Nicotine is the principal constituent of tobacco responsible for its addictive character, but other smoke constituents and behavioral associations contribute to the strength of the addiction. Addicted smokers regulate their nicotine intake by adjusting the frequency and intensity of their tobacco use both to obtain the desired psychoactive effects and avoid withdrawal.
The major diseases caused by cigarette smoking are heart diseases, cerebrovascular disease, Cancer mainly of lungs, larynx and oral cavity. In case of pregnant female; Sudden infant death syndrome, infant respiratory distress syndrome, Low birth weight at delivery may occur.
Cigarette smokers are more likely than nonsmokers to develop both large-vessel atherosclerosis and small-vessel disease. Cigarette smoking also increases the likelihood of myocardial infarction and sudden cardiac death by promoting platelet aggregation and vascular occlusion.
Tobacco smoking causes cancer of the lung, oral cavity, pharynx, nasal cavity and para nasal sinuses, larynx, esophagus, stomach, pancreas, liver, colon and rectum, kidney, ureter and also causes myeloid leukemia.The risks of cancer increase with the increasing number of cigarettes smoked per day and with increasing duration of smoking.
Cigarette smoking is responsible for 90% of chronic obstructive pulmonary disease, a lung disease.
Cigarette smoking is very harmful during pregnancy. Premature rupture of membranes, abruptio placentae, and placenta previa; there is also a small increase in the risk of spontaneous abortion among smokers. Infants of smoking mothers are more likely to experience preterm delivery, have a higher perinatal mortality rate, be small for their gestational age, and have higher rates of infant respiratory distress syndrome; they are more likely to die of sudden infant death syndrome and appear to have a developmental lag for at least the first several years of life.
Smoking also delays healing of peptic ulcers; increases the risk of developing diabetes, active tuberculosis, rheumatoid arthritis, osteoporosis, senile cataracts, and results in premature menopause, wrinkling of the skin, gallstones and cholecystitis in women, and male impotence.
Approximately 85% of individuals who become cigarette smokers initiate the behavior during adolescence. Factors that promote adolescent initiation are parental or older-sibling cigarette smoking, tobacco advertising and promotional activity, the availability of cigarettes, and the social acceptability of smoking. The need for an enhanced self image and to imitate adult behavior is greatest for those adolescents who have the least external validation of their self-worth, which may explain in part the enormous differences in adolescent smoking prevalence by socioeconomic and school performance strata. Prevention of smoking initiation must begin early, preferably in the elementary school years. Physicians should ask all adolescents whether they have experimented with tobacco or currently use tobacco.
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