special subjects
Smoking and Other Tobacco Use
Introduction
Tobacco use is a major individual and public health problem. Dependence develops rapidly. Major consequences include premature death and morbidity caused by cardiovascular disease, lung and many other types of cancer, and COPD (chronic obstructive pulmonary disease). All patients who use tobacco should be advised to quit and offered assistance and/or referrals to increase their success with becoming tobacco-free. Tobacco is used because of the effects ofnicotine.Nicotineis highly addictive when inhaled into the lung. The combustion products of tobacco contain other substances that can cause significant morbidity and mortality. Tobacco can be smoked in Cigarettes , cigars, or pipes, including hookah. Oral tobacco products include chew and dip. Products marketed as tobacco-free oralnicotinepouches are newer to the United States market. They are also available in nontobacco flavors with a discreet design and are offered at highernicotineconcentrations than U.S. Federal Drug Administration (FDA)–approvednicotinegums and lozenges. With diversification in the tobacco product market, dual or poly-tobacco product use has become more common. Cigarette smoking, which is the most harmful form of tobacco use, remains the predominant form of tobacco use by adults, while Vaping are the most common form of tobacco use among adolescents. All tobacco products contain carcinogens and other toxins; smokeless tobacco products are not safe alternatives to smoking. (See also Vaping .) 