Tobacco Prevention and Control - FAQs

Smoking causes many chronic diseases, such as lung cancer and many other forms of cancer; heart disease; and respiratory diseases, including emphysema, chronic bronchitis, and pneumonia. Each year in the United States, about 480,000 people die as a result of smoking. This is about one in every five deaths. Overall, smokers are less healthy than nonsmokers. Smoking affects the immune system, which increases a person's risk for infections. Smoking also increases the risk for fractures, dental diseases, sexual problems, eye diseases, and peptic ulcers. When people quit smoking, their bodies begin to recover, and their risk for smoking-related diseases decreases over time. Although people who smoke will never be as healthy as they would have been had they never smoked at all, risks continue to decrease the longer they stay smoke free.

Nicotine is the highly addictive drug found naturally in tobacco. Nicotine is found in cigarettes, cigars, smokeless tobacco, shisha (the flavored tobacco smoked in a hookah or water pipe), bidis, and kreteks (clove cigarettes). Even if a tobacco product is marketed as "all natural," it is still addictive because of its nicotine content. Some of today's cigarette are more addictive than those from earlier decades. In part, this is a result of chemicals added to today's cigarettes that cause the nicotine to reach brain more quickly. It only takes 10 seconds for the nicotine from one puff of smoke to reach the brain.

Nicotine meets the following criteria for an addictive substance:

• The user's behavior is largely controlled by a substance that causes mood change, primarily because of the substance's effects on the brain.
• The individual will continue to use the substance, often putting it before other priorities.
• The person develops a tolerance for the drug, so increasing amounts are needed to create the same effect.
• Withdrawal symptoms occur if the person does not use the drug.
• A strong tendency for relapse exists after quitting.

Nicotine reaches the brain within 10 seconds after smoke enters the lungs and affects the body. Nicotine raises the heart and respiration (breathing) rates. Nicotine also causes more glucose (blood sugar) to be released into the blood, which may explain why smokers say they feel more alert after smoking. Nicotine also causes the brain cells to release an unusually large amount of a chemical called dopamine. Dopamine stimulates pleasure centers in the brain, making the smoker feel good.

The effects of nicotine do not last very long. When the effects wear off, the smoker feels a strong urge to smoke again to get more nicotine. Repeated doses of nicotine alter the brain's activities. The brain reduces the amount of dopamine that it produces. The number of receptors that carry dopamine to the cells is also reduced. When this happens, the smoker needs nicotine just to have normal levels of dopamine in the brain. If the level of dopamine drops, the smoker feels irritable and depressed.

Both young and older smokers can become addicted to nicotine. In adults, nicotine addiction is linked to the amount and frequency of tobacco used. In teens, nicotine addiction appears to be linked to the length of time they have been regular tobacco users. Teens who only smoke small amounts but who smoke daily are still at high risk of becoming addicted to nicotine.

Some people believe that smoking only in social situations or smoking only a few cigarettes a day is not harmful. Although health risks related to smoking increase with the amount smoked and the length of time a person smokes, there is no safe amount to smoke. Any time that tobacco smoke touches a living cell, some damage is done. When a person inhales cigarette smoke, the smoke enters the lungs and damages lung tissue. Nicotine in the smoke is then rapidly absorbed into the blood. Within 10 seconds, nicotine starts affecting the brain. Nicotine quickly increases heart rate and blood pressure and restricts blood flow to the heart. Nicotine also lowers skin temperature and reduces blood flow in the legs and feet. A major concern is that most people who start as casual smokers think they can stop whenever they choose. However, studies show that many of them become regular smokers.

A hookah pipe is used to smoke a tobacco mixture called shisha. Shisha contains tobacco and flavorings such as fruit pulp, molasses, and honey. The hookah pipe uses coals to heat the shisha, and the smoke that is created passes through tubes and water so it is cooled before it is inhaled. When smoking shisha, a person not only inhales tobacco smoke but also inhales smoke from the burning flavorings. Because hookah smoking is a relatively new activity in the United States, no research is available on the health effects of inhaling smoke from the substance. According to the American Cancer Society, several types of cancer, as well as other negative health effects, have been linked to smoking a hookah pipe. Passing the smoke through water may remove some compounds, but research shows that many toxins remain in the water-filtered smoke. These toxins include nicotine, which is the highly addictive compound in tobacco smoke. Consequently, hookah users suffer the same effects of nicotine use (e.g., increases in blood pressure and heart rate, changes in dopamine production in the brain, etc.) that occur in cigarette smokers.

Smokeless tobacco products are not a safe replacement for smoking. These products have significant health risks. All tobacco products contain the highly addictive drug called nicotine. Smokeless tobacco products generally deliver more nicotine than cigarettes. The use of these products can lead to nicotine addiction and dependence. Youth who use smokeless tobacco also are more likely to become cigarette smokers. Smokeless tobacco contains more than 25 cancer-causing compounds, including arsenic and formaldehyde. People who use these products have an increased risk of developing cancers of the mouth and throat. Smokeless tobacco use also is strongly associated with the formation of skin lesions in the mouth. These include leukoplakia (lu-ko-pla-kee-uh), which are white patches that can turn into cancer over time, and erythroplakia (e-rith-ro-pla-kee-uh), which are red patches that have a high potential for becoming cancerous. Smokeless tobacco also is strongly associated with gum recession. Gum recession not only is unsightly; it increases one's risk of getting cavities on the tooth roots and can make teeth sensitive.

• Stroke risk is reduced to that of a person who never smoked after 5 to 15 years of not smoking.
• Cancers of the mouth, throat, and esophagus risks are halved 5 years after quitting.
• Cancer of the larynx risk is reduced after quitting.
• Coronary heart disease risk is cut by half 1 year after quitting and is nearly the same as someone who never smoked 15 years after quitting.
• Chronic obstructive pulmonary disease risk for death is reduced after quitting.
• Lung cancer risk drops by as much as half 10 years after quitting.
• Ulcer risk drops after quitting.
• Bladder cancer risk is halved a few years after quitting.
• Peripheral artery disease declines after quitting.
• Cervical cancer risk is reduced a few years after quitting.
• Low birth weight baby risk drops to normal if pregnant women quit before pregnancy or during their first trimester.

The Nevada Tobacco Quitline is a FREE online service available to Nevada residents 18 years or older. When you become a member, you get special tools, a support team of coaches, research-based information, and a community of others trying to become tobacco free. Our expert coaches can talk to you about overcoming common barriers, such as dealing with stress, fighting cravings, coping with irritability, and controlling weight gain. We also offer a free telephone service, so you can speak to a coach in person, if you'd prefer. Through the telephone program you can receive a free supply of patches, gum or lozenges, too. If you would like the free nicotine patches, gum, or lozenges, you can call the QuitLine at 1-800-784-8669. Coaches will determine if you are eligible to receive the patches, gum or lozenges.

You must be a Nevada resident that is 18 year old or older to participate in the program. If you want free nicotine patches, gum or lozenges, you must also be 18 years of age or older. It may also be helpful to discuss quitting with your doctor.

Secondhand smoke, which is also called environmental tobacco smoke or ETS, is a mixture of sidestream smoke and mainstream smoke. Sidestream smoke is the smoke released from the burning end of a cigarette pipe, cigar, bidi, or kretek or that seeps from the mouthpiece of one of these products. Mainstream smoke is the smoke that is exhaled by the smoker. Cigarette smoke contains more than 7,000 chemical compounds. Secondhand smoke contains many of the same chemicals that are present in the smoke inhaled by smokers. The National Toxicology Program estimates that at least 250 chemicals in secondhand smoke are known to be toxic or carcinogenic (cancer causing). People’s exposure to secondhand smoke is greater than many realize. People are exposed to secondhand smoke in homes, workplaces, vehicles, and in public areas such as restaurants, bars, bowling alleys, and casinos. The percentage of the nonsmoking population exposed to secondhand smoke dropped significantly from 52.5% in 1999-2000 to 40.1% in 2007-2008. However, approximately 88 million nonsmokers were exposed to secondhand smoke during 2007–2008. This includes 53.6% of children aged 3-11 years and about 46.5% of youth aged 12-19 years.

The odor of tobacco smoke on a smoker’s clothing or hair or the stale smoke odor that lingers in vehicles and spaces where people smoke can be extremely unpleasant to nonsmokers. Harmful residues from secondhand smoke may be present in areas where no one is currently smoking. Smoke-free rules in homes and vehicles substantially reduce secondhand smoke exposure among children and nonsmoking adults, but do not totally eliminate their exposure. A study of households with at least one child under three years of age found that infants who live in homes with a smoker have higher levels of nicotine in their bodies than infants who do not live with a smoker, even when smoking only occurs outside the home. A possible explanation is that secondhand smoke may enter the house in the air, on dust particles, or on the smoker's breath or clothing. Nicotine levels in household dust, air, and on household surfaces were higher in smokers’ homes, even those who did smoke inside. According to the 2006 Surgeon General's Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. 

The best way to protect yourself and your family from the harmful effects of secondhand smoke is to avoid exposure whenever possible. The Surgeon General has concluded that the only way to fully protect yourself and your loved ones from the dangers of secondhand smoke is through 100% smoke-free environments. Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot completely eliminate secondhand smoke exposure. To protect yourself and your loved ones, make your home and vehicles smoke-free, ask people not to smoke around you and your children, make sure that your children's day care center or school is smoke-free, and choose restaurants and other businesses that are smoke-free. If you live with a smoker who is not interested in quitting, the simplest and most effective solution is to ask the smoker to go outside to smoke. This measure will not completely eliminate your exposure to secondhand smoke, but it will significantly reduce it. Some studies report that smoke-free home rules also help smokers quit and reduce the risk of adolescents becoming smokers.

Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system. Nonsmoking adults who are exposed to secondhand smoke at home or at work have a 25% to 30% increased risk of developing heart disease and a 20% to 30% increased risk of developing lung cancer. Exposure to secondhand smoke can also cause strokes in nonsmokers. Babies of nonsmoking women who are exposed to secondhand smoke during pregnancy are at risk of experiencing a small reduction in birth weight. In infants and children, secondhand smoke exposure causes sudden infant death syndrome (SIDS), acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth. Since 1964, 2.5 million nonsmokers have died because of exposure to secondhand smoke.