Though tobacco use trends have been declining since the mid-20th century, it still accounts for more than 8 million deaths each year. Half of the smokers die because they don’t quit tobacco smoking. ^(1,2)

More than 80% of tobacco smokers belong to low to mid-socioeconomic backgrounds. Passive smoking also accounts for 1.3 million deaths each year. ⁽³⁾

Certain motives play an essential role in smoking initiation;

It affects most of the adolescents. Some friends, family members, and other community members persuade their peers to adopt this harmful habit. There is an image of people who smoke that they look handsome, mature, and more confident.

A study indicates that due to peer pressure, young university and college students are more predisposed to the habit of smoking. ⁽⁴⁾

Some cultures have rites that normalises the smoking on many occasions and celebrations. Most religions don’t endorse to refrain from smoking categorically.

Tobacco contains nicotine, which stimulates dopamine production and causes mood elevation. ⁽⁵⁾

In the long term, persistent use of nicotine substances can lead to dopamine receptor exhaustion, causing depression due to low levels of dopamine. ⁽⁶⁾

Dopamine receptor exhaustion leads to increased requirements of nicotine to stimulate the receptors. It also causes nicotine dependence. ⁽⁷⁾

Lack of knowledge and awareness breeds false beliefs regarding smoking.

A study reveals that most people who were denying the side effects of smoking believed that the amount of smoke is too little to cause any harm to health. ⁽⁸⁾

Nicotine suppresses appetite; some people quote this benefit to use smoking in weight management. ⁽⁹⁾

It can benefit weight management but can predispose to several risks to health.

Earlier in the 1900s, the notion was that smoking helps a lot in weight loss. Cigarette advertisements in the 1930s revealed that women should “reach a cigarette instead of a sweet.” Young individuals who are desirous of weight loss are more prone to the habit of smoking. ⁽¹⁰⁾

Nicotine can cause weight loss by increasing metabolism. This notion is explained by the direct effect of nicotine on catecholamines release. Catecholamines increase blood pressure, heart rate, and BMR. ^(11,12)

Lipolysis is mediated by α7-nicotinic acetylcholine receptors found in white adipose tissue. Low nicotine levels open these channels, but they desensitize at higher nicotine concentrations. ⁽¹³⁾

^{Nicotine can also act on peroxisome proliferator-activator receptor alpha(PPAR-α), which mediates fatty acid oxidation in the liver; PPAR-γ performs the same action in skeletal muscle, which ultimately causes weight loss. (14)}

Nicotine acts on both CNS and PNS to suppress appetite. In CNS, it promotes the release of norepinephrine, dopamine, serotonin, and γ-amino-butyric acid, all suppressing appetite. ⁽¹⁵⁾

Leptin neurotransmitter released from adipose tissue increases after nicotine stimulation and reduces appetite. ⁽¹⁶⁾

Until the 1960s, tobacco was considered safe, and companies funded healthcare physicians to prove it was healthy. In 1964, US Surg. Gen. report revealed harmful side effects of smoking. Since then, the smoking graph has been sliding down, which is a good omen. ⁽¹⁷⁾

Smoking can cause the following diseases and complications, i.e.,

1. Respiratory System:

• Lung cancer(leading cause)
• COPD & Emphysema
• Bronchitis

2. CNS & CVS:

• Myocardial Infarction
• Stroke

3. Miscellaneous:

• Gastric Ulcers
• Subfertility & Erectile dysfunction
• Low birth weight babies
• Cataracts
• Premature aging⁽¹⁸⁾
• Diabetes(smoking cessation side effect)

4. Cancers:

Smoking can cause cancer in all the organs of the body, i.e.,⁽¹⁹⁾

• Mouth, oesophagus, lungs
• Liver, kidney, pancreas, cervix

Smoking can cause weight loss and can be used in weight management, but its health risks outweigh the benefits. For the sole purpose of weight loss, it should never be tried. Better physical well-being can be achieved through diet and exercise scheduling.

1. https://www.ncbi.nlm.nih.gov/books/NBK294302/figure/ch13.f1/?report=objectonly
2. https://www.who.int/news-room/fact-sheets/detail/tobacco
3. https://www.who.int/news-room/fact-sheets/detail/tobacco
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC6788683/#sec028
5. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/smoking-and-mental-health#:~:text=Smoking%20and%20depression,to%20go%20through%20it%20alone.
6. https://www.charliehealth.com/research/the-impacts-of-nicotine-on-depression#:~:text=These%20feelings%20of%20pleasure%20and,dopamine%20receptors%20begin%20to%20recover.
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8802724/
8. https://pubmed.ncbi.nlm.nih.gov/16750305/
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC2367209/#S2
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC3195407/
11. https://pmc.ncbi.nlm.nih.gov/articles/PMC8162771/#S20
12. https://www.nejm.org/doi/full/10.1056/NEJM197609092951101
13. https://pmc.ncbi.nlm.nih.gov/articles/PMC8162771/#S20
14. https://pubmed.ncbi.nlm.nih.gov/15497675/
15. https://www.nmcd-journal.com/article/S0939-4753(07)00132-9/abstract
16. https://pmc.ncbi.nlm.nih.gov/articles/PMC6074209/#:~:text=Nicotine%20is%20believed%20to%20underlie%20the%20effect%20of%20smoking%20on%20body%20weight.&text=It%20is%20suggested%20that%20nicotine,and%20resulted%20in%20decreased%20feeding.&text=Hence%20suggested%20the%20inverse%20relationship%20between%20nicotine%20and%20body%20weight.&text=Therefore%2C%20the%20role%20of%20leptin,for%20weight%20changes%20among%20smokers.&text=On%20the%20other%20hand%2C%20other,smoking%20and%20body%20weight%20relationship.&text=Nicotine%20dependency%20might%20be%20a,based%20on%20their%20nicotine%20dependency.https://pmc.ncbi.nlm.nih.gov/articles/PMC6074209/
17. https://www.npr.org/sections/health-shots/2014/01/07/260438987/50-years-after-landmark-warning-8-million-fewer-smoking-deaths
18. https://pubmed.ncbi.nlm.nih.gov/17951030/
19. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/how-does-smoking-cause-cancer#:~:text=The%20link%20between%20smoking%20and,nose%20and%20sinuses