From the Guidelines
Smoking regularly is a highly hazardous behavior that significantly increases the risk of serious health problems, including lung cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD), and the best health recommendation is to avoid smoking entirely or to quit if you currently smoke, as there is no safe level of tobacco use. Regular smoking leads to nicotine dependence, where the body becomes physically and psychologically addicted to nicotine. This addiction develops because nicotine triggers the release of dopamine in the brain, creating pleasurable sensations that reinforce the smoking behavior. The harmful effects of smoking accumulate over time, with longer and heavier smoking patterns causing more severe damage. Even smoking just a few cigarettes per day constitutes regular smoking and carries substantial health risks. According to the study published in Circulation 1, tobacco use is the single largest preventable cause of disease and premature death in the United States, and approximately 440,000 Americans die each year from illnesses related to active smoking. Additionally, the study published in Pediatrics 1 found that nicotine dependence develops early and drives the progression from intermittent to daily smoking, and that counseling and medication are effective when used by themselves for treating tobacco dependence, but the combination of counseling and medication is more effective than either alone. The American Academy of Pediatrics recommends that pediatricians inquire about tobacco use and tobacco smoke exposure as part of health supervision visits and visits for diseases that may be caused or exacerbated by tobacco smoke exposure, and that they recommend tobacco dependence treatment of tobacco-dependent parents and caregivers 1. Key points to consider:
- Smoking regularly increases the risk of serious health problems
- Nicotine dependence develops early and drives the progression from intermittent to daily smoking
- Counseling and medication are effective for treating tobacco dependence, but the combination of both is more effective
- There is no safe level of tobacco use, and the best health recommendation is to avoid smoking entirely or to quit if you currently smoke.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Pharmacologic Action Nicotine, the chief alkaloid in tobacco products, binds stereo-selectively to nicotinic-cholinergic receptors at the autonomic ganglia, in the adrenal medulla, at neuromuscular junctions, and in the brain. Acute and chronic tolerance to nicotine develops from smoking tobacco or ingesting nicotine preparations.
Smoking regularly is not explicitly defined in the provided drug labels. However, it can be inferred that smoking regularly refers to the repeated and frequent use of tobacco products, which leads to the development of acute and chronic tolerance to nicotine 2.
- Key points:
- Nicotine is the chief alkaloid in tobacco products.
- Smoking tobacco leads to the development of tolerance to nicotine.
- The exact definition of smoking regularly is not provided in the drug labels. However, based on the information provided, it can be conservatively decided that smoking regularly would involve frequent and repeated use of tobacco products, leading to nicotine tolerance. 2
From the Research
Definition of Smoking Regularly
Smoking regularly can be defined as the habitual inhalation of the smoke of burned tobacco, which may occur as a consequence of a physical addiction to some chemicals, primarily nicotine 3.
Health Effects of Smoking
Regular smoking is associated with various health risks, including:
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and emphysema 4
- Cardiovascular hazards, such as increased vascular spasm and atherosclerosis leading to acute and chronic myocardial events, cerebral and peripheral vascular diseases 4
- Cancers, including lung cancer, which is the leading cause of cancer death in most high-income countries 4
- Premature mortality, with a 2-fold greater risk in smokers than in nonsmokers throughout middle age 4
Prevalence of Smoking
According to recent studies, more than a billion people smoke worldwide, and without major increases in cessation, at least half will die prematurely from tobacco-related complications 5. In the United States, 1 in 5 adults uses tobacco products, and cigarette smoking is the leading cause of preventable disease and death 6.
Addiction and Nicotine
Smoking is addictive due to nicotine, and nicotine withdrawal causes many side effects of quitting smoking 3. The brain changes caused by nicotine contribute to the maintenance of nicotine or tobacco use despite knowledge of its negative consequences, a hallmark of addiction 5.
Smoking Cessation
Effective approaches to screen, prevent, and treat tobacco use can be widely implemented to limit tobacco's effect on individuals and society 5. The use of evidence-based treatments, such as pharmacotherapy and behavioral strategies, can help promote smoking cessation 6, 7.