Smoking

Smoking in Russia

Main article: Smoking and cigarette market in Russia

Cigarettes (Global Market)

Main article: Cigarettes (global market)

Cigarettes (US market)

Main article: Cigarettes (US market)

Smoking in the world

2023

WHO: The proportion of people smoking in the world in 14 years decreased from 22.8% to 17%

The share of people smoking in the world decreased from 22.8% in 2007 to 17% in 2021. Each year, about 1.3 million people die from exposure to second-hand smoke. All these deaths can be prevented. Passive inhalation of second-hand tobacco smoke creates a risk of death from cardiovascular, respiratory, cancer, stroke, and type 2 diabetes. Such data are provided in a report by the World Health Organization (WHO), published on July 31, 2023.

By the end of 2022, approximately 5.6 billion people, or 71% of the world's population, are covered by at least one strategic measure aimed at protecting people from the harmful effects of tobacco. This is five times more than the figure recorded in 2007.

The report was prepared with the support of the Bloomberg Charitable Foundation. Since 2007, the world has been implementing the MPOWER package of WHO tobacco control measures. Such measures include: monitoring tobacco consumption and its prevention policy; protecting people from tobacco smoke; ensuring that help is available to stop tobacco use; placing warnings about tobacco hazards; control over compliance with advertising bans, promotion of sales and sponsorship of tobacco products; raising taxes on such products.

It is said that almost 40% of countries have introduced a complete ban on smoking in closed public premises. However, in 44 countries, the population is still not protected by any of the MPOWER measures, and in 53 countries a complete ban on smoking in medical institutions is still not introduced. In addition, only half of countries ban smoking in workplaces in the private sector and in restaurants.

WHO urges all countries to fully implement MPOWER measures at the best practice level in order to contain the tobacco epidemic, which kills 8.7 million people worldwide, "said Dr. Rudiger Kreh, Director of the WHO Department for Health Promotion.[1]

France's anti-tobacco strategy fails

In early July 2023, it became known that the strategy of anti-tobacco bans in France was ineffective. This was stated by the French oncologist, professor at the University of Pierre and Marie Curie David Khayat. Read more here.

2022

WHO: One in five adults on the planet use tobacco

In 2022, every fifth adult resident of the planet, or about 1.25 billion people, used tobacco, while in 2000 its consumers were 1.36 billion people. Such data were released by the World Health Organization (WHO) in mid-January 2024.

The good news is that 1.25 billion people are still smoking, this is the latest data... But it also means there are now 19 million fewer smokers than two years ago. For the first time, we see such a decrease, and this is despite the continuing growth of the world population, which has increased by 149 million people, "said Dr. Rudiger Kreh, Director of the WHO Department for Health Promotion.

According to a WHO study, the highest proportion of the population using tobacco in 2022 was recorded in the Southeast Asia region - 26.5%. Next comes the European region - 25.3%. By the end of 2022, the prevalence of tobacco use had decreased in 150 countries.

It is noted that the level of tobacco consumption among women in the European Region is more than twice the global average and decreases much more slowly than in all other regions.

According to experts, by 2025, tobacco use in the world as a whole will decrease by 25% compared to 2010. Only 56 countries around the world will achieve a 30% reduction. Six countries still saw an increase in tobacco use in 2022 - Egypt, Indonesia, Jordan, Congo, Moldova and Oman.

The tobacco industry, aiming for profit, "sacrifices countless lives, manipulates health policy and sells dangerous products," Rudiger Krech said. In this regard, the World Health Organization calls on countries to continue to resist tobacco and the influence of the tobacco industry, he added.^[2]

New Zealand banned for life from selling cigarettes to people born after 2008

On December 13, 2022, it became known that New Zealand passed a strict law aimed at preventing smoking among minors: in particular, a lifetime ban is introduced on the sale of tobacco products to everyone who was born after 2008.

New Zealand continues to tighten anti-tobacco laws as part of the government's push to make the country "smoke free" by 2025. Already, the state has one of the lowest rates of smoking among adults out of all 38 countries of the Organization for Economic Cooperation and Development (OECD). The number of adult New Zealanders smoking has halved over the past decade to 8%, with approximately 56,000 people quitting in 2021. By comparison, OECD data suggests that 25% of adults in France smoked in 2021 .

Under the new regulations, the sale of tobacco to anyone born on or after January 1, 2009 is prohibited. For violation, a fine of up to 150,000 New Zealand dollars (about $95,910) is provided. Moreover, the ban will be valid throughout a person's life. In addition, by the end of 2023, the number of retail outlets licensed to sell tobacco will decrease by 90% - from 6,000 to 600.

Thousands of people will live longer and healthier lives, and the health care system will receive $5 billion more money due to the lack of need to treat diseases caused by smoking, such as various types of cancer, heart attacks, strokes and amputations, said Ayesha Verrall, Deputy Minister of Health of New Zealand.

However, opponents of the law, in particular, the ACT New Zealand party (10 out of 120 seats in parliament), say that such strict restrictive measures will destroy small stores in the country and provoke the development of the black market.^[3]

2020: UK company gives 4 extra days off to non-smoking staff

The head of one of the British recruitment companies decided to encourage his non-smoking subordinates with an additional four-day vacation, writes in January 2020 BBC. At the same time, it does not prohibit smoking employees from breaking away from work at the smacking^[4].

Managing director of KCJ Training and Employment Solutions in Swindon, Don Brayden, himself was once a smoker. Now he wants to motivate him to give up cigarettes and his employees - for this he uses a mild method of incentives, not sanctions.

"If you say you're going to do three 10-minute smoke breaks a day, that's equal to the 16.5 working days a year you'll spend smoking. If you cut back and have one 10-minute smoke break, it would equal 5 working days a year.'

Brayden made the decision to award non-smoking employees four days of extra leave. At the same time, smoking workers can continue to take breaks for cigarettes. Everyone agreed with this decision of the head.

2019

The number of smokers in the world has reached 1.1 billion people

At the end of May 2021, a study was published in the Lancet journal, according to which in 20 years the number of smokers increased by 150 million and in 2019 reached a record level of 1.1 billion people. At the same time, in 2019 alone, smoking caused the death of 8 million people.

The authors of the study said that government agencies should take measures to combat smoking among young people, since 89% of new smokers develop addiction by the age of 25, and people over this age rarely start smoking.

In 2019, about 8 million people around the world died due to smoking

Although the prevalence of smoking has declined worldwide over the past three decades, new smokers have become more frequent among men in 20 countries and among women in 12 countries. Ten of these countries account for two-thirds of the world's smoking population:,,,,,,,,, and China India Indonesia USA Russia. Bangladesh Japan Turkey Vietnam One in three Philippines smokers (341 million) live in. China

In 2019, smoking caused 1.7 million deaths from coronary heart disease, 1.6 million deaths from chronic obstructive pulmonary disease, 1.3 million deaths from cancer of the trachea, bronchi and lungs, and almost 1 million deaths from stroke. Previous studies have shown that at least half of long-term smokers will die from causes directly related to smoking, and that the average life expectancy of smokers is 10 years lower than that of those who have never smoked.

According to the study, half of all countries have never made improvements in the fight against smoking among 15 to 24-year-olds, and the average smoking start age is 19, and is legal in most countries.

Despite the fact that 182 countries signed the Convention on Tobacco Smoking Control in 2005, measures to combat this unhealthy habit were different. The researchers said high taxation proved to be the most effective policy.^[5]

Electronic Tobacco Heating Systems Cause Cigarette Market to Fall in Japan

Published in 2020, a study by an international group of scientists shows that the popularity of electronic tobacco heating products contributes to a significant decrease in sales of conventional cigarettes, much more than before the entry into the market of electronic tobacco products.

Researchers analyzed cigarette sales trends Japan from 2011 to 2019 and concluded that it was the spread of electronic tobacco heating products (ESNT) that was the main reason for the accelerated drop in demand for conventional cigarettes. The article is published in the peer-reviewed scientific journal International Journal of Environmental Research and Public Health. health care

Researchers considered that from 2011 to 2015, Japan experienced a slow but steady decline in cigarette sales. However, since 2016, the decline in cigarette sales has accelerated significantly, which is most likely due to the entry of ESNT into the Japanese market at this time. In general, from 2016 to 2019, the annual decline in cigarette sales accelerated 5 times compared to the period 2011-2015.

Scientists note that Japan is the world's most developed electronic tobacco market, which, according to analysts, accounted for up to 85% of ESNT's global sales in 2018. Japan also became one of the first countries where ESNT sales began in 2014. At the same time, it is known that Japan lags behind other developed countries in terms of introducing measures to limit smoking. In particular, the Japanese government failed to fully implement the plan to ban smoking during the 2020 Summer Olympics (canceled due to the COVID-19 epidemic).

According to one of the authors of the study, University of Ottawa professor David Sweanor, this is "the fastest drop in cigarette sales ever seen on the market." "A third of the cigarette market disappeared in a surprisingly short period of time, and this was achieved without enforcement measures," says the researcher.

The study by Dr. Svenor and his co-authors supports the findings of an earlier study by a team of researchers from the American Cancer Society, who also confirmed that the drop in sales of conventional cigarettes in the Japanese market is caused by smokers switching to ESNT. The rate of decline in cigarette sales increased from 1.8% per year in 2011-2015 to 9.5% per year in 2015-2018, with no significant changes in government policy on tobacco smoking.

2006

A little gypsy boy smokes a cigarette, which is considered absolutely normal in the community of Saint Jacks, Perpignan, southern France. 2006.

1954

In 1954, inventor Robert Stern presented an unusual mouthpiece to citizens dependent on tobacco. This device had a special "umbrella" directly above the cigarette, so it allowed smoking even during rain or, for example, snow.

1939

Mouthpiece that allows you to smoke two cigarettes at the same time, 1939.

Nicotine

The side effects of nicotine are similar to caffeine, however, nicotine, as well as coffee, does not cause cancer. This point of view was expressed in December 2020 by Swedish professor Karl Fageström. In his opinion, humanity will not be able to completely abandon nicotine consumption, just like alcohol and caffeine. Banning some substances will immediately lead to the emergence of others, more dangerous.

"Nicotine has a number of positive effects - effects on attention, motivation, cognitive processes, appetite suppression, improved metabolism. Side negative effects of nicotine are similar to caffeine, the consumption of which in high doses increases the risk of developing type 2 diabetes, and also has an impact on myocardial function. However, nicotine, like caffeine, does not cause cancer, unlike tobacco smoke, which contains carcinogens, carbon dioxide and other dangerous components, "said Karl Fageström.

According to Karl Fageström, the degree of addiction to nicotine varies depending on the form of its delivery, and it is more behavioral than pharmacological.

Can a drop of nicotine kill a person

The average lethal dose for people is 0.5-mg/kg of live weight, that is, with a weight of 70 kg, the amount of 35-70 mg will be fatal.

One cigarette contains about 0.7-1.4 mg of nicotine. This means that about 35 - 60 cigarettes can be killed if they are smoked one after another, however, not all nicotine from the cigarette ends up in the lungs, in addition, toxic formaldehyde contained in tobacco neutralizes nicotine.

If we talk about drops, then in one drop about 50 mg of nicotine, it means that one and a half drops can well kill a person.

Tobacco heating systems

• E-cigarettes (tobacco heating systems)

Smoking dependence

2023: Russia conducted a large study that showed the presence of a genetic predisposition to smoking

Genetics affects the interest in smoking in order to obtain dopamine and the transition from episodic smoking to regular smoking. This was announced at the end of November 2023 by Russian scientists from the N.N. Petrov National Medical Research Center of Oncology based on the results of a large scientific study.

Scientists under the leadership of the head of the Department of Tumor Growth Biology of the N.N. Petrov Evgeny Imyanitov conducted a study of 1230 people. To do this, they divided them into 4 groups: they never smoked or tried smoking (147 people); non-smokers who tried smoking (267 people); smokers (570 people); former smokers (246 people).

Genetics influence interest in smoking

Nicotine entering the body through smoking releases dopamine, a stimulant of the reward center in the brain. From a genetic point of view, the rate of synthesis, decay and the duration of action of dopamine in different people are not the same. Thus, depending on the features of dopamine receptors, different people have a different predisposition to smoking, as well as to some other addictions, commented on the study by Imyanitov.

Scientists proceeded from the fact that non-smokers differ in some way from smokers, since they do not smoke or try, because they did not have interest. According to the researchers, some people have an increased predisposition to harmful habits that cause the preparation of dopamine.

According to Professor Imyanitov, the study confirmed the original hypothesis - genetics really has an impact on the interest in starting smoking and on fixing smoking as a habit. Specific study results are currently unavailable, but the result of Imyanitov's study opens up new scope for genetic research - perhaps with the help of gene research, new ways to combat smoking will open up.^[6]

Hookah smoking

Main article: Hookah smoking

Harm from smoking

Along with what we all know about the harm that smoking causes to the lungs (see lung cancer) and heart, studies have shown that it also exacerbates kidney disease (see kidney failure). Smoking is a load for blood vessels and the heart.

Smoking has been proven to increase platelet counts and shorten their lifespan. Smoking also negatively affects adhesion (the ability to adhere to the walls of damaged vessels) and aggregation (the ability to connect with each other) of platelets, which increases the risk of blood clots, the researchers write.

Regular smoking, according to doctors, leads to the fact that the cause of death of 75% of smokers is chronic diseases caused by chemicals released when tobacco burns.

"Many people still don't realise enough that two in three smokers do die from exposure to tobacco smoke. A quarter of them die before retirement. Smoking also affects the occurrence of chronic diseases such as chronic obstructive pulmonary disease, heart failure, or cerebrovascular accident. The risk, for example, of a heart attack in smokers is three to six times higher, "said Professor Rene Medema, chairman of the board, director of the Netherlands Cancer Institute in 2020.

The video below compares the volume of the lungs of a smoker and a healthy person.

Of the 7,000 chemicals that are released by tobacco combustion, at least 69 are carcinogens. For example, methanol, benzene, lead, acetic acid, carbon monoxide, arsenic, ammonium, acetone, hexamine, as well as naphthalene, butane, tar and others.

According to 2020 data, smoking is caused by oncological diseases of the oropharynx, larynx, esophagus, trachea, bronchi. In addition, tobacco smoke carcinogens provoke leukemia, colorectal cancer, malignant tumors of the bladder. In addition to cancer, other chronic diseases are associated with smoking - stroke, cataract, pneumonia, arthritis, as well as erectile dysfunction, 23% of all cases of which are due only to smoking.

Premature mortality due to tobacco use

2023: Experienced smokers live 20-25 years less than non-smokers

Smokers with experience live much less than non-smokers. This was reported in July 2023 by Rospotrebnadzor with reference to data from the World Health Organization (WHO).

Statistics are given according to which people who started smoking in adolescence (and this is more than 70% of all smokers) and who smoke with 20 or more years of experience die 20-25 years earlier than never smokers. According to WHO, every 6 seconds in the world, 1 person dies from diseases associated with tobacco smoking, and the annual death rate from them is 5 million people.

Smokers with experience live much less than non-smokers

In addition, as reported in Rospotrebnadzor, smoking can cause impotence in men, as it damages the blood vessels that supply blood to the genitals. It is also possible to have a negative impact on the quality of seminal fluid, as well as a decrease in the number of sperm, the press service of the department noted. Smoking women have an increased risk of developing infertility and cervical cancer, they added.

Smoking accounts for 36% of the population's risk of the former, according to Interheart's global study. myocardial infarction The incidence of myocardial infarction in those who smoke more than a pack of cigarettes a day is 6 times higher for women and 3 times higher for men, compared to those who have never smoked. At the same time, smoking cessation reduces mortality to a greater extent than a decrease in level cholesterol blood or blood pressure (BP).

Candidate of Medical Sciences, Associate Professor of the Department of Polyclinic Therapy and Family Medicine, medicine FSBEI HE KrasGMU named after Prof. V.F. Voino-Yasenetsky Ekaterina Zorina says that tobacco smoke contains more than 7 thousand chemicals, of which at least 250 are harmful and at least 69 cause. In cancer cigarette smoke, monoxide (carbon carbon monoxide) is present in high concentration - gas one of the most toxic gases, the ability of which combines with hemoglobin is 200 times higher than that of oxygen.^[7]

2020: Smoking is one of the leading causes of premature mortality in Europe

According to the WHO, available for 2020, tobacco use is one of the main causes of premature mortality in Europe, and is responsible for 25%, 41% and 63% of deaths from cardiovascular, oncological and respiratory diseases in men, and 6%, 10% and 37% of deaths in women.

Cancer development

2023

In countries where smoking was banned in public places, the incidence of lung cancer decreased by 17%

The introduction of legislative bans on smoking in transport and public places in many countries of the world has led to a 17% decrease in the incidence of lung cancer. This is stated in a study by Hitotsubashi University, the results of which were released in early July 2023. Read more here.

90% of head and neck squamous cell carcinoma patients are smokers

Approximately 90% of head and neck squamous cell carcinoma patients globally are smokers. This is evidenced by the results of the study, published at the end of June 2023. Read more here.

Mutations in DNA

"Tobacco smoke causes metabolic activation. Carcinogens interact and integrate into DNA regions, which leads to incorrect coding and, as a result, mutations. Free radicals cause oxidative DNA damage, activation of oncogenes and deactivation of the tumor suppressor gene, "said Doctor of Medical Sciences, Professor Lyudmila Laktionova in January 2021

Tobacco smoke leads to transformation from papillomavirus to cancer

Research by Russian and international scientists suggests that smoking triggers the activation of carcinogens in organs such as cervical, genital, rectum, bladder and other organs not directly exposed to tobacco smoke. This is stated in an article by Doctor of Medical Sciences, oncologist Yulia Payanidi and Candidate of Sciences Svetlana Vinokurova, published in the medical journal Oncogynecology (October 2020). Read more here.

Hair loss

Cigarette smoke contains more than 5,000 toxic and carcinogenic chemicals and heavy metals.

Resinous substances, chromium, arsenic, lead, cadmium, formaldehyde, dioxin, benzene, nitrosamines and radioactive polonium are just some of them. They damage DNA in the hair follicle, cause inflammation and scarring of the follicle, and block the growth-promoting effect of estrogen.

In addition, the blood supply to the hair root deteriorates and the result is that we get hair loss. Naturally, if you quit smoking, there is every chance that the quality of hair will improve significantly and the formation of a "smoker's bald head" can be avoided.

Risk to cancer patients

In 2020, Russian oncologist, president of the Anti-Cancer Society of Russia, visiting professor at Oxford University David Zaridze especially notes the fact that smoking not only leads to cancer, but also negatively affects the prognosis in cancer patients, even those whose diseases are not directly related to smoking (for example, breast or prostate cancer). These data, based on numerous studies, were presented in a 2014 report by the US Surgeon General (the position roughly corresponds to the chief sanitary doctor in Russia). The risk of death can be reduced by 30-40% if the patient gives up smoking immediately after making an oncological diagnosis. And for some forms of cancer, the benefits of quitting smoking may be equivalent to, or even superior to, current anticancer therapy.

Filter-free cigarettes scientists link to even greater risk of lung cancer

On May 23, 2019, it was reported that scientists at the Medical University of South Carolina linked cigarette smoking without a filter to a 40 percent higher risk of developing lung cancer compared to smoking filter cigarettes. This conclusion was reached by American scientists, having studied information on tobacco consumption and the health of Americans who took part in the National Lung Screening Trial project.

In the laboratory of experimental cancer of the Tbilisi Institute of Oncology, 1967. USSR

Despite the fact that large medical studies unequivocally declare that the only way to reduce the harm caused to the body by smoking is to abandon tobacco at all, smokers are still looking for ways to reduce the risks caused by their habit. One such method - a cigarette filter - has been actively used in tobacco products since the 1950s: artificial filter fibers made of cellulose acetate reduce the level of inhaled resins and incoming nicotine. Theoretically, it is possible to reduce the harm to the body by smoking cigarettes with a filter (compared to cigarettes without one), but little work has been devoted to this issue.

Researchers at the Medical University of South Carolina, led by Gerard Silvesti, decided to assess how different types of tobacco products are associated with the risk of lung cancer and death from it. To do this, they used data from the National Lung Screening Trial project: it collected health information from almost 53.5 thousand Americans. As variables for analysis, scientists used cases of lung cancer diagnosis and mortality from it on the one hand, and on the other, the preferred type of cigarettes. The researchers also studied the dependence on the type of cigarettes of some habits associated with tobacco consumption: the indicator of dependence on nicotine, the number of cigarettes and others.

Compared to those who smoke filtered cigarettes, for those who smoke unfiltered cigarettes, the risk of developing lung cancer is 40 percent higher (p = 0.0051), the risk of dying from lung cancer is twice as high (p <0,0001), а от всех причин — на 30 процентов (p = 0,0033). Также любители сигарет без фильтра оказались больше зависимы от никотина. Курение различных разновидностей легких и ультралегких сигарет не было связано с изменением риска развития рака легких и смерти от него по сравнению с курением обычных сигарет; тем не менее, исследователи выяснили, что любители легких сигарет менее зависимы от курения по сравнению с теми, кто курит обычные сигареты, а вот бросают курить они реже. Ментоловые сигареты и сигареты с другими ароматизаторами по сравнению с обычными сигаретами никакого влияния на изученные переменные не показали.

The authors of the study concluded that smoking cigarettes without a filter is associated with an increased risk of lung cancer and death from it, although they do not speak out about the reasons for this relationship - this will need to be studied in subsequent works.

Another strategy smokers who want to reduce harm from their habit can use is reducing the number of cigarettes. However, scientists have shown that this may be useless: according to a meta-analysis of 55 works, it turned out that reducing cigarettes does not reduce the risk of developing cardiovascular diseases.^[8]

Smoke from cigarette pack stains teeth from inside in 3 weeks

Tooth enamel, the hardest tissue in the human body, consists of tightly placed hydroxyapatite crystals, which are usually impermeable to water and therefore resist darkening. However, microscopic cracks may occur on enamel surfaces that make the tissue vulnerable to infiltration of external colorants and pigments from natural sources such as cigarette smoke.

When tobacco is burned, resin is formed - solid particles that do not contain nicotine and water, but contain pigments that can stain and discolor the tissues of the human body. The skin, nails and teeth suffer the most from their impact. Read more here.

Anti-smoking tools

Each age has its own preferences in choosing means to combat smoking. According to the Russian Target Group Index for Q4 2011, the most popular anti-smoking tool in the 16-19 age group is nicotine gum, used by 28% of teenagers who smoke. Only 4% of respondents use an electronic cigarette in this group, which may be due to the high price of this device. Other means of quitting smoking teenagers practically do not use.

Nicotine tablets (12%) and chewing gums (12%) are equally popular in the 20-34 age group. E-cigarettes were used (8%) by respondents of this age, only 5% of respondents resorted to nicotine patch.

Among Russians 35 years old and older, the most popular means of combating smoking is an electronic cigarette, in 2011 it was used by (12%) of respondents. Approximately one in 10 of this age group used nicotine tablets (11%) and chewing gum (10%); slightly less - 7% of respondents - resorted to a nicotine patch.

At the same time, about 70% of respondents answered that they tried to quit smoking using any other methods.

The impact of quitting smoking

After 20 minutes, the first health improvements begin, this is a drop in heart rate and blood pressure. Within 12 hours, carbon monoxide levels return to normal, and after a few weeks, lung function increases and blood circulation improves. An increased risk of stroke or coronary heart disease disappears within 15 years. Lung cancer also becomes a much less significant threat after about a decade.

There is confirmed evidence that the heart rate decreases as early as 20 minutes after smoking cessation.

• Within 12 hours, the level of carbon monoxide in the blood normalizes;
• after 2-12 weeks, blood circulation improves, lung function normalizes;
• after 1-9 months, cough and shortness of breath decrease;
• within 5-15 years, the risk of stroke is reduced to the level of risk in a non-smoking person;
• in 10 years, the risk of lung cancer death is roughly halved compared to that of people who smoke;
• over 15 years, the risk of cardiovascular disease is reduced to the level of risk in a non-smoking person.

See also

• Drugs

Notes