Tobacco smoking

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Tobacco smoking, most often associated with "coffin nails," or cigarettes, is a foul, disgusting habit that stains your fingers and teeth, costs a fortune, and tends eventually to cause nasty lung and heart diseases.[1] Unfortunately, the smokers that visit this page will not care about that sentence.

As drugs go, tobacco has a ridiculously low buzz/harm ratio - in other words, very little buzz, and extremely harmful. And nicotine is actually at least as addictive as heroin or cocaine.[2] And delivered like crack.

Contents

[edit] Medicinal use

Buy some 100% all-natural medicinal cigarette cures today! Available at your local naturopath's health food store. (Or at least they would be, if it weren't for those pesky regulations...)
The cure "They" don't want you to know about.

The Native Americans used tobacco as traditional remedy for centuries; they considered it a panacea, using it for teeth whitening, pain relief, diarrhea, neck gland diseases, ulcerated abscesses, burns, wounds, fistulas, sores, polyps, colds, catarrh, headaches, and many other things.[3] The Europeans, when they came, immediately took a liking to it, calling it "God's remedy", and the "holy herb", and started using it for virtually everything. Nicolas Monardes, a physician from Seville, claimed tobacco could cure 36 diseases, including cancer, toothache, and worms.[4] Here are some of his thoughts on tobacco:[5]

I having ministered it to many people as well men as women, in great number, and being grieved of ten, and of twenty years they have healed old rotten sores in legs, and other parts of the body, with only this remedy to the great admiration of all men.
I saw a man that had certain old sores in his nose, whereby he did cast out from him much matter, and daily did rot and canker, and I caused him to take at his nose the juice of this Tobacco, and so he did, and at the second time, he did cast out from him, more then twenty little worms, and afterward a few more, until that he remained clean of them, and using it so certain days, he did heal of the sores, that he had in the inner part of his nose: and if he had tarried any longer, I think that there had remained nothing of his nose, but all had been eaten away, as it does happen to many, which we do see without them. And being writing of this, a daughter of a gentle man of this City, had many years a certain manner of dry scabs, or well near scurvy in her head, I had cured her, and done unto her many benefits, universal, and particular: and also Masters of Surgery had done their diligence, and all did not profit.

Aren't anecdotes fun?

The name nicotiana derives from the name of the French ambassador to Portugal Jean Nicot, who considered tobacco to be a very good remedy and used it to treat cancer (among other things).[4] He also used it for wounds:[3]

When a cook in Nicot's household nearly cut off his thumb with a chopping knife, the steward ran for the tobacco plant and bound the thumb back on; after five or six dressings of the same sort, the wound healed.

Critics of tobacco starting being active from the 17th century onward (though medicinal tobacco use never really ceased); a notable opponent of tobacco was King James VI of Scotland, who wrote A Counterblaste to Tobacco in 1604. According to that work, tobacco was also used for smallpox:

For Tobacco being a common herbe, which (though under divers names) growes almost every where, was first found out by some of the barbarous Indians, to be a Preservative, or Antidot against the Pockes, a filthy disease, whereunto these barbarous people are (as all men know) very much subject, what through the uncleanly and adust constitution of their bodies, and what through the intemperate heate of their Climat: so that as from them was first brought into Christendome, that most detestable disease, so from them likewise was brought this use of Tobacco, as a stinking and unsavorie Antidot, for so corrupted and execrable a Maladie, the stinking Suffumigation whereof they yet use against that disease, making so one canker or venime to eate out another.[6]

Wouldn't it have been wonderful if humanity had used the tried-and-true remedies of tobacco and birthwort[7] instead of inventing that harmful smallpox vaccine?

As late as 1931, the herbalist book A Modern Herbal promoted the use of tobacco (emphasis added):

The alkaloid nicotine is a virulent poison producing great disturbance in the digestive and circulatory organs. It innervates the heart, causing palpitation and cardiac irregularities and vascular contraction, and is considered one of the causes of arterial degeneration.

[...]

Tobacco was once used as a relaxant, but is no longer employed except occasionally in chronic asthma. Its active principle is readily absorbed by the skin, and serious, even fatal, poisoning, from a too free application of it to the surface of the skin has resulted.

The smoke acts on the brain, causing nausea, vomiting and drowsiness.

Medicinally it is used as a sedative, diuretic, expectorant, discutient, and sialagogue, and internally only as an emetic, when all other emetics fail. The smoke injected into the rectum or the leaf rolled into a suppository has been beneficial in strangulated hernia, also for obstinate constipation, due to spasm of the bowels, also for retention of urine, spasmodic urethral stricture, hysterical convulsions, worms, and in spasms caused by lead, for croup, and inflammation of the peritoneum, to produce evacuation of the bowels, moderating reaction and dispelling tympanitis, and also in tetanus. To inject the smoke it should be blown into milk and injected, for croup and spasms of the rima glottides it is made into a plaster with Scotch snuff and lard and applied to throat and breast, and has proved very effectual. A cataplasm of the leaves may be used as an ointment for cutaneous diseases. The leaves in combination with the leaves of belladonna or stramonium make an excellent application for obstinate ulcers, painful tremors and spasmodic affections. A wet Tobacco leaf applied to piles is a certain cure. The inspissated juice cures facial neuralgia if rubbed along the tracks of the affected nerve. The quantity of the injection must never exceed a scruple to begin with; half a drachm has been known to produce amaurosis and other eye affections, deafness, etc.

[...]

Externally nicotine is an antiseptic. It is eliminated partly by the lungs, but chiefly in the urine, the secretion of which it increases. Formerly Tobacco in the form of an enema of the leaves was used to relax muscular spasms, to facilitate the reduction of dislocations.[8]

The admission that "nicotine is a virulent poison" is based not on traditional knowledge, but on scientific research conducted in 1828, meaning that if science had left tobacco alone, the book would have probably been much more positive.[3] Note also that no mention is made of the carcinogenity of the plant.[9]

The reason that naturopaths and herbalists today don't recommend tobacco probably has more to do with social taboos rather than any real thought on their part. From a traditional and anecdotal point of view (Native Americans used tobacco for hundreds of years as a panacea and didn't notice any harmful effects,[3]), there is no reason not to prescribe tobacco. It is true that, from a scientific point of view, medicinal tobacco use is indefensible, but then so are homeopathy and Reiki, key parts of naturopathic healthcare. Naturopaths have absolutely no problem denying the evidence when it suits them, and this anti-science attidude is completely compatible with the prescribing of medicinal tobacco. (Even today, some insist on using cansema, bleach, and bloodletting for medicinal purposes. Tobacco denialism wouldn't be a very radical addition to CAM "thought".)

Governments around the world have tried to warn the public of the dangers of tobacco by initiating anti-smoking campaigns, mandating warnings and graphic images of tobacco-induced diseases on cigarette packs, and banning pro-tobacco ads, to the point that the harms of tobacco are common knowledge; there is virtually no one who does not know tobacco is harmful. In other words, the governments of the world forcibly imposed the scientific consensus that a traditional herbal remedy is ineffective and harmful on the general public, and curtailed its sale by means of stringent regulation. (This is very similar to the sort of scenario that health freedom advocates try to prevent, and it also reminds one of Big Pharma conspiracy theories.) Naturopathy is based pretty much on believing whatever "feels" good, regardless of the evidence, so the position of most naturopaths that tobacco is harmful is probably due to social attitudes caused by governmental regulation (people who seriously claim that tobacco is harmless or even beneficial are met with suspicion or hostility.) Not that it's a bad thing naturopaths reject tobacco, but it's a sheer accident that has nothing to do with their cherry-picking approach being correct. In all likelihood, if it had not been for evidence-based medicine and government regulation, herbalists would still be prescribing medicinal tobacco today.

[edit] Who wins and who loses?

Inherently sexy and rock'n'roll!

Smoking not only fills the coffers of the death industry but also those of the government through high tobacco taxation.[10] At the same time it is also profitable to the pension providers[11] because they don't have to pay out so much to those who die before their time, and also the health insurance companies who can charge higher premiums for smokers. It is estimated that some 15,000 children in the UK end up with asthma as result of their parents' tobacco addiction.[12]

It is also immensely irritating to non-smokers who may be in the vicinity.[13]

[edit] What's in it for the smoker?

The nicotine provides both stimulant and relaxant effects in one go. (That other site has the full list.) The really addictive element is inhaled through the lungs and straight into the brain - even weeks or months after your body has finished withdrawal from the drug, your brain remembers and craves the hit.

In addition to nicotine, tobacco smoke also contains MAO Inhibitors, which may make the nicotine even more addictive.[14]

Unsurprisingly, users rationalize smoking as a relaxing and deliciously addictive pastime. Most nicotine addicts claim to be aware of the health risks posed by smoking, but aren't really worried until they approach 50, or until they get cancer[15] - whichever comes first. Other favored arguments by proponents are personal freedom (of the tobacco industry to make money) or the "Ah, but X is worse" fallacy.

Logic doesn't work here. Either they're addicted and know the dangers, they're addicted and in denial or they're in the business and want to keep the money rolling in.

While it has been alleged that cigarette smoking makes one look sexy and glamorous, in truth only people who are already sexy and glamorous look this way when smoking[16]. No robust findings have been published on smoking's effect on how fabulously sexy one is. (If you're smoking during sex, get a decent water-based lubricant.)

Tobacco is one of the very rare occurrences of a situation (perhaps the only thing similar is the advertising for marmite) in which the producers of a product are paying[17] for advertisements attempting to get people to stop using the product.[18]

For those who absolutely must fill their lungs with gook, pot smoking is much more fun, but, according to some, more dangerous.[19] Marijuana is, however, not correlated with lung cancer like tobacco smoking is.[20][21][22] (The lack of marijuana chain smokers who inhale 2 packs a day may have something to do with this.) The possession of marijuana is also illegal in many countries, with punishments ranging from a small fine to execution. So, at least you get the thrill of being a genuine rebel.

[edit] Advantages of smoking

A cigarette, with an attached cancer-causing "filter".

If you smoke, you need no longer pay any attention to the putative health hazards of:

  • Air pollution (that you don't create)
  • Radon leaking up into your house
  • Pesticides in your food
  • Volcanic dust

Think of it like consolidating a pile of small debts into one big debt. But dumber.

[edit] Disadvantages of smoking

If you really need to be told that smoking is bad for you and extremely stupid, you should probably be on a wiki that cares more about the hard of thinking.

[edit] Dirty tricks played by cigarette manufacturers

[edit] Menthol

Menthol (basically mint crystals) was originally added to cigarettes to make the smoke less harsh. However, it was soon discovered that it could also increase the sensation from smoking, to make it a more "fun" (read: addictive) experience. There's now a movement afoot to ban menthol in cigarettes.[23]

[edit] Asbestos filters

In the 1960s, it was not yet known that asbestos contributed to lung cancer. So, Winston cigarettes came out with a new, "safer" filter that would supposedly block more of the harmful chemicals in cigarette smoke and wouldn't catch fire. Unbeknownst to most of the public, the secret of this new filter was that it was made of asbestos.

Asbestos filters, mercifully, have been discontinued.

[edit] "Low tar" cigarettes

"Tar", in double-quotes, is a catch-all term for everything in cigarette smoke that isn't carbon dioxide, carbon monoxide, or nicotine.

Low "tar" cigarettes were all the rage in the 1970s. They didn't use new tobacco formulations, or filter tips that were more selective to screening out "tar" compounds, or anything of the sort. Instead, they relied on the way the Federal Trade Commission tested each brand for its "tar" content: The testers plugged the filter end of a cigarette into a suction machine, ignited the other end, collected all the gases that came out, and measured the amount of "tar" in the collected sample. By adding tiny perforations to the filter in front of the point where it plugged into the suction nozzle, a significant fraction of the gases produced would escape into the air and not be collected by the machine.

Smokers, of course, could simply cover up the filter perforations with their fingers, thus getting far more "tar" in their lungs than the FTC method would suggest. They had an incentive to do so, too: Every bit of escaping "tar" smoke also took some of the precious nicotine with it.

[edit] Added ammonia

Ever on the lookout for new ways to keep their customers hooked, cigarette companies eventually stumbled upon the notion of adding ammonia to the tobacco. This resulted in the nicotine being absorbed more quickly into the smoker's lungs, thereby increasing the "hit" that the smoker experienced and deepening his addiction.

[edit] Who should smoke?

Nobody. You might hear some people claim that smoking can help alleviate symptoms from maladie du jour, but just remember: bleach would be a perfectly good antibacterial if it didn't also kill the patient. There is nothing that smoking could treat that would offset the harm done by smoking... that said, smoking has some known effects that some people might consider for self-medication.

People with mental disorders and schizophrenics in particular have heavy rates of smoking.[24] While some of them use this to "self-medicate" by reducing the movement side-effects of anti-psychotics, or producing a sense of well-being as a coping mechanism, the high rate of smoking in schizophrenics and other mentally ill patients has resulted in 30 percent more heart disease and 30 percent more respiratory disorders than the general population. A doctor would be ill advised to recommend smoking as any advisable course of action for any patient with a mental disorder.

Nicotine has been found to provide limited help with cognition (memory, attention and thought organization) impairment in patients suffering from schizophrenia,[25] but since nicotine is still less than ideal even without the carcinogenic burning vegetable matter (e.g. it correlates with Alzheimer's[26]), scientists are at work on drugs similar to nicotine to provide the benefits without the dangers. Smoking is however still not in any way recommendable to schizophrenics for helping with these cognition impairments because the positive effects are short-lived as resistance sets in very quickly, while the high addictive nature of nicotine results in a quick dependence upon the drug even though positive benefits have already been exhausted.

In short, even if you're schizophrenic, you might only find temporary relief of cognition impairment, but once the positive effects have fully faded away, you're now addicted to a deadly poison that is killing you. So, don't smoke.

It is well known that smoking causes an increase in blood pressure,[27] which is just one of the many reasons why doctors recommend people quit smoking, as raising blood pressure is typically a bad idea for almost everyone. However, some conditions result in symptoms of chronic low blood pressure (hypotension), and while this is typically regarded as a fortunate situation, in some cases low blood pressure can become so drastic that it starts becoming symptomatic, i.e. dizziness and fainting. But since doctors typically only deal with acute hypotension due to shock or blood loss, most treatments for symptomatic hypotension focus on treatments that are really only available in hospitals on an emergency basis. Thus, people struggling with chronic low blood pressure and inadequate healthcare might be tempted to self-medicate their condition with smoking, and unlike the case with schizophrenics, this relatively beneficial raising of the blood pressure does not quickly disappear, and would actually work as a long-term solution... You know, if it weren't for the lung and heart problems, cancer, and other generally lethal consequences of smoking.

[edit] Second-hand smoke

See the main article on this topic: Second-hand smoke

[edit] Second-hand smoke deniers

[edit] Quitting

Stopping smoking is very difficult for most people. Nicotine is ridiculously addictive. The removal of nicotine's antipsychotic effects means that many quitters find themselves becoming crazy people for a time.

Nicotine patches or gum work for some people, but don't provide the hit.

Electronic cigarettes, or Vapourisers, (dispensing a still-dodgy nicotine hit without the immense amounts of intensely carcinogenic burning vegetable matter) are ostensibly less harmful than the fiery variety and are becoming quite popular, but many governments are making them even harder to get than cigarettes, which are still on sale bloody everywhere (except Bhutan). We're sure there's a firm evidence-based reason for this, as there usually is behind drug policy.[citation NOT needed] On the other hand, they are also much more convenient, as the user does not have to worry about smoke detectors/smoking bans, a lasting smell, having an ashtray on hand indoors etc. and is not restricted to single cigarette lengths, easily turning a light smoker into a chain smoker. There are also no credible controlled studies on the health effects of electronic cigarettes yet; all health claims are based on knowledge about the ingredients of the concotions used: nicotine (duh), tobacco extraction impurities, various aromas and propylene glycol or glycerin. While the latter are recognised as safe for ingestion, there are again no studies about their effects when inhaled.

Alternatively one can read a certain book, which has the effect of brainwashing the reader into believing quitting smoking is easy and the best thing you will do in your life by repeating an analogy about smoking being like wearing tight shoes all day to experience the relief of taking them off (a lot). This (along with hypnosis and other self-help programs and support groups) might rely on the placebo effect, but unfortunately, when it comes to any addiction without a convenient agonist (and nicotine doesn't have one), the placebo effect is in medical terms the only effect you can count on.

All that aside, the horrifying fact is that the pathways physical dependency emerges from are highly flexible, but not elastic. They adapt to a certain dosage schedule and respond (as any ex-smoker can tell you, do they ever!) when that schedule isn't met. The result for most narcotics (and certainly for nicotine) is a ratchet effect. The only way to go from the constant agony of withdrawal to the occasional agony of post-addiction is to stop introducing the addictive stimulus. Or, in even simpler terms, if you're addicted to nicotine to the point that you need a biologically significant amount in your system at all times, whenever you stop taking nicotine, you will undergo severe withdrawals. Once you're habituated, the severity and length of habit make only a minor difference in how nasty it is to break that habit.

What's worse, significantly undercutting the habitual dosage schedule is also highly unpleasant - and can only reduce the body's anticipated dosage schedule glacially. You are going to experience what many people rate as the worst experience of their lives, and levels of discomfort, unease, mental instability, and craving you literally have no way to imagine, for no less than a week. And that's being optimistic. (If you don't smoke or are only doing so "occasionally", best to avoid that, huh?) Any smoking cessation plan in which one actually quits smoking eventually ends in 1-2 weeks of withdrawal, months to years of situational cravings, and a lifetime with that much less respiratory damage, carcinogenic risk, and hand-over-fist expense to worry about.

There's medically just no way better than cold turkey. Unlike alcohol, heroin, and certain benzodiazepines, abrupt cessation is never going to kill you. (Don't go cold turkey from those after long-term addiction, please.) Nicotine delivery methods other than cigarettes as a quitting system will only kick the can down the road. They are, on the other hand, a good way for the people selling them to make money off of your anxiety, and their commercials look almost as scientific as the ones for shampoo. It's your call, isn't it?

[edit] Support

The best advice for supporting a quitter is to take it seriously. Help them avoid nicotine, even though everything in their body is incessantly begging for it. If they've given over the pack or carton they have on hand just in case, put a few degrees of separation between it and you. At the very least, never make it easier for them to lapse.

If you're a smoker, keep it out of the environment. Don't smoke around them, try not to have cigarettes on you when dealing with them if possible, and don't talk about smoking. If their quitting bothers you for some reason, suck it up and deal with it like an adult; if you blow smoke in their face or offer them one on the side like a giant Goddamn baby, you're basically angling to sentence them to more time in withdrawal, which is a lot like Hell only it's a real thing and there's no way to cheat your way out of it by being a nice person or pitching woo to a bearded man. Don't be Dennis Leary.

If you're not a smoker or a vicious prick, by all means make yourself useful, but don't get in their way. They're likely to snap at you, like everything else in the world, because their brains have temporarily replaced the 'response' part of stimulus/response with 'impotent rage'. Let them have it after they're out of the woods, by all means, but don't bother trying to beat it out of them - their reptile brain would swan dive into a family of bears for another smoke before being hugged to a paste and devoured, and you're no bear.

If you're a bear, why are you here? This is a wiki. There is nothing for bears here.

[edit] What about quitting smoking, without quitting nicotine?

Since nicotine is so ferociously addictive, it may not be possible for every smoker to quit. Some may see the alternative of getting their nicotine fix in a non-carcinogenic package as preferable to both the incessant cravings of quitting and the death sentence of continuing to smoke cigarettes.

If you're planning to go this route -- whether through nicotine gum, inhalers, e-cigarettes, air-cured smokeless tobacco, or some other nicotine delivery system -- be aware of two things:

  1. Other means of getting nicotine are not guaranteed to eliminate your craving for cigarettes. Cigarettes deliver the nicotine to your lungs in a very specific way, which contributes to its addictive quality and which other means might lack. Cigarette smoke also contains MAO Inhibitors, which contribute to the addictive nature of smoking and which other nicotine delivery systems lack.
  2. Nicotine itself has some health risks, separate and distinct from tobacco smoke. It's linked with Alzheimers (though correlation does not imply causation), it causes a temporary constriction of the blood vessels and increase in blood pressure, and may very well be the component of cigarette smoke that contributes to atherosclerosis.

Quitting all nicotine products entirely carries the greatest potential health benefit. You'll just have to weigh that benefit against its cost.

[edit] Ye Olde Cigarette Shoppe

These claims are completely different from the ones used to sell supplements. Not the same at all. Really.

Many of these ancient "medicinal" cigarettes used cubeb[wp] instead of tobacco. While cubeb is not known for containing nicotine, setting it on fire and inhaling the smoke will surely impart just as nasty a cocktail of carcinogens to your lungs as smoking a tobacco cigarette will.

More vintage cigarette ads that can't be added to RationalWiki for copyright reasons can be found here (medical claims abound).

[edit] See also

Icon fun.svg For those of you in the mood, RationalWiki has a fun article about Tobacco.

[edit] External links

[edit] Footnotes

  1. netdoctor: Smoking - health risks
  2. Nicotine and addiction, June 2013 - http://ash.org.uk/files/documents/ASH_114.pdf
  3. 3.0 3.1 3.2 3.3 Medicinal uses of tobacco in history, Anne Charlton, J R Soc Med. 2004 June; 97(6): 292–296. PMCID: PMC1079499.
  4. 4.0 4.1 A history of the medicinal use of tobacco 1492-1860, Grace G. Stewart, Med Hist. 1967 July; 11(3): 228–268. PMCID: PMC1033728.
  5. Of the Tabaco and of His Greate Vertues
  6. A Counterblaste to Tobacco, Wikisource.
  7. Birthwort, A Modern Herbal.
  8. Tobacco, A Modern Herbal, Maud Grieve.
  9. Raw tobacco leaves actually contain no carcinogens. During flue-curing (but not air-curing), a carcinogenic compound develops in tobacco leaves, which is why chewing tobacco has been known to cause cancer of the mouth. Setting tobacco on fire, on the other hand, creates a far worse cocktail of carcinogens; this is the main reason cigarette smoking causes cancer.
  10. Subject to change depends on the health care expenses incurred (if government pays for health care) due to the consequences of smoking.
  11. Unless the pension is defined-benefit and includes post-employment health care coverages for some odd reason.
  12. 15,000 kids with asthma
  13. Especially those with pre-existing attitude or lung problems
  14. Monoamine Oxidase Inhibition Dramatically Increases the Motivation to Self-Administer Nicotine in Rats, The Journal of Neuroscience, August (?) 2005
  15. Or emphysema, heart disease, chronic hacking coughs, etc.
  16. Unless you have a smoking fetish. Then the smoker might as well be hideous.
  17. Mostly involuntarily, due to legislation or court rulings.
  18. Yes, they are daring you not to buy cigarettes!
  19. Lung damage from pot
  20. Study finds no cancer-marijuana connection
  21. Cannabis 'safer than alcohol and tobacco'
  22. Cannabis smoke less carcinogenic than tobacco smoke
  23. Not Kool: It’s time to ban menthol cigarettes., New Scientist, 26-Oct-2013
  24. Most people with schizophrenia smoke tobacco, says research (myDr.com.au, 9 April 2001)
  25. Smoking away Schizophrenia? (Lisa Conti, Scientific American, 2007-11-28)
  26. Nicotine tied to Alzheimer's risk (Wendy Zukerman, New Scientist, 2010-04-14). This appears to supersede earlier reports that nicotine might help break up the amyloid plaques.
  27. Smoking and high blood pressure
  28. http://web.archive.org/web/20080508022124/http://www.forestonline.org/files/pdf/JJ%20Essay%20web.pdf
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