In 1989, the U.S. Surgeon General issued a report that concluded cigarettes and other forms of tobacco are addictive and nicotine is the drug in tobacco that causes addiction. The report also concluded that that smoking is the leading cause of stroke and the third leading cause of death in the United States. In 1995, among college students, 39.3 percent had smoked cigarettes within the past year and 26.9 percent within the past month.
Nicotine is highly addictive. It is both a stimulant and a sedative to the central nervous system. Nicotine is readily absorbed whether it is smoked or chewed. Stress and anxiety affect nicotine tolerance and dependence. Therefore, more nicotine is required to achieve the same effect. Thus one's tolerance to nicotine escalates. It takes only seconds for nicotine to reach the brain once smoked, and it lasts up to 30 minutes in the body.
Withdrawal symptoms are common for smokers who go long periods without cigarettes. One study that was conducted by the National Institute on Drug Abuse resulted in subjects with behavior changes that included anger, hostility, aggression, and loss of social cooperation. People who went long periods without smoking exhibited psychomotor and cognitive impairment.
Women who smoke are at risk to have earlier onset of menopause, and the combination of oral contraceptives with smoking has led to an increased risk to cardiovascular and cerebrovascular diseases.
Cigarette smoke also contains many gases, most notably carbon monoxide and tar. The tar in cigarettes has been known to cause a high rate of lung cancer, emphysema, and bronchial disorders. The Environmental Protection Agency has concluded that secondhand smoke causes lung cancer and greatly increases the risk of respiratory illnesses in children and sudden infant death.
Smoking cessation should be a gradual process because withdrawal symptoms can be less severe than for those who quit "cold turkey" or all at once. Studies have shown that medication combined with counseling and skills training have resulted in positive outcomes.
Those interested in quitting are recommended to speak with their doctor concerning a type of smoking cessation program that takes into account the person's complete medical history.