Smoking and Tobacco

Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Nearly 40 million US adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one tobacco product, including e-cigarettes. Every day, more than 3,800 youth younger than 18 years smoke their first cigarette. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. Another 16 million live with a serious illness caused by smoking. Each year, the United States spends nearly $170 billion on medical care to treat smoking-related disease in adults.

Smoking leads to disease and disability and harms nearly every organ of the body. More than 16 million Americans are living with a disease caused by smoking. For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

Secondhand smoke exposure contributes to approximately 41,000 deaths among nonsmoking adults and 400 deaths in infants each year. Secondhand smoke causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.

How does tobacco affect the brain?

The nicotine in any tobacco product readily absorbs into the blood when a person uses it. Upon entering the blood, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with drugs such as cocaine and heroin, nicotine activates the brain’s reward circuits and also increases levels of the chemical messenger dopamine, which reinforces rewarding behaviors. Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain.

Can a person overdose on nicotine?

Nicotine is poisonous and, though uncommon, overdose is possible. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. Nicotine poisoning usually occurs in young children who accidentally chew on nicotine gum or patches used to quit smoking or swallow e-cigarette liquid. Symptoms include difficulty breathing, vomiting, fainting, headache, weakness, and increased or decreased heart rate. Anyone concerned that a child or adult might be experiencing a nicotine overdose should seek immediate medical help.

For more information about how to quit smoking, visit smokefree.gov.