Nicotine: Personal and social consequences

Last modified: Saturday, 20. June 2009 - 1:18 pm

The personal consequences of nicotine dependence are clearly the potentially life threatening illnesses that tobacco causes. Additional negative consequences become evident as tobacco use becomes less socially acceptable. Unlike the use of other recreational drugs or alcohol, tobacco use does not alter consciousness or cause escape from social responsibility. Therefore, until recently, smoking was regarded as a matter of personal choice. The links between second-hand smoke and disease in nonsmokers altered that view. Smokers often must face isolation and the outdoor elements to avoid exposing family, friends, and coworkers to second-hand smoke. Even then, they may face negative feedback from those around them.
Smoking causes several cosmetic changes too. Tobacco stains teeth and fingers. Smoke odor on breath, clothes, and hair may be offensive to others. Smokers are nearly five times more likely to develop more and deeper skin wrinkles, and have a higher risk for baldness and prematurely gray hair.
Environmental tobacco smoke
The smoke from smoldering tobacco together with exhaled smoke are called environmental tobacco smoke (ETS), second-hand smoke, or passive smoke. ETS is classified by the Environmental Protection Agency as a class A carcinogen (proven cancer-causing substance). The smoldering tobacco, called “sidestream smoke,” contains more toxic byproducts than the inhaled/exhaled “mainstream smoke,” which is burned more completely as it is drawn through the cigarette.
ETS increases the risk of heart disease and lung conditions, especially asthma and bronchitis in children. In 2000, the National Cancer Institute (NCI) estimated that 3,000 lung cancer deaths, and as many as 40,000 cardiac deaths per year among adult nonsmokers in the United States can be attributed to ETS. Passive smoke also causes increased angina symptoms, allergic attacks, eye irritation, headaches, cough, and nasal symptoms. ETS is linked with low birth weight babies, sudden infant death syndrome (SIDS), and increased pneumonia and middle ear infections in children. More than 88% of nonsmokers in the United States, aged four years and older, have detectable levels of serum cotinine, an indication of ETS exposure.
Costs
Tobacco use has the highest cost to society of any substance of abuse, with the possible exception of alcohol. The American Lung Association estimated in the year 2000 that direct medical costs of tobacco-caused illness were approximately $50 billion. However, this cost is well below the total medical costs to society because it does not include such costs as burn care from smoking-related fires, and hospital care for low birth-weight infants of mothers who smoke.
Additionally, tobacco use creates an estimated $47 billion in indirect costs such as lost productivity. Smokers of one pack of cigarettes per day have 50% greater illness, absenteeism, and rate of hospitalization than nonsmokers. In 1996 the United States Department of Health and Human Services estimated the total cost of tobacco use to businesses to be more than $5,000 per employee per year

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