{{Short description|Small roll of tobacco made to be smoked}} {{About||other uses|Cigarette (disambiguation)|and|Cigarettes (disambiguation)}} {{Redirect|Cig}} {{protection padlock|small=yes}} {{More citations needed|date=January 2026}} {{cs1 config|name-list-style=vanc}} {{Use mdy dates|date=May 2022}} thumb|A filtered cigarette A '''cigarette''' is a thin cylinder of smoking 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.<ref name=":1" /> 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.
Deaths from smoking cigarettes are caused by diseases 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, but 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 a result of exposure to secondhand smoke.<ref name=":1">{{Cite web |title=Tobacco |url=https://www.who.int/news-room/fact-sheets/detail/tobacco |archive-url=https://web.archive.org/web/20210709165139/https://www.who.int/news-room/fact-sheets/detail/tobacco |archive-date=2021-07-09 |access-date=2025-11-26 |website=World Health Organization |language=en-US}}</ref> 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.[[File:2015 E-papieros mod 01.JPG|thumb|An electronic cigarette]]In the 21st century, electronic cigarettes (also called ''e-cigarettes'' or ''vapes'') were developed, whereby a substance contained within the device (typically a liquid solution containing nicotine) is vaporized by a battery-powered heating element as opposed to being burned. Although e-cigarettes are less harmful than conventional cigarettes there are significant health risks associated with their use.
Cigarettes and other smoking materials, especially when people fall asleep with a lit item, are a major cause of residential fires, accounting for about 28% of fires involving upholstered furniture.<ref name=Ahrens2008>{{cite book | author = Ahrens, M. | title = Home fires that began with upholstered furniture | year = 2008 | publisher = National Fire Protection Association | location = Quincy, MA}}</ref> Fire-safe cigarettes reduce the risk to some extent (by approximately 11-45%, depending on the country and type of fire), but the risk remains high.<ref name=Butry2017>{{cite journal | last1=Butry | first1=D. T. | last2=Thomas | first2=D. S. | title = Cigarette Fires Involving Upholstered Furniture in Residences: The Role that Smokers, Smoker Behavior, and Fire Standard Compliant Cigarettes Play | journal = Fire Technology | volume = 53 | issue = 3 | pages = 1123–1146 | date = 2017 | doi = 10.1007/s10694-016-0621-3 | pmid = 28751788 | pmc = 5524378 }}</ref>
== History == ===Global=== {{see also|History of tobacco}}
[[File:Mayan priest smoking.jpg|thumb|upright|A reproduction of a carving from the temple at Palenque, Mexico, depicting a Maya deity using a smoking tube]]
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.<ref>{{Cite book |last1=Gilman |first1=Sander L. |url=https://books.google.com/books?id=mM5bYb_uVcwC |title=Smoke: A Global History of Smoking |last2=Zhou |first2=Xun |date=2004 |publisher=Reaktion Books |isbn=978-1-86189-200-3 |pages=30–37 |language=en}}</ref>
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).<ref name=Goodman93>{{Cite book |author=Goodman, Jordan Elliot |title=Tobacco in history: the cultures of dependence |publisher=Routledge |location=New York |year=1993 |page=[https://archive.org/details/tobaccoinhistory0000good/page/97 97] |isbn=978-0-415-04963-4 |url=https://archive.org/details/tobaccoinhistory0000good/page/97 }}</ref>
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.<ref name=Goodman93/> The French word made its way into English in the 1840s.<ref>''Oxford English Dictionary'', ''[http://www.oed.com/view/Entry/33001 s.v.]''</ref> Some American reformers promoted the spelling ''cigaret'',<ref>Circulars of Information of the Bureau of Education, ''The Spelling Reform'', No. 7-1880, 1881, [https://books.google.com/books?id=gLoV7NUHXBQC&pg=PA25#q=%22cigaret%22 p. 25]</ref><ref>Henry Gallup Paine, Simplified Spelling Board, ''Handbook of Simplified Spelling'', New York, 1920, [https://archive.org/details/handbookofsimpli00simprich/page/6 p. 6]</ref> but this was never widespread and is now largely abandoned.<ref>{{Cite web |title=Google Books Ngram Viewer |url=https://books.google.com/ngrams/graph?content=cigaret/cigarette,cigaret:eng_us_2012/cigarette:eng_us_2012,cigaret:eng_gb_2012/cigarette:eng_gb_2012&year_start=1860&year_end=2008&corpus=15&smoothing=3&share=&direct_url=t1;,(cigaret%20/%20cigarette);,c0;.t1;,(cigaret:eng_us_2012%20/%20cigarette:eng_us_2012);,c0;.t1;,(cigaret:eng_gb_2012%20/%20cigarette:eng_gb_2012);,c0 |archive-url=https://web.archive.org/web/20200729131018/https://books.google.com/ngrams/graph?content=cigaret/cigarette,cigaret:eng_us_2012/cigarette:eng_us_2012,cigaret:eng_gb_2012/cigarette:eng_gb_2012&year_start=1860&year_end=2008&corpus=15&smoothing=3&share=&direct_url=t1;,(cigaret%20/%20cigarette);,c0;.t1;,(cigaret:eng_us_2012%20/%20cigarette:eng_us_2012);,c0;.t1;,(cigaret:eng_gb_2012%20/%20cigarette:eng_gb_2012);,c0 |archive-date=2020-07-29 |access-date=2025-11-26 |website=Google Books Ngram Viewer |language=en}}</ref>
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847.<ref>{{cite web |last1=Office |first1=Patent |date=December 29, 1870 |title=Patents for inventions. Abridgments of specifications |url=https://books.google.com/books?id=xoThFsOZfskC&q=Cigarette+Patent+Abridgment&pg=PA180 |access-date=2025-11-26 |via=Google Books}}</ref> In the 1850s, Turkish cigarette leaves became popular.{{Sfn|Cox|2000|p=21}} 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.<ref name=advertising>{{cite magazine|last=James |first=Randy |url=http://www.time.com/time/magazine/article/0,9171,1905530,00.html |archive-url=https://web.archive.org/web/20110921054816/http://www.time.com/time/magazine/article/0,9171,1905530,00.html |archive-date=September 21, 2011 |title=A Brief History Of Cigarette Advertising |magazine=Time |date=June 15, 2009 |access-date=March 25, 2012}}</ref> At the time, these imported cigarettes from the United States had significant sales among British smokers.{{Sfn|Cox|2000|p=21}}
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.<ref name=Goodman93/> This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
[[File:La cometa.jpg|thumb|left|Francisco Goya's ''La Cometa'', depicting a (foreground left) man smoking an early quasicigarette]]
Initially, not all cigarette smokers inhaled the smoke produced by cigarettes due to its high alkalinity levels. Starting in the 1930s, the tobacco industry began to conduct advertising campaigns encouraging the inhaling of cigarette smoke.<ref>{{Cite web |title=Collection: Do you inhale? |url=https://tobacco.stanford.edu/cigarettes/for-your-health/do-you-inhale/# |access-date=2024-02-23 |website=Stanford Research into the Impact of Tobacco Advertising |publisher=Stanford University}}</ref> However, Helmuth von Moltke noticed in the 1830s that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes<ref>{{Cite news |last=von Molke |first=Helmuth Graf |title=Unter dem Halbmond - Kapitel 30 |url=http://gutenberg.spiegel.de/buch/3038/30 |archive-url=https://web.archive.org/web/20120119053202/http://gutenberg.spiegel.de/buch/3038/30 |archive-date=2012-01-19 |access-date=2025-11-26 |work=SPIEGEL ONLINE}}</ref> (both are initially sun-cured, acidic leaf varieties). [[File:There's nothing like a Camel, 1942.jpg|thumb|right|230px|A 1942 ad encourages women to smoke Camel brand cigarettes.]] 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''<ref>{{Cite web |title=Definition of COFFIN NAIL |url=https://www.merriam-webster.com/dictionary/coffin%20nail |archive-url=https://web.archive.org/web/20190110014005/https://www.merriam-webster.com/dictionary/coffin%20nail |archive-date=2019-01-10 |access-date=2025-11-26 |website=www.merriam-webster.com |language=en}}</ref> but the link between lung cancer and smoking was not established until the 20th century.<ref>{{Cite web |title=The Study That Helped Spur the U.S. Stop-Smoking Movement |url=https://www.cancer.org/latest-news/the-study-that-helped-spur-the-us-stop-smoking-movement.html |archive-url=https://web.archive.org/web/20210520150108/https://www.cancer.org/latest-news/the-study-that-helped-spur-the-us-stop-smoking-movement.html |archive-date=May 20, 2021 |access-date=May 25, 2021 |website=www.cancer.org |language=en}}</ref> German doctors were the first to make the link, and it led to the first antitobacco movement in Nazi Germany.<ref>Roffo, A. H. (January 8, 1940). "Krebserzeugende Tabakwirkung" [Carcingogenic effects of tobacco]. (in German). Berlin: J. F. Lehmanns Verlag. Retrieved September 13, 2009.</ref><ref>{{Cite journal | doi = 10.2471/BLT.06.031682 | last1 = Proctor | first1 = R. N. | title = Angel H Roffo: The forgotten father of experimental tobacco carcinogenesis | journal = Bulletin of the World Health Organization | volume = 84 | issue = 6 | pages = 494–496 | year = 2006 | pmid = 16799735 | pmc = 2627373 |issn = 0042-9686 }}</ref><ref>{{Cite journal |last=Morabia |first=Alfredo |date=November 2017 |title=Anti-Tobacco Propaganda: Soviet Union Versus Nazi Germany |journal=American Journal of Public Health |volume=107 |issue=11 |pages=1708–1710 |doi=10.2105/AJPH.2017.304087 |issn=0090-0036 |pmc=5637694 |pmid=29019774}}</ref>
[[File:London , Kodachrome by Chalmers Butterfield edit.jpg|thumb|300px|left|Cigarette brands, including Craven "A", advertised in Shaftesbury Avenue, London in 1949]] During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, the U.S. included cigarettes with C-ration meals; however, cigarettes were removed from U.S. military rations in 1975. 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.<ref>{{Cite journal |vauthors=Hammond D, Fong GT, McNeill A, Borland R, Cummings KM |title=Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey |journal=Tob Control |volume=15 |issue= Suppl 3|pages=iii19–25 |date=June 2006 |pmid=16754942 |doi=10.1136/tc.2005.012294 |pmc=2593056}}</ref> Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands,<ref>{{cite web |title=WHO report on the global tobacco epidemic, 2019 Country profile Netherlands |url=https://www.who.int/tobacco/surveillance/policy/country_profile/nld.pdf |archive-url=https://web.archive.org/web/20120322212801/http://www.who.int/tobacco/surveillance/policy/country_profile/nld.pdf |archive-date=March 22, 2012 |website=who.int |publisher=World Health Organization |access-date=December 14, 2020}}</ref> 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, 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 tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. 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.<ref>{{cite news |url=https://www.telegraph.co.uk/lifestyle/9509679/Will-smoking-ever-be-safe.html |title=Quest for a safer cigarette |location=London |work=The Daily Telegraph |first=Will |last=Storr |date=September 6, 2012 |access-date=April 5, 2018 |archive-date=January 30, 2018 |archive-url=https://web.archive.org/web/20180130091309/http://www.telegraph.co.uk/lifestyle/9509679/Will-smoking-ever-be-safe.html |url-status=live }}</ref><ref>{{Cite web |title=James D. Mold - SourceWatch |url=http://www.sourcewatch.org/index.php/James_D._Mold |archive-url=https://web.archive.org/web/20130220122352/http://www.sourcewatch.org/index.php/James_D._Mold |archive-date=2013-02-20 |access-date=2025-11-26 |website=www.sourcewatch.org |language=en}}</ref><ref>{{Cite web |title="Safer" Cigarettes: A History — NOVA {{!}} PBS |url=http://www.pbs.org/wgbh/nova/body/safer-cigarettes-history.html |archive-url=https://web.archive.org/web/20180423105102/http://www.pbs.org/wgbh/nova/body/safer-cigarettes-history.html |archive-date=2018-04-23 |access-date=2025-11-26 |website=www.pbs.org |date=October 2, 2001 }}</ref>
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 of smoke per puff.<ref>{{cite journal | title=The changing cigarette, 1950-1995 | last1=Hoffmann | first1=D | journal=Journal of Toxicology and Environmental Health |date=March 1997 | volume=50 | issue=4 |pages=307–364 | pmid=9120872 | doi=10.1080/009841097160393| bibcode=1997JTEHA..50..307H }}</ref>
===United States=== 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, and by 1889 his was the largest cigarette manufacturer in the country. The new Bonsack machines were of decisive importance in the 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 to the firm. It was also 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 the 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 cigars produced in the country.<ref>Richard B. Tennant, "The Cigarette Industry" in ''The Structure of American Industry,'' edited by Walter Adams (1961) pp 357-392, at pp 358-362.</ref>
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 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).<ref>{{Cite journal |title=Tobacco Use, United States 1990-1999 |journal=Oncology (Williston Park) |volume=13 |issue=12 |date=December 1999}}</ref> 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,<ref>Tobacco Outlook Report, Economic Research Service, U.S. Dept. of Agriculture</ref> corresponding to about 21% of the population smoking 100 cigarettes or more per year.
== Construction == thumb|Diagram of a cigarette {{olist|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".<ref>{{cite journal |last1=Hurt |first1=RD |last2=Robertson |first2=CR |date=October 7, 1998 |title=Prying open the door to the tobacco industry's secrets about nicotine: the Minnesota Tobacco Trial. |journal=JAMA |volume=280 |issue=13 |pages=1173–81 |doi=10.1001/jama.280.13.1173 |pmid=9777818}}</ref><ref>{{cite journal |last1=Cummings |first1=KM |date=September 2015 |title=Is it not time to reveal the secret sauce of nicotine addiction? |journal=Tobacco Control |volume=24 |issue=5 |pages=420–1 |doi=10.1136/tobaccocontrol-2015-052631 |pmid=26293383 |doi-access=free}}</ref><ref>{{cite book |last1=Teague |first1=CE |title=Research planning memorandum on the nature of the tobacco business and the crucial role of the nicotine therein. |date=1972 |publisher=R.J. Reynolds Tobacco Company}}</ref><ref>{{cite book |last1=Dunn |first1=W |title=Smoker psychology program review |date=1977 |publisher=Philip Morris Tobacco Company}}</ref> Modern commercially manufactured cigarettes consist mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter.<ref>{{Cite web |last=Clean Virginia Waterways |title=Cigarette Litter --Filters |url=http://www.longwood.edu/cleanva/cigbuttfilters.htm |archive-url=https://web.archive.org/web/20090126185943/http://www.longwood.edu/cleanva/cigbuttfilters.htm |archive-date=2009-01-26 |access-date=2025-11-26 |website=www.longwood.edu}}</ref> 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.<ref name=WigandWHOReport>Wigand, J.S. [http://www.jeffreywigand.com/WHOFinal.pdf ''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] {{Webarchive|url=https://web.archive.org/web/20110516151158/http://www.jeffreywigand.com/WHOFinal.pdf |date=May 16, 2011 }}</ref>
=== Paper === {{Main|Rolling paper}} {{See also|List of rolling papers}} The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning embers 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.<ref>{{Cite web |title=Corporate Responsibility - Ingredient Database |url=http://www.jti.com/english/corp_responsibility/ingredients/ingredients_links/comp_tab_nonmat.aspx |archive-url=https://web.archive.org/web/20080524200406/http://www.jti.com/english/corp_responsibility/ingredients/ingredients_links/comp_tab_nonmat.aspx |archive-date=2008-05-24 |access-date=2025-11-26 |website=www.jti.com}}</ref>
=== Tobacco blend === [[File:LeonesCigs.JPG|thumb|Leones Africanos brand cigarettes from the mid-20th century, part of the permanent collection of the Museo del Objeto del Objeto]] The process of blending gives the end product a consistent taste, as batches of tobacco grown in different regions may change in flavor profile from year to year due to different environmental conditions.<ref name="DEMerrill">{{Citation |title=How Cigarettes Are Made: A Presentation by David E. Merrill [Parts 1- 2] |url=http://archive.org/details/haq23e00 |access-date=2025-11-26}}</ref>
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").<ref name=DEMerrill/> 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 a 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.<ref>{{Cite web |title=PCL Sheet Tobacco Cigarettes |url=http://g2public.library.ucsf.edu/tobacco/batco/html/13000/13099/ |archive-url=https://web.archive.org/web/20090212175208/http://g2public.library.ucsf.edu/tobacco/batco/html/13000/13099/ |archive-date=2009-02-12 |access-date=2025-11-26 |website=g2public.library.ucsf.edu |language=English}}</ref> * 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.<ref>{{Cite web |last=Gellatly |first=Grant |title=Method and apparatus for coating reconstituted tobacco - Patent 4706692 |url=http://www.freepatentsonline.com/4706692.html |archive-url=https://web.archive.org/web/20070929120436/http://www.freepatentsonline.com/4706692.html |archive-date=2007-09-29 |access-date=2025-11-26 |website=www.freepatentsonline.com |language=en}}</ref> RL is made by extracting soluble chemicals in 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 paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.<ref name=WigandWHOReport/> * Expanded (ES) or improved stem (IS): Expanded stem 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.<ref name=DEMerrill/>
According to data from the World Health Organization,<ref>{{Cite web |title=The Tobacco Atlas |url=http://www.who.int/tobacco/statistics/tobacco_atlas/en/ |archive-url=https://web.archive.org/web/20111203212748/http://www.who.int/tobacco/statistics/tobacco_atlas/en/ |archive-date=2011-12-03 |access-date=2025-11-26 |website=www.who.int}}</ref> the amount of tobacco per 1000 cigarettes fell from {{convert|2.28|lb|kg|abbr=in|order=flip}} in 1960 to {{convert|0.91|lb|kg|abbr=in|order=flip}} 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 === Various additives are combined into shredded tobacco product mixtures, including humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa powder, licorice, tobacco extracts, and various sugars, which are known collectively as "casings".<ref name=":0">{{Cite web |last=Bregman |first=Rutger |date=2024-05-08 |title=Abolish the tobacco industry – no one should be allowed to addict and poison others on an industrial scale |url=https://www.moralambition.org/stories/abolish-the-tobacco-industry |access-date=2025-03-27 |website=www.moralambition.org |language=en}}</ref> 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.<ref name=DEMerrill/> Additionally, they replace flavors lost 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 cigarette packs. These chemicals are added for organoleptic purposes, and many boost the addictive properties of cigarettes, especially when burned.<ref>{{Cite journal |last1=Rabinoff |first1=Michael |last2=Caskey |first2=Nicholas |last3=Rissling |first3=Anthony |last4=Park |first4=Candice |date=November 2007 |title=Pharmacological and chemical effects of cigarette additives |journal=American Journal of Public Health |volume=97 |issue=11 |pages=1981–1991 |doi=10.2105/AJPH.2005.078014 |issn=1541-0048 |pmc=2040350 |pmid=17666709}}</ref>
One of the classes of chemicals on the list, ammonia salts, converts bound nicotine molecules in tobacco smoke into free nicotine molecules.<ref name=":0" /> 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.<ref>{{cite journal |doi=10.1016/j.fct.2008.02.021 |pmid=18450355 |title=The possible role of ammonia toxicity on the exposure, deposition, retention, and the bioavailability of nicotine during smoking |journal=Food and Chemical Toxicology |volume=46 |issue=6 |pages=1863–81 |year=2008 |last1=Seeman |first1=Jeffrey I. |last2=Carchman |first2=Richard A. }}</ref>
===Cigarette tube=== {{Main|Cigarette tube}} 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 do not contain any tobacco or smoking material inside, as the consumer is intended to fill the tube themself. They may vary in length from regular (70 mm) to king size (84 mm) as well as 100s (100 mm) and 120s (120 mm).<ref name="ref1058918916">{{cite web|url=http://www.wikihow.com/Roll-Your-Own-Filter-Cigarettes|title=How to Roll Your Own Filter Cigarettes: 6 Steps (with Pictures)|work=wikiHow |publisher=wikihow.com|access-date=February 14, 2014|archive-url=https://web.archive.org/web/20140222231725/http://www.wikihow.com/Roll-Your-Own-Filter-Cigarettes|archive-date=February 22, 2014}}{{self-published source|date=March 2017}}</ref>{{self-published inline|date=March 2017}}
Cigarette tubes are usually filled 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. This is because the cone shape allows more tobacco to be burned at the beginning than the end, allowing for an even flavor.<ref name="ref-653500596">{{cite web|url=http://www.ryomagazine.com/july/filters.htm|title=Review: Zig-Zag Filtered Tubes|work=Roll Your Own Magazine|access-date=February 14, 2014|archive-date=October 6, 2014|archive-url=https://web.archive.org/web/20141006032800/http://www.ryomagazine.com/july/filters.htm|url-status=live}}</ref><ref>{{Cite web |title=Review: Zig-Zag Filtered Tubes |url=http://www.ryomagazine.com/july/filters.htm |archive-url=https://web.archive.org/web/20141006032800/http://www.ryomagazine.com/july/filters.htm |archive-date=2014-10-06 |access-date=2025-11-26 |website=www.ryomagazine.com}}</ref>
The United States Tobacco Taxation Bureau defines a cigarette tube as "cigarette paper made into a hollow cylinder for use in making cigarettes."<ref>{{Cite web |title=Forms Tutorial: Glossary Text Version |url=http://www.ttb.gov/forms_tutorials/glossary/glossary-text.html |archive-url=https://web.archive.org/web/20130508152731/http://www.ttb.gov/forms_tutorials/glossary/glossary-text.html |archive-date=2013-05-08 |access-date=2025-11-26 |website=www.ttb.gov}}</ref>
=== Cigarette filter === {{Main|Cigarette filter}} 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 the presence of some substances, such as tar, in cigarette smoke, but do not actually make them any safer to smoke.
=== Cigarette butt === {{See also|Ashtray|Cigarette pack#Features}} thumb|right|Discarded cigarette butts
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'' or a ''fag end''.<ref>The Nelson Contemporary English Dictionary - Page 187, W. T. Cunningham - 1977</ref><ref>{{Cite web |url=https://www.lamontagne.fr/gueret-23000/actualites/litting-cigarette-butts-beware-the-fine_11613266 |title=Littering cigarette butts: beware the fine! |work=La Montagne |date=2015-10-07 |accessdate=2025-11-23}}</ref> The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remaining tobacco mixed with ash.
They are the most numerically frequent litter in the world.<ref name="Archives of Environmental Contamination and Toxicology">{{cite journal|last1=Micevska|first1=T.|last2=Warne|first2=M. St. J.|last3=Pablo|first3=F.|last4=Patra|first4=R.|year=2005|title=Variation in, and Causes of, Toxicity of Cigarette Butts to a Cladoceran and Microtox|journal=Archives of Environmental Contamination and Toxicology|volume=50|issue=2|pages=205–212|doi=10.1007/s00244-004-0132-y|pmid=16328625|s2cid=26207468}}<!--|access-date= 2012-01-01 --></ref> Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches.<ref name="longwood">Kathleen M. Register. "[http://www.longwood.edu/cleanva/ciglitterarticle.htm Cigarette Butts as Litter—Toxic as Well as Ugly] {{Webarchive|url=https://web.archive.org/web/20201212143743/http://www.longwood.edu/cleanva/ciglitterarticle.htm |date=December 12, 2020 }}", Longwood University. Retrieved June 28, 2011. First published in ''Underwater Naturalist'', Volume 25, Number 2, August 2000.</ref> In a 2013 trial, the city of Vancouver, British Columbia, partnered with TerraCycle to create a system to encourage the 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.<ref>{{Cite news |title=Penny for your butts? Vancouver group pushes cigarette-butt recycling plan |url=http://www.ctvnews.ca/canada/penny-for-your-butts-vancouver-group-pushes-cigarette-butt-recycling-plan-1.1335827 |archive-url=https://web.archive.org/web/20150706150326/http://www.ctvnews.ca/canada/penny-for-your-butts-vancouver-group-pushes-cigarette-butt-recycling-plan-1.1335827 |archive-date=2015-07-06 |access-date=2025-11-26 |work=CTVNews |language=en}}</ref><ref>{{cite web|url=http://vancouver.ca/news-calendar/cigarette-butt-collection-and-recycling.aspx|title=City and TerraCycle launch cigarette butt collection and recycling program|author=City of Vancouver|access-date=May 30, 2015|date=November 13, 2013|archive-date=May 3, 2015|archive-url=https://web.archive.org/web/20150503041335/http://vancouver.ca/news-calendar/cigarette-butt-collection-and-recycling.aspx}}</ref>
== Electronic cigarette == {{Main|Electronic cigarette}} {{further|Safety of electronic cigarettes |Composition of electronic cigarette aerosol}} [[File:Electronic Nicotine Delivery Systems.jpg|thumb|upright=1.25|Various types of electronic cigarettes|alt=Various types of electronic cigarettes.]] <!-- Definition and Construction --> 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.<ref name=Caponnetto2012>{{cite journal|last1=Caponnetto|first1=Pasquale|last2=Campagna|first2=Davide|last3=Papale|first3=Gabriella|last4=Russo|first4=Cristina|last5=Polosa|first5=Riccardo|title=The emerging phenomenon of electronic cigarettes|journal=Expert Review of Respiratory Medicine|volume=6|issue=1|year=2012|pages=63–74|issn=1747-6348|doi=10.1586/ers.11.92|pmid=22283580|s2cid=207223131}}</ref> Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper".<ref name="Orellana-Barrios2015">{{cite journal |last1 = Orellana-Barrios |first1 = Menfil A. |last2 = Payne |first2 = Drew |last3 = Mulkey |first3 = Zachary |last4 = Nugent |first4 = Kenneth |title = Electronic cigarettes-a narrative review for clinicians |journal = The American Journal of Medicine |year = 2015 |issn = 0002-9343 |doi = 10.1016/j.amjmed.2015.01.033 |pmid = 25731134 |volume=128 |issue = 7 |pages=674–81|doi-access = free }}</ref> Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor.<ref name=Cheng2014>{{cite journal|last1=Cheng|first1=T.|title=Chemical evaluation of electronic cigarettes|journal=Tobacco Control|volume=23|issue=Supplement 2|year=2014|pages=ii11–ii17|issn=0964-4563|doi=10.1136/tobaccocontrol-2013-051482|pmc=3995255|pmid=24732157}}</ref> E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid.<ref name=Weaver2014>{{cite journal|last1=Weaver|first1=Michael|last2=Breland|first2=Alison|last3=Spindle|first3=Tory|last4=Eissenberg|first4=Thomas|title=Electronic Cigarettes|journal=Journal of Addiction Medicine|volume=8|issue=4|year=2014|pages=234–240|issn=1932-0620|doi=10.1097/ADM.0000000000000043|pmc=4123220|pmid=25089953}}</ref> E-cigarettes are automatically activated by taking a puff;<ref name=Rahman2014>{{cite journal|last1=Rahman|first1=Muhammad|last2=Hann|first2=Nicholas|last3=Wilson|first3=Andrew|last4=Worrall-Carter|first4=Linda|title=Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues|journal=Tobacco Induced Diseases|volume=12|issue=1|year=2014|page=21|doi=10.1186/1617-9625-12-21|pmc=4350653|pmid=25745382 |doi-access=free }}</ref> others turn on manually by pressing a button.<ref name=Orellana-Barrios2015/> Some e-cigarettes look like traditional cigarettes,<ref name=Pepper2013>{{cite journal |last1=Pepper |first1=J. K. |last2=Brewer |first2=N. T. |title=Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review |journal=Tobacco Control |volume=23 |issue=5 |year=2013 |pages=375–384 |issn=0964-4563 |doi=10.1136/tobaccocontrol-2013-051122 |pmid=24259045 |pmc=4520227}}</ref> but they come in many variations.<ref name=Orellana-Barrios2015/> Most versions are reusable, though some are disposable.<ref name=DropeCahn2017>{{cite journal|last1=Drope|first1=Jeffrey|last2=Cahn|first2=Zachary|last3=Kennedy|first3=Rosemary|last4=Liber|first4=Alex C.|last5=Stoklosa|first5=Michal|last6=Henson|first6=Rosemarie|last7=Douglas|first7=Clifford E.|last8=Drope|first8=Jacqui|title=Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine|journal=CA: A Cancer Journal for Clinicians|volume=67|issue=6|pages=449–471|year=2017|issn=0007-9235|doi=10.3322/caac.21413|pmid=28961314|doi-access=free}}</ref> There are first-generation,<ref name=Bhatnagar2014>{{cite journal |last1=Bhatnagar |first1=A. |last2=Whitsel |first2=L.P. |last3=Ribisl |first3=K.M. |last4=Bullen |first4=C. |last5=Chaloupka |first5=F. |last6=Piano |first6=M.R. |last7=Robertson |first7=R.M. |last8=McAuley |first8=T. |last9=Goff |first9=D. |last10=Benowitz |first10=N. |title=Electronic Cigarettes: A Policy Statement From the American Heart Association |journal=Circulation |date=August 24, 2014 |volume=130 |issue=16 |pages=1418–1436 |doi=10.1161/CIR.0000000000000107 |pmid=25156991 |pmc=7643636 |bibcode=2014Circu.130.1418B |s2cid=16075813 |url=https://escholarship.org/content/qt52p2317d/qt52p2317d.pdf?t=otldep |access-date=September 2, 2019 |archive-date=March 14, 2020 |archive-url=https://web.archive.org/web/20200314040852/https://escholarship.org/content/qt52p2317d/qt52p2317d.pdf?t=otldep |url-status=live }}</ref> second-generation,<ref name=McRobbie2014>{{cite web |url=http://www.ncsct.co.uk/usr/pub/e-cigarette_briefing.pdf |access-date= April 21, 2026 |archive-url=https://ghostarchive.org/archive/20221009/http://www.ncsct.co.uk/usr/pub/e-cigarette_briefing.pdf |archive-date=9 October 2022 |url-status=dead |title=Electronic cigarettes |first=Hayden |last=McRobbie |pages=1–16 |publisher=National Centre for Smoking Cessation and Training |date=2014}}</ref> third-generation,<ref name=Farsalinos2014>{{cite journal |vauthors=Farsalinos KE, Spyrou A, Tsimopoulou K, Stefopoulos C, Romagna G, Voudris V | title=Nicotine absorption from electronic cigarette use: Comparison between first and new-generation devices |journal=Scientific Reports |volume=4 |article-number=4133 |year=2014 |doi=10.1038/srep04133 |pmc=3935206 |pmid=24569565| bibcode=2014NatSR...4.4133F }}</ref> and fourth-generation devices.<ref name=Farsalinos2015>{{cite web |first1=Konstantinos |last1=Farsalinos |title=Electronic cigarette evolution from the first to fourth generation and beyond |url=https://gfn.net.co/downloads/2015/Plenary%203/Konstantinos%20Farsalinos.pdf |website=gfn.net.co |page=23 |publisher=Global Forum on Nicotine |access-date=September 23, 2015 |archive-url=https://web.archive.org/web/20150708172614/http://gfn.net.co/downloads/2015/Plenary%203/Konstantinos%20Farsalinos.pdf |archive-date=July 8, 2015 }}</ref> E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants.<ref name=England2015>{{cite journal|last1=England|first1=Lucinda J.|last2=Bunnell|first2=Rebecca E.|last3=Pechacek|first3=Terry F.|last4=Tong|first4=Van T.|last5=McAfee|first5=Tim A.|title=Nicotine and the Developing Human|journal=American Journal of Preventive Medicine|year=2015|volume=49|issue=2|pages=286–93|issn=0749-3797|doi=10.1016/j.amepre.2015.01.015|pmc=4594223|pmid=25794473}}</ref> E-liquids are also sold without propylene glycol,<ref name=Kacker2014>{{cite journal |last1=Oh |first1=Anne Y. |last2=Kacker |first2=Ashutosh |s2cid=10560264 |title=Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?: Review on e-cigarette vapor versus tobacco smoke |journal=The Laryngoscope |date=December 2014 |volume=124 |issue=12 |pages=2702–2706 |doi=10.1002/lary.24750 |pmid=25302452|doi-access=free }}</ref> nicotine,<ref name=LeducQuoix2016>{{cite journal|last1=Leduc|first1=Charlotte|last2=Quoix|first2=Elisabeth|title=Is there a role for e-cigarettes in smoking cessation?|journal=Therapeutic Advances in Respiratory Disease|volume=10|issue=2|year=2016|pages=130–135|issn=1753-4658|doi=10.1177/1753465815621233|pmid=26668136|pmc=5933562}}</ref> or flavors.{{sfn|Wilder|2016|p=82}}
<!-- Health effects, Safety, and Addiction and dependence --> The benefits and the health risks of e-cigarettes are uncertain.<ref name=EbbertAgunwamba2015>{{cite journal|last1=Ebbert|first1=Jon O.|last2=Agunwamba|first2=Amenah A.|last3=Rutten|first3=Lila J.|title=Counseling Patients on the Use of Electronic Cigarettes|journal=Mayo Clinic Proceedings|volume=90|issue=1|year=2015|pages=128–134|issn=0025-6196|doi=10.1016/j.mayocp.2014.11.004|pmid=25572196|doi-access=free}}</ref><ref name=Siu2015>{{cite journal |last1=Siu |first1=A.L. |title=Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement. |journal=Annals of Internal Medicine |date=September 22, 2015 |pmid=26389730 |doi=10.7326/M15-2023 |volume=163 |issue=8 |pages=622–34|doi-access=free }}</ref><ref name=Harrell2014>{{cite journal |last1=Harrell |first1=P.T. |last2=Simmons |first2=V.N. |last3=Correa |first3=J.B. |last4=Padhya |first4=T.A. |last5=Brandon |first5=T.H. |title=Electronic Nicotine Delivery Systems ("E-cigarettes"): Review of Safety and Smoking Cessation Efficacy.|journal=Otolaryngology–Head and Neck Surgery |date= June 4, 2014 |pmid=24898072 |doi=10.1177/0194599814536847 |volume=151 |issue=3 |pages=381–393 |pmc=4376316}}</ref> 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.<ref name="Hartmann-Boyce CD010216">{{Cite journal |last1=Hartmann-Boyce |first1=Jamie |last2=McRobbie |first2=Hayden |last3=Butler |first3=Ailsa R. |last4=Lindson |first4=Nicola |last5=Bullen |first5=Chris |last6=Begh |first6=Rachna |last7=Theodoulou |first7=Annika |last8=Notley |first8=Caitlin |last9=Rigotti |first9=Nancy A. |last10=Turner |first10=Tari |last11=Fanshawe |first11=Thomas R. |date=September 14, 2021 |title=Electronic cigarettes for smoking cessation |url= |journal=The Cochrane Database of Systematic Reviews |volume=9 |issue=6 |article-number=CD010216 |doi=10.1002/14651858.CD010216.pub6 |issn=1469-493X |pmc=8438601 |pmid=34519354}}</ref> However, other studies have not supported the finding that e-cigarettes are more effective than smoking cessation medicine.<ref name=McDonough2015>{{cite journal|last1=McDonough|first1=Mike|title=Update on medicines for smoking cessation|journal=Australian Prescriber|volume=38|issue=4|year=2015|pages=106–111|issn=0312-8008|doi=10.18773/austprescr.2015.038|pmc=4653977|pmid=26648633}}</ref> 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.{{sfn|WHO|2014|p=6}} Following the possibility of nicotine addiction from e-cigarette use, there is also concern children may start smoking traditional cigarettes in greater numbers as well,{{sfn|WHO|2014|p=6}} as youth who use e-cigarettes are more likely to go on to smoke cigarettes.<ref name=SGUSFactSheet2016>{{cite web|url=https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Fact_Sheet_508.pdf |archive-url=https://ghostarchive.org/archive/20221009/https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Fact_Sheet_508.pdf |archive-date=2022-10-09 |url-status=live|title=E-Cigarette Use Among Youth and Young Adults A Report of the Surgeon General: Fact Sheet|publisher=Surgeon General of the United States|year=2016}}{{PD-notice}}</ref><ref>{{cite book |author1=((National Academies of Sciences, Engineering, and Medicine)) |author2=((Health and Medicine Division)) |author3=((Board on Population Health and Public Health Practice)) |author4=((Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems)) |editor-first1=Kathleen |editor-first2=Leslie Y |editor-first3=David L |editor-last1=Stratton |editor-last2=Kwan |editor-last3=Eaton |title=Public Health Consequences of E-Cigarettes |date=23 January 2018 |doi=10.17226/24952 |pmid=29894118 |bibcode=2018nap..book24952N |isbn=978-0-309-46834-3 |url=https://www.nap.edu/resource/24952/012318ecigaretteHighlights.pdf |archive-url=https://web.archive.org/web/20180127094412/https://www.nap.edu/resource/24952/012318ecigaretteHighlights.pdf |archive-date=2018-01-27 |url-status=live}}</ref> Their part in tobacco harm reduction is unclear,<ref name=Drummond2014>{{cite journal |last1=Drummond |first1=M.B. |last2=Upson |first2=D |title=Electronic cigarettes: Potential harms and benefits |journal=Annals of the American Thoracic Society |date=February 2014 |volume=11 |issue=2 |pages=236–42 |doi=10.1513/annalsats.201311-391fr |pmid=24575993|pmc=5469426 }}</ref> while another review found they appear to have the potential to lower tobacco-related death and disease.<ref name=Cahn2011>{{cite journal |last1= M. |first1=Z. |last2=Siegel |title=Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? |journal=Journal of Public Health Policy |date=February 2011 |volume=32 |issue=1 |pages=16–31 |pmid=21150942 |doi= 10.1057/jphp.2010.41 |first2= M|doi-access=free }}</ref> Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes,<ref name=Drummond2014/> but e-cigarettes are generally seen as safer than combusted tobacco products.<ref name=KnorstBenedetto2014>{{cite journal|last1=Knorst|first1=Marli Maria|last2=Benedetto|first2=Igor Gorski|last3=Hoffmeister|first3=Mariana Costa|last4=Gazzana|first4=Marcelo Basso|title=The electronic cigarette: the new cigarette of the 21st century?|journal=Jornal Brasileiro de Pneumologia|volume=40|issue=5|year=2014|pages=564–572|issn=1806-3713|doi=10.1590/S1806-37132014000500013|pmc=4263338|pmid=25410845}}</ref><ref name=Burstyn2014>{{cite journal|last1=Burstyn|first1=Igor|title=Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks|journal=BMC Public Health|volume=14|issue=1|date=January 9, 2014|article-number=18|issn=1471-2458|doi=10.1186/1471-2458-14-18|pmc=3937158|pmid=24406205 |doi-access=free }}</ref> It is estimated their safety risk to users is similar to that of smokeless tobacco.<ref name=Caponnetto2013>{{cite journal |title=Electronic cigarette: a possible substitute for cigarette dependence |journal=Monaldi Archives for Chest Disease |date=March 2013 |author1=Caponnetto P. |author2=Russo C. |author3=Bruno C.M. |author4=Alamo A. |author5=Amaradio M.D. |author6=Polosa R. |volume=79 |issue=1 |pages=12–19 |pmid=23741941 |doi=10.4081/monaldi.2013.104|doi-access=free }}</ref> The long-term effects of e-cigarette use are unknown.<ref name="Hartmann-Boyce CD010216"/><ref name=BradyDeLaRosa2019>{{cite journal|last1=Brady|first1=Benjamin R.|last2=De La Rosa|first2=Jennifer S.|last3=Nair|first3=Uma S.|last4=Leischow|first4=Scott J.|title=Electronic Cigarette Policy Recommendations: A Scoping Review|journal=American Journal of Health Behavior|volume=43|issue=1|year=2019|pages=88–104|issn=1087-3244|doi=10.5993/AJHB.43.1.8|pmid=30522569|s2cid=54566712 }}</ref><ref name=BalsBoyd2019>{{cite journal|last1=Bals|first1=Robert|last2=Boyd|first2=Jeanette|last3=Esposito|first3=Susanna|last4=Foronjy|first4=Robert|last5=Hiemstra|first5=Pieter S.|last6=Jiménez-Ruiz|first6=Carlos A.|last7=Katsaounou|first7=Paraskevi|last8=Lindberg|first8=Anne|last9=Metz|first9=Carlos|last10=Schober|first10=Wolfgang|last11=Spira|first11=Avrum|last12=Blasi|first12=Francesco|title=Electronic cigarettes: a task force report from the European Respiratory Society|journal=European Respiratory Journal|volume=53|issue=2|year=2019|page=1801151|issn=0903-1936|doi=10.1183/13993003.01151-2018|pmid=30464018|doi-access=free}}</ref> The risk from serious adverse events was reported in 2016 to be low.<ref name=PaleyEchalier2016>{{cite journal|last1=Paley|first1=Grace L.|last2=Echalier|first2=Elizabeth|last3=Eck|first3=Thomas W.|last4=Hong|first4=Augustine R.|last5=Farooq|first5=Asim V.|last6=Gregory|first6=Darren G.|last7=Lubniewski|first7=Anthony J.|title=Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions|journal=Cornea|volume=35|issue=7|year=2016|pages=1015–1018|issn=0277-3740|doi=10.1097/ICO.0000000000000881|pmc=4900417|pmid=27191672}}</ref> Less serious adverse effects include abdominal pain, headache, blurry vision,<ref name=BrelandSpindle2014>{{cite journal|last1=Breland|first1=Alison B.|last2=Spindle|first2=Tory|last3=Weaver|first3=Michael|last4=Eissenberg|first4=Thomas|title=Science and Electronic Cigarettes|journal=Journal of Addiction Medicine|volume=8|issue=4|year=2014|pages=223–233|issn=1932-0620|doi=10.1097/ADM.0000000000000049|pmc=4122311|pmid=25089952}}</ref> throat and mouth irritation, vomiting, nausea, and coughing.<ref name=Grana2014/> Nicotine itself is associated with some health harms.<ref name=Edgar2013>{{cite web|url=https://www.webmd.com/smoking-cessation/news/20131112/e-cigarettes-cdc#1|title=E-Cigarettes: Expert Q&A With the CDC|last=Edgar|first=Julie|website=WebMD|date=November 12, 2013|access-date=September 7, 2019|archive-date=April 9, 2022|archive-url=https://web.archive.org/web/20220409055819/https://www.webmd.com/smoking-cessation/news/20131112/e-cigarettes-cdc#1|url-status=live}}</ref> In 2019 and 2020, an outbreak of severe lung illness throughout the US was linked to the use of vaping products.<ref name=CDC2020>{{cite web|url=https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html|title=Outbreak of Lung Illness Associated with Using E-cigarette Products|publisher=Centers for Disease Control and Prevention|date=January 28, 2020|access-date=September 8, 2019|archive-date=April 12, 2021|archive-url=https://web.archive.org/web/20210412020842/https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html|url-status=live}}{{PD-notice}}</ref>
<!-- E-liquid and aerosol --> E-cigarettes create vapor made of fine and ultrafine particles of particulate matter,<ref name=Grana2014/> which have been found to contain propylene glycol, glycerin, nicotine, flavors, small amounts of toxicants,<ref name=Grana2014/> carcinogens,<ref name=Hajek2014>{{cite journal|last1=Hajek|first1=P|last2=Etter|first2=JF|last3=Benowitz|first3=N|last4=Eissenberg|first4=T|last5=McRobbie|first5=H|title=Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit.|url=http://tobonline.com/Media/Default/Article/Addiction-%20Hajek%2014.pdf |archive-url=https://web.archive.org/web/20141205205447/http://tobonline.com/Media/Default/Article/Addiction-%20Hajek%2014.pdf |archive-date=2014-12-05 |url-status=live|journal=Addiction|date=July 31, 2014|pmid=25078252|doi=10.1111/add.12659|volume=109|issue=11|pages=1801–10|pmc=4487785}}</ref> and heavy metals, as well as metal nanoparticles, and other substances.<ref name=Grana2014/> 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.<ref name=Cheng2014/> E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke.<ref name=Hildick-SmithPesko2015>{{cite journal|last1=Hildick-Smith|first1=Gordon J.|last2=Pesko|first2=Michael F.|last3=Shearer|first3=Lee|last4=Hughes|first4=Jenna M.|last5=Chang|first5=Jane|last6=Loughlin|first6=Gerald M.|last7=Ipp|first7=Lisa S.|title=A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population|journal=Journal of Adolescent Health|year=2015|issn=1054-139X|doi=10.1016/j.jadohealth.2015.07.020|pmid=26422289|volume=57|issue=6|pages=574–9|doi-access=free}}</ref> E-cigarette vapor contains fewer toxic chemicals,<ref name=Grana2014>{{cite journal|last=Grana|first=R|author2=Benowitz, N|author3=Glantz, SA|title=E-cigarettes: a scientific review.|journal=Circulation|date=May 13, 2014|volume=129|issue=19|pages=1972–86|doi=10.1161/circulationaha.114.007667|pmc=4018182|pmid=24821826}}</ref> and lower concentrations of potential toxic chemicals than cigarette smoke.<ref name="FernándezBallbè2015">{{cite journal|last1=Fernández|first1=Esteve|last2=Ballbè|first2=Montse|last3=Sureda|first3=Xisca|last4=Fu|first4=Marcela|last5=Saltó|first5=Esteve|last6=Martínez-Sánchez|first6=Jose M.|title=Particulate Matter from Electronic Cigarettes and Conventional Cigarettes: a Systematic Review and Observational Study|journal=Current Environmental Health Reports|volume=2|issue=4|pages=423–9|year=2015|issn=2196-5412|doi=10.1007/s40572-015-0072-x|pmid=26452675|doi-access=free|bibcode=2015CEHR....2..423F }}</ref> The vapor is probably much less harmful to users and bystanders than cigarette smoke,<ref name=Hajek2014/> although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.<ref name=Rom2014>{{cite journal|last1=Rom|first1=Oren|last2=Pecorelli|first2=Alessandra|last3=Valacchi|first3=Giuseppe|last4=Reznick|first4=Abraham Z.|title=Are E-cigarettes a safe and good alternative to cigarette smoking?|journal=Annals of the New York Academy of Sciences|volume=1340|issue=1|year=2014|pages=65–74|issn=0077-8923|bibcode=2015NYASA1340...65R|doi=10.1111/nyas.12609|pmid=25557889|s2cid=26187171}}</ref>
== Health effects == === Smokers === {{Main|Health effects of tobacco}} [[File:MODOArtistas.jpg|thumb|Artistas brand cigarette package of Mexico from the Museo del Objeto del Objeto collection]] [[File:BahnhofsuhrZuerich RZ.jpg|thumb|A 2024 study estimated that each cigarette reduces life expectancy by 20 minutes]] The harm from smoking comes from the many toxic chemicals in the natural tobacco leaf and those formed in smoke from burning tobacco.<ref>{{cite web|publisher=Centers for Disease Control and Prevention|date=March 5, 2018|title=2014 SGR: The Health Consequences of Smoking—50 Years of Progress|access-date=November 25, 2019|url=https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm|archive-url=https://web.archive.org/web/20131201130315/https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm|archive-date=December 1, 2013}}</ref> A 2024 study estimated that each cigarette reduces life expectancy by 20 minutes,<ref>{{cite journal|author1=Sarah Jackson |author2=Martin Jarvis|author3=Robert West|title=The price of a cigarette: 20 minutes of life?|url=https://onlinelibrary.wiley.com/doi/10.1111/add.16757|journal=Addiction|date=29 December 2024 |volume=120 |issue=5 |pages=810–812 |doi=10.1111/add.16757|pmid=39734064 |access-date=22 January 2025}}</ref><ref>{{Cite news |last1=Sample |first1=Ian |last2=Science |first2=Ian Sample |date=2024-12-30 |title=Single cigarette takes 20 minutes off life expectancy, study finds |url=https://www.theguardian.com/society/2024/dec/30/single-cigarette-takes-20-minutes-off-life-expectancy-study |access-date=2025-11-26 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref> while other studies estimate that each one reduces life expectancy by about 11 minutes on average.<ref name="m11"/><ref>{{Cite web |title=BBC News {{!}} HEALTH {{!}} Cigarettes 'cut life by 11 minutes' |url=http://news.bbc.co.uk/1/hi/health/583722.stm |archive-url=https://web.archive.org/web/20081202074346/http://news.bbc.co.uk/1/hi/health/583722.stm |archive-date=2008-12-02 |access-date=2025-11-26 |website=news.bbc.co.uk}}</ref><ref>{{cite journal|title=Time for a smoke? One cigarette reduces your life by 11 minutes |journal=BMJ |doi=10.1136/bmj.320.7226.53 |volume=320 |year=2000 |page=53 | last1 = Shaw | first1 = M.|issue=7226 |pmid=10617536 |pmc=1117323 }}</ref> Humans continue to smoke because nicotine, the primary psychoactive chemical in cigarettes, is highly addictive.<ref>{{Cite web |title=Why is it so hard to quit? |url=http://www.heart.org/HEARTORG/GettingHealthy/QuitSmoking/QuittingSmoking/Why-is-it-so-hard-to-quit_UCM_324053_Article.jsp |archive-url=https://web.archive.org/web/20120402173038/http://www.heart.org/HEARTORG/GettingHealthy/QuitSmoking/QuittingSmoking/Why-is-it-so-hard-to-quit_UCM_324053_Article.jsp |archive-date=2012-04-02 |access-date=2025-11-26 |website=www.heart.org |language=en}}</ref> Cigarettes, like narcotics, have been described as "strategically addictive", with their addictive properties being a core component of the business strategy.{{citation needed|date=January 2026}} About half of smokers die from a smoking-related cause.<ref name=":1" /><ref name="bmj.bmjjournals.com.331">{{cite journal |last1=Doll |first1=R. |last2=Peto |first2=R. |last3=Boreham |first3=J. |last4=Sutherland |first4=I. |year=2004 |title=Mortality in relation to smoking: 50 years' observations on male British doctors |journal=BMJ (Clinical Research Ed.) |volume=328 |issue=7455 |page=1519 |doi=10.1136/bmj.38142.554479.AE |pmc=437139 |pmid=15213107}}</ref><ref name="m11">{{cite web |title=ASK EVERY PATIENT ABOUT SMOKING STATUS |url=http://www.nyc.gov/html/doh/downloads/pdf/chi/chi24-4-pktguide.pdf |archive-url=https://web.archive.org/web/20091229042543/http://www.nyc.gov/html/doh/downloads/pdf/chi/chi24-4-pktguide.pdf |archive-date=December 29, 2009 |access-date=November 13, 2009}}</ref> Smoking harms nearly every organ of the body. Smoking leads most commonly to diseases affecting the heart,<ref name="Nicotine Addiction">{{cite journal |last1=Benowitz |first1=Neal L. |title=Nicotine Addiction |journal=The New England Journal of Medicine |date=June 17, 2010 |volume=362 |issue=24 |pages=2295–2303 |doi=10.1056/NEJMra0809890 |pmid=20554984 |issn=0028-4793|pmc=2928221 }}</ref> liver, and lungs, being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis), and cancer<ref name="Nicotine Addiction"/><ref name="framework-treaty">{{cite web |date=February 27, 2005 |title=WHO Framework Convention on Tobacco Control |url=https://www.who.int/tobacco/framework/WHO_FCTC_english.pdf |archive-url=https://web.archive.org/web/20050906213831/http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf |archive-date=September 6, 2005 |access-date=January 12, 2009 |publisher=World Health Organization |quote=Parties recognize that scientific evidence has unequivocally established that exposure to tobacco has the potential to cause death, disease and disability}}</ref><ref name="sg-report">{{cite web |date=June 27, 2006 |title=The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General |url=https://www.ncbi.nlm.nih.gov/books/NBK44324/ |access-date=June 16, 2014 |publisher=Surgeon General of the United States |pmid=20669524 |quote=Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke |author1=Office on Smoking Health (US) |archive-date=February 15, 2017 |archive-url=https://web.archive.org/web/20170215064658/https://www.ncbi.nlm.nih.gov/books/NBK44324/ |url-status=live }}</ref><ref name="calepa2005">{{cite report |url=http://repositories.cdlib.org/context/tc/article/1194/type/pdf/viewcontent/ |title=Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant |last1=Board |date=June 24, 2005 |publisher=California Environmental Protection Agency |access-date=January 12, 2009 |via=University of California San Francisco: Center for Tobacco Control Research and Education}}</ref><ref name="iarc-monograph">{{cite book |url=http://monographs.iarc.fr/ENG/Monographs/vol83/index.php |title=Tobacco Smoke and Involuntary Smoking |publisher=International Agency for Research on Cancer |year=2004 |isbn=978-92-832-1583-7 |format=PDF |quote=There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) has the potential to cause lung cancer in humans |access-date=January 12, 2009 |archive-date=June 7, 2018 |archive-url=https://web.archive.org/web/20180607085206/http://monographs.iarc.fr/ENG/Monographs/vol83/index.php |url-status=live }}</ref> (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.<ref name="pmid15924009">{{cite journal |author=Peate I |year=2005 |title=The effects of smoking on the reproductive health of men |journal=British Journal of Nursing |volume=14 |issue=7 |pages=362–6 |doi=10.12968/Bjorn.2005.14.7.17939 |doi-broken-date=July 1, 2025 |pmid=15924009}}</ref><ref name="pmid15146084">{{cite journal |vauthors=Korenman SG |year=2004 |title=Epidemiology of erectile dysfunction |journal=Endocrine |volume=23 |issue=2–3 |pages=87–91 |doi=10.1385/ENDO:23:2-3:087 |pmid=15146084 |s2cid=29133230}}</ref> Children born to women who smoke during pregnancy are at higher risk of congenital disorders, cancer, respiratory disease, and sudden death.<ref name="CsordasBernhard2013">{{cite journal |last1=Csordas |first1=Adam |last2=Bernhard |first2=David |year=2013 |title=The biology behind the atherothrombotic effects of cigarette smoke |journal=Nature Reviews Cardiology |volume=10 |issue=4 |pages=219–230 |doi=10.1038/nrcardio.2013.8 |issn=1759-5002 |pmid=23380975 |s2cid=25491622}}</ref> Starting smoking earlier in life and smoking cigarettes higher in tar content increases the risk of these diseases. The World Health Organization <!-- (WHO) --> estimates that tobacco causes 8 million deaths each year as of 2019<ref name=":1" /> and ultimately caused 100 million deaths over the course of the 20th century.<ref name="urlwww.who.int">{{cite web | url =https://www.who.int/entity/tobacco/mpower/mpower_report_prevalence_data_2008.pdf | archive-url =https://wayback.archive-it.org/all/20080910041812/http://www.who.int/entity/tobacco/mpower/mpower_report_prevalence_data_2008.pdf | archive-date =September 10, 2008 | title = WHO Report on the Global Tobacco Epidemic | year = 2008 | publisher = World Health Organization }}</ref> Cigarettes produce an aerosol containing over 4,000 chemical compounds, including nicotine, carbon monoxide, acrolein, and oxidant substances.<ref name=CsordasBernhard2013/><ref>{{Cite web |title=ScienceDaily: Smoking While Pregnant Causes Finger, Toe Deformities |url=http://www.sciencedaily.com/releases/2006/01/060106122922.htm |archive-url=https://web.archive.org/web/20070304070934/http://www.sciencedaily.com/releases/2006/01/060106122922.htm |archive-date=2007-03-04 |access-date=2025-11-26 |website=www.sciencedaily.com}}</ref> Over 70 of these are carcinogens.<ref name="IARC">{{cite book |title=Personal Habits and Indoor Combustions |publisher=International Agency for Research on Cancer |year=2012 |volume=100E |page=44 |chapter=Tobacco Smoking |chapter-url=https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100E-6.pdf |archive-url=https://ghostarchive.org/archive/20221009/https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100E-6.pdf |archive-date=2022-10-09 |url-status=live}}</ref>
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.<ref name="pmid18403632">{{cite journal |vauthors=Kastan MB |title=DNA damage responses: mechanisms and roles in human disease: 2007 G.H.A. Clowes Memorial Award Lecture |journal=Mol. Cancer Res. |volume=6 |issue=4 |pages=517–24 |year=2008 |pmid=18403632 |doi=10.1158/1541-7786.MCR-08-0020 |doi-access=free }}</ref> 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).<ref name = Ajileye2024>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</ref> DNA damage was found in a population study to be significantly increased in 250 cigarette smokers compared to 200 non-cigarette smokers.<ref name = Ajileye2024/> Cunningham et al.<ref name=Cunningham>{{cite journal |vauthors=Cunningham FH, Fiebelkorn S, Johnson M, Meredith C |title=A novel application of the Margin of Exposure approach: segregation of tobacco smoke toxicants |journal=Food Chem. Toxicol. |volume=49 |issue=11 |pages=2921–33 |year=2011 |pmid=21802474 |doi=10.1016/j.fct.2011.07.019 }}</ref> combined the microgram weight of each compound in the smoke of one cigarette with the known genotoxic effect of that compound per microgram to identify the most carcinogenic compounds in cigarette smoke. The seven most important carcinogens in tobacco smoke are shown in the table below, along with the DNA alterations they cause. {| class="wikitable sortable" |+'''The most genotoxic cancer-causing chemicals in cigarette smoke''' !width="75"|Compound !width="75"|Micrograms per cigarette !width="225"|Effect on DNA !width="10"| {{Refh}} |- |Acrolein |align="left"|122.4 |Reacts with deoxyguanine and forms DNA crosslinks, DNA-protein crosslinks and DNA adducts |<ref name="pmid20158384">{{cite journal |vauthors=Liu XY, Zhu MX, Xie JP |title=Mutagenicity of acrolein and acrolein-induced DNA adducts |journal=Toxicol. Mech. Methods |volume=20 |issue=1 |pages=36–44 |year=2010 |pmid=20158384 |doi=10.3109/15376510903530845 |s2cid=8812192 }}</ref> |- |Formaldehyde |align="left"|60.5 |DNA-protein crosslinks causing chromosome deletions and re-arrangements |<ref name="pmid11971987">{{cite journal |vauthors=Speit G, Merk O |title=Evaluation of mutagenic effects of formaldehyde in vitro: detection of crosslinks and mutations in mouse lymphoma cells |journal=Mutagenesis |volume=17 |issue=3 |pages=183–7 |year=2002 |pmid=11971987 |doi= 10.1093/mutage/17.3.183|doi-access=free }}</ref> |- |Acrylonitrile |align="left"|29.3 |Oxidative stress causing increased 8-oxo-2'-deoxyguanosine |<ref name="pmid19546159">{{cite journal |vauthors=Pu X, Kamendulis LM, Klaunig JE |title=Acrylonitrile-induced oxidative stress and oxidative DNA damage in male Sprague-Dawley rats |journal=Toxicol. Sci. |volume=111 |issue=1 |pages=64–71 |year=2009 |pmid=19546159 |pmc=2726299 |doi=10.1093/toxsci/kfp133 }}</ref> |- |1,3-butadiene |align="left"|105.0 |Global loss of DNA methylation (an epigenetic effect) as well as DNA adducts |<ref name="pmid21602187">{{cite journal |vauthors=Koturbash I, Scherhag A, Sorrentino J, Sexton K, Bodnar W, Swenberg JA, Beland FA, Pardo-Manuel Devillena F, Rusyn I, Pogribny IP |title=Epigenetic mechanisms of mouse interstrain variability in genotoxicity of the environmental toxicant 1,3-butadiene |journal=Toxicol. Sci. |volume=122 |issue=2 |pages=448–56 |year=2011 |pmid=21602187 |pmc=3155089 |doi=10.1093/toxsci/kfr133 }}</ref> |- |Acetaldehyde |align="left"|1448.0 |Reacts with deoxyguanine to form DNA adducts |<ref name="pmid21604744">{{cite journal |vauthors=Garcia CC, Angeli JP, Freitas FP, Gomes OF, de Oliveira TF, Loureiro AP, Di Mascio P, Medeiros MH |title=[13C2]-Acetaldehyde promotes unequivocal formation of 1,N2-propano-2'-deoxyguanosine in human cells |journal=J. Am. Chem. Soc. |volume=133 |issue=24 |pages=9140–3 |year=2011 |pmid=21604744 |doi=10.1021/ja2004686 |url=https://figshare.com/articles/_sup_13_sup_C_sub_2_sub_Acetaldehyde_Promotes_Unequivocal_Formation_of_1_i_N_i_sup_2_sup_Propano_2_deoxyguanosine_in_Human_Cells/2639098 |access-date=December 1, 2019 |archive-date=November 6, 2020 |archive-url=https://web.archive.org/web/20201106102427/https://figshare.com/articles/_sup_13_sup_C_sub_2_sub_Acetaldehyde_Promotes_Unequivocal_Formation_of_1_i_N_i_sup_2_sup_Propano_2_deoxyguanosine_in_Human_Cells/2639098 |url-status=live |url-access=subscription }}</ref> |- |Ethylene oxide |align="left"|7.0 |Hydroxyethyl DNA adducts with adenine and guanine |<ref name="pmid19477295">{{cite journal |vauthors=Tompkins EM, McLuckie KI, Jones DJ, Farmer PB, Brown K |title=Mutagenicity of DNA adducts derived from ethylene oxide exposure in the pSP189 shuttle vector replicated in human Ad293 cells |journal=Mutat. Res. |volume=678 |issue=2 |pages=129–37 |year=2009 |pmid=19477295 |doi=10.1016/j.mrgentox.2009.05.011 |bibcode=2009MRGTE.678..129T }}</ref> |- |Isoprene |align="left"|952.0 |Single and double strand breaks in DNA |<ref name="pmid17317274">{{cite journal |vauthors=Fabiani R, Rosignoli P, De Bartolomeo A, Fuccelli R, Morozzi G |title=DNA-damaging ability of isoprene and isoprene mono-epoxide (EPOX I) in human cells evaluated with the comet assay |journal=Mutat. Res. |volume=629 |issue=1 |pages=7–13 |year=2007 |pmid=17317274 |doi=10.1016/j.mrgentox.2006.12.007 |bibcode=2007MRGTE.629....7F }}</ref> |} {| class="wikitable" |+Number of current and expected smokers, and expected deaths<ref>{{Cite book |last1=Jha |first1=Prabhat |chapter=Global Hazards of Tobacco and the Benefits of Smoking Cessation and Tobacco Taxes |date=2015 |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK343639/ |title=Cancer: Disease Control Priorities, Third Edition (Volume 3) |editor-last=Gelband |editor-first=Hellen |access-date=2023-11-20 |place=Washington (DC) |publisher=The International Bank for Reconstruction and Development / The World Bank |isbn=978-1-4648-0349-9 |pmid=26913345 |last2=MacLennan |first2=Mary |last3=Chaloupka |first3=Frank J. |last4=Yurekli |first4=Ayda |last5=Ramasundarahettige |first5=Chintanie |last6=Palipudi |first6=Krishna |last7=Zatońksi |first7=Witold |last8=Asma |first8=Samira |last9=Gupta |first9=Prakash C. |doi=10.1596/978-1-4648-0349-9_ch10 |editor2-last=Jha |editor2-first=Prabhat |editor3-last=Sankaranarayanan |editor3-first=Rengaswamy |editor4-last=Horton |editor4-first=Susan}}</ref> !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 |} One study by University Hospital of Wales found that "ulcerative colitis is a condition of nonsmokers in which nicotine is of therapeutic benefit."<ref>{{Cite journal | doi = 10.1046/j.1365-2036.2000.00847.x | last1 = Green | first1 = J. T. | last2 = Richardson | first2 = C. | last3 = Marshall | first3 = R. W. | last4 = Rhodes | first4 = J. | last5 = McKirdy | first5 = H. C. | last6 = Thomas | first6 = G. A. | last7 = Williams | first7 = G. T. | s2cid = 21358737 | title = Nitric oxide mediates a therapeutic effect of nicotine in ulcerative colitis | journal = Alimentary Pharmacology & Therapeutics | volume = 14 | issue = 11 | pages = 1429–1434 | year = 2000 | pmid = 11069313 }}</ref> A 2002 review of the available scientific literature concluded that the apparent decrease in Alzheimer's 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 states, noting that smokers are only half as likely as nonsmokers to survive to the age of 80.<ref name="alzheimer-almeida">{{Cite journal | doi = 10.1046/j.1360-0443.2002.00016.x | title = Smoking as a risk factor for Alzheimer's disease: contrasting evidence from a systematic review of case-control and cohort studies | year = 2002 |vauthors=Almeida OP, Hulse GK, Lawrence D, Flicker L | s2cid = 22936675 | journal = Addiction | volume = 97 | pages = 15–28| pmid = 11895267 | issue = 1 }}</ref>
==== Gateway theory ==== An association has been found between adolescent exposure to nicotine by smoking conventional cigarettes and the subsequent onset of using other dependence-producing substances.{{sfn|SGUS|2016|p=106; Chapter 3}} 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.{{sfn|SGUS|2016|p=106; Chapter 3}} 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).{{sfn|SGUS|2016|p=106; Chapter 3}} 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.{{sfn|SGUS|2016|p=106; Chapter 3}} 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.{{sfn|SGUS|2016|p=106; Chapter 3}} 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.{{sfn|SGUS|2016|p=106; Chapter 3}}
=== Secondhand smoke === Secondhand 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.<ref name="ALASecondhandSmokeFactSheet">{{cite web|url=http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35422#one |title=Secondhand Smoke |date=June 2007 |publisher=American Lung Association |access-date=May 6, 2012 |archive-url=https://web.archive.org/web/20091016220328/http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35422 |archive-date=October 16, 2009 }}</ref> 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.<ref>{{cite web |url=http://www.tobaccofreefloridanewsroom.com/?cat=6 |title=Centers for Disease Control & Prevention Fact Sheets |publisher=Tobacco Free Florida |access-date=January 2, 2013 |archive-date=December 2, 2008 |archive-url=https://web.archive.org/web/20081202074323/http://www.tobaccofreefloridanewsroom.com/?cat=6 |url-status=live }}</ref> Sudden infant death syndrome, ear infections, respiratory infections, and asthma attacks can occur in children who are exposed to second-hand smoke.<ref name="Secondhand Smoke">{{cite web |url=http://www.cancer.org/Cancer/CancerCauses/TobaccoCancer/secondhand-smoke |title=Secondhand Smoke |publisher=Cancer.org |access-date=March 25, 2012 |archive-date=January 7, 2017 |archive-url=https://web.archive.org/web/20170107025355/http://www.cancer.org/cancer/cancercauses/tobaccocancer/secondhand-smoke |url-status=live }}</ref><ref name="NCI">{{cite web |url=http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS |title=Secondhand Smoke and Cancer - National Cancer Institute |publisher=Cancer.gov |date=August 18, 2005 |access-date=March 25, 2012 |archive-date=March 25, 2012 |archive-url=https://web.archive.org/web/20120325183133/http://cancer.gov/cancertopics/factsheet/Tobacco/ETS |url-status=live }}</ref><ref>{{Cite news |date=2021-01-05 |title=Secondhand Smoke (SHS) Facts |url=https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm |archive-url=https://web.archive.org/web/20220819034536/https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm |archive-date=2022-08-19 |access-date=2025-11-26 |work=Centers for Disease Control and Prevention |language=en-us}}</ref> Scientific evidence shows that no level of exposure to second-hand smoke is safe.<ref name="Secondhand Smoke"/><ref name="NCI"/>
== Politics and lobbying == {{Excerpt|Tobacco politics}}
== Legislation ==
=== Smoking restrictions === {{further|List of smoking bans}} Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of secondhand smoke.<ref name=second>{{usurped|1=[https://web.archive.org/web/20050906213831/http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf 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."</ref> 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 === {{main|Smoking age}}
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.
[[File:Tabak-Trafik 12.2006.jpg|right|thumb|''Tabak-Trafik'' in Vienna. Since January 1, 2007, all cigarette machines in Austria must attempt to verify a customer's age by requiring the insertion of a debit card or mobile phone verification.]]
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), increased 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, it is only illegal for a retailer to sell a tobacco-associated item to them. 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 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, Prime Minister Rishi Sunak proposed a ban on sales of cigarettes to anyone born after 2008.<ref>{{Cite web |date=2023-10-04 |title=Prime Minister to create 'smokefree generation' by ending cigarette sales to those born on or after 1 January 2009 |url=https://www.gov.uk/government/news/prime-minister-to-create-smokefree-generation-by-ending-cigarette-sales-to-those-born-on-or-after-1-january-2009 |access-date=2025-11-26 |website=GOV.UK |language=en}}</ref>
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 percentages of smokers by population,<ref>{{Cite web |title=NationMaster - Tobacco > Total adult smokers (most recent) by country |url=http://www.nationmaster.com/graph/hea_tob_tot_adu_smo-health-tobacco-total-adult-smokers |archive-url=https://web.archive.org/web/20080607074448/http://www.nationmaster.com/graph/hea_tob_tot_adu_smo-health-tobacco-total-adult-smokers |archive-date=2008-06-07 |access-date=2025-11-26 |website=www.nationmaster.com}}</ref> 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|date=August 2011}} 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.<ref>{{cite web|date=2009|url=http://www.abc.state.va.us/licensing/downloads/underagebuyer.pdf|archive-url=https://web.archive.org/web/20090326205920/http://www.abc.state.va.us/licensing/downloads/underagebuyer.pdf|archive-date=March 26, 2009|title=Underage Operatives}}</ref> Similar enforcement practices are regularly performed by Trading Standards officers in the UK, and by equivalents in Israel and <!-- the Gardaí Siochana, the police force of --> the Republic of Ireland.<ref>{{Cite web |title=BBC NEWS {{!}} England {{!}} Bristol {{!}} Retailers sell tobacco to youths |url=http://news.bbc.co.uk/1/hi/england/bristol/4205066.stm |archive-url=https://web.archive.org/web/20070313151744/http://news.bbc.co.uk/1/hi/england/bristol/4205066.stm |archive-date=2007-03-13 |access-date=2025-11-26 |website=news.bbc.co.uk |date=September 2005 }}</ref>
=== Taxation === {{Main|Tobacco taxation}} {{owidslider |start = 2022 |list = Template:OWID/taxes as a share of cigarette price#gallery |location = commons |caption = |title = |language = |file = link=|thumb|upright=1.6|right|Taxes as a share of cigarette price |startingView = World }} 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%.<ref>{{Cite web |title=Special Report: Higher Cigarette Taxes: Reduce Smoking, Save Lives, Save Money |url=http://tobaccofreekids.org/reports/prices/ |archive-url=https://web.archive.org/web/20090904183535/http://tobaccofreekids.org/reports/prices/ |archive-date=2009-09-04 |access-date=2025-11-26 |website=tobaccofreekids.org}}</ref> The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of at least 75% of their sale price as a way of deterring cancer, cardiovascular diseases and other negative health outcomes.<ref>{{Cite web |author=<!-- not stated --> |date= |title=Promoting taxation on tobacco products |url=https://www.who.int/europe/activities/promoting-taxation-on-tobacco-products |publisher=World Health Organization |access-date=19 December 2025}}</ref><ref>{{Cite news |title=Closing in on cancer |url=https://www.economist.com/news/leaders/21728893-science-will-win-technical-battle-against-cancer-only-half-fight-closing |archive-url=https://web.archive.org/web/20170923033052/https://www.economist.com/news/leaders/21728893-science-will-win-technical-battle-against-cancer-only-half-fight-closing |archive-date=2017-09-23 |access-date=2025-11-26 |newspaper=The Economist |language=en}}</ref>
Cigarette sales are a significant source of tax revenue in many countries. 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.<ref>{{Cite news |url=https://www.washingtonpost.com/wp-srv/national/longterm/tobacco/stories/asia.htm |title=U.S. Aided Cigarette Firms in Conquests Across Asia |work=Washingtonpost.com |date=November 17, 1996 |access-date=November 13, 2009 |archive-date=July 4, 2008 |archive-url=https://web.archive.org/web/20080704144106/http://washingtonpost.com/wp-srv/national/longterm/tobacco/stories/asia.htm |url-status=live }}</ref>
===Fire-safe cigarette=== {{main|Fire-safe cigarette}}
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.<ref>{{Cite web |title=Les cigarettes anti-incendie seront obligatoires en 2011 |url=http://www.lexpansion.com/economie/actualite-high-tech/les-cigarettes-anti-incendie-seront-obligatoires-en-2011_160019.html |archive-url=https://web.archive.org/web/20090223214800/http://www.lexpansion.com/economie/actualite-high-tech/les-cigarettes-anti-incendie-seront-obligatoires-en-2011_160019.html |archive-date=2009-02-23 |access-date=2025-11-26 |website=www.lexpansion.com |language=fr |quote=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}}</ref><ref name=":2">{{Cite web |title=European Union Pushes for Self-Extinguishing Cigarettes {{!}} Europe {{!}} Deutsche Welle {{!}} 05.08.2008 |url=http://www.dw-world.de/dw/article/0,2144,3540489,00.html |archive-url=https://web.archive.org/web/20081013113850/http://www.dw-world.de/dw/article/0,2144,3540489,00.html |archive-date=2008-10-13 |access-date=2025-11-26 |website=www.dw-world.de |language=en}}</ref> 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.<ref name=":2" /> 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.<ref>{{Cite news |last=O'Connell V |date=2004-04-23 |title=U.S. Suit Alleges Philip Morris Hid Cigarette-Fire Risk - WSJ |url=https://www.wsj.com/articles/SB108267528721891341 |archive-url=https://web.archive.org/web/20190415184518/https://www.wsj.com/articles/SB108267528721891341 |archive-date=April 15, 2019 |access-date=2025-11-26 |work=Wall Street Journal |language=en-US |issn=0099-9660}}</ref> The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper.<ref>{{Cite journal |last1=Baldwin |first1=Sheryl D. |last2=Navin |first2=Gautam |last3=Houghton |first3=Kenneth S. |last4=Rogers |first4=Robert M. |last5=Ryder |first5=Judith L. |date=1993-11-23 |title=Smoking article wrapper for controlling burn rate and method for making same |url=http://www.freepatentsonline.com/5263999.html |journal=Free Patents Online |language=en |archive-url=https://web.archive.org/web/20131004215504/http://www.freepatentsonline.com/5263999.html |archive-date=2013-10-04}}</ref> 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.<ref>{{Cite web |last=David |first=Rozehnal |date=2025-11-18 |title=Topsmoke.com.au |url=https://topsmoke.com.au/ |access-date=2025-11-26 |website=Top Smoke |language=en}}</ref><ref>{{Cite web |title=Fire Safe Cigarettes :: About fire-safe cigarettes :: What is a fire-safe cigarette? |url=http://firesafecigarettes.org/itemDetail.asp?categoryID=48&itemID=1190&URL=About%20fire-safe%20cigarettes/What%20is%20a%20fire-safe%20cigarette |archive-url=https://web.archive.org/web/20110816103154/http://firesafecigarettes.org/itemDetail.asp?categoryID=48&itemID=1190&URL=About%20fire-safe%20cigarettes/What%20is%20a%20fire-safe%20cigarette |archive-date=2011-08-16 |access-date=2025-11-26 |website=firesafecigarettes.org}}</ref> This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.<ref>{{Cite web |title=Method and apparatus for making banded smoking article wrappers - US Patent 5342484 |url=http://www.patentstorm.us/patents/5342484-fulltext.html |archive-url=https://web.archive.org/web/20080512113150/http://www.patentstorm.us/patents/5342484-fulltext.html |archive-date=2008-05-12 |access-date=2025-11-26 |website=www.patentstorm.us}}</ref> 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.<ref>{{Cite web |title=Fire Safe Cigarettes :: States that have passed fire-safe cigarette laws |url=http://www.firesafecigarettes.org/categoryList.asp?categoryID=77&URL=Legislative%20updates/Adoptions |archive-url=https://web.archive.org/web/20110923040102/http://www.firesafecigarettes.org/categoryList.asp?categoryID=77&URL=Legislative%20updates/Adoptions |archive-date=2011-09-23 |access-date=2025-11-26 |website=www.firesafecigarettes.org}}</ref>
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union of 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.<ref>{{Cite web |title=Les cigarettes anti-incendie seront obligatoires en 2011 |url=http://www.lexpansion.com/economie/actualite-high-tech/les-cigarettes-anti-incendie-seront-obligatoires-en-2011_160019.html |archive-url=https://web.archive.org/web/20090223214800/http://www.lexpansion.com/economie/actualite-high-tech/les-cigarettes-anti-incendie-seront-obligatoires-en-2011_160019.html |archive-date=2009-02-23 |access-date=2025-11-26 |website=www.lexpansion.com |language=fr}}</ref>
=== Cigarette advertising === {{Main|Nicotine marketing{{!}}Tobacco advertising}}
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.<ref>{{Cite news |url=http://www.cbc.ca/news/health/a-legal-history-of-smoking-in-canada-1.982213 |title=A legal history of smoking in Canada |date=November 9, 2012 |access-date=December 29, 2014 |publisher=CBC News |quote=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. |archive-date=January 1, 2015 |archive-url=https://web.archive.org/web/20150101221608/http://www.cbc.ca/news/health/a-legal-history-of-smoking-in-canada-1.982213 |url-status=live }}</ref> In the Canadian provinces of Ontario, Manitoba, Newfoundland and Labrador, and Quebec, as well as 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.<ref>{{cite web |url=https://www.ctvnews.ca/ontario-set-to-ban-cigarette-display-cases-1.290422 |title=Ontario set to ban cigarette display cases |date=April 20, 2008 |access-date=January 31, 2009 |publisher=CTV News |quote=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. |archive-url=https://web.archive.org/web/20090212065947/http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080420/ont_cigs_080420 |archive-date=February 12, 2009 }}</ref><ref>{{cite web|url=http://www.hc-sc.gc.ca/hc-ps/consult/_2006/tob-ret/4-draft-ebauche-eng.php |title=A Proposal to Regulate the Display and Promotion of Tobacco and Tobacco-Related Products at Retail |publisher=Hc-sc.gc.ca |access-date=November 13, 2009 |archive-url=https://web.archive.org/web/20110607113117/http://www.hc-sc.gc.ca/hc-ps/consult/_2006/tob-ret/4-draft-ebauche-eng.php |archive-date=June 7, 2011 }}</ref>
=== Warning messages on packaging === {{Main|Tobacco packaging warning messages}}
As a result of tight advertising and marketing prohibitions, tobacco companies view packaging as a vital factor in displaying brand imagery and 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 is displayed in alternative packaging. Companies have manipulated a variety of elements on packaging designs to communicate the impression of lower tar content or milder cigarettes, although the actual contents were the same.<ref>"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. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1766062/pdf/v011p00i73.pdf online]</ref>
Some countries require cigarette packs to display warnings about the health impact of smoking. The United States was the first,<ref name="nytimes 2010">{{cite news | newspaper= The New York Times | date= November 10, 2010 | last= Harris | first= Gardiner | title= F.D.A. Unveils Proposed Graphic Warning Labels for Cigarette Packs | url= https://www.nytimes.com/2010/11/11/health/policy/11tobacco.html | access-date= February 24, 2017 | archive-date= February 28, 2017 | archive-url= https://web.archive.org/web/20170228154939/http://www.nytimes.com/2010/11/11/health/policy/11tobacco.html | url-status= live }}</ref> later followed by other countries including Canada, most of Europe, the United Kingdom, Australia,<ref name="australia">{{Cite web |last1=Scollo |first1=Michelle |last2=Haslam |first2=Indra |date=2008 |title=Attachment 12.1 Health warnings - Tobacco In Australia |url=http://www.tobaccoinaustralia.org.au/chapter-12-tobacco-products/attachment-12-1-health-warnings |archive-url=https://web.archive.org/web/20101030003331/http://www.tobaccoinaustralia.org.au/chapter-12-tobacco-products/attachment-12-1-health-warnings |archive-date=2010-10-30 |access-date=2025-11-26 |website=www.tobaccoinaustralia.org.au |language=en-US}}</ref> Pakistan,<ref name="pakistan">{{Cite news |last=Junaidi |first=Ikram |date=2015-10-02 |title=Enlarged health warning on cigarette packs delayed again |url=https://www.dawn.com/news/1210407 |archive-url=https://web.archive.org/web/20160601090014/http://www.dawn.com/news/1210407 |archive-date=2016-06-01 |access-date=2025-11-26 |url-status=live |language=en}}</ref> India and Hong Kong. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging.<ref>{{cite web |url=http://articles.sun-sentinel.com/1985-09-17/features/8502080902_1_abuse-dentists-iceland |title=Iceland Tough On Cigarettes – Sun Sentinel |publisher=Articles.sun-sentinel.com |date=September 17, 1985 |access-date=January 2, 2013 |archive-date=May 24, 2013 |archive-url=https://web.archive.org/web/20130524170034/http://articles.sun-sentinel.com/1985-09-17/features/8502080902_1_abuse-dentists-iceland }}</ref><ref>{{cite journal |last=Bardi |first=Jason |url=http://www.ucsf.edu/news/2012/11/13151/cigarette-pack-health-warning-labels-us-lag-behind-world |title=Cigarette Pack Health Warning Labels in US Lag Behind World |journal=Tobacco Control |volume=23 |issue=1 |pages=e2 |doi=10.1136/tobaccocontrol-2012-050541 |pmid=23092884 |pmc=3725195 |date=November 16, 2012 |access-date=January 2, 2013 |archive-date=December 2, 2012 |archive-url=https://web.archive.org/web/20121202131737/http://www.ucsf.edu/news/2012/11/13151/cigarette-pack-health-warning-labels-us-lag-behind-world |url-status=live }}</ref> At the end of December 2010, new regulations in Canada increased the size of tobacco warnings to cover three-quarters of cigarette packaging.<ref>{{Cite web |title=Ottawa to increase size of tobacco warning to cover 3/4 of cigarette package |url=https://vancouversun.com/health/Ottawa+increase+size+tobacco+warnings/4039002/story.html%5B%5D |access-date=2025-11-26 }}{{Dead link|date=May 2026 |bot=InternetArchiveBot }}</ref> As of November 2010, 39 countries have adopted similar legislation.<ref name="nytimes 2010" />
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.<ref>{{cite web|url=https://vancouversun.com/health/Tobacco+warning+labels+appear+interior+exterior+package/4312065/story.html |access-date=February 19, 2011 |title=Story of a shattered life: A single childhood incident pushed Dawn Crey into a downward spiral | Vancouver Sun |date=November 24, 2001 }}{{dead link|date=June 2016|bot=medic}}{{cbignore|bot=medic}}</ref>
As of April 2011, Australian regulations require all packaging to use a bland olive green that researchers determined to be the least attractive color,<ref>{{Cite web|url=https://www.legislation.gov.au/Details/F2013C00801/Html/Text#_Toc367282493|title=Tobacco Plain Packaging Regulations 2011|date=August 8, 2013|at=2.2.1 (2) & passim|website=Australian Government Federal Register of Legislation|access-date=March 29, 2018|archive-date=March 30, 2018|archive-url=https://web.archive.org/web/20180330075938/https://www.legislation.gov.au/Details/F2013C00801/Html/Text#_Toc367282493|url-status=live}}</ref> 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.<ref>{{cite web |url=http://www.channelnewsasia.com/stories/afp_asiapacific/view/1121281/1/.html |title=Australia unveils tough new cigarette pack rules |publisher=Channel NewsAsia |date=April 7, 2011 |access-date=March 25, 2012 |archive-date=August 30, 2011 |archive-url=https://web.archive.org/web/20110830124748/http://www.channelnewsasia.com/stories/afp_asiapacific/view/1121281/1/.html }}</ref> 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.<ref>{{Cite news |title=Australia's Top Court Backs Plain-Pack Tobacco Laws |url=http://www.bloomberg.com/news/2012-08-15/australia-top-court-upholds-tobacco-plain-packaging-legislation.html |archive-url=https://web.archive.org/web/20131113204349/http://www.bloomberg.com/news/2012-08-15/australia-top-court-upholds-tobacco-plain-packaging-legislation.html |archive-date=2013-11-13 |access-date=2025-11-26 |work=Bloomberg}}</ref>
Similar policies have since been introduced in the United Kingdom, where standardised packaging of tobacco products regulations (SPOT) were introduced in 2015. These regulations were also challenged by cigarette manufacturers.<ref>{{Cite web |title=The Standardised Packaging of Tobacco Products Regulations 2015 |url=https://www.legislation.gov.uk/uksi/2015/829/contents |access-date=2025-08-18 |website=Legislation.gov.uk}}</ref><ref>{{Cite news |date=2015-12-10 |title=Tobacco firms challenge plain packaging rules |url=https://www.bbc.com/news/business-35058074 |access-date=2025-08-18 |work=BBC News |language=en-GB}}</ref>
===Prohibition of tobacco=== 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.<ref>{{cite web |first=Gayatri |last=Parameswaran |url=http://www.aljazeera.com/indepth/features/2012/09/201292095920757761.html |title=Bhutan smokers huff and puff over tobacco ban - Features |publisher=Al Jazeera English |access-date=January 2, 2013 |archive-date=January 2, 2013 |archive-url=https://web.archive.org/web/20130102163919/http://www.aljazeera.com/indepth/features/2012/09/201292095920757761.html |url-status=live }}</ref> 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 as of 2008.<ref>{{cite news |last=Marks |first=Kathy |url=https://www.independent.co.uk/news/world/australasia/worlds-smallest-state-aims-to-become-the-first-smokefree-paradise-island-862977.html |title=World's smallest state aims to become the first smoke-free paradise island - Australasia - World |newspaper=The Independent |date=July 9, 2008 |access-date=January 2, 2013 |location=London |archive-date=November 11, 2012 |archive-url=https://web.archive.org/web/20121111230150/http://www.independent.co.uk/news/world/australasia/worlds-smallest-state-aims-to-become-the-first-smokefree-paradise-island-862977.html }}</ref> Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders.<ref>{{Cite news |last=Pidd |first=Helen |date=2011-07-04 |title=What a drag … Iceland considers prescription-only cigarettes |url=https://www.theguardian.com/world/2011/jul/04/iceland-considers-prescription-only-cigarettes |archive-url=https://web.archive.org/web/20130930132047/http://www.theguardian.com/world/2011/jul/04/iceland-considers-prescription-only-cigarettes |archive-date=September 30, 2013 |access-date=2025-11-26 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref> 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. <!-- See: Smoking age, Smoking bans in private vehicles, Retail display ban, Cigarette machine. -->
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 noncompliant cigarettes, and 24 months to remove other forms of noncompliant tobacco.<ref>{{Cite web |title=WHO {{!}} Brazil - Flavoured cigarettes banned |url=http://www.who.int/fctc/implementation/news/news_brazil/en/index.html |archive-url=https://web.archive.org/web/20130220124551/http://www.who.int/fctc/implementation/news/news_brazil/en/index.html |archive-date=2013-02-20 |access-date=2025-11-26 |website=www.who.int}}</ref><ref>{{Cite web |title=Eyes on Trade: Brazil's flavored cigarette ban now targeted |url=http://citizen.typepad.com/eyesontrade/2012/04/brazils-flavored-cigarette-ban-now-targeted.html |archive-url=https://web.archive.org/web/20140307184104/http://citizen.typepad.com/eyesontrade/2012/04/brazils-flavored-cigarette-ban-now-targeted.html |archive-date=2014-03-07 |access-date=2025-11-26 |website=citizen.typepad.com}}</ref> Under sharia law, the consumption of cigarettes by Muslims is prohibited.<ref>Dubai: The Complete Residents' Guide - Page 27, 2006</ref>
== Environmental impact ==
{{Excerpt|Environmental impact of cigarettes}}
== Consumption == [[File:Cigarettecounter pd.jpg|thumb|A Woolworths supermarket cigarette counter in New South Wales, Australia. In January 2011, Australia prohibited the display of cigarettes in retail outlets countrywide.<ref>{{cite news | url = http://www.theage.com.au/victoria/tobacco-display-ban-from-tomorrow-20101230-19b5h.html | title = Tobacco display ban from tomorrow | access-date = June 28, 2012 | last = Willingham | first = Richard | date = December 31, 2010 | work = The Age(Melbourne) | publisher = Fairfax Media | archive-date = June 17, 2012 | archive-url = https://web.archive.org/web/20120617195250/http://www.theage.com.au/victoria/tobacco-display-ban-from-tomorrow-20101230-19b5h.html | url-status = live }}</ref>]] [[File:Konter Rokok Circle K, Pagedangan, Kab Tangerang, Banten (5 November 2024).jpg|thumb|Various cigarettes being sold at a minimarket in Bumi Serpong Damai, Tangerang Regency, Indonesia]] Smoking has become less popular, but is still a large public health problem globally.<ref name="autogenerated1">{{cite web |title=Cigarette Smoking Among Adults - United States, 2006 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a2.htm#fig |access-date=November 13, 2009 |publisher=Cdc.gov |archive-date=August 16, 2019 |archive-url=https://web.archive.org/web/20190816014306/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a2.htm#fig |url-status=live }}</ref><ref name="autogenerated2">{{cite web |date=May 28, 2002 |title=WHO/WPRO-Smoking Statistics |url=http://www.wpro.who.int/media_centre/fact_sheets/fs_20020528.htm |archive-url=https://web.archive.org/web/20091108181404/http://www.wpro.who.int/media_centre/fact_sheets/fs_20020528.htm |archive-date=November 8, 2009 |access-date=November 13, 2009 |publisher=Wpro.who.int}}</ref><ref>{{cite web |title=Home |url=http://www.tobaccoatlas.org/ |website=The Tobacco Atlas |access-date=March 5, 2018 |archive-date=January 2, 2023 |archive-url=https://web.archive.org/web/20230102224359/https://tobaccoatlas.org/ |url-status=live }}</ref> Worldwide, smoking rates fell from 41% in 1980 to 31% in 2012, although the actual number of smokers increased because of population growth.<ref>{{Cite journal|last1=Ng|first1=Marie|last2=Freeman|first2=Michael K.|last3=Fleming|first3=Thomas D.|last4=Robinson|first4=Margaret|last5=Dwyer-Lindgren|first5=Laura|last6=Thomson|first6=Blake|last7=Wollum|first7=Alexandra|last8=Sanman|first8=Ella|last9=Wulf|first9=Sarah|date=January 8, 2014|title=Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012|journal=JAMA|language=en|volume=311|issue=2|pages=183–92|doi=10.1001/jama.2013.284692|pmid=24399557|bibcode=2014JAMA..311..183N |issn=0098-7484|doi-access=free}}{{Dead link|date=October 2019 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> In 2017, 5.4 trillion cigarettes were produced globally, and were smoked by almost 1 billion people.<ref>{{Cite web|url=https://www.tobaccofreekids.org/global-resource/the-global-cigarette-industry|title=The Global Cigarette Industry|date=August 2018|access-date=July 17, 2019|archive-date=July 17, 2019|archive-url=https://web.archive.org/web/20190717190147/https://www.tobaccofreekids.org/global-resource/the-global-cigarette-industry|url-status=live}}</ref> Smoking rates have leveled off or declined in most countries, but are 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|date=December 2019}} have been offset by 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.{{citation needed|date=January 2026}} Australia is cutting their overall smoking consumption faster than most of the developed world, in part due to the 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 which the government's associate health minister said "takes away the last means of promoting tobacco as a desirable product."<ref>{{cite news|url=https://www.nytimes.com/2014/06/12/business/international/australias-graphic-cigarette-pack-warnings-appear-to-work.html|title=Australia's Graphic Cigarette Pack Warnings Appear to Work|first=Michelle|last=Innis|newspaper=The New York Times|date=June 11, 2014|access-date=February 24, 2017|archive-date=December 29, 2017|archive-url=https://web.archive.org/web/20171229113152/https://www.nytimes.com/2014/06/12/business/international/australias-graphic-cigarette-pack-warnings-appear-to-work.html|url-status=live}}</ref> {| class="wikitable" |+Smoking prevalence by sex (ages 15 or older, 2016)<ref>{{Cite web|url=http://apps.who.int/gho/data/view.sdg.3-a-data-reg?lang=en|title=Age-standardized prevalence of current tobacco smoking among persons aged 15 years or older, 2016|date=2018|access-date=July 17, 2019|archive-date=July 30, 2018|archive-url=https://web.archive.org/web/20180730093712/http://apps.who.int/gho/data/view.sdg.3-a-data-reg?lang=en|url-status=live}}</ref> |- ! ! colspan="2" | 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% |}
{| class="wikitable" |+Leading consumers of cigarettes (2016)<ref>Cigarette numbers and per capita consumption from The Tobacco Atlas: https://tobaccoatlas.org/topic/consumption/ {{Webarchive|url=https://web.archive.org/web/20190325150157/https://tobaccoatlas.org/topic/consumption/ |date=March 25, 2019 }}
Population numbers from World Bank 2017</ref>
! Country !! Population<br />(millions) !! Cigarettes consumed<br />(billions) !! Cigarettes consumed<br />(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 |} <div style="display:inline-table; vertical-align:top;"> {{owidslider |start = 2022 |list = Template:OWID/affordability cigarettes#gallery |location = commons |caption = |title = |language = |file = link=|thumb|upright=1.6|right|Affordability cigarettes |startingView = World }} </div> <div style="display:inline-table; vertical-align:top;"> {{owidslider |start = 2012 |list = Template:OWID/consumption per smoker per day#gallery |location = commons |caption = |title = |language = |file = link=|thumb|upright=1.6|right|Consumption per smoker per day |startingView = World }} </div><div style="display:inline-table; vertical-align:top;"> {{owidslider |start = 2015 |list = Template:OWID/sales of cigarettes per adult per day#gallery |location = commons |caption = |title = |language = |file = link=|thumb|upright=1.6|right|Sales of cigarettes per adult per day |startingView = World }} </div>
== Lights == {{main|Ventilated cigarette{{!}}Lights (cigarette type)}}
Some cigarettes are marketed as "lights", "milds", or "low-tar".<ref name=netcom>{{cite web|url=http://pw1.netcom.com/~rdavis2/cigra.html|access-date=October 5, 2011|title=Nicotine, Tar, and Co Content of Domestic Cigarettes|archive-url=https://web.archive.org/web/20120401150517/http://pw1.netcom.com/~rdavis2/cigra.html|archive-date=April 1, 2012}}</ref> These cigarettes were historically marketed as being less harmful, but there is no research showing that they are actually any less harmful than other types of cigarettes. 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 dilute the concentration of 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.<ref name="Koch">Koch 2009</ref>
Research shows that smoking "light" or "low-tar" cigarettes is just as harmful as smoking other cigarettes.<ref name="National">U.S. National 2004</ref><ref name="Benowitz">Benowitz 2005, p. 1</ref><ref>NCI's Smoking 2007, p.7</ref>
== Smoking cessation == {{main|Smoking cessation}}
Smoking cessation (quitting smoking) is the process of discontinuing the practice of tobacco smoking.<ref>{{cite web| url=http://www.cancer.org/docroot/ped/content/ped_10_13x_guide_for_quitting_smoking.asp| title=Guide to quitting smoking| publisher=American Cancer Society| date=January 31, 2011| access-date=February 15, 2011| archive-url=https://web.archive.org/web/20100627084514/http://www.cancer.org/docroot/PED/content/PED_10_13X_Guide_for_Quitting_Smoking.asp| archive-date=June 27, 2010}}</ref> Quitting can be difficult for many smokers due to the addictive nature of nicotine.<ref name=Benowitz2010>{{Cite journal | author = Benowitz NL | last2 = Benowitz | first2 = Neal L. | title = Nicotine addiction | journal = N Engl J Med | volume = 362 | issue = 24 | pages = 2295–303 | year = 2010 | doi = 10.1056/NEJMra0809890 | pmid = 20554984 | pmc = 2928221}}</ref>{{rp|2300–2301}} Addiction begins when nicotine acts on nicotinic acetylcholine receptors to release neurotransmitters such as dopamine, glutamate, and gamma-aminobutyric acid.<ref name=Benowitz2010/>{{rp|2296}} Cessation of smoking leads to symptoms of nicotine withdrawal such as anxiety and irritability.<ref name=Benowitz2010/>{{rp|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.<ref name=Chapman-MacKenzie>{{cite journal|title=The global research neglect of unassisted smoking cessation: causes and consequences|vauthors=Chapman S, MacKenzie R |date=February 9, 2010|journal=PLOS Medicine|doi=10.1371/journal.pmed.1000216|pmid=20161722|volume=7|issue=2|article-number=e1000216|pmc=2817714 |doi-access=free }}</ref> 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. At the University of Buffalo, researchers found that fruit and vegetable consumption can help a smoker cut down on or even quit smoking.<ref>{{cite news|title=Fruits And Vegetables May Help Smokers Quit -- And Stay Off -- Tobacco|url=https://www.huffingtonpost.com/2012/06/10/fruits-vegetables-quit-smoking-smokers-tobacco_n_1581465.html|work=Huffington Post|date=June 10, 2012|first=Amanda L.|last=Chan|access-date=February 20, 2020|archive-date=June 12, 2017|archive-url=https://web.archive.org/web/20170612025133/http://www.huffingtonpost.com/2012/06/10/fruits-vegetables-quit-smoking-smokers-tobacco_n_1581465.html|url-status=live}}</ref> Although stopping smoking can cause short-term side effects such as reversible weight gain, smoking cessation services and activities are cost-effective because of their positive health benefits.
A growing number of countries have more ex-smokers than smokers.<ref name=autogenerated3>{{cite journal|title=The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences|author1=Chapman, Simon |author2=MacKenzie, Ross|date=February 9, 2010|journal=PLOS Medicine|doi=10.1371/journal.pmed.1000216|pmid=20161722|volume=7|issue=2|article-number=e1000216|pmc=2817714 |doi-access=free }}</ref> 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.<ref name=Chapman-MacKenzie /> NRT, other prescribed pharmaceuticals, and professional counselling or support also help many smokers.<ref name=Chapman-MacKenzie /> 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.<ref name=Chapman-MacKenzie />
The number of nicotinic receptors in the brain returns to the level of a nonsmoker between 6 and 12 weeks after quitting.<ref>{{cite web|title=Abstinent Smokers' Nicotinic Receptors Take More Than a Month to Normalize|date=October 2009|url=http://www.drugabuse.gov/news-events/nida-notes/2009/10/abstinent-smokers-nicotinic-receptors-take-more-than-month-to-normalize|access-date=July 7, 2013|archive-date=June 25, 2013|archive-url=https://web.archive.org/web/20130625235011/http://www.drugabuse.gov/news-events/nida-notes/2009/10/abstinent-smokers-nicotinic-receptors-take-more-than-month-to-normalize}}</ref> In 2019, the FDA authorized the selling of low-nicotine cigarettes in hopes of lowering the number of people addicted to nicotine.<ref>{{Cite web|url=https://www.cnbc.com/2019/12/17/fda-clears-22nd-centurys-moonlight-and-menthol-moonlight-low-nicotine-cigarettes.html|title=FDA authorizes low-nicotine cigarettes by 22nd Century Group for public sale|last=LaVito|first=Angelica|date=December 17, 2019|website=CNBC|language=en|access-date=December 19, 2019|archive-date=December 18, 2019|archive-url=https://web.archive.org/web/20191218215542/https://www.cnbc.com/2019/12/17/fda-clears-22nd-centurys-moonlight-and-menthol-moonlight-low-nicotine-cigarettes.html|url-status=live}}</ref>
== Notable cigarette brands == {{main|List of cigarette brands}}
{{div col|colwidth=18em}} * 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 * Peter Stuyvesant * Peter Jackson * Philip Morris * Player's * Prince * Salem * Sampoerna * Senior Service * Sobranie * Sterling * Surya * Tareyton * Vantage * Viceroy * Virginia Slims * West * Woodbine * Winfield * Winston {{div col end}}
==See also== {{Col-begin}} {{Col-break}} * List of tobacco-related topics * Tobacco industry * History of commercial tobacco in the United States ** Altria, the current name *** Philip Morris USA the original name ** American Tobacco Company ** Liggett Group ** R. J. Reynolds Tobacco Company * List of additives in cigarettes * List of cigarette smoke carcinogens * Smoking culture * Tobacco smoking * List of countries by cigarette consumption per capita {{Col-break}} ;Similar products * Beedi * Cigar * Cigarillo * Electronic cigarette * Herbal cigarette * Kretek * Papirosa * Shag {{Col-end}}
== References == {{Reflist|30em}}
==Sources== * {{Cite book |last=Cox |first=Howard |url=https://books.google.com/books?id=ciE52XzUgJ8C |title=The Global Cigarette: Origins and Evolution of British American Tobacco, 1880-1945 |publisher=Oxford University Press |year=2000 |isbn=978-0-19-829221-0}} * {{cite web|url=https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf |archive-url=https://ghostarchive.org/archive/20221009/https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf |archive-date=2022-10-09 |url-status=live|title=E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General|publisher=United States Department of Health and Human Services|agency=Surgeon General of the United States|pages=1–298|year=2016|ref={{harvid|SGUS|2016}}}}{{PD-notice}} * {{cite web|url=http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf|title=Electronic nicotine delivery systems|website=World Health Organization|pages=1–13|date=21 July 2014|ref={{harvid|WHO|2014}}}} * {{cite web|last1=Wilder|first1=Natalie|last2=Daley|first2=Claire|last3=Sugarman|first3=Jane|last4=Partridge|first4=James|title=Nicotine without smoke: Tobacco harm reduction|url=https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0|location=UK|website=Royal College of Physicians|pages=1–191|date=April 2016|ref={{harvid|Wilder|2016}}|access-date=June 2, 2019|archive-date=May 5, 2016|archive-url=https://web.archive.org/web/20160505193314/https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0}}
== Further reading == {{Further|History of tobacco#Further reading}} * 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). [https://archive.org/details/cigarettecentury00bran 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) [https://archive.org/details/smokeofgodssocia0000burn 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) [https://archive.org/details/historyofsmoking0000cort online] * Durden, Robert F. ''The Dukes of Durham, 1865-1929'' (1975) [https://archive.org/details/dukesofdurham1860000durd/page/n6/mode/1up online] * Enstad, Nan. ''Cigarettes, Inc.: An Intimate History of Corporate Imperialism'' (U of Chicago, 2018) [https://www.amazon.com/Cigarettes-Inc-Intimate-Corporate-Imperialism/dp/022653331X/ 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)[https://archive.org/details/tobaccoinhistory0000unse/page/n6/mode/1up 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 [http://www.jstor.org/stable/3875105 online], argues most historians misinterpret the company. * Harrald, Chris. ''The cigarette book: the history and culture of smoking'' (2010) [https://archive.org/details/cigarettebookhis0000harr online] * Heimann, Robert K. ''Tobacco and Americans'' (McGraw-Hill, 1960) [https://archive.org/details/tobaccoamericans00heim online] * Hilton, Matthew, ''Smoking in British Popular Culture, 1800–2000'' (Manchester University Press, 2000) * Hirschfelder, Arlene B. ''Encyclopedia of smoking and tobacco'' (1999) [https://archive.org/details/encyclopediaofsm0000hirs 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. [https://archive.org/details/cigarettesaresub00klei online] * Kluger, Richard. ''Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris'' (Vintage, 1997). [https://www.amazon.com/Ashes-Americas-Hundred-Year-Cigarette-Unabashed/dp/0394570766/ 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) [https://archive.org/details/cigarettesanatom00park online] * Porter, Patrick G. "Origins of the American Tobacco Company." ''Business History Review'' 43.1 (1969): 59–76. [http://people.duke.edu/~rcd2/Dissertation/References/Tobacco%20Specific/Company%20Specific/3111987.pdf 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. [https://archive.org/details/storyoftobaccoin0000robe 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) [https://archive.org/details/peoplevsbigtobac00moll online] * Sivulka, Juliann. ''Soap, Sex, and Cigarettes: A Cultural History of American Advertising'' (2nd ed. 2012) [https://archive.org/details/soapsexcigarette0000sivu_d3l4 online] * Sobel, Robert. ''They satisfy: the cigarette in American life'' (1978) [https://archive.org/details/theysatisfycigar00sobe/page/n5/mode/2up online] * {{cite book|chapter=James Buchanan Duke: Opportunism Is the Spur|title=The Entrepreneurs: Explorations Within the American Business Tradition|last=Sobel|first=Robert|year=1974|publisher=Weybright & Talley|location=New York|isbn=0-679-40064-8|chapter-url-access=registration|chapter-url=https://archive.org/details/entrepreneursexp00sobe}} * 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) [https://archive.org/details/americancigarett0001rich online] * Tennant, Richard B. "The Cigarette Industry" in ''The Structure of American Industry,'' edited by Walter Adams (1961) pp 357–392. [https://archive.org/details/structureofameri0000adam/page/362/mode/1up 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. [https://archive.org/details/rjreynoldstobacc00till online] * Tilley, Nannie M. ''The bright-tobacco industry, 1860-1929'' (1948) [https://archive.org/details/brighttobaccoind0000till 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). [https://archive.org/details/cigarettecountry00wagn/page/n5/mode/2up online] * Wailoo, Keith. ''Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette'' (2021) [https://www.amazon.com/Pushing-Cool-Tobacco-Marketing-Cigarette/dp/022679413X/ 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) [https://archive.org/details/tobaccolandbooka00wernuoft/page/n10/mode/1up online] * Winkler, John K. ''Tobacco tycoon, the story of James Buchanan Duke'' (1942) [https://archive.org/details/tobaccotycoonsto00wink online] * Woofter Jr. T.J. ''The Plight of Cigarette Tobacco'' (1931) * {{Cite book |author1=Zhou, Xun Yu |author2=Gilman, Sander L. |title=Smoke: a global history of smoking |publisher=Reaktion Books |location=London |year=2004 |isbn=978-1-86189-200-3 }}
===Epidemiological and medical=== * {{Cite journal |vauthors=Bogden JD, Kemp FW, Buse M |title=Composition of tobaccos from countries with high and low incidences of lung cancer. I. Selenium, polonium-210, Alternaria, tar, and nicotine |journal=J. Natl. Cancer Inst. |volume=66 |issue=1 |pages=27–31 |date=January 1981 |pmid=6935462 |display-authors=etal | doi = 10.1093/jnci/66.1.27 }} * {{Cite journal |author=Hecht SS |title=Tobacco smoke carcinogens and lung cancer |journal=J. Natl. Cancer Inst. |volume=91 |issue=14 |pages=1194–210 |date=July 1999 |pmid=10413421 |doi=10.1093/jnci/91.14.1194|doi-access=free }} * Ernster, Virginia, et al. "Women and tobacco: moving from policy to action." ''Bulletin of the World Health Organization'' 78 (2000): 891–901. [https://www.scielosp.org/article/bwho/2000.v78n7/891-901/en/ online] * Frieden, Thomas R. et al. ''The Health Consequences of Smoking: 50 Years of Progress: A Report of the Surgeon General'' (2014) [https://archive.org/details/full-report online] * Kluger, Richard. ''Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris'' (Vintage, 1997). [https://www.amazon.com/Ashes-Americas-Hundred-Year-Cigarette-Unabashed/dp/0394570766/ excerpt] * {{cite web|last1=Matuszko|first1=Jan|title=Tobacco Products Processing Detailed Study|url=https://www.epa.gov/sites/default/files/2015-09/documents/tobacco-products-processing-study_2006.pdf |archive-url=https://ghostarchive.org/archive/20221009/https://www.epa.gov/sites/production/files/2015-09/documents/tobacco-products-processing-study_2006.pdf |archive-date=2022-10-09 |url-status=live|website=www.epa.gov|publisher=U.S. Environmental Protection Agency|access-date=March 29, 2017|date=November 2006}} * 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. [https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=ca24367d21f01b984db622e99349861d66742b1b online] * Warner, Kenneth E. 1986. ''Selling Smoke: Cigarette Advertising and Public Health'' (American Public Health Association, 1986). [https://archive.org/details/sellingsmokeciga0000warn online]
== External links == {{Commons}} * {{usurped|1=[https://web.archive.org/web/20050813011756/http://www.cdc.gov/tobacco/search/index.htm US Center for Disease Control]}} - Smoking and Health Database * [http://www.srnt.org/ Society for Research on Nicotine and Tobacco] {{Webarchive|url=https://web.archive.org/web/20190815122246/http://www.srnt.org/ |date=August 15, 2019 }} * {{usurped|1=[https://web.archive.org/web/20070515052607/http://www.library.ucsf.edu/tobacco/bibliography.html Bibliography on History of Cigarette Smoking]}}
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