Tobacco AUSTRALIAN DRUG FOUNDATION
12 HOW DRUGS AFFECT YOU
This pamphlet is part of the “How Drugs Affect You� series. It aims to provide the facts about tobacco for anyone interested in understanding more about this drug. It has been written for the general public, including employees and employers, and health professionals and their clients.
Other titles in this series include alcohol, amphetamines, analgesics, benzodiazepines, cannabis, cocaine, drugs and their effects, ecstasy, GHB, hallucinogens, heroin, ice, inhalants and ketamine.
12 HOW DRUGS AFFECT YOU
What is tobacco? Tobacco comes from the leaves of the tobacco plant (Nicotiana tabacum and Nicotiana rustica). The leaves are dried, cured, aged and combined with other ingredients to produce a range of products such as cigarettes, cigars, pipe tobacco, chewing tobacco, and wet and dry snuff.
Leaves from the tobacco plant contain nicotine. Nicotine is a stimulant drug. Stimulant drugs act on the central nervous system to speed up the messages travelling between the brain and the body.
Other names Cigs, fags, butts, darts, smokes, cancer sticks, ciggies, rollies.
What’s in tobacco smoke? There are more than 4000 chemicals in tobacco smoke. Many of these chemicals are poisonous and at least 43 of them are carcinogenic (cause cancer). The three major chemicals in tobacco smoke are:
»» Nicotine—the chemical on which smokers become dependent.
»» Tar—which is released when a cigarette burns. »» Carbon monoxide (CO)—a colourless, odourless and very toxic gas. Smokers typically have high levels of CO in the blood.
How is it used? Cigarettes are the most common way to smoke tobacco. Smoking tobacco in cigars and pipes is less popular. When tobacco is smoked, nicotine is absorbed through the membranes of the mouth and upper respiratory tract. When tobacco is chewed (as chewing tobacco or wet snuff), the nicotine is absorbed through the membranes in the mouth. It can also be sniffed (dry snuff) and the nicotine is then absorbed through the lining of the nose.
“Light” or “low tar” cigarettes Some people believe that smoking “light” or “low tar” cigarettes is less harmful than regular cigarettes. However, there is little difference between the amount of chemicals inhaled by people who smoke “light” cigarettes and those who smoke regular ones.
Tobacco in Australia According to the National Drug Strategy Household Survey1, in 2007:
»» one in six (16.6 per cent) Australians aged over 14 years smoked daily
»» males were more likely to be daily smokers than
females except in the 14–19 year age group where females were more likely to be daily smokers »» the average age at which Australians had their first full cigarette was 15.8 years.
Australian Institute of Health and Welfare (AIHW) 2008 2007 National Drug Strategy Household Survey: Detailed findings, Canberra: Australian Institute of Health and Welfare.
1
Effects of tobacco smoking The effects of any drug (including tobacco) vary from person to person. How tobacco affects a person depends on many things including their size, weight and health, also whether the person is used to taking it. The effects of tobacco, as with any drug, also depend on the amount taken. In Australia, tobacco use is responsible for approximately 15,000 deaths each year. In 2004–2005 approximately three-quarters of a million hospital bed-days were because of tobacco use.2
Immediate effects Low to moderate doses Some of the effects that may be experienced after smoking tobacco include:
»» initial stimulation,
then reduction in activity of brain and nervous system »» increased alertness and concentration »» feelings of mild euphoria »» feelings of relaxation »» increased blood pressure and heart rate »» decreased blood flow to fingers and toes
»» decreased skin temperature
»» bad breath »» decreased appetite »» dizziness »» nausea, abdominal
cramps and vomiting
»» headache »» coughing, due to
smoke irritation.
Collins D & Lapsley H 2008 The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004–05, Canberra: Department of Health and Ageing.
2
Higher doses A high dose of nicotine can cause a person to overdose. This means that a person has taken more nicotine than their body can cope with. The effects of very large doses can include:
»» an increase in the
unpleasant effects »» feeling faint »» confusion
»» rapid decrease in blood
pressure and breathing rate
»» seizures »» respiratory arrest (stop breathing) and death.
Sixty milligrams of nicotine taken orally can be fatal for an adult.
Long-term effects Tar in cigarettes coats the lungs and can cause lung and throat cancer in smokers. It is also responsible for the yellow–brown staining on smokers’ fingers and teeth Carbon monoxide in cigarettes reduces the amount of oxygen available to the muscles, brain and blood. This means the whole body—especially the heart—must work harder. Over time this causes airways to narrow and blood pressure to rise, which can lead to heart attack and stroke. High levels of CO, together with nicotine, increase the risk of heart disease, hardening of the arteries and other circulatory problems. Some of the long-term effects of smoking3 that may be experienced include:
See diagram
Diagram reference (see right) Quit Victoria 2010 “Smoking and surgery” at www.quit.org.au/ article asp?ContentID=surgery (accessed 14/10/10).
3
Damage to blood vessel walls in arms/hands and legs/feet can lead to atherosclerotic peripheral vascular disease (PVD) that can result in gangrene and amputation.
4
Immune system Increased susceptibility to infection
Skin » grey appearance » early wrinkles » stained yellowish–brown by tar » slower healing wounds
Back Back pain
Heart and blood » heart disease and a heart attack » high blood pressure » cancer that affects bone marrow and organs that make blood
Face, mouth, nose, eyes » cataracts, macular degeneration, yellowing of whites of eyes » loss of sense of smell and taste » yellow teeth, tooth decay and bad breath » cancer of the nose, lip, tongue and mouth
Sexual organs – males » damaged sperm and reduced sperm » impotence
Legs and feet Damage to blood vessel walls4
Sexual organs – females » lower fertility » increased risk of miscarriage » irregular periods » early menopause
Stomach and bowel » stomach and bladder cancers » stomach ulcers » decreased appetite
Lungs » cancer » shortness of breath » trigger for asthma and emphysema » coughing andchronic bronchitis
Arms and hands Damage to blood vessel walls4
Muscles and bones Contributes to osteoporosis
Throat Cancers
Ears Hearing loss
Brain Stroke and brain damage
Long-term effects
Tolerance and dependence People who use tobacco regularly tend to develop a tolerance to the effects of nicotine. This means they need to smoke more tobacco to get the same effect. People who smoke regularly may become dependent on nicotine. Dependence can be psychological, physical, or both. People who are dependent on nicotine find that using the drug becomes far more important than other activities in their life. They crave the drug and will find it very difficult to stop using it. People who are psychologically dependent on nicotine may find they feel an urge to smoke when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person’s body adapts to the nicotine and gets used to functioning with the nicotine present. Withdrawal If a dependent person stops smoking or reduces the amount they smoke, they may experience withdrawal symptoms. This is because their body has to get used to functioning without nicotine. Most of the symptoms will stop within days or weeks of quitting smoking, but the desire to smoke may go on for years. Some of the withdrawal symptoms that may be experienced include:
»» cravings »» irritability, agitation, depression and anxiety »» insomnia and disturbed sleeping patterns »» increased appetite and weight gain »» restlessness and loss of concentration »» headaches »» coughing and sore throat »» body aches and pains »» stomach and bowel upsets. Passive smoking Passive smoking occurs when a person who is not smoking breathes in the smoke from people who are smoking. Passive smoking can irritate the eyes and nose and cause a number of health problems such as heart disease and lung cancer. Tobacco smoke is especially harmful to babies and young children.
Pregnancy and breastfeeding Smoking tobacco can affect fertility in both men and women. Many drugs, including tobacco, can cross the placenta and affect an unborn child. In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight. Babies whose parents smoke also have an increased risk of sudden infant death syndrome (SIDS). They are more likely to suffer from asthma and other respiratory infections than babies of non-smokers. If a mother smokes while breastfeeding, the nicotine may be present in her breast milk. This may have an effect on the baby. Check with your doctor or other health professional if you are using or planning to use tobacco or any other drugs during pregnancy or while breastfeeding.
Tobacco and other drugs Nicotine can affect the way the body processes many different drugs. This can affect how these drugs work. For example, nicotine can decrease the effectiveness of benzodiazepines. Smoking while taking the contraceptive pill increases the risk of blood clots forming. Check with your doctor or other health professional whether nicotine might affect any medications you are taking.
Tobacco and the law Federal and state laws make it an offence to sell or supply tobacco products to people under 18 years of age. It is also illegal for anyone under 18 years to purchase tobacco products. There are laws that regulate and restrict how tobacco products are advertised, promoted and packaged. There are also laws and regulations that restrict smoking in public areas such as shopping centres, cafes and workplaces. Most states and territories have laws that ban smoking in cars with children. For more information contact a legal aid service in your state or territory.
Quitting tobacco People are generally more successful at quitting smoking if they get help and use a combination of methods that suit their individual situation. Different strategies can include:
»» going “cold turkey” »» nicotine replacement
therapy, such as patches, gum, lozenges, inhalers, nasal sprays and tablets »» individual counselling or advice
»» other medications
(pharmacotherapies) such as bupropion »» support groups »» alternative therapies, such as acupuncture and hypnosis.
For more information and support in quitting tobacco, contact the Quitline on tel. 131 848 or see your doctor, pharmacist or other health professional.
Benefits of quitting After a person stops smoking:
»» Almost all the nicotine is out of their system after 12 hours. »» After 24 hours, the level of carbon monoxide in their blood is reduced and they will have more oxygen in their bloodstream. »» Most of the nicotine by-products are out of their system after five days. »» Their sense of taste and smell will have improved after a couple of days. »» Their blood pressure returns to its normal level within a month. »» Their immune system starts to show signs of returning to normal within a month. »» Blood flow to their hands and feet has improved within three months. »» After a year, the increased risk of dying from heart disease is half that of a person who has continued to smoke tobacco.
Quitting smoking also reduces the threat of passive smoking to friends and family, and leaves a person with more money to spend on other things.
Preventing and reducing harms Many Australians take at least one psychoactive drug on a regular basis—they might take medication (i.e. over-the-counter or via a prescription), drink alcohol, smoke tobacco or use an illegal drug. All drugs have the potential to cause harm. As use increases, so does the potential for harm. Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. It aims to reduce all types of drug-related harm to both the individual and the community.
There is no safe level of tobacco use Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.
What to do if you are concerned about someone’s tobacco use If you are concerned about someone else’s tobacco use, there is confidential help available. Contact Quitline or the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
For information, counselling or other assistance, contact the alcohol and other drug service in your state or territory.
Quitline (all states) 131 848 ACT (02) 6207 9977
Tas. 1800 811 994
NSW (02) 9361 8000 (Sydney) 1800 422 599 (NSW)
Vic. 1300 85 85 84 (information)
NT 1800 131 350
QLD 1800 177 833 SA
1300 131 340
1800 888 236 (counselling)
WA (08) 9442 5000 (Perth)
1800 198 024 (WA)
Produced by the Australian Drug Foundation Š 2010. Celebrating more than 50 years of service to the community, the Australian Drug Foundation is Australia’s leading body committed to preventing alcohol and other drug problems in communities around the nation. www.adf.org.au For further copies of this pamphlet: Post: PO Box 818 North Melbourne Vic 3051 Street: 409 King Street West Melbourne Vic 3003 Email: druginfo@adf.org.au Web: www.druginfo.adf.org.au