Tobacco & Nicotine
Also known as:
Cigarettes, cigs, smokes, darts, chew, spit, snuff, dip, shisha, hookah, vape, and e-liquid.
What is it?
Tobacco is a plant (Nicotiana tabacum and Nicotiana rustica) that contains nicotine, an addictive drug with both stimulant and depressant effects. Tobacco products are made from the cured, fermented, and aged leaves of the tobacco plant. These products often contain many other chemicals that can cause serious health problems. Nicotine is one of the most commonly used psychoactive drugs in the world (CAMH, 2010).
Tobacco and nicotine are commonly smoked as cigarettes and vaped, snuffed, and chewed. Nicotine is increasingly being consumed through vaping, by inhaling and exhaling an aerosol produced by a vaping product, such as an electronic cigarette. The liquid (vape juice) used in e-cigarettes is heated into a vapour, condensed into an aerosol, and breathed-in by the user.
How Does it Work?
Nicotine acts on multiple neurotransmitters, such as dopamine, acetylcholine and epinephrine (adrenaline), which has very strong reinforcing and rewarding effects, contributing to its highly addictive properties. Nicotine has both stimulating and sedating effects on the body, relevant to the amount of nicotine consumed. The stimulating effects are exerted on the cardiovascular system, increasing heart rate and breathing, and reduces levels of oxygen in the bloodstream (CAMH, 2010).
The sedating effects can be attributed to the user’s dependence on the drug, going through acute withdrawal between acts of consumption (between cigarettes, pulls on a vape, etc.).
What Does it Look Like?
Tobacco leaves are dark brown and naturally have a slightly bitter taste. Flavour is normally added to tobacco that is consumed through a hookah, and nicotine juice comes in a variety of different flavours.
Tobacco looks and is prepared differently depending on how it will be consumed:
Cigarettes use finely cut tobacco leaves that are rolled in thin paper.
Cigars use whole tobacco leaves.
Snuff is a finely ground powder of tobacco leaves that often comes in teabag-like pouches.
Chewing tobacco uses shredded or twisted tobacco leaves.
Hookah uses flavoured and sweetened tobacco that is heated, and the smoke filters through water into a mouthpiece.
Vape juice is most often in liquid form, but is also sold as wax and herbs. The colour of the juice varies relevant to the nicotine content within it, nicotine-free liquid is nearly translucent, the low nicotine concentrations are slightly brownish-yellow, and become a darker shade of brown the higher the nicotine content.
Is There a Safe Dose?
A standard or “safe dose” of nicotine, like all drugs, is dependent on an individual’s personal biology, tolerance to the drug, and experience with the drug. Dosages can also vary on the method of consumption (cigarette, vaping, chewing tobacco) relevant to nicotine content/concentration. A single cigarette would be an example of a standard dose; nicotine vape juice can come in a variety of strengths (0mg, 3mg, 6mg, 12mg) and also in salt form (which is absorbed differently into your bloodstream).
Because nicotine is highly addictive and tobacco consumption comes with many known health risks, it is not safe to use long-term. However, because the drug is legally regulated, its concentration is generally known and it is unlikely to be contaminated like many street drugs.
Effects
The mood-altering effects of nicotine are subtle, complex and powerful. Some people feel that smoking helps them to be alert and to concentrate, and also that it helps them feel relaxed (Government of Canada, 2013). Smoking raises levels of a brain chemical called dopamine, which increases feelings of pleasure and reinforces the desire to continue to smoke (CAMH, 2010). The relaxing/sedating properties of the drug are can be attributed to the acute withdrawal that is experienced between periods of nicotine consumption (Government of Canada, 2013).
Side effects and cautions
Addiction
Nicotine, the active ingredient in tobacco, is highly addictive and people can become dependent on the mood-enhancing properties of the drug very quickly.
Cancer
Tobacco consumption has been linked to many health problems. These health issues are not directly linked to nicotine, but rather the by-product of tar, which is formed when tobacco is burned (CAMH, 2010). Tar contains hundreds of chemicals, many of which are highly carcinogenic. This means that they are linked to causing or exacerbating various types of cancer in the body, such as bladder and lung cancer, and contribute to stroke, heart disease, and impotence (Government of Canada, 2013).
COPD
Smoking cigarettes and small cigars is linked to the onset of Chronic Obstructive Pulmonary Disease (COPD). COPD is a combination of chronic bronchitis and emphysema which causes inflammation of the air pathways to the lungs and destruction of lung tissue. It can result in constant coughing, difficulty breathing, and shortness of breath. The risk of dying from COPD is influenced by how many cigarettes a person typically smokes and the number of years a person has smoked (Government of Canada, 2019).
Heart Disease
Smoking can also increase a person’s risk of developing heart disease, which affects the structure and function of the heart. Heart disease can take many forms such as an enlarged heart, coronary heart disease, or a heart attack. The risk of developing these conditions can increase dramatically depending on the number of cigarettes a person smokes and how long they have been smoking. Heart disease has also been linked to exposure to second-hand smoke (Government of Canada, 2019).
Brain development and Poisoning
Exposure to nicotine at a young age has been shown to affect memory and concentration, and can alter teen brain development—possibly causing a reduction in impulse controls and/or cognitive and behavioural problems (Government of Canada, 2019). Vaping liquid containing nicotine can also be very harmful if it is swallowed or absorbed through the skin, causing nicotine poisoning (Government of Canada, 2019).
Therapeutic Uses?
Many peoples throughout the world use tobacco as a form of medicine in cultural practices.
Across Canada, tobacco has been used in Indigenous communities for ritual, ceremony, and prayer for thousands of years. It has long been considered sacred for its spiritual and healing benefits (First Nations Health Authority, 2019).
For those who use tobacco in this way, it is seen as promoting various benefits such as physical, spiritual, emotional and community well-being. In many Indigenous cultures, traditional tobacco may also take the form of an offering or gift to another person, being, place, or to the Creator. It may also be presented when an individual is seeking protection, guidance or knowledge. For Indigenous elders, adults, and youth, these methods of preparation and use of traditional tobacco contribute to developing, rebuilding, and maintaining intergenerational connections (National Native Network, 2015).
Harm Reduction Tips
to reduce the possible harms of tobacco & nicotine, the following is suggested:
If you are a non-smoker, it is best to limit your consumption of nicotine products. This is true whether they are cigarettes, cigars, hookahs, or e-cigarettes—since you can develop a dependence and/or addiction to the nicotine in any of these products.
If you are a smoker, try limiting/cutting down on the number of cigarettes you have daily. It may help to invest in smoking cessation products to aid in the process of cutting down or quitting tobacco use—such as the patch, nicotine gum, or e-cigarettes, which have all been approved as nicotine replacement therapies (Government of Canada, 2019).
Lifestyle changes can also aid in reducing nicotine consumption/cravings, such as exercising, a healthy diet, and mindfulness practices.
Legal Status: Use, Possession, & Distribution
Tobacco and vaping products are regulated by the federal government in Canada, which governs the manufacture, sale, labelling, and promotion of tobacco and vaping products. The Tobacco and Vaping Products Act came into law on May 23, 2018, replacing the former Tobacco Act (Government of Canada, 2019).
There are a number of federal regulations with regards to tobacco and tobacco products which are addressed in the previous Tobacco Act and the new Tobacco and Vaping Products Act. These include:
Tobacco Product Labelling Regulations (ensuring health-related labels being displayed on tobacco packages)
Promotion of Tobacco Products and Accessories Regulations (prohibiting the use of terms “light” and “mild”, and variations of these terms on various tobacco products)
Tobacco Products Information Regulations (requiring graphic health warnings to be displayed on packaging, and inclusion of health messages containing information to help people quit smoking) (Government of Canada, 2011).
Some of the key elements of the Tobacco and Vaping Products Act that are related to vaping include:
Not allowing vaping products to be sold or given to anyone under 18 years of age
Not allowing the sale of vaping products that appeal to youth in how they look or work
Setting rules about vaping product promotion (not promoting directly to youth and not misleading consumers about the health effects of these products)
Banning the use of certain ingredients (Government of Canada, 2019).
The Non-smokers’ Health Act addresses the issues of second-hand smoke and vapour, and this act applies to federally regulated workplaces such as banks, ferries, commercial aircrafts, and federal government offices (Government of Canada, 2019).
In Ontario, the Smoke-Free Ontario Act prohibits the use of tobacco and vaping products at all restaurant and bar patios and public places and within 9 metres of a restaurant, bar patio, or public door. The acts also prohibits smoking on school property and within 20 metres of public and private school property, as well as community recreational facility property (Government of Ontario, 2019).
References
CAMH. (2010). Tobacco. Retrieved August 21, 2019 from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/tobacco
Government of Canada. (2019). About vaping. Retrieved August 21, 2019, from https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html
Government of Canada. (2013). Nicotine addiction. Retrieved August 21, 2019, from https://www.canada.ca/en/health-canada/services/smoking-tobacco/effects-smoking/smoking-your-body/nicotine-addiction.html#a3
Government of Ontario. (2018). Where You Can't Smoke or Vape in Ontario. Retrieved August 21, 2019, from https://www.ontario.ca/page/where-you-cant-smoke-or-vape-ontario