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Cigarette
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A cigarette is a thin cylinder of tobacco rolled in thin paper for smoking. The cigarette is ignited at one end, causing it to smolder, and the resulting smoke is orally inhaled via the opposite end. Cigarette smoking is the most common method of tobacco consumption. The term cigarette, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white.
There are significant negative health effects from smoking cigarettes such as cancer, chronic obstructive pulmonary disease (COPD), heart disease, birth defects, and other health problems relating to nearly every organ of the body. Most modern cigarettes are filtered, however this does not make the smoke inhaled from them contain fewer carcinogens or harmful chemicals. Nicotine, the psychoactive drug in tobacco, makes cigarettes highly addictive. About half of cigarette smokers die of tobacco-related disease and lose on average 14 years of life. Every year, cigarette smoking causes more than 8 million deaths worldwide; more than 1.3 million of these are non-smokers dying as the result of exposure to secondhand smoke.[1] These harmful effects have led to legislation that has prohibited smoking in many workplaces and public areas, regulated marketing and purchasing age of tobacco, and levied taxes to discourage cigarette use.
In the 21st century electronic cigarettes (also called e-cigarettes or vapes) were developed, whereby a substance contained within (typically a liquid solution containing nicotine) is vaporized by a battery-powered heating element as opposed to being burned. Such devices are commonly promoted by their manufacturers as safer alternatives to conventional cigarettes. Since e-cigarettes are a relatively new product, scientists do not have data on their possible long-term health effects, but there are significant health risks associated with their use.
History
[edit]Global
[edit]
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.[2]
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).[3]
By 1830 the cigarette had become known in France, where it received the name cigarette, and in 1845 the French state tobacco monopoly began manufacturing them.[3] The French word made its way into English in the 1840s.[4] Some American reformers promoted the spelling cigaret,[5][6] but this was never widespread and is now largely abandoned.[7]
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847.[8] In the 1850s, Turkish cigarette leaves had become popular.[9] However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.[10] At the time, these imported cigarettes from the United States had significant sales among British smokers.[9]
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf.[3] This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.

Initially, not all cigarette smokers inhale the smoke produced by cigarette due to the high alkalinity levels. Starting in the 1930s, an advertising campaign was done by the tobacco industry to encourage inhaling.[11] However, Helmuth von Moltke noticed in the 1830s that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes[12] (which are both initially sun-cured, acidic leaf varieties).

The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. By the late 19th century cigarettes were known as coffin nails[13] but the link between lung cancer and smoking was not established until the 20th century.[14] German doctors were the first to make the link, and it led to the first antitobacco movement in Nazi Germany.[15][16][17]

During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and printed health warnings became common on cigarette packets.
Graphical cigarette warning labels are a more effective method to communicate to the public the dangers of cigarette smoking.[18] Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru,[19] Greece, the Netherlands,[20] New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Jordan, Nepal and Turkey all have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body. The United States has implemented textual but not graphical warnings.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.[21][22][23]
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.[24]
United States
[edit]One entrepreneur who was quick to spot the advantages of machine-made cigarettes was James Buchanan Duke. Previously a producer of smoking tobacco only, his firm, W. Duke & Sons & Co., entered the cigarette industry in the early 1880s. After installing two Bonsack machines, Duke spent heavily on advertising and sales promotion with the result that by 1889 his was the largest cigarette manufacturer in the country. The new Bonsack machines were of decisive importance in rapid, cheap manufacture of all tobacco products but one. Cigars needed slow, laborious hand rolling and were produced in hundreds of small workshops, especially in New York City. In 1890 Duke and the other four major cigarette companies combined to form the American Tobacco Company, a firm that dominated the market and used aggressive tactics on hundreds of small competitors until they sold out. It was called the "Tobacco Trust." The trust soon expanded its operations to include cigars, smoking, chewing tobacco and snuff. Among the companies drawn into this organization were plug manufacturers, Liggett & Myers and R. J. Reynolds Tobacco Company, which at the time produced twist and flat plug, and P. Lorillard, an old-line manufacturer of snuff. By 1910 the trust produced 86% of all cigarettes produced in the United States, and 75% to 95% of other forms, but only 14% of the cigars.[25]
At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with fewer than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year).[26] By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691;[27] implying that about 21% of the population smoked 100 cigarettes or more per year.
Construction
[edit]
- Mainstream smoke
- Filtration material
- Adhesives
- Ventilation holes
- Ink
- Adhesive
- Sidestream smoke
- Filter
- Tipping Paper
- Tobacco and ingredients
- Paper
- Burning point and ashes
Manufacturers have described the cigarette as "a drug administration system for the delivery of nicotine in acceptable and attractive form".[28][29][30][31] Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter.[32] While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.[33]
Paper
[edit]The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.[34]
Tobacco blend
[edit]The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.[35]
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate").[35] To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
- Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.[36]
- Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing:[37] RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.[33]
- Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.[35]
According to data from the World Health Organization,[38] the amount of tobacco per 1000 cigarettes fell from 1.03 kg (2.28 pounds) in 1960 to 0.41 kg (0.91 pounds) in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors. Most commercially available cigarettes today contain tobacco that is treated with sugar to counter the harshness of the smoke.
Additives
[edit]Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings".[39] The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[35] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette packs. Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.[40]
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules.[39] This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.[41]
Cigarette tube
[edit]Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from Regular (70 mm) to King Size (84 mm) as well as 100s (100 mm) and 120s (120 mm).[42][self-published source?]
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor[43]
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."[44]
Cigarette filter
[edit]A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
Cigarette butt
[edit]
In North America, the common name for the remains of a cigarette after smoking is a cigarette butt. In Britain, it is also called a dog-end.[45] The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash.
They are the most numerically frequent litter in the world.[46] Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches.[47] In a 2013 trial, the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers.[48][49]
Electronic cigarette
[edit]
An electronic cigarette (commonly known as a vape) is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco.[50] Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper".[51] Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor.[52] E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid.[53] E-cigarettes are automatically activated by taking a puff;[54] others turn on manually by pressing a button.[51] Some e-cigarettes look like traditional cigarettes,[55] but they come in many variations.[51] Most versions are reusable, though some are disposable.[56] There are first-generation,[57] second-generation,[58] third-generation,[59] and fourth-generation devices.[60] E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants.[61] E-liquids are also sold without propylene glycol,[62] nicotine,[63] or flavors.[64]
The benefits and the health risks of e-cigarettes are uncertain.[65][66][67] There is moderate-certainty evidence that e-cigarettes with nicotine may help people quit smoking when compared with e-cigarettes without nicotine and nicotine replacement therapy.[68] However, other studies have not supported the finding that e-cigarettes are proven to be more effective than smoking cessation medicine.[69] There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created.[70] Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes.[70] Youth who use e-cigarettes are more likely to go on to smoke cigarettes.[71][72] Their part in tobacco harm reduction is unclear,[73] while another review found they appear to have the potential to lower tobacco-related death and disease.[74] Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes,[73] but e-cigarettes are generally seen as safer than combusted tobacco products.[75][76] It is estimated their safety risk to users is similar to that of smokeless tobacco.[77] The long-term effects of e-cigarette use are unknown.[68][78][79] The risk from serious adverse events was reported in 2016 to be low.[80] Less serious adverse effects include abdominal pain, headache, blurry vision,[81] throat and mouth irritation, vomiting, nausea, and coughing.[82] Nicotine itself is associated with some health harms.[83] In 2019 and 2020, an outbreak of severe lung illness throughout the US was linked to the use of vaping products[84]
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter,[82] which have been found to contain propylene glycol, glycerin, nicotine, flavors, small amounts of toxicants,[82] carcinogens,[85] and heavy metals, as well as metal nanoparticles, and other substances.[82] Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors.[52] E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke.[86] E-cigarette vapor contains fewer toxic chemicals,[82] and lower concentrations of potential toxic chemicals than cigarette smoke.[87] The vapor is probably much less harmful to users and bystanders than cigarette smoke,[85] although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.[88]
Health effects
[edit]Smokers
[edit]

The harm from smoking comes from the many toxic chemicals in the natural tobacco leaf and those formed in smoke from burning tobacco.[89] A 2024 study estimated that each cigarette reduces life expectancy by 20 minutes.[90][91] Humans continue to smoke because nicotine, the primary psychoactive chemical in cigarettes, is highly addictive.[92] Cigarettes, like narcotics, have been described as "strategically addictive", with the addictive properties being a core component of the business strategy.[93] About half of smokers die from a smoking-related cause.[1][94][95] Smoking harms nearly every organ of the body. Smoking leads most commonly to diseases affecting the heart,[96] liver, and lungs, being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis), and cancer[96][97][98][99][100] (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer). It also causes peripheral vascular disease and hypertension. The incidence of erectile dysfunction is approximately 85 percent higher in men who smoke compared to men who do not smoke.[101][102] Children born to women who smoke during pregnancy are at higher risk of congenital disorders, cancer, respiratory disease, and sudden death.[103] On average, each cigarette smoked is estimated to shorten life by 11 minutes.[95][104][105] Starting smoking earlier in life and smoking cigarettes higher in tar increases the risk of these diseases. The World Health Organization estimates that tobacco causes 8 million deaths each year as of 2019[1] and 100 million deaths over the course of the 20th century.[106] Cigarettes produce an aerosol containing over 4,000 chemical compounds, including nicotine, carbon monoxide, acrolein, and oxidant substances.[103][107] Over 70 of these are carcinogens.[108]
The most important chemical compounds causing cancer are those that produce DNA damage since such damage appears to be the primary underlying cause of cancer.[109] Cigarette smoking results in oxidative stress and oxidative DNA damage. DNA damage can be estimated by measuring urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and 8-oxoguanine DNA glycosylase (OGG1).[110] DNA damage was found in a population study to be significantly increased in 250 cigarette smokers compared to 200 non-cigarette smokers.[110] Cunningham et al.[111] combined the microgram weight of the compound in the smoke of one cigarette with the known genotoxic effect per microgram to identify the most carcinogenic compounds in cigarette smoke. The seven most important carcinogens in tobacco smoke are shown in the table, along with DNA alterations they cause.
| Compound | Micrograms per cigarette | Effect on DNA | Ref. |
|---|---|---|---|
| Acrolein | 122.4 | Reacts with deoxyguanine and forms DNA crosslinks, DNA-protein crosslinks and DNA adducts | [112] |
| Formaldehyde | 60.5 | DNA-protein crosslinks causing chromosome deletions and re-arrangements | [113] |
| Acrylonitrile | 29.3 | Oxidative stress causing increased 8-oxo-2'-deoxyguanosine | [114] |
| 1,3-butadiene | 105.0 | Global loss of DNA methylation (an epigenetic effect) as well as DNA adducts | [115] |
| Acetaldehyde | 1448.0 | Reacts with deoxyguanine to form DNA adducts | [116] |
| Ethylene oxide | 7.0 | Hydroxyethyl DNA adducts with adenine and guanine | [117] |
| Isoprene | 952.0 | Single and double strand breaks in DNA | [118] |
| Country | Current and future smokers,
ages 15+ (millions) |
Approximate number of deaths in current
and future smokers younger than 35, unless they quit (millions) |
|---|---|---|
| China (2010) | 193 | 97 |
| Indonesia (2011) | 58 | 29 |
| Russian Federation
(2008) |
32 | 16 |
| United States (2011) | 26 | 13 |
| India (2009) | 95 | 48 |
| Bangladesh (2009) | 25 | 13 |
"Ulcerative colitis is a condition of nonsmokers in which nicotine is of therapeutic benefit."[120] A recent review of the available scientific literature concluded that the apparent decrease in Alzheimer disease risk may be simply because smokers tend to die before reaching the age at which it normally occurs. "Differential mortality is always likely to be a problem where there is a need to investigate the effects of smoking in a disorder with very low incidence rates before age 75 years, which is the case of Alzheimer's disease", it stated, noting that smokers are only half as likely as nonsmokers to survive to the age of 80.[121]
Gateway theory
[edit]A very strong argument has been made about the association between adolescent exposure to nicotine by smoking conventional cigarettes and the subsequent onset of using other dependence-producing substances.[122] Strong temporal and dose-dependent associations have been reported, and a plausible biological mechanism (via rodent and human modeling) suggests that long-term changes in the neural reward system take place as a result of adolescent smoking.[122] Adolescent smokers of conventional cigarettes have disproportionately high rates of comorbid substance use, and longitudinal studies have suggested that early adolescent smoking may be a starting point or "gateway" for substance use later in life, with this effect more likely for persons with attention deficit hyperactivity disorder (ADHD).[122] Although factors such as genetic comorbidity, innate propensity for risk-taking, and social influences may underlie these findings, both human neuroimaging and animal studies suggest a neurobiological mechanism also plays a role.[122] In addition, behavioral studies in adolescent and young adult smokers have revealed an increased propensity for risk-taking, both generally and in the presence of peers, and neuroimaging studies have shown altered frontal neural activation during a risk-taking task as compared with nonsmokers.[122] In 2011, Rubinstein and colleagues used neuroimaging to show decreased brain response to a natural reinforcer (pleasurable food cues) in adolescent light smokers (1–5 cigarettes per day), with their results highlighting the possibility of neural alterations consistent with nicotine dependence and altered brain response to reward even in adolescent low-level smokers.[122]
Second-hand smoke
[edit]Second-hand smoke is a mixture of smoke from the burning end of a cigarette and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled, lingers in the air for hours after cigarettes have been extinguished, and can cause a wide range of adverse health effects, including cancer, respiratory infections, and asthma.[123] Nonsmokers who are exposed to second-hand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%. Second-hand smoke has been estimated to cause 38,000 deaths per year, of which 3,400 are deaths from lung cancer in nonsmokers.[124] Sudden infant death syndrome, ear infections, respiratory infections, and asthma attacks can occur in children who are exposed to second-hand smoke.[125][126][127] Scientific evidence shows that no level of exposure to second-hand smoke is safe.[125][126]
Legislation
[edit]Smoking restrictions
[edit]Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke.[128] Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues.
Smoking age
[edit]In the United States, the age to buy tobacco products is 21 in all states as of 2020.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.

Since October 1, 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland), rising from 16. It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on September 1, 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking. In October 2023 it was announced that the government proposed introducing a ban on sales of cigarettes to anyone born after 2008.[129]
Most countries in the world have a legal vending age of 18. In North Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population,[130] has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age. Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.[citation needed] Germany raised the purchase age from 16 to 18 on September 1, 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine.[131] Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.[132]
Taxation
[edit]Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue. Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%.[134] The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.[135]
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.[136]
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate.[137] Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York. As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
Fire-safe cigarette
[edit]Cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.[138][139]
According to Simon Chapman, a professor of public health at the University of Sydney, reduction of burning agents in cigarettes would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes.[140] Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds have developed fire safe cigarettes, but Phillip Morris was later the subject of a government lawsuit for allegedly hiding the even greater dangers associated with their brand of such cigarettes.[141]
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper.[142] Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish.[143] This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.[144]
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.[145]
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.[146]
Cigarette advertising
[edit]Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises.[147] In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.[148][149]
Warning messages on packaging
[edit]As a result of tight advertising and marketing prohibitions, tobacco companies look at the packaging differently: they view it as a strong component in displaying brand imagery and a creating in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in alternative packaging. Companies have manipulated a variety of elements on packaging designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.[150]
Some countries require cigarette packs to contain warnings about the health impact of smoking. The United States was the first,[151] later followed by other countries including Canada, most of Europe, the United Kingdom, Australia,[152] Pakistan,[153] India and Hong Kong. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging.[154][155] At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette packaging in Canada.[156] As of November 2010, 39 countries have adopted similar legislation.[151]
In February 2011, the Canadian government passed regulations requiring cigarette packaging to contain 12 new images to cover three quarters of the outside panel and eight new health messages on the inside panel with full color.[157]
As of April 2011, Australian regulations require all packaging to use a bland olive green that researchers determined to be the least attractive color,[158] with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style.[159] In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90% of the back and 70% of the front packaging. This took effect on December 1, 2012.[160]
Similar policies have since been introduced in the United Kingdom. The United Kingdom introduced the standardised packaging of tobacco products regulations (SPOT) in 2015. These regulations were also challenged by cigarette manufacturers.[161][162]
Prohibition of tobacco
[edit]A few countries have outlawed tobacco completely or made plans to do so. In 2004, Bhutan became the first country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products. Enforcement of the prohibition increased with the passage of the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties.[163] The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco.[164] Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders.[165] Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco.[166][167] Under sharia law, the consumption of cigarettes by Muslims is prohibited.[168]
Environmental effects
[edit]
Cigarette filters are made up of thousands of polymer chains of cellulose acetate, which has the chemical structure shown to the right. Once discarded into the environment, the filters create a large waste problem. Cigarette filters are the most common form of litter in the world, as approximately 5.6 trillion cigarettes are smoked every year worldwide.[169] Of those, an estimated 4.5 trillion cigarette filters become litter every year.[170] To develop an idea of the waste weight amount produced a year the table below was created.
| Number of filters | weight |
|---|---|
| 1 pack (20) | 3.4 grams (0.12 oz) |
| sold daily (15 billion) | 2,551,000 kilograms (5,625,000 lb) |
| sold yearly (5.6 trillion) | 950,000,000 kilograms (2,100,000,000 lb) |
| estimated trash (4.5 trillion) | 765,400,000 kilograms (1,687,500,000 lb) |
Discarded cigarette filters usually end up in the water system through drainage ditches and are transported by rivers and other waterways to the ocean.
Aquatic life health concerns
[edit]In the 2006 International Coastal Cleanup, cigarettes and cigarette butts constituted 24.7% of the total collected pieces of garbage, over twice as many as any other category, which is not surprising seeing the numbers in the table above of waste produced each year.[171] Cigarette filters contain the chemicals filtered from cigarettes and can leach into waterways and water supplies.[172] The toxicity of used cigarette filters depends on the specific tobacco blend and additives used by the cigarette companies. After a cigarette is smoked, the filter retains some of the chemicals, and some of those are considered carcinogenic.[46] When studying the environmental effects of cigarette filters, the various chemicals that can be found in cigarette filters are not studied individually, due to the complexity of doing so. Researchers instead focus on the whole cigarette filter and its LD50. LD50 is defined as the lethal dose that kills 50% of a sample population. This allows for a simpler study of the toxicity of cigarette filters. One recent study has looked at the toxicity of smoked cigarette filters (smoked filter + tobacco), smoked cigarette filters (no tobacco), and unsmoked cigarette filters (no tobacco). The results of the study showed that for the LD50 of both marine topsmelt (Atherinops affinis) and freshwater fathead minnow (Pimephales promelas), smoked cigarette filters + tobacco are more toxic than smoked cigarette filters, but both are severely more toxic than unsmoked cigarette filters.[173]
| Cigarette type | Marine topsmelt | Fathead minnow |
|---|---|---|
| Smoked cigarette filter (smoked filter + tobacco) | 1.0 | 1.0 |
| Smoked cigarette filters (no tobacco) | 1.8 | 4.3 |
| Unsmoked cigarette filters (no tobacco) | 5.1 | 13.5 |
Other health concerns
[edit]Toxic chemicals are not the only human health concern to take into considerations; the others are cellulose acetate and carbon particles that are breathed in while smoking. These particles are suspected of causing lung damage.[174] The next health concern is that of plants. Under certain growing conditions, plants on average grow taller and have longer roots than those exposed to cigarette filters in the soil. A connection exists between cigarette filters introduced to soil and the depletion of some soil nutrients over time. Another health concern to the environment is not only the toxic carcinogens that are harmful to the wildlife, but also the filters themselves pose an ingestion risk to wildlife that may presume filter litter as food.[175] The last major health concern to make note of for marine life is the toxicity that deep marine topsmelt and fathead minnow pose to their predators. This could lead to toxin build-up (bioaccumulation) in the food chain and have long reaching negative effects. Smoldering cigarette filters have also been blamed for triggering fires from residential areas[176] to major wildfires and bushfires which has caused major property damage and also death[177][178][179] as well as disruption to services by triggering alarms and warning systems.[180]
Degradation
[edit]Once in the environment, cellulose acetate can go through biodegradation and photodegradation.[181][182][183] Several factors go into determining the rate of each degradation process. This variance in rate and resistance to biodegradation in many conditions is a factor in littering[184] and environmental damage.[185]

Biodegradation
[edit]
The first step in the biodegradation of cellulose acetate is the deactylation of the acetate from the polymer chain (which is the opposite of acetylation). An acetate is a negative ion with the chemical formula of C2H3O2−. Deacetylation can be performed by either chemical hydrolysis or acetylesterase. Chemical hydrolysis is the cleavage of a chemical bond by addition of water. In the reaction, water (H2O) reacts with the acetic ester functional group attached the cellulose polymer chain and forms an alcohol and acetate. The alcohol is simply the cellulose polymer chain with the acetate replaced with an alcohol group. The second reaction is exactly the same as chemical hydrolysis with the exception of the use of an acetylesterase enzyme. The enzyme, found in most plants, catalyzes the chemical reaction shown below.[186]
- acetic ester + H2O ⇌ alcohol + acetate
In the case of the enzymatic reaction, the two substrates (reactants) are again acetic ester and H2O, the two products of the reaction are alcohol and acetate. This reaction is exactly the same as the chemical hydrolysis. Both of these products are perfectly fine in the environment. Once the acetate group is removed from the cellulose chain, the polymer can be readily degraded by cellulase, which is another enzyme found in fungi, bacteria, and protozoans. Cellulases break down the cellulose molecule into monosaccharides ("simple sugars") such as beta-glucose, or shorter polysaccharides and oligosaccharides.

These simple sugars are not harmful to the environment and are in fact are a useful product for many plants and animals. The breakdown of cellulose is of interest in the field of biofuel.[187] Due to the conditions that affect the process, large variation in the degradation time of cellulose acetate occurs.
Factors in biodegradation
[edit]The duration of the biodegradation process is cited as taking as little as one month[181] to as long as 15 years or more, depending on the environmental conditions. The major factor that affects the biodegradation duration is the availability of acetylesterase and cellulase enzymes. Without these enzymes, biodegradation only occurs through chemical hydrolysis and stops there. Temperature is another major factor: if the organisms that contain the enzymes are too cold to grow, then biodegradation is severely hindered. Availability of oxygen in the environment also affects the degradation. Cellulose acetate is degraded within 2–3 weeks under aerobic assay systems of in vitro enrichment cultivation techniques and an activated sludge wastewater treatment system.[188] It is degraded within 14 weeks under anaerobic conditions of incubation with special cultures of fungi.[189] Ideal conditions were used for the degradation (i.e., a suitable temperature, and available organisms to provide the enzymes). Thus, filters last longer in places with low oxygen concentration, such as swamps and bogs. Overall, the biodegradation process of cellulose acetate is not an instantaneous process.
Photodegradation
[edit]The other process of degradation is photodegradation, which is when a molecular bond is broken by the absorption of photon radiation (i.e. light). Due to cellulose acetate carbonyl groups, the molecule naturally absorbs light at 260 nm,[190] but it contains some impurities which can absorb light. These impurities are known to absorb light in the far UV light region (< 280 nm).[191] The atmosphere filters radiation from the sun and allows radiation of > 300 nm only to reach the surface. Thus, the primary photodegradation of cellulose acetate is considered insignificant to the total degradation process, since cellulose acetate and its impurities absorb light at shorter wavelengths. Research is focused on the secondary mechanisms of photodegradation of cellulose acetate to help make up for some of the limitations of biodegradation. The secondary mechanisms would be the addition of a compound to the filters that would be able to absorb natural light and use it to start the degradation process. The main two areas of research are in photocatalytic oxidation[192] and photosensitized degradation.[193] Photocatalytic oxidation uses a species that absorbs radiation and creates hydroxyl radicals that react with the filters and start the breakdown. Photosensitized degradation, though, uses a species that absorbs radiation and transfers the energy to the cellulose acetate to start the degradation process. Both processes use other species that absorbed light > 300 nm to start the degradation of cellulose acetate.[citation needed]
Solution and remediation projects
[edit]
Several options are available to help reduce the environmental effects of cigarette butts. Proper disposal into receptacles leads to decreased numbers found in the environment and their effect on the environment. Another method is making fines and penalties for littering filters; many governments have sanctioned stiff penalties for littering of cigarette filters; for example, Washington imposes a penalty of $1,025 for littering cigarette filters.[194] Another option is developing better biodegradable filters; much of this work relies heavily on the research in the secondary mechanism for photodegradation as stated above, but a new research group has developed an acid tablet that goes inside the filters, and once wet enough, releases acid that speeds up the degradation to around two weeks.[195] The research is still only in test phase and the hope is soon it will go into production. The next option is using cigarette packs with a compartment in which to discard cigarette butts, implementing monetary deposits on filters, increasing the availability of butt receptacles, and expanding public education. It may even be possible to ban the sale of filtered cigarettes altogether on the basis of their adverse environmental effects.[196] Recent research has been put into finding ways to use the filter waste to develop a desired product. One research group in South Korea has developed a simple one-step process that converts the cellulose acetate in discarded cigarette filters into a high-performing material that could be integrated into computers, handheld devices, electrical vehicles, and wind turbines to store energy. These materials have demonstrated superior performance as compared to commercially available carbon, grapheme, and carbon nanotubes. The product is showing high promise as a green alternative for the waste problem.[197]
Consumption
[edit]

Smoking has become less popular, but is still a large public health problem globally.[199][200][201] Worldwide, smoking rates fell from 41% in 1980 to 31% in 2012, although the actual number of smokers increased because of population growth.[202] In 2017, 5.4 trillion cigarettes were produced globally, and were smoked by almost 1 billion people.[203] Smoking rates have leveled off or declined in most countries, but is increasing in some low- and middle-income countries. The significant reductions in smoking rates in the United States, United Kingdom, Australia, Brazil, and other countries that implemented strong tobacco control programs[according to whom?] have been offset by the increasing consumption in low income countries, especially China. The Chinese market now consumes more cigarettes than all other low- and middle-income countries combined.
Other regions are increasingly playing larger roles in the growing global smoking epidemic. The WHO Eastern Mediterranean Region (EMRO) now has the highest growth rate in the cigarette market, with more than a one-third increase in cigarette consumption since 2000. Due to its recent dynamic economic development and continued population growth, Africa presents the greatest risk in terms of future growth in tobacco use.
Within countries, patterns of cigarette consumption also can vary widely. For example, in many of the countries where few women smoke, smoking rates are often high in males (e.g., in Asia). By contrast, in most developed countries, female smoking rates are typically only a few percentage points below those of males. In many high and middle income countries lower socioeconomic status is a strong predictor of smoking.
Smoking rates in the United States have dropped by more than half from 1965 to 2016, falling from 42% to 15.5% of US adults.[204] Australia is cutting their overall smoking consumption faster than most of the developed world, in part due to landmark Plain Packaging Act, which standardized the appearance of cigarette packs. Other countries have considered similar measures. In New Zealand, a bill has been presented to parliament in which the government's associate health minister said "takes away the last means of promoting tobacco as a desirable product."[205]
| Percent smoking | ||
|---|---|---|
| Region | Men | Women |
| Africa | 18% | 2% |
| Americas | 21% | 12% |
| Eastern Mediterranean | 34% | 2% |
| Europe | 38% | 21% |
| Southeast Asia | 32% | 2% |
| Western Pacific | 46% | 3% |
| Country | Population (millions) |
Cigarettes consumed (billions) |
Cigarettes consumed (per capita) |
|---|---|---|---|
| China | 1,386 | 2,351 | 2,043 |
| Indonesia | 264 | 316 | 1,675 |
| Russia | 145 | 278 | 2,295 |
| United States | 327 | 266 | 1,017 |
| Japan | 127 | 174 | 1,583 |
Lights
[edit]Some cigarettes are marketed as "lights", "milds", or "low-tar".[208] These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. The majority of major cigarette manufacturers offer a light, low-tar, or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.[209]
Research shows that smoking "light" or "low-tar" cigarettes is just as harmful as smoking other cigarettes.[210][211][212]
Notable cigarette brands
[edit]- 555
- Amber Leaf
- Army Club
- Basic
- Benson & Hedges
- Barclay
- Camel
- Capri
- Chesterfield
- Davidoff
- Dunhill
- Djarum
- Dji Sam Soe
- Doral
- du Maurier
- Eclipse
- Embassy
- Eve
- Export
- Fatima
- Fortuna
- Fortune International
- Gauloises
- Gitanes
- Gold Flake
- Golden Virginia
- Gold Leaf
- Kyriazi Freres
- Kent
- Kool
- Lambert and Butler
- L&M
- Lark
- Lucky Strike
- Marlboro
- Mayfair
- Merit
- Mild Seven
- More
- Nat Sherman
- Natural American Spirit
- Newport
- Next
- Nil
- Old Gold
- Pall Mall
- Parliament
- Perilly's
- Peter Stuyvesant
- Peter Jackson
- Philip Morris
- Player's
- Prince
- Dunhill
- Salem
- Sampoerna
- Senior Service
- Sobranie
- Sterling
- Surya
- Tareyton
- Vantage
- Viceroy
- Virginia Slims
- West
- Woodbine
- Winfield
- Winston
Smoking cessation
[edit]Smoking cessation (quitting smoking) is the process of discontinuing the practice of tobacco smoking.[213] Quitting can be difficult for many smokers due to the addictive nature of nicotine.[214]: 2300–2301 The addiction begins when nicotine acts on nicotinic acetylcholine receptors to release neurotransmitters such as dopamine, glutamate, and gamma-aminobutyric acid.[214]: 2296 Cessation of smoking leads to symptoms of nicotine withdrawal such as anxiety and irritability.[214]: 2298 Professional smoking cessation support methods generally endeavour to address both nicotine addiction and nicotine withdrawal symptoms.
Smoking cessation can be achieved with or without assistance from healthcare professionals or the use of medications.[215] Methods that have been found to be effective include interventions directed at or through health care providers and health care systems; medications including nicotine replacement therapy (NRT) and varenicline; individual and group counselling; and web-based or stand-alone computer programs. Although stopping smoking can cause short-term side effects such as reversible weight gain, smoking cessation services and activities are cost-effective because of the positive health benefits.
At the University of Buffalo, researchers found out that fruit and vegetable consumption can help a smoker cut down or even quit smoking[216]
- A growing number of countries have more ex-smokers than smokers.[217]
- Early "failure" is a normal part of trying to stop, and more than one attempt at stopping smoking prior to longer-term success is common.[215]
- NRT, other prescribed pharmaceuticals, and professional counselling or support also help many smokers.[215]
- However, up to three-quarters of ex-smokers report having quit without assistance ("cold turkey" or cut down then quit), and cessation without professional support or medication may be the most common method used by ex-smokers.[215]
The number of nicotinic receptors in the brain returns to the level of a nonsmoker between 6 and 12 weeks after quitting.[218] In 2019, the FDA authorized the selling of low-nicotine cigarettes in hopes of lowering the number of people addicted to nicotine.[219]
See also
[edit]References
[edit]- ^ a b c "Tobacco". World Health Organization. Archived from the original on July 9, 2021. Retrieved July 17, 2019.
- ^ Robicsek, Francis Smoke; Ritual Smoking in Central America pp. 30–37
- ^ a b c Goodman, Jordan Elliot (1993). Tobacco in history: the cultures of dependence. New York: Routledge. p. 97. ISBN 978-0-415-04963-4.
- ^ Oxford English Dictionary, s.v.
- ^ Circulars of Information of the Bureau of Education, The Spelling Reform, No. 7-1880, 1881, p. 25
- ^ Henry Gallup Paine, Simplified Spelling Board, Handbook of Simplified Spelling, New York, 1920, p. 6
- ^ Google Books Ngram Viewer for cigaret vs. cigarette Archived July 29, 2020, at the Wayback Machine in US and British corpora
- ^ Office P (December 29, 1870). "Patents for inventions. Abridgments of specifications" – via Google Books.
- ^ a b Cox 2000, p. 21.
- ^ James R (June 15, 2009). "A Brief History Of Cigarette Advertising". Time. Archived from the original on September 21, 2011. Retrieved March 25, 2012.
- ^ "Collection: Do you inhale?". Stanford Research into the Impact of Tobacco Advertising. Stanford University. Retrieved February 23, 2024.
- ^ "Projekt Gutenberg-DE - SPIEGEL ONLINE - Nachrichten - Kultur". Gutenberg.spiegel.de. Archived from the original on January 19, 2012. Retrieved March 25, 2012.
- ^ "Definition of coffin nail". Archived from the original on January 10, 2019. Retrieved January 9, 2019.
- ^ "The Study That Helped Spur the U.S. Stop-Smoking Movement". www.cancer.org. Archived from the original on May 20, 2021. Retrieved May 25, 2021.
- ^ Roffo, A. H. (January 8, 1940). "Krebserzeugende Tabakwirkung" [Carcingogenic effects of tobacco]. (in German). Berlin: J. F. Lehmanns Verlag. Retrieved September 13, 2009.
- ^ Proctor RN (2006). "Angel H Roffo: The forgotten father of experimental tobacco carcinogenesis". Bulletin of the World Health Organization. 84 (6): 494–496. doi:10.2471/BLT.06.031682. ISSN 0042-9686. PMC 2627373. PMID 16799735.
- ^ Morabia A (November 2017). "Anti-Tobacco Propaganda: Soviet Union Versus Nazi Germany". American Journal of Public Health. 107 (11): 1708–1710. doi:10.2105/AJPH.2017.304087. ISSN 0090-0036. PMC 5637694. PMID 29019774.
- ^ Hammond D, Fong GT, McNeill A, Borland R, Cummings KM (June 2006). "Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey". Tob Control. 15 (Suppl 3): iii19–25. doi:10.1136/tc.2005.012294. PMC 2593056. PMID 16754942.
- ^ ccpa.unc.edu
- ^ "WHO report on the global tobacco epidemic, 2019 Country profile Netherlands" (PDF). who.int. World Health Organization. Archived from the original (PDF) on March 22, 2012. Retrieved December 14, 2020.
- ^ Storr W (September 6, 2012). "Quest for a safer cigarette". The Daily Telegraph. London. Archived from the original on January 30, 2018. Retrieved April 5, 2018.
- ^ "Project XA". Archived from the original on February 20, 2013. Retrieved September 25, 2012.
- ^ "Safer cigarette history". PBS. October 2, 2001. Archived from the original on April 23, 2018. Retrieved August 25, 2017.
- ^ Hoffmann D (March 1997). "The changing cigarette, 1950-1995". Journal of Toxicology and Environmental Health. 50 (4): 307–364. Bibcode:1997JTEHA..50..307H. doi:10.1080/009841097160393. PMID 9120872.
- ^ Richard B. Tennant, "The Cigarette Industry" in The Structure of American Industry, edited by Walter Adams (1961) pp 357-392, at pp 358-362.
- ^ "Tobacco Use, United States 1990-1999". Oncology (Williston Park). 13 (12). December 1999.
- ^ Tobacco Outlook Report, Economic Research Service, U.S. Dept. of Agriculture
- ^ Hurt RD, Robertson CR (October 7, 1998). "Prying open the door to the tobacco industry's secrets about nicotine: the Minnesota Tobacco Trial". JAMA. 280 (13): 1173–81. doi:10.1001/jama.280.13.1173. PMID 9777818.
- ^ Cummings KM (September 2015). "Is it not time to reveal the secret sauce of nicotine addiction?". Tobacco Control. 24 (5): 420–1. doi:10.1136/tobaccocontrol-2015-052631. PMID 26293383.
- ^ Teague CE (1972). Research planning memorandum on the nature of the tobacco business and the crucial role of the nicotine therein. R.J. Reynolds Tobacco Company.
- ^ Dunn W (1977). Smoker psychology program review. Philip Morris Tobacco Company.
- ^ Clean Virginia Waterways, Cigarette Butt Litter - Cigarette Filters Archived January 26, 2009, at the Wayback Machine, Longwood University. Retrieved October 31, 2006.
- ^ a b Wigand, J.S. Additives, Cigarette Design and Tobacco Product Regulation, A Report To: World Health Organization, Tobacco Free Initiative, Tobacco Product Regulation Group, Kobe, Japan, 28 June-2 July 2006 Archived May 16, 2011, at the Wayback Machine
- ^ "Composite List of Ingredients in Non-Tobacco Materials". Archived from the original on May 24, 2008. www.jti.com. Retrieved November 2, 2006.
- ^ a b c d David E. Merrill, (1994), "How cigarettes are made". Video presentation at Philip Morris USA, Richmond offices. Retrieved October 31, 2006.
- ^ "Legacy Tobacco Documents Library". G2public.library.ucsf.edu. Archived from the original on February 12, 2009. Retrieved March 25, 2012.
- ^ Grant Gellatly, "Method and apparatus for coating reconstituted tobacco". Archived from the original on September 29, 2007. Retrieved November 4, 2006.. Retrieved November 2, 2006.
- ^ "13 Manufacturing Tobacco". Archived from the original on December 3, 2011.. Retrieved May 11, 2011.
- ^ a b Bregman R (May 8, 2024). "Abolish the tobacco industry – no one should be allowed to addict and poison others on an industrial scale". www.moralambition.org. Retrieved March 27, 2025.
- ^ Rabinoff M, Caskey N, Rissling A, Park C (November 2007). "Pharmacological and chemical effects of cigarette additives". American Journal of Public Health. 97 (11): 1981–1991. doi:10.2105/AJPH.2005.078014. ISSN 1541-0048. PMC 2040350. PMID 17666709.
- ^ Seeman JI, Carchman RA (2008). "The possible role of ammonia toxicity on the exposure, deposition, retention, and the bioavailability of nicotine during smoking". Food and Chemical Toxicology. 46 (6): 1863–81. doi:10.1016/j.fct.2008.02.021. PMID 18450355.
- ^ "How to Roll Your Own Filter Cigarettes: 6 Steps (with Pictures)". wikihow.com. Archived from the original on February 22, 2014. Retrieved February 14, 2014.[self-published source]
- ^ "Review: Zig-Zag Filtered Tubes". Roll Your Own Magazine. Archived from the original on October 6, 2014. Retrieved February 14, 2014.
- ^ "Forms Tutorial: Glossary Text Version". ttb.gov. Archived from the original on May 8, 2013. Retrieved February 14, 2014.
- ^ The Nelson contemporary English dictionary - Page 187, W. T. Cunningham - 1977
- ^ a b Micevska T, Warne MS, Pablo F, Patra R (2005). "Variation in, and Causes of, Toxicity of Cigarette Butts to a Cladoceran and Microtox". Archives of Environmental Contamination and Toxicology. 50 (2): 205–212. doi:10.1007/s00244-004-0132-y. PMID 16328625. S2CID 26207468.
- ^ Kathleen M. Register. "Cigarette Butts as Litter—Toxic as Well as Ugly Archived December 12, 2020, at the Wayback Machine", Longwood University. Retrieved June 28, 2011. First published in Underwater Naturalist, Volume 25, Number 2, August 2000.
- ^ "Penny for your butts? Vancouver group pushes cigarette-butt recycling plan". CTVNews. June 21, 2013. Archived from the original on July 6, 2015. Retrieved May 30, 2015.
- ^ City of Vancouver (November 13, 2013). "City and TerraCycle launch cigarette butt collection and recycling program". Archived from the original on May 3, 2015. Retrieved May 30, 2015.
- ^ Caponnetto P, Campagna D, Papale G, Russo C, Polosa R (2012). "The emerging phenomenon of electronic cigarettes". Expert Review of Respiratory Medicine. 6 (1): 63–74. doi:10.1586/ers.11.92. ISSN 1747-6348. PMID 22283580. S2CID 207223131.
- ^ a b c Orellana-Barrios MA, Payne D, Mulkey Z, Nugent K (2015). "Electronic cigarettes-a narrative review for clinicians". The American Journal of Medicine. 128 (7): 674–81. doi:10.1016/j.amjmed.2015.01.033. ISSN 0002-9343. PMID 25731134.
- ^ a b Cheng T (2014). "Chemical evaluation of electronic cigarettes". Tobacco Control. 23 (Supplement 2): ii11 – ii17. doi:10.1136/tobaccocontrol-2013-051482. ISSN 0964-4563. PMC 3995255. PMID 24732157.
- ^ Weaver M, Breland A, Spindle T, Eissenberg T (2014). "Electronic Cigarettes". Journal of Addiction Medicine. 8 (4): 234–240. doi:10.1097/ADM.0000000000000043. ISSN 1932-0620. PMC 4123220. PMID 25089953.
- ^ Rahman M, Hann N, Wilson A, Worrall-Carter L (2014). "Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues". Tobacco Induced Diseases. 12 (1): 21. doi:10.1186/1617-9625-12-21. PMC 4350653. PMID 25745382.
- ^ Pepper JK, Brewer NT (2013). "Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review". Tobacco Control. 23 (5): 375–384. doi:10.1136/tobaccocontrol-2013-051122. ISSN 0964-4563. PMC 4520227. PMID 24259045.
- ^ Drope J, Cahn Z, Kennedy R, Liber AC, Stoklosa M, Henson R, Douglas CE, Drope J (2017). "Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine". CA: A Cancer Journal for Clinicians. 67 (6): 449–471. doi:10.3322/caac.21413. ISSN 0007-9235. PMID 28961314.
- ^ Bhatnagar A, Whitsel L, Ribisl K, Bullen C, Chaloupka F, Piano M, Robertson R, McAuley T, Goff D, Benowitz N (August 24, 2014). "Electronic Cigarettes: A Policy Statement From the American Heart Association" (PDF). Circulation. 130 (16): 1418–1436. doi:10.1161/CIR.0000000000000107. PMC 7643636. PMID 25156991. S2CID 16075813. Archived (PDF) from the original on March 14, 2020. Retrieved September 2, 2019.
- ^ McRobbie H (2014). "Electronic cigarettes" (PDF). National Centre for Smoking Cessation and Training. pp. 1–16. Archived (PDF) from the original on October 9, 2022.
- ^ Farsalinos KE, Spyrou A, Tsimopoulou K, Stefopoulos C, Romagna G, Voudris V (2014). "Nicotine absorption from electronic cigarette use: Comparison between first and new-generation devices". Scientific Reports. 4 4133. Bibcode:2014NatSR...4.4133F. doi:10.1038/srep04133. PMC 3935206. PMID 24569565.
- ^ Farsalinos K. "Electronic cigarette evolution from the first to fourth generation and beyond" (PDF). gfn.net.co. Global Forum on Nicotine. p. 23. Archived from the original (PDF) on July 8, 2015. Retrieved September 23, 2015.
- ^ England LJ, Bunnell RE, Pechacek TF, Tong VT, McAfee TA (2015). "Nicotine and the Developing Human". American Journal of Preventive Medicine. 49 (2): 286–93. doi:10.1016/j.amepre.2015.01.015. ISSN 0749-3797. PMC 4594223. PMID 25794473.
- ^ Oh AY, Kacker A (December 2014). "Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?: Review on e-cigarette vapor versus tobacco smoke". The Laryngoscope. 124 (12): 2702–2706. doi:10.1002/lary.24750. PMID 25302452. S2CID 10560264.
- ^ Leduc C, Quoix E (2016). "Is there a role for e-cigarettes in smoking cessation?". Therapeutic Advances in Respiratory Disease. 10 (2): 130–135. doi:10.1177/1753465815621233. ISSN 1753-4658. PMC 5933562. PMID 26668136.
- ^ Wilder 2016, p. 82.
- ^ Ebbert JO, Agunwamba AA, Rutten LJ (2015). "Counseling Patients on the Use of Electronic Cigarettes". Mayo Clinic Proceedings. 90 (1): 128–134. doi:10.1016/j.mayocp.2014.11.004. ISSN 0025-6196. PMID 25572196.
- ^ Siu A (September 22, 2015). "Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement". Annals of Internal Medicine. 163 (8): 622–34. doi:10.7326/M15-2023. PMID 26389730.
- ^ Harrell P, Simmons V, Correa J, Padhya T, Brandon T (June 4, 2014). "Electronic Nicotine Delivery Systems ("E-cigarettes"): Review of Safety and Smoking Cessation Efficacy". Otolaryngology–Head and Neck Surgery. 151 (3): 381–393. doi:10.1177/0194599814536847. PMC 4376316. PMID 24898072.
- ^ a b Hartmann-Boyce J, McRobbie H, Butler AR, Lindson N, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe TR (September 14, 2021). "Electronic cigarettes for smoking cessation". The Cochrane Database of Systematic Reviews. 9 (6) CD010216. doi:10.1002/14651858.CD010216.pub6. ISSN 1469-493X. PMC 8438601. PMID 34519354.
- ^ McDonough M (2015). "Update on medicines for smoking cessation". Australian Prescriber. 38 (4): 106–111. doi:10.18773/austprescr.2015.038. ISSN 0312-8008. PMC 4653977. PMID 26648633.
- ^ a b WHO 2014, p. 6.
- ^ "E-Cigarette Use Among Youth and Young Adults A Report of the Surgeon General: Fact Sheet" (PDF). Surgeon General of the United States. 2016. Archived (PDF) from the original on October 9, 2022.
This article incorporates text from this source, which is in the public domain.
- ^ National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems (January 23, 2018). Stratton K, Kwan LY, Eaton DL (eds.). Public Health Consequences of E-Cigarettes (PDF). doi:10.17226/24952. ISBN 978-0-309-46834-3. PMID 29894118. Archived (PDF) from the original on January 27, 2018.
- ^ a b Drummond M, Upson D (February 2014). "Electronic cigarettes: Potential harms and benefits". Annals of the American Thoracic Society. 11 (2): 236–42. doi:10.1513/annalsats.201311-391fr. PMC 5469426. PMID 24575993.
- ^ M Z, Siegel M (February 2011). "Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes?". Journal of Public Health Policy. 32 (1): 16–31. doi:10.1057/jphp.2010.41. PMID 21150942.
- ^ Knorst MM, Benedetto IG, Hoffmeister MC, Gazzana MB (2014). "The electronic cigarette: the new cigarette of the 21st century?". Jornal Brasileiro de Pneumologia. 40 (5): 564–572. doi:10.1590/S1806-37132014000500013. ISSN 1806-3713. PMC 4263338. PMID 25410845.
- ^ Burstyn I (January 9, 2014). "Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks". BMC Public Health. 14 (1) 18. doi:10.1186/1471-2458-14-18. ISSN 1471-2458. PMC 3937158. PMID 24406205.
- ^ Caponnetto P., Russo C., Bruno C.M., Alamo A., Amaradio M.D., Polosa R. (March 2013). "Electronic cigarette: a possible substitute for cigarette dependence". Monaldi Archives for Chest Disease. 79 (1): 12–19. doi:10.4081/monaldi.2013.104. PMID 23741941.
- ^ Brady BR, De La Rosa JS, Nair US, Leischow SJ (2019). "Electronic Cigarette Policy Recommendations: A Scoping Review". American Journal of Health Behavior. 43 (1): 88–104. doi:10.5993/AJHB.43.1.8. ISSN 1087-3244. PMID 30522569. S2CID 54566712.
- ^ Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, Jiménez-Ruiz CA, Katsaounou P, Lindberg A, Metz C, Schober W, Spira A, Blasi F (2019). "Electronic cigarettes: a task force report from the European Respiratory Society". European Respiratory Journal. 53 (2): 1801151. doi:10.1183/13993003.01151-2018. ISSN 0903-1936. PMID 30464018.
- ^ Paley GL, Echalier E, Eck TW, Hong AR, Farooq AV, Gregory DG, Lubniewski AJ (2016). "Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions". Cornea. 35 (7): 1015–1018. doi:10.1097/ICO.0000000000000881. ISSN 0277-3740. PMC 4900417. PMID 27191672.
- ^ Breland AB, Spindle T, Weaver M, Eissenberg T (2014). "Science and Electronic Cigarettes". Journal of Addiction Medicine. 8 (4): 223–233. doi:10.1097/ADM.0000000000000049. ISSN 1932-0620. PMC 4122311. PMID 25089952.
- ^ a b c d e Grana R, Benowitz, N, Glantz, SA (May 13, 2014). "E-cigarettes: a scientific review". Circulation. 129 (19): 1972–86. doi:10.1161/circulationaha.114.007667. PMC 4018182. PMID 24821826.
- ^ Edgar J (November 12, 2013). "E-Cigarettes: Expert Q&A With the CDC". WebMD. Archived from the original on April 9, 2022. Retrieved September 7, 2019.
- ^ "Outbreak of Lung Illness Associated with Using E-cigarette Products". Centers for Disease Control and Prevention. January 28, 2020. Archived from the original on April 12, 2021. Retrieved September 8, 2019.
This article incorporates text from this source, which is in the public domain.
- ^ a b Hajek P, Etter JF, Benowitz N, Eissenberg T, McRobbie H (July 31, 2014). "Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit" (PDF). Addiction. 109 (11): 1801–10. doi:10.1111/add.12659. PMC 4487785. PMID 25078252. Archived (PDF) from the original on December 5, 2014.
- ^ Hildick-Smith GJ, Pesko MF, Shearer L, Hughes JM, Chang J, Loughlin GM, Ipp LS (2015). "A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population". Journal of Adolescent Health. 57 (6): 574–9. doi:10.1016/j.jadohealth.2015.07.020. ISSN 1054-139X. PMID 26422289.
- ^ Fernández E, Ballbè M, Sureda X, Fu M, Saltó E, Martínez-Sánchez JM (2015). "Particulate Matter from Electronic Cigarettes and Conventional Cigarettes: a Systematic Review and Observational Study". Current Environmental Health Reports. 2 (4): 423–9. Bibcode:2015CEHR....2..423F. doi:10.1007/s40572-015-0072-x. ISSN 2196-5412. PMID 26452675.
- ^ Rom O, Pecorelli A, Valacchi G, Reznick AZ (2014). "Are E-cigarettes a safe and good alternative to cigarette smoking?". Annals of the New York Academy of Sciences. 1340 (1): 65–74. Bibcode:2015NYASA1340...65R. doi:10.1111/nyas.12609. ISSN 0077-8923. PMID 25557889. S2CID 26187171.
- ^ "2014 SGR: The Health Consequences of Smoking—50 Years of Progress". Centers for Disease Control and Prevention. March 5, 2018. Archived from the original on December 1, 2013. Retrieved November 25, 2019.
- ^ Sarah Jackson, Martin Jarvis, Robert West (December 29, 2024). "The price of a cigarette: 20 minutes of life?". Addiction. 120 (5): 810–812. doi:10.1111/add.16757. Retrieved January 22, 2025.
- ^ Sample, Ian (December 30, 2024). "Single cigarette takes 20 minutes off life expectancy, study finds". The Guardian. Retrieved January 22, 2025.
- ^ "Why is it so hard to quit?". Heart.org. Archived from the original on April 2, 2012. Retrieved March 25, 2012.
- ^ Day R. "Strategically Addictive Drugs". Archived from the original on October 30, 2020. Retrieved September 4, 2020.
- ^ Doll R, Peto R, Boreham J, Sutherland I (2004). "Mortality in relation to smoking: 50 years' observations on male British doctors". BMJ (Clinical Research Ed.). 328 (7455): 1519. doi:10.1136/bmj.38142.554479.AE. PMC 437139. PMID 15213107.
- ^ a b "Archived copy" (PDF). Archived from the original (PDF) on December 29, 2009. Retrieved November 13, 2009.
{{cite web}}: CS1 maint: archived copy as title (link) - ^ a b Benowitz NL (June 17, 2010). "Nicotine Addiction". The New England Journal of Medicine. 362 (24): 2295–2303. doi:10.1056/NEJMra0809890. ISSN 0028-4793. PMC 2928221. PMID 20554984.
- ^ "WHO Framework Convention on Tobacco Control" (PDF). World Health Organization. February 27, 2005. Archived from the original (PDF) on September 6, 2005. Retrieved January 12, 2009.
Parties recognize that scientific evidence has unequivocally established that exposure to tobacco has the potential to cause death, disease and disability
- ^ Office on Smoking Health (US) (June 27, 2006). "The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General". Surgeon General of the United States. PMID 20669524. Archived from the original on February 15, 2017. Retrieved June 16, 2014.
Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke
- ^ Board (June 24, 2005). Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant (Report). California Environmental Protection Agency. Retrieved January 12, 2009 – via University of California San Francisco: Center for Tobacco Control Research and Education.
- ^ Tobacco Smoke and Involuntary Smoking (PDF). International Agency for Research on Cancer. 2004. ISBN 978-92-832-1583-7. Archived from the original on June 7, 2018. Retrieved January 12, 2009.
There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) has the potential to cause lung cancer in humans
- ^ Peate I (2005). "The effects of smoking on the reproductive health of men". British Journal of Nursing. 14 (7): 362–6. doi:10.12968/Bjorn.2005.14.7.17939 (inactive July 1, 2025). PMID 15924009.
{{cite journal}}: CS1 maint: DOI inactive as of July 2025 (link) - ^ Korenman SG (2004). "Epidemiology of erectile dysfunction". Endocrine. 23 (2–3): 87–91. doi:10.1385/ENDO:23:2-3:087. PMID 15146084. S2CID 29133230.
- ^ a b Csordas A, Bernhard D (2013). "The biology behind the atherothrombotic effects of cigarette smoke". Nature Reviews Cardiology. 10 (4): 219–230. doi:10.1038/nrcardio.2013.8. ISSN 1759-5002. PMID 23380975. S2CID 25491622.
- ^ "Health | Cigarettes 'cut life by 11 minutes'". BBC News. December 31, 1999. Archived from the original on December 2, 2008. Retrieved March 25, 2012.
- ^ Shaw M (2000). "Time for a smoke? One cigarette reduces your life by 11 minutes". BMJ. 320 (7226): 53. doi:10.1136/bmj.320.7226.53. PMC 1117323. PMID 10617536.
- ^ "WHO Report on the Global Tobacco Epidemic" (PDF). World Health Organization. 2008. Archived from the original (PDF) on September 10, 2008.
- ^ "Smoking While Pregnant Causes Finger, Toe Deformities". Science Daily. Archived from the original on March 4, 2007. Retrieved March 6, 2007.
- ^ "Tobacco Smoking" (PDF). Personal Habits and Indoor Combustions. Vol. 100E. International Agency for Research on Cancer. 2012. p. 44. Archived (PDF) from the original on October 9, 2022.
- ^ Kastan MB (2008). "DNA damage responses: mechanisms and roles in human disease: 2007 G.H.A. Clowes Memorial Award Lecture". Mol. Cancer Res. 6 (4): 517–24. doi:10.1158/1541-7786.MCR-08-0020. PMID 18403632.
- ^ a b Ajileye AB, Akinbo FO. Oxidative DNA damage estimated by urinary 8-Hydroxy-2' –Deoxyguanosine (8-OHdG) and 8-Oxoguanine DNA Glycosylase (OGG1) in cigarette and non-cigarette smokers in South West Nigeria. Journal of Cellular Biotechnology. 2024;10(1):25-34. doi:10.3233/JCB-230120
- ^ Cunningham FH, Fiebelkorn S, Johnson M, Meredith C (2011). "A novel application of the Margin of Exposure approach: segregation of tobacco smoke toxicants". Food Chem. Toxicol. 49 (11): 2921–33. doi:10.1016/j.fct.2011.07.019. PMID 21802474.
- ^ Liu XY, Zhu MX, Xie JP (2010). "Mutagenicity of acrolein and acrolein-induced DNA adducts". Toxicol. Mech. Methods. 20 (1): 36–44. doi:10.3109/15376510903530845. PMID 20158384. S2CID 8812192.
- ^ Speit G, Merk O (2002). "Evaluation of mutagenic effects of formaldehyde in vitro: detection of crosslinks and mutations in mouse lymphoma cells". Mutagenesis. 17 (3): 183–7. doi:10.1093/mutage/17.3.183. PMID 11971987.
- ^ Pu X, Kamendulis LM, Klaunig JE (2009). "Acrylonitrile-induced oxidative stress and oxidative DNA damage in male Sprague-Dawley rats". Toxicol. Sci. 111 (1): 64–71. doi:10.1093/toxsci/kfp133. PMC 2726299. PMID 19546159.
- ^ Koturbash I, Scherhag A, Sorrentino J, Sexton K, Bodnar W, Swenberg JA, Beland FA, Pardo-Manuel Devillena F, Rusyn I, Pogribny IP (2011). "Epigenetic mechanisms of mouse interstrain variability in genotoxicity of the environmental toxicant 1,3-butadiene". Toxicol. Sci. 122 (2): 448–56. doi:10.1093/toxsci/kfr133. PMC 3155089. PMID 21602187.
- ^ Garcia CC, Angeli JP, Freitas FP, Gomes OF, de Oliveira TF, Loureiro AP, Di Mascio P, Medeiros MH (2011). "[13C2]-Acetaldehyde promotes unequivocal formation of 1,N2-propano-2'-deoxyguanosine in human cells". J. Am. Chem. Soc. 133 (24): 9140–3. doi:10.1021/ja2004686. PMID 21604744. Archived from the original on November 6, 2020. Retrieved December 1, 2019.
- ^ Tompkins EM, McLuckie KI, Jones DJ, Farmer PB, Brown K (2009). "Mutagenicity of DNA adducts derived from ethylene oxide exposure in the pSP189 shuttle vector replicated in human Ad293 cells". Mutat. Res. 678 (2): 129–37. Bibcode:2009MRGTE.678..129T. doi:10.1016/j.mrgentox.2009.05.011. PMID 19477295.
- ^ Fabiani R, Rosignoli P, De Bartolomeo A, Fuccelli R, Morozzi G (2007). "DNA-damaging ability of isoprene and isoprene mono-epoxide (EPOX I) in human cells evaluated with the comet assay". Mutat. Res. 629 (1): 7–13. Bibcode:2007MRGTE.629....7F. doi:10.1016/j.mrgentox.2006.12.007. PMID 17317274.
- ^ Jha P, MacLennan M, Chaloupka FJ, Yurekli A, Ramasundarahettige C, Palipudi K, Zatońksi W, Asma S, Gupta PC (2015), Gelband H, Jha P, Sankaranarayanan R, Horton S (eds.), "Global Hazards of Tobacco and the Benefits of Smoking Cessation and Tobacco Taxes", Cancer: Disease Control Priorities, Third Edition (Volume 3), Washington (DC): The International Bank for Reconstruction and Development / The World Bank, doi:10.1596/978-1-4648-0349-9_ch10, ISBN 978-1-4648-0349-9, PMID 26913345, retrieved November 20, 2023
- ^ Green JT, Richardson C, Marshall RW, Rhodes J, McKirdy HC, Thomas GA, Williams GT (2000). "Nitric oxide mediates a therapeutic effect of nicotine in ulcerative colitis". Alimentary Pharmacology & Therapeutics. 14 (11): 1429–1434. doi:10.1046/j.1365-2036.2000.00847.x. PMID 11069313. S2CID 21358737.
- ^ Almeida OP, Hulse GK, Lawrence D, Flicker L (2002). "Smoking as a risk factor for Alzheimer's disease: contrasting evidence from a systematic review of case-control and cohort studies". Addiction. 97 (1): 15–28. doi:10.1046/j.1360-0443.2002.00016.x. PMID 11895267. S2CID 22936675.
- ^ a b c d e f SGUS 2016, p. 106; Chapter 3.
- ^ "Secondhand Smoke". American Lung Association. June 2007. Archived from the original on October 16, 2009. Retrieved May 6, 2012.
- ^ "Centers for Disease Control & Prevention Fact Sheets". Tobacco Free Florida. Archived from the original on December 2, 2008. Retrieved January 2, 2013.
- ^ a b "Secondhand Smoke". Cancer.org. Archived from the original on January 7, 2017. Retrieved March 25, 2012.
- ^ a b "Secondhand Smoke and Cancer - National Cancer Institute". Cancer.gov. August 18, 2005. Archived from the original on March 25, 2012. Retrieved March 25, 2012.
- ^ "CDC - Fact Sheet - Secondhand Smoke Facts - Smoking & Tobacco Use". Cdc.gov. Archived from the original on August 19, 2022. Retrieved March 25, 2012.
- ^ WHO Framework Convention on Tobacco Control; First international treaty on public health, adopted by 192 countries and signed by 168. Its Article 8.1 states, "Parties recognize that scientific evidence has unequivocally established that exposure to tobacco causes death, disease and disability."
- ^ "Prime Minister to create 'smokefree generation' by ending cigarette sales to those born on or after 1 January 2009". October 4, 2023. Retrieved February 14, 2024.
- ^ "Total adult smokers by country". NationMaster.com. Archived from the original on June 7, 2008. Retrieved June 4, 2008.
- ^ "Underage Operatives" (PDF). 2009. Archived from the original (PDF) on March 26, 2009.
- ^ "UK | England | Bristol/Somerset | Retailers sell tobacco to youths". BBC News. September 1, 2005. Archived from the original on March 13, 2007. Retrieved March 25, 2012.
- ^ Ritchie H, Roser M (May 23, 2013). "Smoking". Our World in Data. Archived from the original on February 28, 2021. Retrieved January 27, 2020.
- ^ "Higher Cigarette Taxes". Tobaccofreekids.org. Archived from the original on September 4, 2009. Retrieved November 13, 2009.
- ^ "Closing in on cancer". The Economist. Archived from the original on September 23, 2017. Retrieved September 25, 2017.
- ^ "U.S. Aided Cigarette Firms in Conquests Across Asia". Washingtonpost.com. November 17, 1996. Archived from the original on July 4, 2008. Retrieved November 13, 2009.
- ^ "State Excise Tax Rates On Cigarettes (January 1, 2007)". Taxadmin.org. Archived from the original on November 9, 2009. Retrieved November 13, 2009.
- ^ "Les cigarettes anti-incendie seront obligatoires en 2011". L'Express (in French). L'Expansion. AFP. Archived from the original on February 23, 2009. Retrieved January 2, 2010.
According to a study made by European union in 16 European countries, 11,000 fires were due to cigarettes between 2005 and 2007. They caused 520 deaths and 1600 injuries.
- ^ "European Union Pushes for Self-Extinguishing Cigarettes". Deutsche Welle. Deutsche Welle. Archived from the original on February 10, 2009. Retrieved January 2, 2010.
- ^ "European Union Pushes for Self-Extinguishing Cigarettes". Deutsche Welle. Archived from the original on February 10, 2009. Retrieved January 1, 2009.
- ^ O'Connell V (April 23, 2004). "U.S. Suit Alleges Philip Morris Hid Cigarette-Fire Risk". The Wall Street Journal. Archived from the original on April 15, 2019. Retrieved February 24, 2019.
- ^ "Smoking article wrapper for controlling burn rate and method for making same - Philip Morris Incorporated". Freepatentsonline.com. Archived from the original on October 4, 2013. Retrieved March 25, 2012.
- ^ "NFPA :: Safety Information :: For consumers :: Causes :: Smoking :: Coalition for Fire-Safe Cigarettes". Firesafecigarettes.org. Archived from the original on August 16, 2011. Retrieved March 25, 2012.
- ^ "Method and apparatus for making banded smoking article wrappers - US Patent 5342484 Full Text". Patentstorm.us. Archived from the original on May 12, 2008. Retrieved March 25, 2012.
- ^ "States that have passed fire-safe cigarette laws". Fire Safe Cigarettes. Archived from the original on September 23, 2011. Retrieved March 25, 2012.
- ^ "Les cigarettes anti-incendie seront obligatoires en 2011" (in French). Lexpansion.com. Archived from the original on February 23, 2009. Retrieved November 13, 2009.
- ^ "A legal history of smoking in Canada". CBC News. November 9, 2012. Archived from the original on January 1, 2015. Retrieved December 29, 2014.
On Jan. 19, 2005, The Supreme Court of Canada rules that Saskatchewan can reinstate a controversial law that forces store owners to keep tobacco products behind curtains or doors. The so-called "shower curtain law" was passed in 2002 to hide cigarettes from children, but was struck down a year later by an appeals court.
- ^ "Ontario set to ban cigarette display cases". CTV News. April 20, 2008. Archived from the original on February 12, 2009. Retrieved January 31, 2009.
The new ban prevents all tobacco products from being displayed in any way and prohibits customers from even touching them before they're paid for.
- ^ "A Proposal to Regulate the Display and Promotion of Tobacco and Tobacco-Related Products at Retail". Hc-sc.gc.ca. Archived from the original on June 7, 2011. Retrieved November 13, 2009.
- ^ "Many smokers are misled by pack design into thinking that cigarettes may be 'safer'," states Melanie Wakefield, et al. "The cigarette pack as image: new evidence from tobacco industry documents." Tobacco control 11.suppl 1 (2002): i73-i80. online
- ^ a b Harris G (November 10, 2010). "F.D.A. Unveils Proposed Graphic Warning Labels for Cigarette Packs". The New York Times. Archived from the original on February 28, 2017. Retrieved February 24, 2017.
- ^ Scollo, Michelle; Haslam, Indra (2008). A12.1.1.3 Pictorial warnings in force since 2006 Archived October 30, 2010, at the Wayback Machine. Tobacco in Australia. Cancer Council Victoria. Retrieved July 23, 2010.
- ^ Warning on cigarette pack Archived June 1, 2016, at the Wayback Machine. Tobacco in Pakistan.
- ^ "Iceland Tough On Cigarettes – Sun Sentinel". Articles.sun-sentinel.com. September 17, 1985. Archived from the original on May 24, 2013. Retrieved January 2, 2013.
- ^ Bardi J (November 16, 2012). "Cigarette Pack Health Warning Labels in US Lag Behind World". Tobacco Control. 23 (1): e2. doi:10.1136/tobaccocontrol-2012-050541. PMC 3725195. PMID 23092884. Archived from the original on December 2, 2012. Retrieved January 2, 2013.
- ^ Ottawa to increase size of tobacco warning to cover 3/4 of cigarette package https://vancouversun.com/health/Ottawa+increase+size+tobacco+warnings/4039002/story.html[permanent dead link]
- ^ "Story of a shattered life: A single childhood incident pushed Dawn Crey into a downward spiral | Vancouver Sun". November 24, 2001. Retrieved February 19, 2011.[dead link]
- ^ "Tobacco Plain Packaging Regulations 2011". Australian Government Federal Register of Legislation. August 8, 2013. 2.2.1 (2) & passim. Archived from the original on March 30, 2018. Retrieved March 29, 2018.
- ^ "Australia unveils tough new cigarette pack rules". Channel NewsAsia. April 7, 2011. Archived from the original on August 30, 2011. Retrieved March 25, 2012.
- ^ "Australia's Top Court Backs Plain-Pack Tobacco Laws". Bloomberg. August 15, 2012. Archived from the original on November 13, 2013. Retrieved March 6, 2017.
- ^ "The Standardised Packaging of Tobacco Products Regulations 2015". Legislation.gov.uk. Retrieved August 18, 2025.
- ^ "Tobacco firms challenge plain packaging rules". BBC News. December 10, 2015. Retrieved August 18, 2025.
- ^ Parameswaran G. "Bhutan smokers huff and puff over tobacco ban - Features". Al Jazeera English. Archived from the original on January 2, 2013. Retrieved January 2, 2013.
- ^ Marks K (July 9, 2008). "World's smallest state aims to become the first smoke-free paradise island - Australasia - World". The Independent. London. Archived from the original on November 11, 2012. Retrieved January 2, 2013.
- ^ Pidd H (July 4, 2011). "What a drag ... Iceland considers prescription-only cigarettes | World news". The Guardian. London. Archived from the original on September 30, 2013. Retrieved January 2, 2013.
- ^ "WHO | Brazil - Flavoured cigarettes banned". Who.int. March 13, 2012. Archived from the original on February 20, 2013. Retrieved January 2, 2013.
- ^ "Eyes on Trade: Brazil's flavored cigarette ban now targeted". Citizen.typepad.com. April 16, 2012. Archived from the original on March 7, 2014. Retrieved January 2, 2013.
- ^ Dubai: The Complete Residents' Guide - Page 27, 2006
- ^ Novotny TE, Lum K, Smith E, et al. (2009). "Cigarettes butts and the case for an environmental policy on hazardous cigarette waste". International Journal of Environmental Research and Public Health. 6 (5): 1691–705. doi:10.3390/ijerph6051691. PMC 2697937. PMID 19543415.
- ^ "The world litters 4.5 trillion cigarette butts a year. Can we stop this?". The Houston Chronicle. Archived from the original on September 20, 2014. Retrieved September 16, 2014.
- ^ "International Coastal Cleanup 2006 Report, page 8" (PDF). Archived from the original (PDF) on November 26, 2008. Retrieved November 13, 2009.
- ^ "CigaretteLitter.org". Archived from the original on May 22, 2007. Retrieved May 28, 2007.
- ^ Slaughter E, Gersberg RM, Watanabe K, Rudolph J, Stransky C, Novotny TE (2011). "Toxicity of cigarette butts, and their chemical components, to marine and freshwater fish". Tobacco Control. 20 (Suppl_1): 25–29. doi:10.1136/tc.2010.040170. PMC 3088407. PMID 21504921.
- ^ Pauly JL, Mepani AB, Lesses JD, Cummings KM, Streck RJ (March 2002). "Cigarettes with defective filters marketed for 40 years: what Philip Morris never told smokers". Tob Control. 11 (Suppl 1). pp. I51–I61; Table 1. doi:10.1136/tc.11.suppl_1.i51. PMC 1766058. PMID 11893815.
- ^ Dahlberg ER (April 11, 2006), Cigarette Filters With Vegetation, soil, and Subterranean Environment, Saint Paul, Minnesota: Hamline University
- ^ "Cigarette butt 'causes $1m house fire'". News.smh.com.au. September 14, 2008. Archived from the original on February 14, 2009. Retrieved November 13, 2009.
- ^ "The Facts About Cigarette Butts and Litter - Fire Danger". CigaretteLitter.Org. Archived from the original on July 8, 2009. Retrieved November 13, 2009.
- ^ Perkin C (February 9, 2009). "Cigarette butt blamed for West Bendigo fire; two dead, 50 homes lost | Victoria". News.com.au. Archived from the original on February 25, 2009. Retrieved November 13, 2009.
- ^ "Can cigarette butts start bushfires? - NSW Fire Brigades". Nswfb.nsw.gov.au. June 21, 2007. Archived from the original on October 17, 2009. Retrieved November 13, 2009.
- ^ "Discarded cigarette butt causes airport chaos - ABC News (Australian Broadcasting Corporation)". Abc.net.au. January 15, 2009. Archived from the original on November 6, 2009. Retrieved November 13, 2009.
- ^ a b "British American Tobacco - Cigarettes". Bat.com. Archived from the original on March 3, 2012. Retrieved March 25, 2012.
- ^ "Kicking butts". Chicago Tribune. June 18, 2008. Archived from the original on August 13, 2011. Retrieved September 16, 2014.
- ^ Puls J, Wilson SA, Holter D (2011). "Degradation of Cellulose Acetate-Based Materials: A Review". Journal of Polymers and the Environment. 19 (1): 152–165. Bibcode:2011JPEnv..19..152P. doi:10.1007/s10924-010-0258-0.
- ^ Ceredigion County Council Archived January 8, 2009, at the Wayback Machine
- ^ "Bulletin of the American Littoral Society, Volume 26, Number 2, August 2000". Longwood.edu. Archived from the original on December 12, 2020. Retrieved November 13, 2009.
- ^ Gou JY, Miller LM, Hou G, Yu XH, Chen XY, Liu CJ (January 2012). "Acetylesterase-mediated deacetylation of pectin impairs cell elongation, pollen germination, and plant reproduction". Plant Cell. 24 (1): 50–65. Bibcode:2012PlanC..24...50G. doi:10.1105/tpc.111.092411. PMC 3289554. PMID 22247250.[dead link]
- ^ "Breaking Down Cellulose". large.stanford.edu. Archived from the original on November 25, 2014. Retrieved November 25, 2014.
- ^ Buchanan CM, Garder RM, Komarek RJ (1993). "Aerobic biodegradation of cellulose acetate". Journal of Applied Polymer Science. 47 (10): 1709–1719. doi:10.1002/app.1993.070471001.
- ^ Rivard CJ, Adney WS, Himmel ME, Mitchell DJ, Vinzant TB, Grohmann K, Moens L, Chum H (1992). "Effects of Natural Polymer Acetlation on the anaerobic Dioconversion to Methane and Carbon Dioxide". Applied Biochemistry and Biotechnology. 34/35: 725–736. doi:10.1007/bf02920592. S2CID 84432678. Archived from the original on June 24, 2019. Retrieved June 24, 2019.
- ^ Hon NS (1977). "Photodegradation of Cellulose Acetate Fibers". Journal of Polymer Science Part A: Polymer Chemistry. 15 (3): 725–744. Bibcode:1977JPoSA..15..725H. doi:10.1002/pol.1977.170150319.
- ^ Hosono K, Kanazawa A, Mori H, Endo T (2007). "Photodegradation of Cellulose Acetate film in the presence of bensophenone as a photosensitizer". Journal of Applied Polymer Science. 105 (6): 3235–3239. doi:10.1002/app.26386.
- ^ "Study on Photocatalytic Oxidation (PCO) Raises Questions About Formaldehyde as a Byproduct in Indoor Air". Archived from the original on April 26, 2015. Retrieved May 30, 2015.
- ^ "photosensitization - chemistry". Encyclopædia Britannica. Retrieved May 30, 2015.
- ^ "Accidents, fires: Price of littering goes beyond fines". Washington: State of Washington Department of Ecology. June 1, 2004. Archived from the original on October 12, 2009. Retrieved May 6, 2009.
- ^ "No more butts: biodegradable filters a step to boot litter problem". Environmental Health News. August 14, 2012. Archived from the original on November 29, 2014. Retrieved November 25, 2014.
- ^ Novotny T, Lum K, Smith E, Wang V, Barnes R (2009). "Cigarette Butts and the Case for an Environmental Policy on Hazardous Cigarette Waste". International Journal of Environmental Research and Public Health. 6 (5): 1691–1705. doi:10.3390/ijerph6051691. PMC 2697937. PMID 19543415.
- ^ Minzae L, Gil-Pyo K, Hyeon DS, Soomin P, Jongheop Y (2014). "Preparation of energy storage material derived from a used cigarette filter for a supercapacitor electrode". Nanotechnology. 25 (34): 34. Bibcode:2014Nanot..25H5601L. doi:10.1088/0957-4484/25/34/345601. PMID 25092115. S2CID 8692351.
- ^ Willingham R (December 31, 2010). "Tobacco display ban from tomorrow". The Age(Melbourne). Fairfax Media. Archived from the original on June 17, 2012. Retrieved June 28, 2012.
- ^ "Cigarette Smoking Among Adults - United States, 2006". Cdc.gov. Archived from the original on August 16, 2019. Retrieved November 13, 2009.
- ^ "WHO/WPRO-Smoking Statistics". Wpro.who.int. May 28, 2002. Archived from the original on November 8, 2009. Retrieved November 13, 2009.
- ^ "Home". The Tobacco Atlas. Archived from the original on January 2, 2023. Retrieved March 5, 2018.
- ^ Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, Wollum A, Sanman E, Wulf S (January 8, 2014). "Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012". JAMA. 311 (2): 183–92. doi:10.1001/jama.2013.284692. ISSN 0098-7484. PMID 24399557.[permanent dead link]
- ^ "The Global Cigarette Industry". August 2018. Archived from the original on July 17, 2019. Retrieved July 17, 2019.
- ^ "Tobacco Merchant Account". Allied Payments. May 21, 2019. Archived from the original on July 31, 2020. Retrieved May 25, 2018.
- ^ Innis M (June 11, 2014). "Australia's Graphic Cigarette Pack Warnings Appear to Work". The New York Times. Archived from the original on December 29, 2017. Retrieved February 24, 2017.
- ^ "Age-standardized prevalence of current tobacco smoking among persons aged 15 years or older, 2016". 2018. Archived from the original on July 30, 2018. Retrieved July 17, 2019.
- ^ Cigarette numbers and per capita consumption from The Tobacco Atlas: https://tobaccoatlas.org/topic/consumption/ Archived March 25, 2019, at the Wayback Machine Population numbers from World Bank 2017
- ^ "Nicotine, Tar, and Co Content of Domestic Cigarettes". Archived from the original on April 1, 2012. Retrieved October 5, 2011.
- ^ Koch 2009
- ^ U.S. National 2004
- ^ Benowitz 2005, p. 1
- ^ NCI's Smoking 2007, p.7
- ^ "Guide to quitting smoking". American Cancer Society. January 31, 2011. Archived from the original on June 27, 2010. Retrieved February 15, 2011.
- ^ a b c Benowitz NL, Benowitz NL (2010). "Nicotine addiction". N Engl J Med. 362 (24): 2295–303. doi:10.1056/NEJMra0809890. PMC 2928221. PMID 20554984.
- ^ a b c d Chapman S, MacKenzie R (February 9, 2010). "The global research neglect of unassisted smoking cessation: causes and consequences". PLOS Medicine. 7 (2) e1000216. doi:10.1371/journal.pmed.1000216. PMC 2817714. PMID 20161722.
- ^ Chan AL (June 10, 2012). "Fruits And Vegetables May Help Smokers Quit -- And Stay Off -- Tobacco". Huffington Post. Archived from the original on June 12, 2017. Retrieved February 20, 2020.
- ^ Chapman, Simon, MacKenzie, Ross (February 9, 2010). "The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences". PLOS Medicine. 7 (2) e1000216. doi:10.1371/journal.pmed.1000216. PMC 2817714. PMID 20161722.
- ^ "Abstinent Smokers' Nicotinic Receptors Take More Than a Month to Normalize". October 2009. Archived from the original on June 25, 2013. Retrieved July 7, 2013.
- ^ LaVito A (December 17, 2019). "FDA authorizes low-nicotine cigarettes by 22nd Century Group for public sale". CNBC. Archived from the original on December 18, 2019. Retrieved December 19, 2019.
Sources
[edit]- Cox H (2000). The Global Cigarette: Origins and Evolution of British American Tobacco, 1880-1945. Oxford University Press. ISBN 978-0-19-829221-0.
- "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General" (PDF). United States Department of Health and Human Services. Surgeon General of the United States. 2016. pp. 1–298. Archived (PDF) from the original on October 9, 2022.
This article incorporates text from this source, which is in the public domain. - "Electronic nicotine delivery systems" (PDF). World Health Organization. July 21, 2014. pp. 1–13.
- Wilder N, Daley C, Sugarman J, Partridge J (April 2016). "Nicotine without smoke: Tobacco harm reduction". Royal College of Physicians. UK. pp. 1–191. Archived from the original on May 5, 2016. Retrieved June 2, 2019.
Further reading
[edit]- Boyle, Peter; Nigel Gray, Jack Henningfield, John Seffrin and Witold Zatonski, Tobacco: Science, Policy and Public Health, Oxford University Press, second edition, 2010, 776 pages (ISBN 9780199566655).
- Brandt, Allan. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America (2007). online
- Brooks, Jerome E. The Mighty Leaf: The Story of Tobacco (Little, Brown, 1952)
- Burns, Eric. The Smoke of the Gods: A Social History of Tobacco (Temple University Press, 2007) online
- Cochran, Sherman. Big Business in China: Sino-Foreign Rivalry in the Cigarette Industry, 1890-1930 (Harvard UP, 1980).
- Corti, Count. (1931) A history of smoking (Bracken 1996 reprint; 1931) online
- Durden, Robert F. The Dukes of Durham, 1865-1929 (1975) online
- Enstad, Nan. Cigarettes, Inc.: An Intimate History of Corporate Imperialism (U of Chicago, 2018) excerpt
- Gately, Iain. Tobacco: A Cultural History of How an Exotic Plant Seduced Civilization (2003)
- Goodman, Jordan, ed. Tobacco in History and Culture. An Encyclopedia (2 vol, Gage Cengage, 2005)online
- Hahn, Barbara. Making Tobacco Bright: Creating an American Commodity, 1617–1937 (Johns Hopkins University Press, 2011). examines how marketing, technology, and demand caused the dominance of Bright Flue-Cured Tobacco.
- Hannah, Leslie. "The Whig Fable of American Tobacco, 1895-1913," Journal of Economic History 66#1 (2006), pp. 42–73 online, argues most historians misinterpret the company.
- Harrald, Chris. The cigarette book: the history and culture of smoking (2010) online
- Heimann, Robert K. Tobacco and Americans (McGraw-Hill, 1960) online
- Hilton, Matthew, Smoking in British Popular Culture, 1800–2000 (Manchester University Press, 2000)
- Hirschfelder, Arlene B. Encyclopedia of smoking and tobacco (1999) online
- Kellner, Irwin L. "THE AMERICAN CIGARETTE INDUSTRY: A RE-EXAMINATION" (PhD dissertation, New School for Social Research, 1973; ProQuest Dissertations Publishing, 1973. 7400153).
- Klein, Richard. Cigarettes are Sublime (Duke University Press, 1993) the meaning of cigarettes in literature, films, war, ads, & sex. online
- Kluger, Richard. Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris (Vintage, 1997). excerpt
- Milov, Sarah. The Cigarette: A Political History (Harvard University Press. 2019)
- Oreskes, Naomi, and Erik M. Conway. Merchants of doubt: How a handful of scientists obscured the truth on issues from tobacco smoke to global warming (Bloomsbury Publishing USA, 2011).
- Parker-Pope, Tara. Cigarettes: Anatomy of an Industry from Seed to Smoke (2002) online
- Porter, Patrick G. "Origins of the American Tobacco Company." Business History Review 43.1 (1969): 59-76. online
- Porter, Patrick G. "Advertising in the early cigarette industry: W. Duke, Sons & Company of Durham." North Carolina Historical Review 48.1 (1971): 31-43.
- Robert, Joseph C. The Story of Tobacco in America (1959), by a scholar. online
- Robinson, Daniel J. Cigarette Nation: Business, Health, and Canadian Smokers, 1930-1975 (McGill-Queen's University Press, 2021)
- Rothfeder, Jeffrey. The People vs. Big Tobacco: How the States Took on the Cigarette Giants (1998) online
- Sivulka, Juliann. Soap, Sex, and Cigarettes: A Cultural History of American Advertising (2nd ed. 2012) online
- Sobel, Robert. They satisfy: the cigarette in American life (1978) online
- Sobel R (1974). "James Buchanan Duke: Opportunism Is the Spur". The Entrepreneurs: Explorations Within the American Business Tradition. New York: Weybright & Talley. ISBN 0-679-40064-8.
- Starks, Tricia. Cigarettes and Soviets: Smoking in the USSR (Cornell University Press, 2022)
- Starr, Michael E. "The Marlboro Man: Cigarette Smoking and Masculinity in America." Journal of Popular Culture 17 (1984): 45-57.
- Swanson, Drew A. A Golden Weed: Tobacco and Environment in the Piedmont South (Yale University Press, 2014) 360pp
- Tennant, Richard B. American Cigarette Industry: A Study in Economic Analysis and Public Policy (Yale UP, 1950) online
- Tennant, Richard B. "The Cigarette Industry" in The Structure of American Industry, edited by Walter Adams (1961) pp 357–392. online
- Tilley, Nannie M. The R.J. Reynolds tobacco company (UNC Press Books, 1985), covers history to 1963; part of American Tobacco Company 1899-191, then independent again. online
- Tilley, Nannie M. The bright-tobacco industry, 1860-1929 (1948) online
- Tilley, Nannie May. "Agitation Against the American Tobacco Company in North Carolina, 1890-1911." North Carolina Historical Review 24.2 (1947): 207-223.
- Wagner, Susan. Cigarette Country: Tobacco in American History and Politics (Praeger, 1971). online
- Wailoo, Keith. Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette (2021) excerpt
- Werner, Carl Avery. Tobaccoland: A book about tobacco; its history, legends, literature, cultivation, social and hygienic influences, commercial development, industrial processes and governmental regulation. (1922) online
- Winkler, John K. Tobacco tycoon, the story of James Buchanan Duke (1942) online
- Woofter Jr. T.J. The Plight of Cigarette Tobacco (1931)
- Zhou, Xun Yu, Gilman, Sander L. (2004). Smoke: a global history of smoking. London: Reaktion Books. ISBN 978-1-86189-200-3.
Epidemiological and medical
[edit]- Bogden JD, Kemp FW, Buse M, et al. (January 1981). "Composition of tobaccos from countries with high and low incidences of lung cancer. I. Selenium, polonium-210, Alternaria, tar, and nicotine". J. Natl. Cancer Inst. 66 (1): 27–31. doi:10.1093/jnci/66.1.27. PMID 6935462.
- Hecht SS (July 1999). "Tobacco smoke carcinogens and lung cancer". J. Natl. Cancer Inst. 91 (14): 1194–210. doi:10.1093/jnci/91.14.1194. PMID 10413421.
- Ernster, Virginia, et al. "Women and tobacco: moving from policy to action." Bulletin of the World Health Organization 78 (2000): 891-901. online
- Frieden, Thomas R. et al. The Health Consequences of Smoking: 50 Years of Progress: A Report of the Surgeon General (2014) online
- Kluger, Richard. Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris (Vintage, 1997). excerpt
- Matuszko J (November 2006). "Tobacco Products Processing Detailed Study" (PDF). www.epa.gov. U.S. Environmental Protection Agency. Archived (PDF) from the original on October 9, 2022. Retrieved March 29, 2017.
- Oreskes, Naomi, and Erik M. Conway. Merchants of doubt: How a handful of scientists obscured the truth on issues from tobacco smoke to global warming (Bloomsbury Publishing USA, 2011).
- Slade, John. "The tobacco epidemic: lessons from history." Journal of psychoactive drugs 21.3 (1989): 281-291. online
- Warner, Kenneth E. 1986. Selling Smoke: Cigarette Advertising and Public Health (American Public Health Association, 1986). online
External links
[edit]- US Center for Disease Control - Smoking and Health Database
- GLOBALink
- National Clearinghouse on Tobacco and Health Archived May 17, 2014, at the Wayback Machine - Canada
- Society for Research on Nicotine and Tobacco Archived August 15, 2019, at the Wayback Machine
- Bibliography on History of Cigarette Smoking
Cigarette
View on GrokipediaHistory
Origins in the Americas and Early European Adoption
Tobacco (Nicotiana tabacum), native to the Americas, was cultivated and used by indigenous peoples for thousands of years prior to European contact, with archaeological evidence indicating human utilization dating back at least 12,300 years. Smoking practices emerged prominently among groups such as the Maya in Central America around the 1st century BC, where dried tobacco leaves were rolled into bundles or used in pipes for ceremonial, medicinal, and religious purposes, often by priests and shamans to invoke spiritual connections.[16][17][18] Biomolecular analysis of ancient residues confirms direct inhalation of tobacco smoke by hunter-gatherers in northwestern North America as early as several millennia ago.[19] Pre-Columbian smoking forms included rolled tobacco leaves or shredded plant material wrapped in corn husks or palm, precursors to the modern cigarette, particularly among the Taíno people of the Caribbean who fashioned "tutun"—dried leaves rolled for inhalation.[20][21] These practices were integral to rituals, healing, and social customs across Mesoamerica and South America, with evidence from Mayan pictographs depicting individuals smoking elongated rolls of tobacco.[22] By the time of European arrival, tobacco smoking was well-established among indigenous elites and commoners alike.[23] European encounter with these practices occurred on October 12, 1492, when Christopher Columbus landed in the Bahamas and later observed Taíno natives in Cuba offering dried tobacco leaves and demonstrating smoking of rolled forms during his expedition.[24][25] Crew member Rodrigo de Jerez adopted the habit, returning to Spain as one of the first Europeans to smoke, though initially met with suspicion and imprisonment for the practice.[26] Tobacco seeds and habits spread via Spanish and Portuguese sailors in the early 16th century, reaching Portugal by 1558 and France through diplomat Jean Nicot in 1560, who promoted it medicinally—lending his name to nicotine.[27][28] Adoption accelerated across Europe by the mid-16th century, with pipe smoking predominant but rolled tobacco (cigarillos) also used, especially in Spain and Portugal, where hand-rolled forms echoed indigenous methods.[24] English explorer John Hawkins introduced it to England around 1565, and by the 1590s, figures like Walter Raleigh popularized recreational smoking amid debates over its health benefits and vices.[29] Initial European uses mirrored indigenous ceremonial and purported therapeutic roles, treating ailments like headaches and wounds, though recreational appeal grew rapidly despite early papal bans and moral opposition.[30] By the late 16th century, tobacco cultivation began in European colonies, facilitating broader adoption.[31]Commercialization and Global Spread (19th Century)
The mid-19th century marked the initial commercialization of cigarettes in Europe, driven by exposure during the Crimean War (1853–1856), when British and French soldiers adopted the Ottoman practice of rolling tobacco in thin paper. Returning troops popularized the habit, shifting preferences from pipes and cigars toward portable cigarettes. In Britain, Philip Morris was founded in 1847 by a London tobacconist, initially retailing hand-rolled Turkish-style cigarettes imported from the Ottoman Empire, which catered to growing demand among the upper classes and military personnel.[4] [32] Production remained artisanal, with workers hand-rolling up to 4 cigarettes per minute, constraining output to small-scale operations.[33] Mechanized production revolutionized commercialization in the late 19th century, enabling mass output and market dominance. In 1880, American inventor James Albert Bonsack developed the first viable cigarette-rolling machine, patented in 1881, which automated the process of cutting, rolling, and pasting paper around tobacco at rates up to 120 cigarettes per minute—equivalent to the daily output of dozens of hand-rollers.[4] [34] Initial adoption faced hurdles due to frequent jams and inconsistent quality, but refinements allowed entrepreneur James Buchanan Duke to license the technology in 1884 for his family's W. Duke, Sons, and Company in Durham, North Carolina. Duke invested in multiple machines, paying a $200 weekly royalty per unit, and by 1885 his firm produced over 10 million cigarettes monthly, slashing costs and undercutting rivals through price wars and innovative packaging.[35] [36] This efficiency propelled Duke to control about 40% of the U.S. cigarette market by the decade's end, culminating in the 1890 formation of the American Tobacco Company trust.[35] The scalability of machine production facilitated cigarettes' global spread, as surplus output fueled exports via established trade networks. European firms, including those in Britain and France, adopted similar technologies, while U.S. brands like Duke's "Cross Cut" and "Duke of Durham" reached Latin America, Asia, and Africa through colonial outposts and emigration waves. By the 1890s, cigarette consumption had risen sharply in urban centers worldwide, with branded products displacing loose tobacco; for instance, British exports targeted India and Australia, where local adoption grew among laborers and elites.[4] This era's innovations laid the groundwork for multinational giants like British American Tobacco, formed in 1902 from mergers of late-19th-century operations.[4]Peak Consumption and Government Promotion (Early 20th Century to WWII)
![Camel cigarette advertisement from 1942][float-right] In the United States, per capita cigarette consumption rose steadily from approximately 54 cigarettes per person in 1900 to 665 by 1920, reflecting the widespread adoption facilitated by mechanized production and aggressive marketing campaigns.[37] [38] By 1935, this figure had reached 1,564 cigarettes per capita, increasing to 1,976 in 1940 amid economic recovery and intensified advertising that often featured endorsements from physicians claiming health benefits or throat-soothing properties.[39] [40] Tobacco companies invested heavily in print media, with advertisements portraying smoking as a modern, stress-relieving habit suitable for both men and women, contributing to cultural normalization.[41] Government involvement significantly boosted consumption during the World Wars, positioning cigarettes as essential for troop morale. In World War I, the U.S. military procured vast quantities from manufacturers like Bull Durham, which sold its entire production to the War Department, distributing tobacco through canteens to combat boredom and enhance soldier welfare.[42] [43] This wartime supply chain not only sustained high usage among servicemen but also reinforced domestic demand upon their return. During World War II, cigarettes became standard components of C-rations and K-rations, with each K-ration box including several packs alongside gum and candy to alleviate combat stress and maintain fighting efficiency; the U.S. military distributed billions, further entrenching smoking as a military norm.[44] [45] This governmental endorsement, coupled with private sector promotion, drove a sharp consumption spike, reaching 3,449 cigarettes per capita by 1945 as returning veterans sustained elevated habits and advertising expenditures soared.[39] Military policies implicitly subsidized the industry by prioritizing tobacco in logistics, with little contemporaneous recognition of long-term health risks despite emerging anecdotal concerns.[46] The era's fusion of state support and commercial hype laid the foundation for post-war peaks, as smoking permeated civilian society.[44]Post-War Boom and Initial Health Concerns (1950s-1960s)
In the years following World War II, cigarette consumption in the United States experienced a significant surge, driven by aggressive marketing campaigns, cultural normalization, and innovations in product design. Annual per capita consumption rose from 3,522 cigarettes in 1950 to a peak of 4,345 by 1963, reflecting widespread adoption across demographics, including increased smoking among women and postwar economic prosperity that facilitated leisure activities like smoking.[38][37] By the mid-1960s, over 40 percent of U.S. adults were regular smokers, with cigarettes often portrayed in media and advertising as symbols of sophistication and stress relief.[47] Tobacco companies invested heavily in promotions, including filtered cigarettes introduced in the early 1950s, which were marketed as safer despite lacking substantive evidence of reduced harm at the time.[48] Emerging epidemiological research in the 1950s began to challenge this boom by identifying strong statistical associations between cigarette smoking and lung cancer. A landmark 1950 case-control study in the United Kingdom by Richard Doll and Austin Bradford Hill analyzed 684 lung cancer cases and found smokers were substantially more likely to develop the disease than non-smokers, with odds ratios indicating a dose-response relationship.[49] Similar retrospective studies in the United States, such as those by Ernst Wynder and Evarts Graham in 1950, corroborated these findings, reporting that over 90 percent of lung cancer patients were heavy smokers.[50] Animal experiments in the same decade further supported potential causality, demonstrating that cigarette tar could induce tumors in mice, though human causation remained debated due to confounding factors like occupational exposures and limited mechanistic understanding.[51] By 1957, scientists within the U.S. Public Health Service had internally concluded that smoking caused lung cancer, predating broader public acknowledgment.[52] The tobacco industry responded to these initial concerns with public denials and efforts to sow doubt, forming alliances like the Tobacco Industry Research Committee in 1954 to fund studies questioning the evidence.[53] A coordinated advertisement campaign that year, titled "A Frank Statement to Cigarette Smokers," asserted that "we believe the products we make are not injurious to health" and called for independent research, effectively framing the science as unsettled despite accumulating data.[54] This strategy delayed regulatory action and public awareness, allowing consumption to continue rising into the early 1960s, even as cohort studies reinforced the smoking-lung cancer link with relative risks exceeding 10-fold for heavy smokers.[55] Critics later noted that industry-funded research often emphasized alternative causes, such as air pollution, to divert attention from tobacco's role.[56]Decline and Regulatory Shifts (1970s-Present)
Cigarette smoking prevalence in the United States declined from 37.4% among adults in 1970 to 25.5% by 1990, continuing to fall to 11.6% by 2022, representing a 73% reduction from 1965 levels.[57][58] Globally, smoking prevalence dropped by 27.2% among men and 37.9% among women since 1990, with larger declines in high-income countries, though absolute consumption remains high in low- and middle-income nations at over 1 billion smokers in 2020.[59] These trends reflect reduced initiation among youth and higher quit rates, driven by accumulating epidemiological evidence linking smoking to lung cancer, cardiovascular disease, and other conditions, as detailed in Surgeon General reports from the 1970s onward. In the United States, the Public Health Cigarette Smoking Act of 1970 banned cigarette advertising on television and radio effective January 2, 1971, and mandated package warnings stating that smoking is "dangerous to health."[60] Subsequent regulations included expanded warnings in 1984 requiring rotation of specific health risks like addiction and fetal injury, alongside state-level indoor smoking bans beginning in the late 1970s, such as California's 1976 restrictions in certain public spaces.[61] Federal aviation rules prohibited smoking on domestic flights under two hours in 1988, later extended nationwide.[61] These measures curtailed youth exposure to marketing and normalized non-smoking environments, contributing to prevalence drops exceeding 1% annually in the 1970s and 1980s.[62] The 1990s saw intensified litigation, culminating in the 1998 Master Settlement Agreement between tobacco companies and 46 states, which imposed $206 billion in payments for health costs, restricted youth-targeted marketing, and funded anti-smoking campaigns like the Truth Initiative.[15] The Family Smoking Prevention and Tobacco Control Act of 2009 granted the FDA authority over tobacco products, enabling flavor bans in cigarettes (except menthol, pending rulemaking), graphic warning labels, and premarket review of new products.[63] Smoke-free laws proliferated, covering workplaces and restaurants in most states by the 2010s, while excise taxes rose, with a federal increase to $1.01 per pack in 2009 correlating with accelerated youth declines.[64] Internationally, the World Health Organization's Framework Convention on Tobacco Control, ratified by over 180 countries since 2003, standardized measures like advertising bans, taxation, and cessation support, yielding a 4-5% consumption drop per 10% price hike.[65] In Europe and Australia, plain packaging laws from 2012 onward further diminished brand appeal.[66] Despite these shifts, challenges persist, including illicit trade and slower declines in developing markets where affordability remains high.[67] Empirical analyses attribute the decline primarily to price elasticity from taxes, reduced accessibility via bans, and public education campaigns highlighting causal links between smoking and mortality, though social denormalization amplified effects beyond direct policy.[68][69] Cessation aids and nicotine replacement therapies, regulated post-1970s, supported quitting, with U.S. quit attempts rising amid these interventions.[70] Regulatory focus has increasingly targeted combustible cigarettes while scrutinizing alternatives like e-cigarettes for youth uptake risks.[71]Composition and Manufacturing
Tobacco Blends and Varieties
Cigarette tobacco blends are formulated by combining varieties selected for complementary flavor profiles, nicotine levels, burn characteristics, and combustibility. The predominant blend in mass-produced cigarettes is the American style, which integrates flue-cured Virginia tobacco for sweetness, air-cured Burley for robustness, and sun-cured Oriental varieties for aromatic complexity.[72][73] This combination balances high sugar content from Virginia with the low-sugar, high-nicotine absorption of Burley, while Orientals contribute spice without dominating.[74] Flue-cured Virginia tobacco, derived from Nicotiana tabacum plants grown primarily in the southeastern United States, Brazil, and Zimbabwe, undergoes curing in heated barns with controlled indirect heat to retain natural sugars and develop a mild, sweet, citrus-like flavor.[73] It features bright yellow-to-orange leaves with medium to high nicotine content and serves as the primary base in blends, comprising the majority of the mix to ensure smooth combustion and a light-bodied smoke.[75] Sub-varieties include bright leaf (lighter, higher sugar) and darker red types (deeper flavor), harvested from the plant's upper leaves for optimal quality.[72] Air-cured Burley tobacco, originating from regions like Kentucky and Tennessee in the U.S., is hung in ventilated barns for 4-8 weeks, resulting in light brown to reddish-brown leaves with negligible sugar, high nicotine, and an earthy, nutty taste.[76][74] Its absorbent quality allows it to hold added flavors or humectants, providing structural body and nicotine strength to blends while moderating the sweetness of Virginia.[75] White Burley, developed in the 1860s, dominates due to its mildness compared to darker subtypes.[73] Sun-cured Oriental tobaccos, cultivated in Turkey, Greece, and the Balkans from small-leafed varieties like Izmir, Basma, and Samsun, are dried outdoors to yield spicy, tangy, and highly aromatic profiles with low nicotine and fast burn rates.[73][74] These are incorporated in smaller proportions—often 10-20%—to enhance overall aroma and exotic notes without overpowering the blend's smoothness.[72] Fire-cured varieties, exposed to smoke during curing, add rare smoky undertones but are used sparingly in cigarettes due to intensity.[73] Regional variations exist; for instance, some international cigarettes, such as those in Canada, rely almost exclusively on flue-cured Virginia for a lighter profile, omitting Burley and Orientals.[73] Blending ratios are adjusted by manufacturers to meet specific taste targets, with Virginia typically predominant, Burley for balance, and Orientals for nuance, ensuring consistent draw and ash quality.[75]Paper, Filters, and Structural Components
A cigarette consists of a tobacco rod encased in cigarette paper, with a filter attached at one end, covered by tipping paper that overlaps the rod slightly for attachment. The tobacco rod is formed by cutting and blending tobacco filler, then wrapping it in cigarette paper using a gummed seam for adhesion. The filter is inserted into the rod end, and tipping paper is applied over the filter and a portion of the rod, secured with adhesive. Plugwrap paper encases the filter material internally.[77] Cigarette paper is primarily composed of bleached wood pulp and hemp pulp fibers, processed into thin, porous sheets to facilitate controlled combustion. These fibers are pulped, refined, and formed into paper with additives such as calcium carbonate to enhance porosity and burning rate, ensuring the paper burns evenly without excessive ash. The paper's basis weight typically ranges from 20 to 30 grams per square meter, optimized for low ignition propensity in modern designs.[78][79] Cigarette filters are constructed from cellulose acetate tow, a synthetic fiber produced by acetylating cellulose derived from wood pulp with acetic acid and acetic anhydride, resulting in plastic-like rods of bundled fibers. The tow is crimped, gathered into a cylindrical plug, and wrapped in porous plugwrap paper to maintain structure while allowing smoke passage. Cellulose acetate dominates due to its high surface area for trapping particulates, with fibers averaging 15,000 to 40,000 denier in fineness. Some filters incorporate activated charcoal granules for gas-phase adsorption, embedded within the acetate or in cavity designs.[80][81] Tipping paper, applied over the filter, is made from cellulose fibers sourced from wood pulp, often printed with cork-like patterns using inks containing titanium dioxide for opacity and aesthetics. It includes laser-perforated ventilation holes in low-tar variants to dilute smoke with air, altering draw resistance and yield measurements. Adhesives, typically starch-based or synthetic, secure the tipping to the rod and form longitudinal seams in both paper and tipping.[82][77]Additives and Chemical Engineering
Cigarette additives encompass a range of organic and inorganic compounds intentionally incorporated during manufacturing to alter tobacco's chemical profile, combustion behavior, and sensory attributes. These substances, often exceeding 100 in number per brand, include humectants such as glycerol and propylene glycol to retain moisture and prevent brittleness; sugars like sucrose and invert sugar for flavor enhancement and to generate caramel-like notes during pyrolysis; and pH modifiers including ammonia salts to adjust smoke alkalinity.[83][14] Burn additives, such as potassium citrate, are added to the paper or tobacco to control ignition propensity and reduce sidestream smoke density, influencing overall heat transfer and pyrolysis efficiency.[84] Chemical engineering processes integrate these via casing—spraying aqueous solutions onto cut tobacco lamina, followed by drying and expansion—or through reconstituted sheet tobacco production, where pulp is mixed with additives before extrusion and cutting.[14] Ammonia engineering exemplifies targeted chemical manipulation: ammonium salts or aqueous ammonia are applied to tobacco, liberating free ammonia during curing or heating, which elevates mainstream smoke pH from approximately 5.5 to 7.5, converting a greater fraction of nicotine to its volatile freebase form for enhanced pulmonary absorption.[14] This adjustment, documented in industry practices since the 1960s, correlates with increased nicotine bioavailability without altering total content, potentially amplifying addictive potential through faster delivery to the brain.[85] Sugars, added at levels up to 20% by weight in some blends, not only mask bitterness but undergo thermal decomposition to yield aldehydes like acetaldehyde, which may potentiate nicotine's reinforcing effects by inhibiting dopamine reuptake or forming protonated nicotine salts for smoother inhalation.[85][14] Engineering extends to mitigating or redistributing combustion byproducts: antioxidants such as vitamin C (ascorbic acid) are trialed to scavenge free radicals, though efficacy in smoke is limited by pyrolysis conditions exceeding 900°C in the cigarette core.[14] Flavors like menthol or vanillin are microencapsulated or top-dressed post-casing to survive processing and volatilize during puffing, reducing perceived harshness from irritants like acrolein.[14] Regulatory disclosures, mandated in jurisdictions like the European Union since 2006, reveal additive lists but often omit proprietary formulations or synergistic interactions, complicating independent verification of causal impacts on toxicity.[86] Overall, these interventions reflect iterative optimization for product stability, yield consistency, and user retention, grounded in empirical smoke chemistry analyses rather than health minimization.[14]Modern Production Techniques and Quality Control
Modern cigarette production relies on highly automated assembly lines capable of outputting up to 20,000 cigarettes per minute, utilizing precision machinery to handle tobacco processing, rod formation, filter attachment, and packaging.[87][88] The process begins with tobacco leaf inspection and blending, where cut shreds from various varieties are mixed to achieve consistent flavor and burn characteristics, followed by conditioning to regulate moisture content at around 12-15%.[89] A continuous spool of cigarette paper, often exceeding 7,000 meters in length, is unrolled as shredded tobacco is fed onto it via pneumatic systems, with adhesive applied for seam formation to create a continuous rod approximately 490 meters per minute in length.[87][90] Subsequent stages involve attaching cellulose acetate filters using laser-guided applicators for alignment, then high-speed cutting blades that slice the filtered rod into individual cigarettes of standard lengths such as 84 mm or 100 mm.[91] Packaging lines integrate secondary automation, including cellophane wrapping, carton formation, and labeling at rates synchronized with primary production to minimize bottlenecks, often employing robotic arms for handling and conveyor systems for material flow.[92] Modern systems incorporate computer vision and servo-driven controls to adjust variables like tobacco density in real-time, reducing waste and enabling production of variants such as slim or flavored cigarettes without retooling delays.[93] Quality control integrates inline sensors and automated inspections throughout the line to monitor parameters including cigarette weight (typically 0.8-1.2 grams per unit), diameter (7.5-8.0 mm), draw resistance (pressure drop of 80-120 mm water gauge), and end stability to ensure uniformity and prevent defects like loose ends or uneven burns.[94] Visual inspection systems using machine vision detect anomalies such as paper tears, discoloration, or filter misalignments at production speeds, rejecting non-conforming items via pneumatic ejection.[95] Laboratory sampling verifies chemical composition, including nicotine levels and additive distribution, while human oversight persists for subjective assessments like leaf quality and blend integrity, as machines cannot fully replicate sensory evaluation.[87][96] Post-production testing on smoking machines simulates consumer use to measure yield consistency, with regulatory compliance driving adherence to standards like ISO 3402 for physical properties.[97] These measures, combining digital precision with empirical validation, maintain product specifications amid competitive pressures and evolving regulations.[94]Types and Variants
Traditional Combustible Cigarettes
Traditional combustible cigarettes consist of dried and fermented tobacco leaves, finely cut and rolled into a thin paper cylinder, which is ignited at one end and inhaled from the other to produce smoke through combustion.[98] This form represents the original and predominant method of cigarette smoking, distinguishing it from non-combustible alternatives like electronic cigarettes or heated tobacco products that avoid burning the tobacco.[2] The basic structure includes a tobacco rod, wrapping paper, and often a filter at the mouthpiece end, designed to deliver nicotine and other compounds via inhaled aerosol.[99] Standard dimensions for these cigarettes vary by market but commonly include lengths of 70 mm for regular size and 84 mm for king size, with diameters of 7.5 to 8.0 mm.[100] Packs typically contain 20 cigarettes, housed in boxes measuring approximately 85 mm x 55 mm x 20 mm to accommodate these sizes. A standard pack of 20 cigarettes thus provides approximately 200 to 300 puffs, based on typical smoking behavior of 10 to 15 puffs per cigarette.[101][102] Unlike slim variants with reduced diameters of 5-6 mm or extended 100 mm and 120 mm lengths, traditional models adhere to these conventional specifications without structural modifications for altered smoke yield.[100] The tobacco blend is primarily combustive, generating over 6,000 chemicals upon burning, many toxic, in contrast to vaporization methods in newer products.[103] These cigarettes are mass-produced and widely available, forming the core of global tobacco use despite shifts toward alternatives, with combustible products accessible to nearly all adult populations worldwide.[104] Their design prioritizes efficient combustion for smoke inhalation, without the flavorings, ventilation, or reduced-tar engineering seen in specialty variants developed post-1950s in response to health concerns.[105] Empirical data indicate that traditional combustibles deliver variable nicotine exposure mimicking historical patterns, though exact yields depend on puffing behavior and composition.[106]Low-Yield and Filtered Variants
Cigarette filters, typically composed of cellulose acetate tow, were introduced in the early 20th century but gained widespread adoption in the 1950s amid rising concerns over lung cancer, as manufacturers shifted from unfiltered to filtered designs to mitigate perceived risks.[107] These filters aimed to trap particulate matter, reducing machine-measured tar yields by 40-50% compared to unfiltered cigarettes.[108] By the late 1950s, filtered cigarettes dominated the market, comprising over 80% of U.S. sales by 1960, promoted as a technological advancement for cleaner smoke delivery.[109] Low-yield variants, often labeled "light," "ultra-light," or low-tar/low-nicotine, emerged in the 1960s and proliferated through the 1970s, featuring innovations like filter ventilation—small perforations allowing dilution of smoke with air to lower Federal Trade Commission (FTC) machine-tested yields to under 15 mg tar and 1 mg nicotine per cigarette.[109] These designs used expanded or reconstituted tobacco blends to further minimize nominal deliveries, capturing significant market share; by 1976, low-tar options accounted for about 15% of sales, rising rapidly thereafter.[110] Manufacturers marketed them as reduced-harm products, with advertising emphasizing engineering for "smoother" inhalation and implied health benefits.[111] However, empirical evidence indicates these variants do not substantially lower health risks, as smokers engage in compensatory behaviors to maintain nicotine intake, including deeper inhalation, more frequent puffs, increased cigarette consumption, and manual occlusion of ventilation holes.[112] [111] Studies measuring biomarkers like cotinine and exhaled carbon monoxide show that actual toxin exposure from low-yield cigarettes approximates that of regular variants, negating machine-yield reductions.[113] For instance, a National Cancer Institute analysis concluded that light cigarettes provide no risk attenuation for lung cancer or other smoking-related diseases, attributing this to unaltered carcinogen uptake despite design changes.[114] [115] Epidemiological data reinforce this, with cohort studies finding no significant difference in lung cancer, COPD, or cardiovascular disease incidence between low-yield and full-flavor smokers after adjusting for total consumption and confounding factors.[116] Partial compensation occurs in roughly 50-70% of cases, per reviews of smoking topography, but full equivalence in exposure is common due to nicotine's reinforcing pharmacology driving behavioral adaptation.[117] [118] Consequently, low-yield and filtered variants have been critiqued as deceptive innovations that prolong addiction without causal risk mitigation, prompting regulatory bans on yield-based descriptors in the U.S. by 2010.[119]Flavored, Slim, and Specialty Cigarettes
Flavored cigarettes incorporate non-tobacco additives to impart distinct tastes, such as menthol, which provides a cooling sensation, or previously fruit and candy profiles. In the United States, the Family Smoking Prevention and Tobacco Control Act of 2009 banned characterizing flavors in combustible cigarettes except for menthol and tobacco, effective September 22, 2009, aiming to curb youth initiation by reducing appeal.[120] [121] Menthol cigarettes, which mask smoke harshness and facilitate deeper inhalation, accounted for over 40% of adult smokers in 2020, with prevalence rising among racial/ethnic minorities, youth, and females.[122] [123] Empirical data indicate menthol use correlates with higher initiation rates and lower cessation success in some cohorts, though direct causation remains debated; studies find no elevated cancer risk compared to non-menthol variants.[124] [125] Regulatory efforts, including FDA proposals in 2022 to eliminate menthol cigarettes, face opposition citing potential black market growth and negligible public health gains, as flavor bans in other jurisdictions have redirected consumption to unflavored or alternative products without reducing overall nicotine use.[61] [126] Slim cigarettes differ from standard variants by having a narrower diameter, typically 5.4 to 6 millimeters versus 7.5 to 8 millimeters for conventional king-size, often with increased length to sustain similar puff volumes and yields. Introduced prominently with brands like Virginia Slims in 1968, they were marketed to women emphasizing slenderness, elegance, and sophistication, associating the product with feminine aesthetics and lighter smoking experiences.[127] [128] Market share has expanded in regions like Europe, appealing to younger demographics through sleek packaging and perceptions of reduced harm, despite evidence showing equivalent tar, nicotine, and health risks to regular cigarettes.[129] [130] Studies confirm slims deliver no meaningful dose reduction, as smokers compensate via adjusted inhalation, underscoring marketing-driven illusions over empirical safety differences.[128] Specialty cigarettes encompass non-standard combustible tobacco products like kreteks and bidis, which deviate from conventional blends in composition and cultural origins. Kreteks, originating from Indonesia, blend tobacco with 30-40% ground cloves, imparting a spicy eugenol flavor and higher tar levels due to clove oils; U.S. imports peaked in the 1990s before FDA classification as drug-device hybrids in 2009 restricted marketing claims.[131] Bidis, hand-rolled in India using tendu leaf wrappers and minimal tobacco, require stronger draws for combustion, yielding 3-5 times higher tar and nicotine than U.S. cigarettes; they gained U.S. traction in the 1990s among youth for exotic appeal but carry elevated risks of oral cancer and respiratory disease from unfiltered, tightly drawn smoke.[132] [131] Other specialties include additive-free "natural" cigarettes like American Spirits, promoted for purer tobacco but lacking evidence of harm reduction, as combustion byproducts remain inherent to burning plant material. These variants often evade standard regulations through import status or niche positioning, though prevalence remains low compared to mass-market types.[133]Non-Combustible and Harm-Reduction Alternatives
Non-combustible alternatives to combustible cigarettes include electronic nicotine delivery systems (ENDS), heated tobacco products (HTPs), and oral nicotine products such as snus and nicotine pouches, which deliver nicotine without burning tobacco and thus limit exposure to combustion-generated toxins like tar, polycyclic aromatic hydrocarbons, and carbon monoxide.[134] These products emerged prominently in the 2010s, with ENDS sales surpassing traditional cigarettes in some markets by 2023, driven by their appeal as lower-risk options for nicotine maintenance.[135] Empirical evidence from biomarker studies shows switching from cigarettes reduces levels of harmful constituents, supporting harm reduction for persistent nicotine users, though absolute risks persist due to nicotine's addictive properties and other constituents.[136] Electronic cigarettes aerosolize propylene glycol, vegetable glycerin, nicotine, and flavorings via battery-powered heating elements, avoiding pyrolysis. Randomized trials demonstrate nicotine ENDS achieve higher smoking abstinence rates than nicotine replacement therapy (NRT) or behavioral support alone, with one meta-analysis reporting a risk ratio of 1.63 for quitting at six months.[137] Toxicological assessments confirm ENDS aerosols contain 90-95% fewer harmful chemicals than cigarette smoke, correlating with lower cytotoxicity and oxidative stress in cellular models.[138] Population studies indicate reduced odds of cardiovascular events among exclusive vapers versus smokers, though dual use with cigarettes attenuates benefits and may elevate relapse risk.[139] Independent reviews highlight aerosol risks, including aldehydes from overheating and potential metal leaching, but emphasize net harm reduction for smokers switching completely.[140] Heated tobacco products like Philip Morris's IQOS heat tobacco sticks to 350°C, releasing nicotine vapor with minimal combustion. Chemical analyses reveal HTP emissions with substantially lower yields of 72 measured toxicants compared to cigarettes, including reduced nitrosamines and volatile organics.[141] Short-term switching trials report decreased urinary biomarkers of exposure, such as NNAL (a tobacco-specific nitrosamine metabolite), by over 90% after five days.[142] Respiratory cohort data show modest declines in infection susceptibility post-switch, though endothelial function improvements lag behind complete cessation.[143] Critiques note residual harmful emissions, including irritants at levels sufficient for acute vascular effects, underscoring HTPs as incremental rather than complete risk eliminators.[144] Smokeless oral products bypass inhalation risks; Swedish snus, a pasteurized tobacco pouch, correlates with lung cancer rates 1-2% of smokers' in long-term Swedish cohorts, attributing causality to absent combustion carcinogens.[145] Nicotine pouches, tobacco-free variants with synthetic or extracted nicotine, exhibit lower in vitro toxicity than snus or cigarettes, with pharmacokinetic studies confirming rapid nicotine delivery comparable to smoking for craving suppression.[146] Clinical trials of pouch substitution reduce cigarette consumption by 50-70%, with minimal impact on cardiovascular biomarkers like blood pressure in short-term use.[147] Oral products carry oral mucosa irritation and nicotine dependence risks, with American Heart Association reviews citing potential for elevated heart rate but absent smoke-related endothelial damage.[148] Overall, these alternatives substantiate harm reduction via reduced toxin profiles, though optimal outcomes require exclusive use and long-term data remain nascent as of 2025.[149]Pharmacology and Immediate Effects
Nicotine as the Primary Psychoactive Agent
Nicotine, a naturally occurring alkaloid comprising 0.6–3.0% of the dry weight of tobacco leaves, serves as the principal psychoactive compound responsible for the rewarding and addictive properties of cigarette smoking.[150] Upon inhalation of tobacco smoke, nicotine is rapidly absorbed through the alveolar membranes of the lungs, achieving peak plasma concentrations within 5–10 seconds and crossing the blood-brain barrier to elicit central nervous system effects almost immediately.[151] This pharmacokinetic profile—far quicker than oral or transdermal routes—underpins the reinforcement of smoking behavior, as the swift delivery mimics intravenous administration and sustains habitual use.[152] As a nicotinic acetylcholine receptor agonist, nicotine binds primarily to α4β2 subtypes in the brain, triggering the release of neurotransmitters including dopamine in the mesolimbic pathway, which generates sensations of pleasure, arousal, and reduced anxiety.[153] These dopaminergic effects, observed consistently in human and animal studies, drive the subjective "buzz" reported by smokers and contribute to the development of dependence, with tolerance emerging through receptor upregulation and desensitization over repeated exposure.[154] Withdrawal from nicotine manifests as irritability, anxiety, and cognitive deficits, further entrenching addiction as users smoke to alleviate these symptoms rather than solely for initial euphoria.[155] Empirical data from positron emission tomography imaging confirm that nicotine's modulation of dopamine transporter activity correlates directly with self-reported craving intensity in abstinent smokers.[156] While cigarette smoke contains over 7,000 chemicals, including monoamine oxidase inhibitors that may potentiate nicotine's effects, nicotine remains the dominant agent for psychoactivity, as evidenced by the comparable addiction profiles of pure nicotine delivery systems like patches or gums, albeit without the rapid onset of smoking.[157] Laboratory studies isolating nicotine from tobacco particulates demonstrate its independent capacity to enhance attention and mood, underscoring that combustion byproducts primarily confer toxicity rather than primary reinforcement.[158] This causal primacy holds despite historical debates, with longitudinal cohort data linking nicotine yield variations in cigarettes to adjusted addiction rates among users.[159]Combustion Byproducts and Acute Physiological Responses
Cigarette combustion at temperatures between 600–900°C generates mainstream smoke comprising particulate matter (tar) and gaseous phase components, yielding over 7,000 distinct chemical compounds, including more than 80 identified carcinogens such as benzene, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), and tobacco-specific nitrosamines (TSNAs).[160][161] Carbon monoxide (CO) constitutes a major gaseous byproduct, with each cigarette delivering 10–20 mg, elevating carboxyhemoglobin (COHb) levels in smokers from baseline values of approximately 4.2% to 8.6% post-smoking, thereby impairing hemoglobin's oxygen-binding capacity and reducing tissue oxygenation.[162][163] Hydrogen cyanide and other cyanogenic compounds further contribute to acute toxicity by inhibiting cellular respiration, while nicotine, absorbed rapidly via inhalation (yielding peak plasma levels within 5–10 minutes), acts as the primary alkaloid driving immediate pharmacological responses.[162][164] Upon inhalation, these byproducts elicit acute cardiovascular responses, including sympathetic nervous system activation from nicotine, which elevates heart rate by 10–15 beats per minute, increases systolic blood pressure by 5–10 mmHg, and promotes adrenaline release, enhancing myocardial contractility and vasoconstriction.[165][166] CO's interference with oxygen delivery exacerbates myocardial oxygen demand-supply mismatch, potentially precipitating ischemia in vulnerable individuals, while particulate matter and irritants trigger bronchial constriction and mucociliary clearance disruption within seconds to minutes.[167][168] Respiratory effects manifest as immediate increases in airway resistance and cough reflex, attributable to aldehydes and acrolein irritating mucosal linings.[168] Central nervous system responses include nicotine-induced dopamine release in reward pathways, fostering acute reinforcement and alertness, alongside mild anxiolytic effects at low doses, though higher exposures can induce nausea via peripheral chemoreceptor stimulation.[164] Oxidative stress from free radicals in smoke—such as hydroxyl radicals and quinones—prompts rapid endothelial dysfunction, measurable as reduced flow-mediated dilation within 30 minutes, and elevates markers of lipid peroxidation.[168] These responses vary by inhalation depth and puff volume, with deep drags maximizing systemic delivery of CO and nicotine, thus amplifying hemodynamic shifts.[169] Empirical studies confirm these effects resolve within 30–60 minutes post-cigarette but recur with subsequent use, contributing to cumulative physiological strain.[169][170]Health Effects on Users
Long-Term Empirical Risks from Smoking
Smoking cigarettes over extended periods demonstrably elevates the incidence of chronic diseases, with cohort studies consistently showing dose-dependent increases in mortality risk proportional to pack-years consumed. Large-scale epidemiological analyses attribute roughly 480,000 annual deaths in the United States to direct and indirect effects of smoking, encompassing primary causes such as lung cancer, chronic obstructive pulmonary disease (COPD), and cardiovascular disease (CVD).[171] Globally, the World Health Organization estimates over 8 million tobacco-related deaths yearly, with more than 7 million stemming from direct use.[65] These figures derive from population-attributable fraction models applied to vital statistics and relative risk data from prospective cohorts, though some independent recalibrations suggest modestly lower first-hand estimates around 420,000 U.S. deaths for recent periods, highlighting potential overattribution in official tallies due to modeling assumptions about never-smoker baselines.[172] Lung cancer represents the paradigmatic long-term risk, with current smokers exhibiting relative risks 15 to 30 times higher than never-smokers across histological subtypes, particularly squamous cell carcinoma.[173] Hazard ratios from Norwegian cohort data place the elevated risk at approximately 14-fold for current smokers versus never-smokers, with risks persisting but declining post-cessation in a time-dependent manner.[174] This association holds after adjusting for confounders like age and occupational exposures, supported by biological evidence of polycyclic aromatic hydrocarbons and nitrosamines in smoke inducing DNA adducts and mutations in lung tissue; quitting reduces incidence by up to 90% after 10-15 years, underscoring causality over mere correlation.[175] For respiratory diseases, smoking accounts for 80-90% of COPD cases in high-income settings, with ever-smokers showing prevalence rates over 17% compared to under 7% in never-smokers.[176] Odds ratios exceed 20 for severe airflow obstruction in older smokers, reflecting cumulative damage from irritants like tar and oxidants that provoke chronic inflammation, emphysema, and small airway remodeling.[177] Empirical dose-response curves confirm progression with intensity and duration, as measured by forced expiratory volume decline in longitudinal spirometry studies. Cardiovascular risks manifest earlier, with current smokers facing 2- to 4-fold higher incidence of coronary artery disease and stroke versus non-smokers, driven by endothelial dysfunction, thrombosis promotion, and accelerated atherosclerosis from carbon monoxide and oxidative stress.[178] Hazard ratios for all-cause CVD mortality approximate 1.4 for current users, escalating to over 4.6-fold in heavy smokers, with benefits of cessation evident within 5 years but residual elevation persisting up to 25 years.[179]| Disease Category | Approximate Relative Risk (Current vs. Never-Smokers) | Key Supporting Evidence |
|---|---|---|
| Lung Cancer | 15-30 | Meta-analyses of cohort studies showing subtype-specific elevations.[173][174] |
| COPD | Odds ratio >20 (severe cases) | Prevalence disparities and spirometric decline in smokers.[176][177] |
| Cardiovascular Disease | 2-4 (incidence); HR ~1.4-4.6 (mortality) | Prospective follow-up data on events and endothelial mechanisms.[178][179] |
Dose-Response Relationships and Individual Variability
The dose-response relationship between cigarette smoking and adverse health outcomes demonstrates a graded increase in risk with greater exposure, quantified primarily through metrics such as pack-years (cigarettes per day divided by 20, multiplied by years smoked) and cigarettes smoked daily. Large cohort studies, including a 25-year follow-up of over 100,000 U.S. adults, reveal that smokers consuming 30 or more cigarettes per day exhibit a 21% higher total mortality rate compared to never-smokers (57.7% vs. 36.3% cumulative deaths), with risks escalating nonlinearly for lung cancer, cardiovascular disease, and chronic obstructive pulmonary disease (COPD).[182] Meta-analyses confirm this pattern for lung cancer, where relative risk rises from approximately 1.76 at 5 pack-years to 21.52 at 85.7 pack-years among adults.[183] Similarly, all-cause mortality risks for cancer and cardiovascular events show dose-dependent elevations, with heavier smoking (e.g., >20 cigarettes/day) correlating to relative risks of 1.5–3.0 or higher, independent of cessation timing.[184] While pack-years integrate duration and intensity, evidence indicates that smoking duration exerts a stronger influence on lung cancer and COPD risk than daily intensity alone, challenging the adequacy of pack-years as a sole predictor.[185][186] For instance, prolonged exposure (e.g., decades of light smoking) yields higher absolute risks than shorter bursts of heavy smoking, as cumulative tobacco-specific nitrosamines and tar deposition drive carcinogenesis more than acute dosing. This duration primacy holds in prospective studies adjusting for confounders like age and comorbidities, though intensity amplifies risks in susceptible tissues like the pancreas, where nonlinear dose-responses differ by sex.[187] Quitting mitigates but does not fully erase risks; individuals with >15 quit-years post-20 pack-years retain elevated 5-year lung cancer risks (up to 2–3% absolute risk in ages 55–74).[188] Individual variability in smoking-related harms arises from genetic, metabolic, and physiological factors that modulate nicotine processing, toxin clearance, and disease susceptibility. Variants in the CYP2A6 gene, which encodes the primary enzyme for nicotine metabolism, significantly influence consumption patterns and risk; slow metabolizers (e.g., with reduced-activity alleles) exhibit lower nicotine clearance rates, leading to reduced cigarette intake (often <10/day) and 30–50% lower lung cancer odds among smokers compared to normal metabolizers.[189][190] This interaction stems from slower nicotine inactivation prompting less frequent smoking to maintain dependence, thereby limiting carcinogen exposure. Polygenic scores incorporating variants near nicotinic acetylcholine receptor genes (e.g., CHRNA5) further explain 5–10% of variance in heavy smoking (>25 cigarettes/day) and interact with exposure to heighten COPD progression.[191][192] Sex, age at initiation, and comorbidities introduce additional heterogeneity; women may experience steeper cardiovascular dose-responses due to estrogen-modulated endothelial effects, while early starters (<15 years) face amplified genetic risks from developmental lung immaturity. Genome-wide association studies across diverse ancestries identify thousands of loci linking smoking propensity to cardiovascular and pulmonary outcomes, underscoring that while average risks follow dose gradients, outliers (e.g., heavy smokers with protective detoxification alleles) evade typical harms, though such cases comprise <5% of populations.[193][194] Empirical data from twin studies affirm heritability estimates of 40–60% for smoking persistence and disease liability, emphasizing causal roles beyond environmental confounders.[195]Relative Risks Compared to Other Substances and Lifestyles
Regular cigarette smoking elevates all-cause mortality risk by a factor of 2.5 to 3.0 relative to never-smokers, based on cohort studies tracking dose-response effects over decades.[184] This translates to a reduction in life expectancy of 10 to 15 years for persistent smokers, primarily from cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease.[196] In comparison, heavy alcohol consumption (e.g., 5 drinks per day) equates to a similar premature mortality burden as smoking 4 to 5 cigarettes daily for women and slightly more for men, per lifetime risk models integrating epidemiological data.[197] Moderate alcohol intake, however, exhibits a lower relative risk (often <1.2 for all-cause mortality due to potential cardioprotective effects in some populations), though causal attribution remains debated given confounding factors like socioeconomic status.[198] Globally, tobacco use caused approximately 8 million deaths in 2019, surpassing alcohol-attributable deaths at 2.6 million and illicit drug-related deaths at around 500,000, reflecting tobacco's higher prevalence and chronic harm profile despite lower acute lethality per use.[199] [200] Among drugs of misuse, multicriteria analyses rank tobacco's physical harm to users moderately high (score of 26 out of 100 overall harm, driven by long-term organ damage), below heroin (55) and crack cocaine (54) but comparable to alcohol (72 overall, due to acute and societal effects).[201] [202] Cannabis ranks lower in harm (20-25), with relative mortality risks 1.2 to 1.5 times higher for heavy users versus non-users, lacking tobacco's combustion-related carcinogenicity.[203] Opioids, conversely, impose acute overdose risks with mortality rates exceeding 10 per 1,000 users annually in high-prevalence cohorts, far outpacing tobacco's per-user fatality rate of 1 in 2 lifetime for long-term smokers.[204]| Risk Factor | Approximate Life Expectancy Reduction (Years) | Primary Mechanism |
|---|---|---|
| Pack-a-day smoking | 10-15 | Chronic inflammation, carcinogenesis from combustion byproducts |
| Severe obesity (BMI >35) | 8-13 | Metabolic syndrome, cardiovascular strain |
| Physical inactivity | 3-5 | Reduced cardiovascular reserve, muscle atrophy |
| Heavy alcohol use (>4 drinks/day) | 5-10 | Liver cirrhosis, neuropathy; J-shaped for moderate |
Secondhand Exposure and Broader Impacts
Evidence on Passive Smoking Effects
Passive smoking, also known as environmental tobacco smoke exposure, involves non-smokers inhaling a mixture of sidestream smoke from burning cigarettes and exhaled mainstream smoke from active smokers. Epidemiological studies, primarily case-control and cohort designs, have investigated associations with various health outcomes, though interpretations are complicated by small relative risks, potential confounders like diet and occupation, and exposure assessment via self-reports prone to misclassification.[209][210] For lung cancer in never-smokers, multiple meta-analyses report relative risks of approximately 1.20 to 1.30 associated with spousal or workplace exposure, based on pooled data from dozens of studies involving thousands of cases.[209] [211] These estimates imply a 20-30% elevated risk, but the absolute increase remains minimal given the low baseline incidence of lung cancer among never-smokers (roughly 1% lifetime risk in high-income countries), translating to an added lifetime absolute risk on the order of 1 in 1,000 even at the upper end of relative risk estimates.[212][209] Contrasting evidence emerges from large prospective cohorts; a 2003 analysis by Enstrom and Kabat of the American Cancer Society's Cancer Prevention Study I cohort (118,094 California adults followed from 1959 to 1998) found no significant association between spousal smoking and lung cancer mortality, with an overall relative risk of 0.94 (95% CI 0.85-1.04) after adjusting for age, race, and other factors.[213] This study, covering 39 years and over 10,000 tobacco-related deaths, highlighted null or protective associations in subgroups, challenging causality claims despite criticisms regarding initial partial industry funding (disclosed and not applicable to the reanalysis).[213][210] Evidence for cardiovascular disease similarly shows meta-analytic relative risks of 1.25 to 1.30 for coronary heart disease in exposed non-smokers, drawn from cohort and case-control data.[214] [215] These modest associations are biologically plausible given sidestream smoke's irritant and thrombogenic components at acute high exposures, but chronic low-level effects lack robust dose-response gradients, and confounders such as shared lifestyle factors may inflate estimates.[215] The Enstrom and Kabat cohort reported no elevated mortality risk for heart disease from spousal exposure (relative risk 0.98, 95% CI 0.94-1.02), aligning with critiques that small relative risks in observational data often fail to establish causation amid residual biases.[213] In children, passive smoking correlates with increased incidence of lower respiratory tract infections, otitis media, and asthma exacerbations, with meta-analyses indicating odds ratios of 1.5 to 2.0 for these acute outcomes, supported by stronger evidence from controlled settings showing immediate airway inflammation.[216] Absolute risks, however, are context-dependent and diminish with reduced exposure levels; for instance, sudden infant death syndrome risk rises by about 2-fold with maternal smoking during pregnancy or postnatal household exposure, but this encompasses confounding prenatal effects.[216] Overall, while short-term irritant effects are empirically clear, long-term disease causation in adults hinges on associative data with inherent limitations, prompting ongoing debate over the proportionality of public policy responses to the quantified risks.[213][210]Methodological Debates in Epidemiological Studies
Epidemiological studies on secondhand smoke (SHS), also known as environmental tobacco smoke (ETS), have relied heavily on observational designs such as case-control and cohort studies due to ethical barriers to randomized controlled trials. Case-control studies, which compare exposure histories between lung cancer cases and controls, have been criticized for recall bias, where nonsmoking cases may over-report spousal smoking to explain their illness, inflating odds ratios typically reported as 1.2 to 1.3 for lung cancer risk.[217] Confounding factors, including dietary habits, socioeconomic status, and occupational exposures, are difficult to fully adjust for in these designs, potentially attributing unrelated risks to SHS.[218] Prospective cohort studies, such as the American Cancer Society's Cancer Prevention Study I (CPS-I) and II (CPS-II), offer stronger evidence by assessing exposure before outcomes occur, but they face challenges in exposure misclassification from self-reported data without biomarkers like cotinine levels, which correlate poorly with long-term ETS effects.[218] A 2003 reanalysis of CPS-I data by Enstrom and Kabat, tracking over 118,000 California adults from 1960 to 1998, found no statistically significant association between spousal smoking and lung cancer (relative risk 0.75, 95% CI 0.42-1.35) or coronary heart disease mortality after adjusting for age, education, and other factors, concluding the data do not support a causal link though a small effect remains possible.[219] [213] This study highlighted low statistical power for detecting small risks in low-exposure settings, where absolute lung cancer incidence among never-smokers is under 20 per 100,000 annually, making even 20-30% relative increases yield few attributable cases.[210] Critics of the Enstrom-Kabat findings argued methodological flaws, including reliance on historical exposure assumptions and partial funding from the Center for Indoor Air Research (a tobacco-linked entity), though the authors maintained data transparency and pre-existing access to CPS-I records.[220] [221] Broader debates question the absence of a clear dose-response relationship in many cohorts, where risks do not consistently rise with reported exposure intensity or duration, challenging Bradford Hill causality criteria.[222] Institutional biases in public health, including tobacco control advocacy funded by governments and NGOs, have led to selective emphasis on positive associations while dismissing null results as industry-influenced, despite similar critiques applying to pro-SHS-harm studies from WHO-affiliated groups.[223] Recent meta-analyses of ETS and non-lung cancers report weak or null associations, underscoring persistent uncertainties in extrapolating from active smoking risks, which involve 4000-fold higher doses.[224] A 2024 reappraisal of CPS-II data similarly found negligible mortality risks from spousal ETS (hazard ratio near 1.0), attributing prior overestimations to unadjusted confounders rather than causation.[210] These debates emphasize the need for improved biomarkers and longitudinal designs to disentangle SHS from correlated lifestyle factors, with empirical evidence suggesting any causal effect, if present, is smaller than commonly portrayed in policy-driven summaries.[225]Comparisons to Other Environmental Exposures
Secondhand smoke exposure elevates the relative risk of lung cancer in never-smokers by approximately 20-30%, based on meta-analyses of spousal and workplace exposure studies.[211] [226] This corresponds to an estimated 7,300 attributable lung cancer deaths annually among U.S. nonsmokers.[227] In comparison, residential radon exposure, the second leading cause of lung cancer overall, is estimated to cause around 21,000 U.S. lung cancer deaths per year, with synergistic effects amplifying risks in smokers but still significant for never-smokers (approximately 2,100-2,900 attributable cases).[228] [229] Radon's excess relative risk is about 15% per 100 Bq/m³ increment for never-smokers, yielding population-level risks comparable to or exceeding those from secondhand smoke at typical indoor concentrations (around 40 Bq/m³ average).[230] Ambient fine particulate matter (PM2.5) from air pollution presents another environmental exposure with lung cancer associations in never-smokers, with meta-estimated relative risks of about 1.10 per unspecified increment in exposure, though long-term average exposures of 10-20 μg/m³ correlate with risks in the 10-40% range across cohorts.[231] [232] Globally, PM2.5 contributes to over 200,000 lung cancer deaths yearly, positioning it as the second leading cause after active smoking, with effects synergistic to tobacco use but independently causal at environmental levels.[232] [233] Diesel exhaust particles, a key PM2.5 component, carry Group 1 carcinogen status from the International Agency for Research on Cancer, yet their relative risks for lung cancer in non-occupational settings mirror secondhand smoke's modest elevations (around 20-40% for high-exposure nonsmokers).[234] Other indoor pollutants, such as those from biomass fuel combustion in poorly ventilated spaces, impose higher acute respiratory burdens in developing regions, with odds ratios for chronic obstructive pulmonary disease and lung cancer exceeding 2.0 in exposed never-smokers—substantially larger than secondhand smoke's effects.[235] Asbestos fibers from environmental sources (e.g., natural deposits or deteriorating building materials) confer low-level risks in the general population, with relative risks below 1.1 for non-occupational exposure, far lower than occupational levels but still contributory to mesothelioma cases.[236] Epidemiological challenges persist across these exposures: small relative risks (typically 1.1-1.3) invite confounding by unmeasured factors like diet, genetics, or residual active smoking, and publication biases in academia—often aligned with regulatory agendas—may inflate secondhand smoke estimates relative to radon or PM2.5, where mechanistic evidence (e.g., alpha particle damage from radon) bolsters causal claims independently of epidemiology.[237][238]| Exposure | Approximate RR for Lung Cancer in Never-Smokers | Key Source of Data |
|---|---|---|
| Secondhand Smoke | 1.20-1.30 | Meta-analyses of cohort studies[211] |
| Radon (per 100 Bq/m³) | 1.15 | Pooled residential exposure data[230] |
| PM2.5 (incremental) | ~1.10 | Global meta-estimates[231] |
| Diesel Exhaust (environmental) | 1.20-1.40 | Occupational/non-occupational cohorts[234] |
Consumption Patterns and Epidemiology
Global Prevalence and Demographic Trends
As of 2024, an estimated 20% of adults aged 15 years and older—approximately 1.25 billion people—used tobacco products worldwide, with cigarettes comprising the predominant form among smokers.[12] [240] This represents a decline from about 33% in 2000, driven by public health interventions, though absolute user numbers remain elevated due to population growth.[241] Regional variations are stark, with the WHO European Region exhibiting the highest prevalence at 24.1% in 2024, surpassing Southeast Asia, where rates have historically been elevated but are now lower on average.[12] In contrast, the Americas and Western Pacific regions report lower averages, around 15-17%, reflecting stronger implementation of tobacco control measures in higher-income settings.[242] Demographic disparities underscore gender imbalances, with males accounting for roughly 80% of global smokers; in 2019, approximately 940 million adult males and 193 million females were current cigarette smokers.[11] This gap persists across regions, particularly in South and Southeast Asia, where male prevalence often exceeds 40% while female rates remain below 5%, influenced by cultural norms restricting women's tobacco use.[243] [9] Age patterns show initiation typically occurring in adolescence or early adulthood, with peak prevalence in the 25-44 age group globally, though daily smoking rates decline after age 55 due to cessation, mortality, or health interventions.[244] [245] In low- and middle-income countries, which host over 80% of users, prevalence correlates inversely with socioeconomic status, higher among lower-income and less-educated populations.[9]| Demographic Factor | Key Trends (Global, Recent Data) |
|---|---|
| Gender | Males: ~36% prevalence; Females: ~8%; Male-to-female ratio ~5:1 in many developing regions.[9] [11] |
| Age | Highest in 25-44 years (~25-30%); Lowest in 65+ (~10-15%) and youth 15-24 (~15%, but rising initiation risks).[244] [245] |
| Region (WHO) | Europe: 24.1%; Southeast Asia: ~20-25% (male-dominated); Africa: ~10-15% (growing in urban youth).[12] [242] |
| Income Level | Low/middle-income: 25%+; High-income: <15%, with faster declines via policy enforcement.[9] |
Recent Declines and Shifts (2000-2025)
Global prevalence of cigarette smoking among adults aged 15 years and older declined from 27% in 2000 to an estimated 16% in 2022, with projections indicating further reduction to around 15% by 2025.[242] This equates to a drop in the absolute number of tobacco users from 1.38 billion in 2000 to 1.2 billion in 2024, driven primarily by reduced cigarette consumption in high- and middle-income countries. Global cigarette stick sales volume decreased by 11.6% between 2008 and 2022, with steeper declines in the Americas (40.6%) and Europe (35.4%), though consumption in low-income regions like parts of Africa and Southeast Asia has plateaued or grown more slowly due to population increases offsetting per capita reductions.[246] In the United States, adult cigarette smoking prevalence fell from 23.3% in 2000 to 11.6% in 2022, representing a 50% relative decline and affecting approximately 28.8 million current smokers in the latter year.[247] Among young adults aged 18-24, the odds of current smoking decreased by one-third between 2000 and 2010, with continued reductions through 2019 amid heightened anti-smoking campaigns and regulations.[248] Similar trends appear in Europe and other high-income areas, where prevalence among men dropped 27.2% and among women 37.9% since 1990, accelerating post-2000 due to indoor bans, taxation, and cessation programs.[59] A key shift has been the rise of alternative nicotine products, particularly electronic nicotine delivery systems (ENDS or e-cigarettes), which gained prominence after 2010. U.S. exclusive cigarette smoking decreased by 6.8 million adults between 2017 and 2023, while e-cigarette use rose, with current adult ENDS prevalence reaching 6.0% by recent estimates—partially offsetting overall tobacco decline but substituting for combustible cigarettes in many cases.[249] Heated tobacco products and smokeless options have also captured market share in regions like Japan and parts of Europe, contributing to cigarette volume erosion despite stable or growing overall nicotine consumption.[12] These transitions reflect causal factors including perceived harm reduction, flavor appeal to youth, and industry pivots, though long-term health impacts remain under empirical scrutiny.[250]Factors Influencing Usage Rates
Socioeconomic status strongly correlates with cigarette usage rates, with lower income, education, and occupational prestige consistently linked to higher prevalence across demographics. In the United States, low socioeconomic status was associated with elevated smoking rates among adults, irrespective of age, race/ethnicity, or region, as evidenced by analyses of national health surveys. Globally, tobacco use prevalence is disproportionately higher among those with lower education levels, manual occupations, and reduced household wealth, particularly in low- and middle-income countries where men in rural areas exhibit the highest rates. These patterns persist into recent years, with financial strain mediating the relationship between low socioeconomic position and both initiation and intensity of smoking.[251][252][253][254] Price sensitivity, driven primarily by excise taxes, exerts a causal downward pressure on consumption volumes. Empirical estimates indicate that a 10% increase in cigarette prices reduces overall usage by 3% to 5%, with youth consumption declining by about 7% due to heightened elasticity among younger smokers. Regulations such as public smoking bans further suppress demand by increasing perceived inconvenience and social costs, complementing tax effects in econometric models of consumption behavior. Advertising restrictions have contributed to reduced initiation, though direct impacts on aggregate consumption remain debated, with U.S. industry expenditures shifting from traditional ads (down to under 3% of marketing by 2019) toward promotions that partially offset price hikes.[255][256][257][258] Social and environmental influences, including family and peer networks, predict initiation and persistence, often overriding individual risk perceptions in adolescence. Youth with smoking parents or friends face elevated odds of experimental and regular use, as behavioral modeling and social support normalize tobacco exposure. Demographic trends show higher male prevalence, with uptake concentrated before age 25; those not smoking regularly by then rarely start later. Recent global declines from 1.38 billion users in 2000 to 1.2 billion in 2024 reflect strengthened anti-smoking campaigns and norms, though vulnerabilities persist in lower socioeconomic groups amid the COVID-19 era. In the U.S., adult smoking fell 17% from 2018 to 2022, driven by cohort effects where those over age 27 in 2020 exhibited lower probabilities of use compared to prior generations.[259][260][261][12][58][262]Economic Dimensions
Tobacco Industry Structure and Global Trade
The tobacco industry exhibits an oligopolistic structure, dominated by a handful of multinational corporations and state-owned enterprises that control the majority of global production, processing, and distribution of tobacco products, particularly cigarettes. The five leading entities—China National Tobacco Corporation (CNTC), Philip Morris International (PMI), British American Tobacco (BAT), Japan Tobacco International (JTI), and Imperial Brands—account for the bulk of worldwide output and sales, with cigarettes comprising approximately 82% of the market segment in 2024.[263][264] CNTC, as China's state monopoly, produces over 40% of global cigarettes but primarily serves domestic consumption, limiting its export role while exerting influence through international joint ventures.[265] In contrast, PMI, BAT, and JTI operate as vertically integrated multinationals, managing cultivation, manufacturing, and marketing across multiple countries, often adapting to local regulations and consumer preferences to maintain market shares exceeding 15-20% each in key regions outside China.[266] State monopolies persist in select nations, such as China and historically in others like Japan before partial privatization, enabling governments to capture revenues while insulating operations from full competitive pressures; however, liberalization in countries like Indonesia and Vietnam has invited foreign investment, fostering hybrid models where multinationals partner with local entities.[265][267] This concentration facilitates economies of scale in leaf sourcing from major growers—Brazil, India, and the United States—and in manufacturing, where facilities in low-cost regions process flue-cured and burley varieties for export-oriented brands. Illicit trade, estimated at 10-15% of global volume, undermines formal structures by bypassing taxes and regulations, though multinationals invest in anti-counterfeiting technologies amid ongoing disputes with regulators over complicity allegations.[266] Global tobacco production reached approximately 6.4 million metric tons in 2023, with projections for a decline to 6.3 million tons by 2028 due to shrinking arable land and regulatory constraints on farming.[268] Trade in tobacco products, valued at $52.09 billion in exports for 2024—a decrease from $54.99 billion in 2023—primarily involves unmanufactured leaf and finished cigarettes, with cigarettes as the leading exported category growing at a 3% compound annual rate prior to recent softening.[269][270] Major exporters include Brazil and the United States for raw leaf, shipping millions of kilograms annually to processors in Europe and Asia, while finished goods flow from multinationals' hubs in Switzerland (PMI) and the UK (BAT) to high-consumption markets in Asia and Africa.[271] Import dependence in consumer nations like Russia and the European Union sustains this flow, though escalating tariffs and WHO Framework Convention adherence have curbed volumes in developed economies, redirecting trade toward emerging markets where demand sustains industry revenues.[272] The overall market, encompassing production to retail, was estimated at $886.09 billion in 2023, underscoring trade's role in balancing surplus production against localized consumption patterns.[273]Employment, Revenue, and Fiscal Contributions
The tobacco industry supports employment across agriculture, manufacturing, distribution, and retail, with the majority of jobs concentrated in tobacco farming in developing countries such as China, India, and Brazil, where leaf production drives rural economies. Globally, precise employment figures are challenging to aggregate due to informal labor and varying definitions, but manufacturing remains a smaller segment; in the United States, cigarette and tobacco manufacturing employed 11,101 workers in 2024, reflecting a decline amid automation and regulatory pressures.[274] These roles often provide livelihoods in regions with limited alternatives, though critics from public health organizations contend that economic diversification could yield more sustainable job growth without health externalities.[15] Industry revenue derives primarily from cigarette sales, which dominate the combustible segment. The global tobacco market reached USD 886.09 billion in 2023, projected to grow to USD 905.57 billion in 2024, driven by persistent demand in emerging markets despite declines in high-income countries.[273] Leading firms like Philip Morris International generated USD 35.7 billion in net sales in 2023, with British American Tobacco deriving 80% of its revenue from combustibles in 2024.[275][276] Revenue streams benefit from pricing power, though offset by illicit trade and shifting consumer preferences toward alternatives like e-cigarettes. Fiscal contributions from tobacco primarily stem from excise taxes, which governments leverage for revenue while aiming to curb consumption. Worldwide, annual tobacco tax collections approach USD 1 trillion, supporting public budgets in both developed and developing nations.[277] In Germany, excise revenue from 66.2 billion taxed cigarettes rose 3.5% in 2024 compared to the prior year.[278] United States states collected taxes averaging USD 1.93 per pack in 2024, varying from USD 5.35 in New York to lower rates elsewhere, funding programs beyond health initiatives.[15] These inflows represent a direct fiscal benefit, though empirical assessments of net economic impact, accounting for enforcement costs and smuggling, vary by jurisdiction and source perspective.[277]Taxation Policies and Their Incentives
Cigarette taxation primarily consists of excise duties imposed by governments to generate revenue and discourage consumption through elevated prices, functioning as a "sin tax" that internalizes perceived externalities of smoking. In the United States, federal excise taxes on cigarettes were first enacted in 1862 for wartime revenue, with the current rate set at $1.01 per pack of 20 since April 1, 2009, while state taxes vary significantly, ranging from $0.17 in Missouri to $5.35 in New York as of 2025.[279] [280] In the European Union, minimum excise requirements mandate at least €1.80 ($2.12) per pack plus 60% of the retail price, with countries like the United Kingdom imposing effective rates exceeding €12 per pack through combined specific and ad valorem components.[281] Globally, the World Health Organization advocates for taxes comprising at least 70% of retail price to maximize health impacts, though implementation differs, with high-tax nations like Australia achieving packs costing over AUD 40 ($26 USD) via annual indexation.[282] These policies create incentives aligned with public health objectives by leveraging the downward-sloping demand curve for cigarettes, where empirical studies demonstrate that price increases reduce smoking prevalence, particularly among youth and low-income groups. A meta-analysis of demand elasticities estimates an average price elasticity of -0.5, indicating a 10% price hike correlates with a 5% drop in consumption, with youth elasticities up to three times higher at -1.0 to -1.5, prompting greater sensitivity to affordability.[283] [284] Longitudinal U.S. data from 2001-2015 link state tax hikes to prevalence declines, with a $1 increase associated with an 8% reduction in adult participation when imposed during adolescence.[285] [286] For governments, incentives include substantial fiscal returns—U.S. federal tobacco excises yielded $14 billion in fiscal year 2014 before declining to $9 billion by 2024 due to falling consumption—often earmarked for health programs, though revenue peaks follow the Laffer curve dynamics where excessive rates diminish net gains.[279] However, high taxes incentivize evasion through smuggling and illicit trade, undermining revenue and health goals by sustaining cheap, unregulated supply. In the U.S., interstate smuggling cost states $4.7 billion in 2022, with high-tax jurisdictions like New York experiencing net inflows of contraband equivalent to 57% of legal sales, while low-tax states like Virginia supply outflows.[287] Cross-border dynamics amplify this in Europe, where tax differentials exceeding 500% between nations foster organized crime, with illicit cigarettes comprising up to 11% of the EU market and evading health warnings or quality controls.[288] Empirical evidence confirms tax gradients predict smuggling rates, though overall consumption still falls as evaders often quit or switch products rather than fully substitute illicit for legal use.[289] [290] This tension highlights causal trade-offs: while taxes causally reduce initiation and prevalence via price signals—supported by difference-in-differences analyses of tax hikes—excessive differentials erode fiscal incentives and may exacerbate criminal economies without proportional health gains.[291]Cultural and Social Roles
Historical Significance in Rituals and Society
Tobacco, the primary component of cigarettes, originated in the Americas where indigenous peoples cultivated it as early as 6000 BC and integrated it into spiritual practices.[26] Native American tribes viewed tobacco as a sacred plant used in ceremonies to communicate with spiritual entities, offer prayers, and facilitate healing rituals, often smoked in pipes or burned as incense.[292] [293] In Woodland Indian traditions, tobacco served as a unifying element in religious observances, symbolizing the connection between humans and higher powers.[293] Among Mesoamerican civilizations, such as the Maya and Aztecs, tobacco held profound ritual importance dating back over a millennium. Mayan priests smoked tobacco during ceremonies to invoke deities, with archaeological evidence from residues in vessels confirming its use as early as 700 AD, including infusions for sacrificial and healing rites.[294] [295] In Aztec feasts, tobacco was distributed via formalized rituals using elongated tubes, underscoring its role in social and religious gatherings.[296] These practices positioned tobacco not as a casual indulgence but as a medium for purification, divination, and offerings to the underworld or gods.[297] Following Christopher Columbus's encounter with tobacco in Cuba in 1492, its introduction to Europe transformed it from a ritual staple to a burgeoning social custom.[298] Initially perceived as a medicinal herb, tobacco smoking spread through trade and exploration, evolving into pipes and cigars before the cigarette's emergence in the 19th century as a convenient, mass-produced form. In European society, smoking became embedded in daily interactions, military traditions, and leisure by the Victorian era, with cigarettes gaining prominence around 1870 for their portability and ritualistic appeal in social settings like post-meal indulgences or communal gatherings.[299] This shift reflected tobacco's adaptation from indigenous shamanism to a secular emblem of sophistication and camaraderie, influencing global cultural norms until health concerns prompted reevaluation.[300]Portrayals in Media, Literature, and Advertising
Cigarette advertising in the early 20th century often emphasized health benefits and social sophistication, with campaigns claiming brands like Camel were preferred by doctors, as in a 1940s slogan stating "More doctors smoke Camels than any other cigarette" based on informal surveys of physicians.[301] Tobacco companies targeted women through themes of emancipation, such as the 1929 Lucky Strike "Torches of Freedom" campaign associating smoking with independence during women's suffrage movements.[302] By the mid-20th century, ads portrayed smoking as a marker of adulthood and pleasure, featuring attractive models in suits or outdoor settings to appeal to youth emulation.[303] Advertising expenditures peaked at $4.6 billion in 1991, equivalent to over $12 million daily, before broadcast bans took effect in the U.S. on January 2, 1971, following legislation signed by President Richard Nixon in April 1970.[303][304] In film and television, cigarettes have been depicted as symbols of rebellion, maturity, and edginess, with on-screen smoking influencing adolescent initiation rates according to longitudinal studies tracking exposure to over 4,000 films.[305] Popular movies from the 1930s to 1960s glamorized smoking among protagonists, rarely showing health consequences, a pattern persisting in modern entertainment where tobacco imagery rose 82% in top-grossing films from 2019 to 2023.[306][307] Historical dramas often include smoking props without depicting harms like cancer, contributing to normalized perceptions despite post-1964 Surgeon General reports.[306] Research from the National Cancer Institute indicates that 90% of smokers begin as teens, with media portrayals correlating to increased trial rates independent of marketing receptivity.[308][309] Literature frequently employs cigarettes as motifs for introspection, vice, or social ritual, evident in Arthur Conan Doyle's Sherlock Holmes stories where pipe tobacco aids deduction, though cigarettes appear in later adaptations.[310] In Erich Maria Remarque's All Quiet on the Western Front (1929), cigarettes serve as currency and comfort amid trench warfare, symbolizing fleeting relief.[310] Post-World War II novels, such as J.D. Salinger's The Catcher in the Rye (1951), use smoking to convey youthful angst and nonconformity, with Holden Caulfield's chain-smoking underscoring alienation. Authors like Oscar Wilde and F. Scott Fitzgerald integrated tobacco use to evoke bohemian lifestyles, mirroring their personal habits amid widespread cultural acceptance before mid-20th-century health revelations shifted symbolic weight toward addiction and decline.[311][312]Social Norms and Stigma Evolution
In the early 20th century, cigarette smoking transitioned from a niche habit to a broadly socially accepted practice, particularly in Western societies, where it was glamorized through advertising and media portrayals associating it with sophistication, independence, and vitality. By the mid-20th century, smoking prevalence peaked, with 42% of American adults smoking in 1964, reflecting norms that tolerated or encouraged the behavior in public spaces, workplaces, and social gatherings without significant disapproval. Tobacco companies actively shaped these norms by marketing cigarettes as essential accessories for modern life, targeting diverse demographics including women and youth through campaigns that normalized uptake across social classes.[37][313][314] The release of the U.S. Surgeon General's 1964 report marked a pivotal shift, conclusively linking cigarette smoking to lung cancer and other diseases, which began eroding public tolerance by disseminating empirical evidence of health risks and prompting initial skepticism toward prior pro-smoking norms. This report, estimating smokers faced a nine- to ten-fold increased risk of lung cancer compared to non-smokers, catalyzed a gradual change in attitudes, though smoking rates remained high initially as cultural inertia persisted. By the late 1960s and into the 1970s, emerging data on secondhand smoke hazards further fueled disapproval, leading to voluntary restrictions like television ad bans in 1971 and the formation of anti-smoking advocacy groups targeting social acceptability.[315][316][317] From the 1970s onward, anti-tobacco movements intensified stigma by emphasizing smoking's unpleasant aesthetics—such as odor, stained teeth, and burned clothing—alongside health imperatives, contributing to workplace and public bans that isolated smokers socially. By the 1980s and 1990s, mass media campaigns and litigation against the tobacco industry reinforced perceptions of smoking as irresponsible and deviant, correlating with a decline in U.S. adult smoking rates to around 18% by the 2010s. This stigmatization, while effective in reducing initiation and prevalence, has been critiqued for fostering self-stigma among persistent smokers, potentially complicating cessation efforts by heightening shame rather than providing supportive pathways.[318][319][320] In contemporary contexts, smoker stigma manifests as widespread public disapproval, with surveys indicating high perceived stigma levels—such as in Norway where it correlates with socio-demographic factors and personal values—and varies by group, often internalized more acutely among women and minorities. Globally, this evolution reflects a reversal from tobacco industry-driven normalization to policy and cultural pressures prioritizing health, though remnants of acceptance persist in certain regions or subcultures where economic ties to tobacco cultivation mitigate stigma. Empirical data links intensified stigma to lower youth uptake but highlights potential backlash, including social isolation that may deter quit attempts without adequate cessation resources.[321][322][323]Regulation and Policy Evolution
Early Government Promotion and Subsidies
In the early 20th century, the United States government promoted cigarette use among military personnel during World War I to enhance soldier morale, alleviate stress, and foster unit cohesion. In 1917, Congress allocated funds specifically to supply cigarettes as part of soldiers' rations, embedding tobacco consumption within federal wartime logistics and marking an explicit endorsement of smoking as a tool for maintaining combat effectiveness.[324] This initiative contributed to rapid increases in per capita cigarette consumption, rising from 54 packs annually in 1900 to higher levels by the war's end, as returning veterans normalized the habit in civilian society.[37] During World War II, such promotion intensified, with cigarettes included as a standard component of K-rations distributed to troops, justified by military officials for calming nerves, suppressing appetite, and promoting alertness amid combat demands. Over 90 percent of U.S. soldiers smoked by 1945, supported by government-facilitated shipments from tobacco companies, while President Franklin D. Roosevelt personally endorsed the practice, reinforcing its perceived benefits for discipline and psychological resilience.[325] [42] Similar encouragements occurred in other Allied nations, where governments viewed tobacco as essential for troop welfare, though Nazi Germany notably pursued anti-smoking policies in contrast.[46] Complementing military efforts, the U.S. government extended economic subsidies to tobacco production via the Agricultural Adjustment Act of 1933, classifying tobacco as a "basic commodity" eligible for price supports, production quotas, and supply management to counteract Depression-era market instability. These New Deal programs stabilized farming incomes and ensured a steady supply of leaf tobacco, the primary raw material for cigarettes, which dominated the industry's output by the mid-20th century.[326] [327] Federal tobacco excise taxes, which accounted for up to one-third of domestic revenue by 1883 and remained substantial thereafter, further incentivized government tolerance and indirect support for the sector until health concerns emerged post-1950s.[328]Shift to Restrictions and Health Warnings (1960s Onward)
In 1962, the Royal College of Physicians in the United Kingdom published the report Smoking and Health, which concluded that smoking causes lung cancer and contributes to other respiratory diseases, based on epidemiological evidence showing a strong association between cigarette consumption and mortality rates from these conditions.[329] This marked an early institutional acknowledgment of tobacco's health risks, prompting initial discussions on policy responses despite ongoing industry challenges to the causal interpretations.[330] The pivotal shift accelerated in the United States with the 1964 Surgeon General's Advisory Committee report, led by Luther Terry, which analyzed over 7,000 scientific studies and determined that cigarette smoking is causally related to lung cancer in men, with smokers facing a nine- to ten-fold increased risk compared to non-smokers, and heavy smokers at least a twenty-fold risk; the report also linked smoking to chronic bronchitis, emphysema, and cardiovascular disease.[315] Released on January 11, 1964, this document catalyzed public awareness and policy changes, coinciding with a peak adult smoking prevalence of 42 percent that year. In response, the U.S. Congress passed the Federal Cigarette Labeling and Advertising Act in 1965, mandating the warning "Caution: Cigarette Smoking May Be Hazardous to Your Health" on all cigarette packages and advertisements starting January 1, 1966, though it preempted stronger state-level actions and prohibited Federal Trade Commission regulation of advertising content.[331] Building on these developments, the Public Health Cigarette Smoking Act of 1969 banned cigarette advertising on television and radio effective January 2, 1971, following evidence that broadcast promotions had sustained high consumption levels amid emerging health data; this legislation also rotated four stronger warning labels on packs, such as "Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Health."[332] Internationally, similar measures followed: Canada introduced package warnings in 1972, while the United Kingdom banned television tobacco advertising in 1965 and required health warnings on packets by 1971, reflecting a broader Western policy pivot toward risk disclosure over promotion.[333] These early restrictions laid the groundwork for escalating controls, including indoor smoking prohibitions in public spaces starting in the 1970s and 1980s, as cohort studies reinforced dose-response relationships between smoking intensity and disease incidence.[334] By the 1980s, warnings evolved to include graphic imagery and specific disease risks in countries like Australia (1984 onward) and Canada (with pictorials by 2001), driven by meta-analyses confirming relative risks exceeding 20-fold for lung cancer among long-term smokers; however, U.S. labels remained text-only until partial updates in 1984, highlighting regulatory divergences amid industry lobbying that emphasized personal choice and disputed absolute causality in some subpopulations.[335] This era's policies correlated with declining per capita consumption—from 4,345 cigarettes annually per adult in the U.S. in 1963 to under 2,000 by 1990—though attribution involves confounding factors like rising taxes and anti-smoking campaigns.[48]Contemporary Bans, Age Limits, and Enforcement
In the early 21st century, comprehensive indoor smoking bans in workplaces, restaurants, bars, and public buildings became widespread globally, driven by concerns over secondhand smoke exposure. By 2025, 28 U.S. states and over 1,000 municipalities had enacted strong smoke-free laws covering non-hospitality workplaces, restaurants, and bars, though enforcement varies by jurisdiction. Internationally, countries like France extended bans outdoors to beaches, parks, forests, and sports facilities effective July 1, 2025, building on prior indoor restrictions from 2007-2008. Similar policies exist in nations such as Australia, Canada, and the UK, prohibiting smoking in enclosed public spaces, with partial outdoor extensions in some areas like bus stops. These measures have reduced smoking prevalence in covered venues but face circumvention through designated outdoor areas or private clubs.[336][337][338] Product-specific bans have intensified, targeting flavored tobacco to curb youth appeal. California prohibited sales of flavored tobacco products, including most menthol cigarettes, with full enforcement by December 31, 2025, following earlier restrictions; online sales of such products were banned effective January 1, 2025. As of April 2025, approximately 400 U.S. localities restricted flavored tobacco sales, though federal proposals to ban menthol cigarettes and flavored cigars were withdrawn in January 2025 amid legal and political challenges. In Europe, the EU Tobacco Products Directive limits certain flavors, but menthol cigarettes remain available pending further reviews. These restrictions have correlated with sales declines in affected areas, such as California, where cigarette and e-cigarette volumes dropped post-ban, yet illicit trade and non-compliant retailers persist.[339][340][341] Minimum purchase age limits for tobacco products have risen in many jurisdictions to deter youth initiation. In the United States, federal law since December 2019 mandates a minimum age of 21 (Tobacco 21), applying to all tobacco products including cigarettes, with states required to align or face enforcement. Europe largely maintains an 18-year threshold, but Latvia increased it to 20 effective January 1, 2025, while Ireland plans 21 by 2028; proposals for "smoke-free generations" in the UK and New Zealand aim to phase out sales for future cohorts by annually raising the age. Globally, ages range from 18 to 21, with some African nations at 19 or 21, though enforcement gaps allow underage access via proxies or online.[342][343][344] Enforcement relies on retailer compliance checks, fines, and licensing revocation, but faces persistent challenges including weak verification and youth circumvention. U.S. sting operations reveal ongoing underage sales despite Tobacco 21, with rates exceeding 10% in some audits, exacerbated by retailer proliferation and online loopholes. Globally, resource constraints limit inspections, fostering black markets; for instance, flavor bans prompt smuggling, as seen in California's post-restriction illicit activity. Penalties include fines up to $10,000 per violation in the U.S., yet studies indicate limited impact on overall youth smoking without broader cultural shifts, as self-reported use declines slower than biomarkers suggest in some analyses.[345][346][347]International Variations and WHO Influence
The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), adopted on May 21, 2003, and entering into force on February 27, 2005, serves as the first global public health treaty, ratified by 182 parties covering over 90% of the world's population. The FCTC promotes six key demand-reduction measures under the MPOWER strategy: monitoring tobacco use, protecting from secondhand smoke, offering cessation help, warning via packaging and media, enforcing advertising bans, and raising taxes. Its influence has driven national adoptions, with studies showing accelerated implementation of these policies post-ratification, including expanded smoke-free laws in 80% of parties and graphic health warnings in over 120 countries by 2018.[348] However, empirical assessments of its causal impact on smoking prevalence remain mixed; while global tobacco use prevalence fell from an estimated 29.3% in 2000 to 22.3% by 2020, one analysis found no statistically significant acceleration in the pre-existing downward trend in cigarette consumption after 2003.[349][350] National policies exhibit substantial variations, shaped by FCTC guidelines but adapted to economic, cultural, and political contexts, leading to divergent enforcement levels and outcomes. High-income countries like Australia implemented plain packaging in December 2012, requiring uniform drab packs with large graphic warnings covering 75% of surfaces, which correlated with a 0.9% quarterly drop in smoking prevalence post-introduction.[351] In contrast, Bhutan enacted a total sales ban on tobacco products in 2004, predating full FCTC alignment but reinforced by it, achieving near-elimination of commercial availability though smuggling persists.[352] Mexico's 2023 reforms imposed one of the world's strictest regimes, banning smoking in all enclosed public spaces, beaches, and parks, alongside prohibitions on free distribution and visibility restrictions in retail.[353] These measures reflect aggressive FCTC-inspired endgame strategies in low-prevalence nations (under 15%), where five countries—Bhutan, New Zealand, Singapore, Sri Lanka, and the UK—score highly on FCTC compliance indices.00085-8/fulltext) In developing regions, implementation lags due to tobacco industry lobbying and fiscal dependencies, resulting in more lenient approaches despite FCTC obligations. For instance, Indonesia, a non-party to the FCTC, maintains minimal restrictions, with advertising still permitted and smoking prevalence at 76.2% among adult males as of 2021, highlighting how non-adoption preserves higher consumption amid weak enforcement elsewhere. Japan, an FCTC party, diverges by promoting heated tobacco products like IQOS through tax incentives since 2017, achieving a shift where such alternatives captured 20% of the nicotine market by 2020, potentially undermining traditional cigarette declines but aligning with harm reduction not emphasized in core FCTC provisions.[354] Cross-nationally, 138 countries mandate graphic warnings on packs as of 2024, yet only 42 require plain packaging, illustrating uneven progress.[355]| Country/Region | Key Policies | Smoking Prevalence (Adults, ~2020) | FCTC Ratification |
|---|---|---|---|
| Australia | Plain packaging (2012), comprehensive bans | 11.6% | 2004 |
| Bhutan | Total sales ban (2004), public use restrictions | <1% | 2004 |
| Mexico | Nationwide bans including outdoors (2023) | 13.1% | 2004 |
| Indonesia | Limited advertising curbs, no plain packs | 34.5% (overall; 76% males) | Non-party |
| Japan | Heated tobacco promotion, indoor bans | 17.8% | 2004 |
Environmental Footprint
Agricultural Production Impacts
Tobacco cultivation, primarily of the Nicotiana tabacum plant, requires intensive land preparation and resource inputs, leading to significant environmental degradation in major producing regions such as China, India, Brazil, and parts of Africa. Global tobacco leaf production occupies approximately 5.3 million hectares of arable land annually, often displacing food crops and contributing to food insecurity in low-income areas.[358] This land-intensive practice exacerbates ecological strain, with farming activities accounting for a disproportionate share of environmental harm relative to the crop's economic output in many regions.[359] Deforestation is a primary impact, as farmers clear forests for new fields and fuelwood for curing leaves, with an estimated 200,000 hectares of forests and woodlands destroyed yearly worldwide.[360] In developing countries, tobacco-related deforestation represents up to 5% of total tree loss, including the felling of around 600 million trees annually to sustain production and processing.[361] This clearing not only releases stored carbon—contributing nearly 5% of global greenhouse gas emissions from agricultural deforestation and curing—but also fragments habitats, reducing biodiversity and ecosystem services like soil stabilization and water regulation.[362] Soil degradation further compounds these effects, as tobacco's high nutrient demands deplete essential minerals such as nitrogen, phosphorus, and potassium, often leaving fields unproductive after 2-3 seasons and necessitating crop rotation or abandonment.[363] Repeated cultivation increases soil acidity and erosion rates, with studies in regions like Bangladesh and Pakistan documenting micronutrient imbalances and structural breakdown due to monocropping practices.[364] Excessive tillage and harvest expose topsoil to wind and rain, accelerating loss estimated at 20-40 tons per hectare in sloped tobacco fields.[365] Intensive pesticide and fertilizer application amplifies contamination risks, with tobacco farming using up to 16 times more pesticides per hectare than staple crops like corn or wheat in some areas.[366] These agrochemicals, including organophosphates and herbicides, leach into groundwater and surface water, causing eutrophication and toxicity to aquatic life, while residues persist in soil, hindering future agricultural viability.[367] Water consumption is equally burdensome, depleting over 22 billion cubic meters globally each year for irrigation and processing, equivalent to the annual needs of 360 million people, and often polluting sources through runoff.[368]| Impact Category | Key Statistic | Primary Regions Affected |
|---|---|---|
| Deforestation | 200,000 ha/year cleared | Brazil, Malawi, Zimbabwe[360] |
| Soil Nutrient Depletion | Fields unproductive after 2-3 seasons | China, India, Bangladesh[363] |
| Pesticide Use | 16x higher than staples per ha | Global, esp. developing countries[366] |
| Water Depletion | 22 billion m³/year | Major producers worldwide[368] |