Many of us are familiar with cigarettes for a variety of reasons. A cigarette, in a simple definition, is a cut or shredded tobacco leaf that is usually wrapped in thin paper and used to inhale tobacco smoke. Cigarette is a Spanish word that is pronounced “cigar”.

Cigarette means wrapped in paper. In English, cigarettes are called cigarettes, which also means wrapping them in paper. There is another type of cigarette called leaf cigar. In this type of cigarette, tobacco leaves are used directly without the use of paper.

What is a cigarette and what substances does it consist of?

Cigarettes have a cylindrical appearance and have a paper containing tobacco. A cigarette butt is a combination of tar and thousands of other chemicals such as polyromatic hydrocarbons, aromatic amines, and dozens of other inorganic and carcinogenic compounds.

Different types of cigarettes are commonly produced by tobacco factories and contain a variety of harmful chemicals. Nicotine is an addictive substance in tobacco; It is commonly used in the form of cigarettes (regular cigarettes), leaf cigarettes, chewing and sucking tobacco, powder and pipe tobacco.

The reason smoking cigarettes are more prevalent than intravenous injections is that the smoking method delivers nicotine to the brain faster; Therefore, smoking is the fastest and most effective way to experience the effects of this substance.

Nicotine has several physical effects.

As a stimulant, it raises heart rate and blood pressure. The paradox is that nicotine has a sedative effect; Because, according to the consumer, it reduces stress and anxiety and anger. In written polls, smokers usually confirm by checking the box next to statements such as “When I’m upset or nervous, smoking calms me down” and “Smoking soothes me”. But nicotine also has negative and negligible effects. Smokers become moody and moody when they stay away from smoking for a while, and they become stressed and irritable between smoking or trying to quit.

These properties indicate that nicotine is a substance that causes physical and mental addiction. First, nicotine releases dopamine into the mesolimbic system. Some of the effects of dopamine release in this area of ​​the brain include refreshing, decreased appetite, and enhanced overall cognitive function (thought opening); That is, consequences that are similar to the effects of other addictive substances, such as cocaine.

Second, the sedative effect of nicotine (according to the consumer) may be simply because it eliminates the unpleasant effects of abstinence; That is, one thinks that smoking makes one feel good; While smoking, it eliminates the bad feelings of not smoking in the last few hours.

 In fact, smoking causes people to lose their initial bad feelings; Not that they feel good.

In various studies, smokers have reported that their mood fluctuates at different times. They are in a normal mood while smoking; But in the distance between cigarettes, they show a lot of stress and irritability. The stress level of smokers immediately after smoking is similar to the stress level of non-smokers and in periods of abstinence or periods between two smokers, the stress level of non-smokers is higher.

In other words, smokers should only smoke in order to experience a level of positive mood that non-smokers normally experience. Therefore, the experience of stress and their irritability between smoking is one of the symptoms of abstinence caused by nicotine addiction.

Prevalence of nicotine use

After alcohol, nicotine is the second most consumed substance in the world. About one-third of the world’s adult population smokes (smoking means all types of tobacco). According to the latest statistics from the DSM-5, about one-fifth of the world’s teens smoke. Smoking rates are declining in developed countries; But in developing countries, smoking rates are growing at 3.4 percent a year.

Evidence shows that about 50 percent of those who start smoking as teenagers continue to do so for 15 to 20 years. Research shows that tobacco use in the United States has been steadily declining since the 1970s; But 25 percent of the US population still smokes regularly, and tobacco use is still too high.

On average, male smokers smoke 15 cigarettes and women smokers 13 cigarettes a day. When we look at the serious health effects of smoking, the above figures seem very worrying. In polls, 68% of smokers say they intend to quit; But 55% of them can not smoke even for a day. One of the main criteria of DSM-5 for drug addiction is repeated and unsuccessful attempts to quit.

Tobacco use disorder

When nicotine is used for the first time, it causes nausea and dizziness. Smoking early in the morning and fasting also has a more severe effect; But as tobacco consumption continues, a level of tolerance develops in the body and the effect of nicotine gradually weakens. Avoiding nicotine or not getting it into the body can cause abstinence syndrome.

Tobacco control syndrome includes sadness, grief, insomnia, irritability, discouragement, anger, anxiety, inability to concentrate, restlessness and impatience, decreased heart rate, increased appetite and weight gain. Highly dependent smokers develop these symptoms within a few hours of voluntary or forced abstinence (eg, flying).

It is estimated that about 80 to 90 smokers meet the criteria for smoking cessation. People with smoking cessation usually smoke more than they originally intended or for longer than previously thought.

They have always wished or tried several times to quit smoking. They spend a lot of time and energy buying tobacco, using it or eliminating its side effects.

The constant use of tobacco in them causes them to not do well in their work, study or home duties.

This feature is associated with several additional features, including:

• It is more difficult to quit smoking

• Smoking very shortly after waking up

• Smoking during illness

• Inability to quit smoking

• Smoking most of the time before noon, not in the afternoon

Tobacco disorder is synonymous with other types of mental disorders. According to ‌DSM-5 statistics, it is estimated that 55 to 90% of smokers also have other mental disorders; This figure is 25 to 30% of the total population.

DSM criteria for tobacco use disorder

A person has a pattern of smoking that is both problematic and leads to severe disorder or suffering clinically. Personal suffering or functional impairment becomes so severe that clinical attention is required.

• People usually smoke more or for longer than they originally intended.

• A person all the time wishes to reduce the amount of tobacco consumed or to control the consumption of tobacco, or has tried several times to do so but has not succeeded.

• A person spends a lot of time acquiring, consuming or eliminating tobacco after smoking.

• The person craves tobacco a lot.

• Frequent smoking prevents a person from performing his or her duties at work, school (university) or at home; For example, he regularly leaves his desk at work to smoke.

• Despite the persistent and frequent social or interpersonal problems caused by nicotine or exacerbated by its use, the person continues to smoke.

• Due to smoking, he quits or reduces his social, occupational or recreational activities.

• He frequently smokes in situations that can physically lead to dangerous consequences, such as smoking in bed.

• The person continues to use it, even though he or she knows he or she has a permanent physical or mental problem that has been caused or exacerbated by smoking.

• The person has developed tolerance syndrome. This is indicated by one or both of the following:

A) To achieve the desired anesthesia or pleasure, much larger amounts of tobacco are needed.

Two) Continued use of a certain amount of tobacco is much less effective.

• The person has abstinence syndrome; This is shown by one of the following two cases:

A) The person has a special criterion for smoking cessation syndrome.

Two) He smokes to avoid the symptoms of smoking cessation syndrome.

Prevalence of tobacco use

Cigarettes are the most common tobacco-derived product and 90% of tobacco consumption is in the form of cigarettes. In the United States, 57% of adults have never smoked, 22% have been smokers before, and 21% are now smokers. About 20% of people who are currently smokers do not smoke every day (only 1% smoke every day).

The prevalence rate of smokeless tobacco is less than five percent and the prevalence rate of tobacco is much higher in men than women. The difference in developed countries is that men start smoking earlier than women.

Why do people smoke?

Why do so many people use a dangerous substance called tobacco (or nicotine in it)? To answer this question, we need to see why people, while aware of the negative consequences of smoking, turn to smoking, continue to smoke, and find it difficult to quit.

Most smokers start smoking from childhood or early adolescence, and the age of onset of smoking, especially in women, is declining. Children and adolescents have social motivations to start smoking; But they are rarely coerced or persuaded by others.

In most cases, adolescents smoke because they conform to the norm of the group; That is, they can become more like the rest of the group and, therefore, engage in behaviors that exist in the group; Including smoking.

Thus, smoking is approved by groups whose main characteristic is smoking, and new members of the smoking group begin to identify themselves as acceptable members of the group.

Exchanging cigarettes and complimenting them shows the bonding of members in adolescent groups, and smoking is necessary to strengthen friendships and show commitment to the group.

Smoking does not seem to be just a simple behavior to change the physical and mental state; Rather, it has a complex social application, especially in the early stages of social development.

Another important factor that causes teens to smoke is advertising. Many countries have banned the overt advertising of cigarettes; But tobacco companies still tacitly promote cigarettes by supporting large social events such as concerts or car races.

In many developing countries, overt advertising of cigarettes is still not banned. Some studies show that advertising makes children aware of a phenomenon called smoking and encourages them to do so.

What causes those who have started smoking to continue to do so, aware of the dire consequences?

Some theorists believe that smoking is an acquired (learned) habit that is perpetuated by a number of reinforcing or rewarding consequences.

They believe that the properties of nicotine – which affect the central nervous system – make smokers benefit from the effects of this effect; Because as a result of this action, the concentration of the senses increases and the cognitive function of the person improves.

These effects are a boosting stimulus that reinforces the habit of smoking; But in the face of serious and dangerous dangers, the rewards of smoking are very weak.

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Nicotine increases the tolerance to the pleasurable effects of caffeine, and caffeine does the same to the pleasurable effects of nicotine.

More recently, theories about the persistence of smoking have focused on its effects on reducing stress as potential reinforcers; But nicotine is not a natural stress reliever: as we said before, it stimulates the central nervous system. So why do smokers say they feel more relaxed after smoking?

Clinical psychologists believe that some time after the last cigarette, the symptoms of abstinence syndrome gradually appear and the smoker becomes increasingly nervous and irritable and can not concentrate.

At this time, lighting a cigarette makes you feel calmer, happier and more focused; Because nicotine levels rise and normal physiological function is restored.

Some people smoke to drink tea and drink tea to smoke.

You might think this sentence sounds like a simple joke; But it is not. Research shows that nicotine can increase the pleasurable properties of caffeine, and caffeine can increase the pleasurable properties of nicotine. According to this research, nicotine and caffeine increase tolerance for each other (mutual tolerance).

In other words, nicotine can increase a person’s tolerance for the pleasurable effects of caffeine, and caffeine does the same with the pleasurable effects of nicotine. Thus, in order to preserve their pleasurable effects, one has to increase the consumption of both. The same is true of alcohol and nicotine. It is estimated that about eighty to eighty-five percent of alcohol users are smokers.

DSM-5 Criteria for Tobacco Control Syndrome

A. The person has been smoking every day for at least a few weeks.

B. The person stops smoking abruptly or abruptly stops smoking, and within 24 hours, four of the following symptoms occur.

• Irritability, nervousness or anger
• Anxiety
• Difficulty concentrating desire
• Increased appetite
• Restlessness
• A depressed mood
• insomnia

C. Signs or symptoms of criterion B cause severe dysfunction in social, occupational, or other important areas of life.
D. The signs or symptoms cannot be attributed to another medical complication, and another mental disorder, such as intoxication or abstinence from another substance, is no better explanation for them.

Prevalence of tobacco abstinence syndrome

About 50% of tobacco users, if they do not smoke for 2 days or more, will have symptoms that meet the criteria for smoking cessation syndrome. The most common signs and symptoms are anxiety, irritability, difficulty concentrating, depression (depressed mood), and insomnia (insomnia), which are the least common.

Mood swings are an important part of nicotine addiction, and smoking can be a conditioned response to any type of stress, not just the stress of abstinence syndrome.

This theory explains why smoking becomes addictive and why getting rid of stress and negative moods plays such an important role in continuing smoking. For example, smoking often resumes when new stressful events occur when trying to quit smoking.

Nicotine addiction is associated with a number of unfortunate childhood experiences and depression in adolescents.

In addition, depressed or anxious people become addicted to nicotine faster than others. We must remember that misconceptions about the stress-relieving properties of nicotine are debilitating. As mentioned earlier, immediately after smoking, the level of stress of smokers is similar to the level of stress of non-smokers. Therefore, smokers should smoke only to reach a normal level of mood.

Studies have also shown that smoking at age 18 increases the risk of depression or anxiety in adulthood; Therefore, it can be said that the effects of smoking are not limited to stress relief.

Costs of smoking

Like most addictive substances, the main harm of nicotine addiction is endangering physical health. Smoking is the single leading and most preventable cause of physical illness and premature death in the world (World Health Organization 2012 statistics) and causes heart disease, stroke, lung cancer, cancer of the larynx, esophagus, mouth, bladder, cervix, pancreas and kidneys.

It is estimated that between 1950 and 2010, 72 million people worldwide died from nicotine-related illnesses.

It is also estimated that 50% of adolescents who now smoke will die from tobacco-related diseases and lose an average of 21 years of life if they continue to smoke.

The economic cost of tobacco-related health problems is dire.

The health risks associated with smoking do not only include smokers. Cigarette smoke contains thousands of chemicals that can have harmful and poisonous effects if inhaled.

The smoke that comes out of the bottom of a cigarette is called secondhand smoke or ambient cigarette smoke, and the whole process is called passive smoking.

The concentration of ammonia, carbon monoxide, nicotine and tar in this smoke is higher than the smoke that a smoker sends into his lungs. Secondhand smoke is very dangerous for those who live in the same place with smokers.

Just 30 minutes of exposure to second-hand smoke is enough to reduce blood flow to the heart. People who live with smokers are 25 percent more likely to develop heart disease. Cigarette smoke is a major health hazard for infants and young children and can increase lung infections and asthma attacks.

In Britain, it is estimated that two people die every day from secondhand smoke. Second-hand smoke kills 2,700 people between the ages of 20 and 64 and 8,000 over the age of 65 each year.

Cigarettes, the third most profitable industry in the world

About 100 million people in the world are engaged in the tobacco industry. According to the statistics provided, 5600 billion cigarettes are consumed annually in the world, which has a turnover of 330 billion dollars per year. Cigarettes are the third most profitable industry in the world after crude oil and pharmaceuticals.

The profits from cigarette sales are so great that governments are reluctant to reduce cigarette sales in other countries and in their own. The latest statistics show that out of 100 million people employed in the tobacco industry, only 1.2 million work in the manufacturing sector, and 40 million in the cultivation and growth of tobacco leaves, more than 20 million in the domestic industry, such as They pack cigarettes by hand (in India and Indonesia).

The rest of the people work in the process of producing tobacco until it is distributing, are selling and finally ready for use.

There is considerable employment in the Tobacco Control Organization. According to reports, the annual production of tobacco in the world is about 6 million tons and the product of 120 countries and 80% of this production is from developing countries.

Among these countries, 7% of tobacco products belong to 6 countries: Brazil, China, India, Indonesia, the United States and Zimbabwe. The highest per capita smoking in the world is in Russia with 2,500 cigarettes and the lowest is in Afghanistan, Pakistan and India with less than 500 cigarettes.

The annual consumption of cigarettes in the world reaches 5600 billion cigarettes. China is the world’s largest producer of cigarettes, producing 2,250 billion cigarettes a year, accounting for 43% of the world’s cigarette production. Annual smoking in China is 38% of the world’s smoking.