanism is not fully understood. Smoking induces vasoconstriction, stimulates sympathetic nervous system, increases blood viscosity by increasing number of erythrocytes, leukocytes, thrombocytes, fibrinogen. It also increases homocysteine and induces dyslipidemia (decreases HDL). Also, insulin resistance increases leading to increased chance of diabetes. In addition, free radicals that are produced damaged the endothelium layer of vessels and cause chronic inflammation.
 * 30% of cancer. Mostly, lung cancer (90%) but also cancer of the pancreas, urinary bladder, larynx, oesophagus and cervix.
 * 75% of chronic respiratory diseases- chronic bronchitis and emphysema
 * Other diseases- ~60 diseases.


 * Diseases that have a little lower occurrence among smokers:
 * 1) Parkinson disease- due to the nicotine effect on brain
 * 2) Ulcerative colitis- mechanism unknown
 * 3) Endometrial cancer after the age of 60- smoking lowers oestrogens

Tobacco Use Epidemic
According to the WHO, the tobacco epidemic is one of the biggest public health threats in the world have ever faced. As previously said, smoking kills nearly 6 million people every year. Approximately, one person dies every six seconds. Most of the world smokers come from low- and middle-income countries where the tobacco-related burdens are the heaviest. Premature deaths of tobacco users has several effects- deprivation of income for their family, increase cost of healthcare and slowing down of economic development.

There is a lag of several years between the time that people start smoking and the time that people start suffering health issues- the tobacco epidemic has just begun. The model of tobacco epidemic is the same for all countries- first people start smoking, then after a peak, the prevalence starts to decrease, however mortality rates cause by smoking still rise, having a peak with about 30-40 years delay.

The tobacco epidemic is shifting towards developing countries which is caused by a shift in global tobacco marketing strategy which targets young people in developing countries.

The tobacco epidemic is preventable. However, only 10% of the world's population live in countries that are implementing the policies can control the tobacco epidemic.

There are 6 policies, outlined by the WHO's MPOWER strategy:
 * 1) Monitoring tobacco use and prevention
 * 2) Protecting people from tobacco smoke
 * 3) Offering help to quit tobacco use
 * 4) Warning people of the dangers of tobacco
 * 5) Enforcing bans on tobacco advertising, promotion and sponsorship
 * 6) Raising taxes on tobacco