Smoking

Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have been rolled into a small rectangle of rolling paper to create a small, round cylinder called a cigarette. Smoking is primarily practised as a route of administration for recreational drug use because the combustion of the dried plant leaves vaporizes and delivers active substances into the lungs where they are rapidly absorbed into the bloodstream and reach bodily tissue. In the case of cigarette smoking, these substances are contained in a mixture of aerosol particles and gases and include the pharmacologically active alkaloid nicotine; the vaporization creates heated aerosol and gas into a form that allows inhalation and deep penetration into the lungs where absorption into the bloodstream of the active substances occurs. In some cultures, smoking is also carried out as a part of various rituals, where participants use it to help induce trance-like states that, they believe, can lead them to spiritual enlightenment.

smoking

Smoking is one of the most common forms of recreational drug use. Tobacco smoking is the most popular form, being practised by over one billion people globally, of whom the majority are in the developing countries.[1] Less common drugs for smoking include cannabis and opium. Some of the substances are classified as hard narcotics, like heroin, but the use of these is very limited as they are usually not commercially available. Cigarettes are primarily industrially manufactured but also can be hand-rolled from loose tobacco and rolling paper. Other smoking implements include pipes, cigars, bidis, hookahs, and bongs.

Smoking has negative health effects, because smoke inhalation inherently poses challenges to various physiologic processes such as respiration. Smoking tobacco is among the leading causes of many diseases such as lung cancer, heart attack, COPD, erectile dysfunction, and birth defects.[1] Diseases related to tobacco smoking have been shown to kill approximately half of long-term smokers when compared to average mortality rates faced by non-smokers. Smoking caused over five million deaths a year from 1990 to 2015.[2] Non-smokers account for 600,000 deaths globally due to second-hand smoke.[3] The health hazards of smoking have caused many countries to institute high taxes on tobacco products, publish advertisements to discourage use, limit advertisements that promote use, and provide help with quitting for those who do smoke.[1]

Smoking can be dated to as early as 5000 BCE, and has been recorded in many different cultures across the world. Early smoking evolved in association with religious ceremonies; as offerings to deities; in cleansing rituals; or to allow shamans and priests to alter their minds for purposes of divination or spiritual enlightenment. After the European exploration and conquest of the Americas, the practice of smoking tobacco quickly spread to the rest of the world. In regions like India and Sub-Saharan Africa, it merged with existing practices of smoking (mostly of cannabis). In Europe, it introduced a new type of social activity and a form of drug intake which previously had been unknown.

Perception surrounding smoking has varied over time and from one place to another: holy and sinful, sophisticated and vulgar, a panacea and deadly health hazard. In the last decade of the 20th century, smoking came to be viewed in a decidedly negative light, especially in Western countries.

The history of smoking dates back to as early as 5000 BCE for shamanistic rituals.[4] Many ancient civilizations, such as the Babylonians, Indians and Chinese, burnt incense as a part of religious rituals, as did the Israelites and the later Catholic and Orthodox Christian churches. Smoking in the Americas probably had its origins in the incense-burning ceremonies of shamans but was later adopted for pleasure, or as a social tool.[5] The smoking of tobacco, as well as various hallucinogenic drugs, was used to achieve trances and to come into contact with the spirit world.

Substances such as cannabis, clarified butter (ghee), fish offal, dried snake skins and various pastes molded around incense sticks dates back at least 2000 years. Fumigation (dhupa) and fire offerings (homa) are prescribed in the Ayurveda for medical purposes, and have been practiced for at least 3,000 years while smoking, dhumrapana (literally "drinking smoke"), has been practiced for at least 2,000 years. Before modern times these substances have been consumed through pipes, with stems of various lengths or chillums.[6] Archaeological findings also show the existence of pipes to smoke opium in Cyprus and Crete as soon as the Bronze Age.[7]

Cannabis smoking was common in the Middle East before the arrival of tobacco, and was early on a common social activity that centered around the type of water pipe called a hookah. Smoking, especially after the introduction of tobacco, was an essential component of Muslim society and culture and became integrated with important traditions such as weddings, funerals and was expressed in architecture, clothing, literature and poetry.[8]

Cannabis smoking was introduced to Sub-Saharan Africa through Ethiopia and the east African coast by either Indian or Arab traders in the 13th century or earlier and spread on the same trade routes as those that carried coffee, which originated in the highlands of Ethiopia.[9] It was smoked in calabash water pipes with terracotta smoking bowls, apparently an Ethiopian invention which was later conveyed to eastern, southern and central Africa.

Religious leaders have often been prominent among those who considered smoking immoral or outright blasphemous. In 1634, the Patriarch of Moscow and all Rus' forbade the sale of tobacco and sentenced men and women who flouted the ban to have their nostrils slit and their backs whipped until skin came off their backs. The Western church leader Pope Urban VII likewise condemned smoking in a papal bull of 1590. Despite many concerted efforts, restrictions and bans were almost universally ignored. When James VI and I, a staunch anti-smoker and the author of A Counterblaste to Tobacco, tried to curb the new trend by enforcing a whopping 4000% tax increase on tobacco in 1604, it proved a failure, as London had some 7,000 tobacco sellers by the early 17th century. Later, scrupulous rulers would realise the futility of smoking bans and instead turned tobacco trade and cultivation into lucrative government monopolies.[18]

By the mid-17th century every major civilization had been introduced to tobacco smoking and in many cases had already assimilated it into its culture, despite the attempts of many rulers to stamp the practice out with harsh penalties or fines. Tobacco, both product, and plant followed the major trade routes to major ports and markets, and then on into the hinterlands. The English language term smoking was coined in the late 18th century; before then the practice was referred to as drinking smoke.[15]

In the 19th century, the practise of smoking opium became widespread in China. Previously, opium had only been ingested via consumption, and then only for its medicinal properties (opium was an anaesthetic). The narcotic was also outlawed in China sometime in the early 18th century due the societal issues it caused. Due to a massive trade imbalance, however, foreign merchants started to smuggle opium into China via Canton, to the chagrin of the Chinese authorities. Attempts by Chinese official Lin Zexu to eliminate the trade led to the outbreak of the First Opium War. The Chinese defeat in the First and Second Opium Wars resulted in the legalization of the importation of opium into China.[21][22]

Opium smoking later spread with Chinese immigrants and spawned many infamous opium dens in Chinatowns around South and Southeast Asia, Europe and the Americas. In the latter half of the 19th century, opium smoking became popular in the artistic community in Europe, especially Paris; artists' neighborhoods such as Montparnasse and Montmartre became virtual "opium capitals". While opium dens that catered primarily to emigrant Chinese continued to exist in Chinatowns around the world, the trend among the European artists largely abated after the outbreak of World War I.[21] The consumption of Opium abated in China during the Cultural Revolution in the 1960s and 1970s.[21]

From 1965 to 2006, rates of smoking in the United States have declined from 42% to 20.8%.[38] A significant majority of those who quit were professional, affluent men. Despite this decrease in the prevalence of consumption, the average number of cigarettes consumed per person per day increased from 22 in 1954 to 30 in 1978. This paradoxical event suggests that those who quit smoked less, while those who continued to smoke moved to smoke more light cigarettes.[39] This trend has been paralleled by many industrialized nations as rates have either leveled-off or declined. In the developing countries, however, tobacco consumption continues to rise at 3.4% in 2002.[40] In Africa, smoking is in most areas considered to be modern, and many of the strong adverse opinions that prevail in the West receive much less attention.[41] Today Russia leads as the top consumer of tobacco followed by Indonesia, Laos, Ukraine, Belarus, Greece, Jordan, and China.[42]

At the global scale, initial ideas of an international convention towards the prevention of tobacco had been initiated in the World Health Assembly (WHA) in 1996.[43] In 1998, along with the successful election of Dr. Gro Harlem Brundtland as the Director-General, the World Health Organization set tobacco control as its leading health concern and has begun a program known as the Tobacco Free Initiative (TFI) in order to reduce rates of consumption in the developing world. However, it was not until 2003 that the Framework Convention on Tobacco Control (FCTC) was accepted in WHA and entered into force in 2005. FCTC marked a milestone as the first international treaty concerning a global health issue that aims to combat tobacco in multiple aspects including tobacco taxes, advertisement, trading, environmental affects, health influences, etc.[44] The birth of this evidence-based and systematic approach has resulted in the reinforcement of tobacco taxes and the implementation of smoke-free laws in 128 countries that led to the decrease of smoking prevalence in developing nations.[45] 041b061a72