This is a dissertation chapter on Smoking:
Wall paint stripper, ant poison, toilet cleaner, lighter fluid, car exhaust gas, insecticide, NASA fuel, mothballs, insecticide/weed killer, PVC pipes added to 4000 other chemicals. Better known as Acetone, Arsenic, Ammonia, Butane, Carbon Monoxide, DDT, Methanol, Naphthalene, Nicotine and finally vinyl chloride. Also known as the components of the modern day cigarette.
The constituents of a cigarette are far from appealing, yet 11.1 billion people have taken to smoking worldwide. The cigarette trade is a billion pound commerce, enticing 52.45% of high school students each year. Youths remain the prime consumers of the cigarette industry. As cigarettes become more commercial the effects are emphasised more, especially to students. Yet 3.5 million deaths, worldwide, each year, occur due to smoking. This figure is significantly high, considering the fact that over 70% of smokers are trying to quit. Sales in cigarette purchase are far from declining but accelerating each year. The question remains, ‘What prevents individuals from discarding an unwanted habit such as smoking?’
There are 343 chemicals in a cigarette known to cause cancer, one being nicotine, recognised as being the most frequently used addictive drug. Nicotine, one of more than 14,000 chemicals found in the smoke from tobacco products such as cigarettes, cigars, and pipes, is the primary component in tobacco that acts on the brain. There have been substantial increases in the sales and consumption of smokeless tobacco products recently. It is this addiction instigated by nicotine that inhibits smokers from quitting. Cigarette smoking is the most prevalent form of nicotine addiction.
Most smokers use cigarettes because of their addiction to nicotine. For non-smokers the attitude taken to smokers is commonly cynical. The fact remains that the addiction to nicotine is usually overlooked and their efforts to eliminate this addiction are usually underestimated. Most smokers identify tobacco and nicotine as harmful and articulate an aspiration to reduce or stop using it. Nearly 35 million smokers make a serious attempt to quit smoking each year, less than 7% who try and quit on their own achieve more than a year of abstinence. Most relapse within a few days of their attempt.
In terms of judging smokers, it is important to consider the addictive properties of nicotine as well as its high level of availability. Other factors include the practically non-existent legal and social consequences of tobacco use, the sophisticated marketing and advertising methods used by tobacco companies. These factors, collectively with the addictive characteristics of nicotine, prompt first use and inevitably addiction. The judgemental public eye fails to finger point social and media influences, advertising and promotion, peer pressure and celebrity manipulation as the instigators for many smokers.
Furthermore, Research has recently concluded that nicotine acts on the brain producing various behavioural effects. The prime effect is the addictive side, though of equal importance is the property that nicotine regulates feelings of pleasure. Cigarette smoking produces a rapid distribution of nicotine to the brain, drug levels peak within 10 seconds of inhaling. The chemical involved in the desire to consume drugs is Dopamine of which nicotine increases the levels. The effects of nicotine dissipate in a few minutes, causing smokers to dose frequently and maintain the gratifying effects preventing withdrawal.
What the general public remain ignorant of is the concept that cigarettes are efficient in use. Through inhaling a smoker rapidly provides the brain with nicotine in every puff. A ‘typical’ smoker takes 10 puffs over a 5-minute period. Therefore an individual smoking 1 or 2 packets a day (30 cigarettes) on a daily basis acquires 300 ‘hits’ of nicotine to the brain every day. Hence increasing the addictive disposition of nicotine through the pleasurable effects. What the smoker remains ignorant of is the reality that on average, every cigarette that is smoked to satisfy this desire for pleasure shortens their life span by 11 minutes.
If this information is insufficient in acting as an insight as to why smokers continue to conform to an act that is self-destructive then advances in medical research provide extended evidence. Recent research identifies other chemicals as being psychoactive constituents of tobacco. Scientists have acknowledged a decrease in an enzyme named Monoamineoxidase (MAO), responsible for breaking down Dopamine. A chemical other than nicotine adding to the pleasurable incentive that smoking generates must cause this adverse effect.
Nicotine remains as one of the most widely abused substances as identified by the 1999 national household survey on Drug abuse. An estimated 57 million Americans were current smokers and a further 7.6 million used smokeless tobacco. Accumulating from this, in 1998 each day in the United States more than 2000 people below the age of 18 began daily smoking. According to the Centres for disease control and prevention,’ in 1991 cigarette smoking for high school students in the U.S increased from 27.5% to 36.4% in 1997. Statistics such as these remain constant sources representative of the dangers of nicotine addiction.
Terminating nicotine consumption stems withdrawal symptoms, which quickly prompt the use of tobacco products. Symptoms include irritability, craving, cognitive and attention deficits, insomnia, and increased appetite. The most important symptom, yet the most overlooked is craving, an urge for nicotine described as ‘the most major obstacle.’ While the withdrawal syndrome is related to the pharmacological effects of nicotine, many behavioural factors also can affect the severity of withdrawal symptoms. For some people, the feel, smell, and sight of a cigarette and the habit of obtaining, handling, lighting, and smoking the cigarette are all associated with the pleasurable effects of smoking, and can make withdrawal or craving worse. While nicotine gum and patches may alleviate the pharmacological aspects of withdrawal, cravings often persist
Chronic exposure to nicotine be it directly or indirectly (passive smoking) results is some sort of addiction. Nicotine addiction cannot be taken lightly and with figures such as 1.1 billion smokers at present, aid in combating this addiction is imperative. 90% of smokers trying to quit without help fail most within a week, hence aid and support needs to be advertised more within homes, school and society.
Smokers are considered by some, an inconvenience to society, polluting the air, the cause to passive smoking. To other non-smokers smoking is less of a problem, ‘if they want to damage their health, that’s their problem.’ This kind of attitude, if taken by everyone would add to nicotine abuse spiralling out of control. Smokers especially youth smokers have to be made more aware of the severity of smoking. To the individuals that remain indifferent passive smoking needs to be highlighted in order for society to recognise and deal with those smokers who are in urgent need of help.
Nicotine addiction stems a variety of diseases, repeated exposure to nicotine results in the development of tolerance. This condition is one of which higher doses of the same drug are need to produce the same effect. Nicotine is metabolised rapidly, the body expels it from the body in a matter of hours. Therefore tolerance is lost over night, as time progresses acute tolerance develops, cigarettes become less effective and more are consumed.
The medical consequences of nicotine exposure result from effects of both the nicotine itself and how it is taken. The most detrimental effect of nicotine addiction is the result of tobacco use, 1accounting for one third of all cancers. Amongst this is lung cancer, one of the leading killers of both men and women. Cigarette smoking has been linked to 90% of all lung cancer cases. The world health organisation, label smoking as the greatest cause of death and disability, known as the cause for 25 diseases. The world health organisation also makes clear that the effect of smoking and ‘its impact on world health is not fully assessed.’
Lung problems caused by smoking are a primary health risk, killing more than 20,000 people in the UK alone each year. UK studies highlight that men who smoke increase their chance of dying from lung cancer by more than 22 times. Female smokers also disadvantage themselves by increasing their risk of lung cancer by nearly 12 times. Lung cancer is difficult to treat and its survival rates are poor. Other forms of Lung cancer such as Emphysema (difficulty in breathing) have 2irreversible effects. A relationship between cigarette smoking and coronary heart disease was first reported in the 1940s. Smoking increases the risk of heart disease including, stroke, heart attack vascular disease and Aneurysm. It is estimated that nearly one fifth of deaths from heart disease are attributed to smoking.
Studies conducted in the Uk reveal smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers. Tobacco contributes to the hardening of the arteries through Atheromas ‘fatty deposits’ leading to ‘Atherosclerosis. The tissue can then become Ischaemic ‘without oxygen’ or block off the blood supply in the coronary arteries supplying the heart, causing myocardial infarction ‘heart attack’ or blood vessels supplying the brain, causing strokes. Smokers that continue to smoke for a lifetime have a 50% chance that their death will be smoking-related (half of these deaths in middle age).
Smoking affects society as whole and not just smokers in general. 130,000 people worldwide burn or suffocate due to fires caused by cigarettes. 1Second hand smoking is an escalating dilemma estimated to cause 3,000 lung cancer deaths per year for non-smokers and over 40,000 deaths due to cardiovascular diseases. Exposure to smoking in the home and increases the severity of asthma for children, as well as contributing to new forms of asthma.
If passive smoking and the complications that arise due to smoking is not enough of an incentive for the average individual to aid others in combating nicotine addiction future impacts should act as motivation. Nicotine addiction in women doesn’t cease at pregnancy and those that continue to smoke if without help put themselves and their foetus at serious risk.
For pregnant women, carbon monoxide (a lethal gas) and high doses of nicotine attained when they inhale tobacco smoke interfere with oxygen supply to the foetus. Nicotine crosses the placenta, and the concentration in the foetus can be 15% higher than maternal levels. Carbon monoxide also inhibits the release of oxygen into foetal tissues. Woman who smokes during pregnancy are at a higher risk than non-smokers for premature delivery, and reduced birth weight of infant.
In the United States 20% of pregnant women smoke throughout their pregnancies. Smoking in pregnancy greatly increases the chance of a miscarriage, it can also promote sudden infant death syndrome, cot death and high rates of infant respiratory illness (bronchitis, colds, pneumonia). Smoking reduces the fertility of both women and men, with escalating figures in terms of smokers especially from an early rate this could soon affect birth rate.
Future problems include the social effects with a decline in birth rate; the amount of working individuals needed to support older generations would also decline. By 2020 the Worldwide Health Organisation expects the worldwide death toll due to nicotine to reach 10 million, causing 17.7% of all deaths in developed countries. With an estimated 1.1 billion smokers in the world only 800,000 of them are in developing countries.
Diseases such as lung cancer and harm to infants through smoking can be reduced, through pharmacological treatment for nicotine. Individuals need to be motivated to quit, and no attempt to help someone quit is worthless. If a 31-year-old man quit smoking on average his life expectancy would increase by 5.1 years.
As well as behavioural and pharmological treatments there are nicotine replacement therapies. These include nasal inhalers, nicotine gum and transdermal patches and work to relieve withdrawal symptoms, producing less severe physiological alterations. These therapies are beneficial as they have little abuse potential since they do not produce such pleasurable effects. Combine therapies such as increased messages in the media to stop smoking and selling over the counter medication has increased successful quitting by 20% each year.
Behavioural treatments are also valuable such as formal smoking-cessation programmes, telephone and written formats and public awareness. These types of therapies take ethical issues and moral standards into consideration. Segregation within society and categorising people stem prejudices and discrimination. The question remains is it ethical or moral to segregate smokers from society? Isn’t this just forcing them to deal with their addiction and problems on their own? Smokers have an addiction and strive to satisfy this, yet public places such as high street shops and public transport don’t acknowledge this. From a smokers perspective they are pushed further and further from society through smokers rooms at work and separate seating arrangements in restaurants. In doing this society is dissolving all support for smokers trying to quit, however Smoking is damaging to the health of individuals. Disease can arise due to passive smoking therefore laws and ethics should work to protect the general public from health problems.
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