Smoking refers to the inhalation and exhalation of fumes from burning tobacco in cigars, cigarettes and pipes. Historically, smoking as a practice, was followed by natives of the Western Hemisphere, in various religious rituals and for medicinal purposes also. The history starts from the late 1500s. Later it was introduced tobacco in Europe, in-spite of the opposition from the then rulers. But the novelty and thrill factor won over many a new user. Towards the end of the 19th century cigarettes were higher in demand than the cigars and pipes, which had been popular amongst smokers until then. Today smoking has been converted into a major health problem. About half a million deaths occur per year in United States due to cancer and breathing problem.

What is Smoking?

Smoking refers to the inhalation and exhalation of fumes from burning tobacco in cigars, cigarettes and pipes.

Historically, smoking as a practice, was followed by natives of the Western Hemisphere, in various religious rituals and for medicinal purposes also. The history starts from the late 1500s.

Later it was introduced tobacco in Europe, in-spite of the opposition from the then rulers. But the novelty and thrill factor won over many a new user. Towards the end of the 19^th century cigarettes were higher in demand than the cigars and pipes, which had been popular amongst smokers until then.

Today smoking has been converted into a major health problem. About half a million deaths occur per year in United States due to cancer and breathing problem.

What’s in a cigarette?

Tobacco is the main ingredient of cigarettes. A manufactured cigarette is made up of two main types.

• Cured types  flue cured, light and dark air cured, sun cured
• Reconstituted (stems, ribs etc) and expanded tobacco

 Both of these lead to cheaper cigarettes by using less tobacco.

Additives present in a cigarette:

Cigarette manufacturers have several manipulations done to decide what should go into cigarettes by changing the additives time to time:

• Flavor
• Humectants
• Carbon monoxide
• Tar                                        
• Nicotine etc.                                 
  

WHAT HAPPENS WHEN YOU SMOKE?

When a smoker inhales, the nicotine contained in the inhaled smoke reaches the brain via the bloodstream in a matter of seconds. It also quickly reaches muscle tissue and a range of physical reactions take place, including the following:

• An increase in the heart rate (measured by your pulse rate).
• An increase in blood pressure, causing small blood vessels to narrow, and slowing of circulation, which is particularly noticeable in the hands and feet.
• An increase in tension in some muscles which can be measured by testing hand tremors with a tremor-testing machine before and after a cigarette.
• An increase in stomach secretions and changes brain activity.
• Smokers of all ages become short of breath and exhausted more quickly than non-smokers of similar age and fitness.
• CO binds with the hemoglobin in the blood so instead of oxygen hemoglobin circulates CO, meaning that less oxygen is available to body organs and tissue. The heart has to pump harder to make sure that enough oxygen can get to all organs.
• Tar causes throat and lung cancer
• Smoking affects those associated with smokers too
• Smoking affects many parts of the body, both inside and outside. Some of the effects happen straight away and others take longer to occur:

Immediate or short term impact:

• Smelly hair
• Less oxygen to the brain
• Stained fingers
• Less oxygen to lungs
• This causes shortness of breath, reduces fitness and can also cause an asthma attack in asthmatics.
• Increased heart rate and blood pressure
• Yucky skin, smelly breath and stained teeth
• More coughs and colds

Medium and long term impacts:

• Heart disease, heart attack
• Skin becomes dry, discolored and wrinkled
• Emphysema
• Stroke
• Blindness
• Gum disease, leading to tooth loss
• Mouth and throat cancer
• Stomach ulcers
• Bladder cancer
• Infertility, impotence
• Poorer muscle tone
  

Stop Smoking Treatments:

There are many different methods that have successfully helped people to quit smoking, including:

• Systematically decreasing the number of cigarettes you smoke.
• Reducing your intake of nicotine gradually over time.
• Using nicotine replacement therapy or non-nicotine medications
• Utilizing nicotine support groups.
• Trying hypnosis, acupuncture, or counseling using cognitive behavioral techniques.

Nicotine replacement therapy (NRT):

Nicotine is very highly addictive drug and it’s the nicotine in the cigarettes that makes it so addictive. Nicotine replacement therapy works by releasing the nicotine into the blood very steadily and at much slower rate.

NRT comes in different forms, including:

• Skin patches
• Chewing gum (Nicotine gum is a type of chewing gum that delivers nicotine to the body. It is used as an aid in NRT. Gum should not be used less than 15 minutes after eating or drinking, as this will reduce absorption. Users are directed to chew the gum until it softens and produces a tingling sensation or "peppery" taste. The gum is then "parked," or tucked, in between the cheek and gums. When the tingling ends the gum is chewed again until it returns, and is then re-parked in a new location)
• Inhalators, which look like plastic cigarettes through which nicotine is inhaled
• Tablets and lozenges, which you put under your tongue
• Nasal spray
• Mouth spray Some smokers find it useful to combine NRT products. For example, smokers can do this by wearing the patches through the day and then use a gum or an inhalator to help relieve a sudden craving for a cigarette. Most courses of NRT last eight to 12 weeks before you gradually reduce the dose and eventually stop. Most people stop using NRT altogether within three months, although heavy smokers may need to use it for longer.

Side effects:

• Skin irritation when using patches
• Nicotine is not good for pregnant women and her  baby
• Irritation of nose, throat or eyes when using a nasal spray
• Disturbed sleep, sometimes with vivid dreams
• Upset stomach
• Dizziness

Non-nicotine medication:

Varenicline

Varenicline is the only medication available currently specially designed to help you quit smoking. It works by preventing nicotine from binding to receptors (parts of your brain that respond to nicotine), which prevents cravings and reduces the reinforcing effects of smoking.

One should try to quit smoking completely 7-14 days ahead of the start of the treatment. The medicine should be taken for 12 weeks as recommended.

Varenicline should not be used by:

• Children and young people under 18
• Women who are pregnant or breastfeeding
• People with epilepsy
• People with advanced kidney disease

Side effects:

• Nausea and vomiting
• Headaches
• Insomnia
• Unusual dreams
• Increased appetite
• constipation or diarrhea
• Swollen stomach
• Slow digestion
• flatulence 
• Drowsiness