Health risks

Tobacco smoking consists of drawing smoke from burning tobacco into the mouth, and usually the lungs. The type of product smoked is most commonly cigarettes, but can also include cigarillos, cigars, pipes or water pipes. Tobacco smoking increases the risk of developing a wide range of diseases, many of which are fatal. Recently alternative heated tobacco products (HTPs) and electronic nicotine delivery systems (ENDS) have entered the market and are growing in popularity. These HTP and ENDS have features similar to smoking tobacco and can carry significant health risks.

Tobacco Smoking Harms:

Cancers, Respiratory Disease and Cardiovascular Disease

Most smoking-related deaths arise from cancers (mainly lung cancer), respiratory disease (mainly chronic obstructive pulmonary disease – COPD), and cardiovascular disease (mainly coronary heart disease). Smoking is an important risk factor for stroke, blindness, deafness, back pain, osteoporosis, and peripheral vascular disease (leading to amputation). After the age of 40, smokers on average have higher levels of pain and disability than non-smokers.

Fertility and Miscarriage

The consequences of smoking on reproduction and fertility are numerous and complex. The risk of fertility problems increases with the number of cigarettes smoked daily. Smoking in both women and men reduces fertility. Exposure to passive smoke, either second-hand or third-hand, including from electronic cigarettes, is particularly dangerous for infants, small children and young people. It can cause them many health problems, including more frequent and severe asthma attacks, respiratory infections, and hearing aid infections, or can lead to sudden infant death syndrome (SIDS).

Mental Health Conditions

Smoking is a major risk factor for both Alzheimer’s and vascular dementia, and a plethora of mental health issues, including cognitive decline, anxiety, depression and other neurodegenerative diseases.


ENDS, often referred as e-cigarettes, are designed to look and feel like a traditional cigarette, a pen or a fashion accessory. Similar to HTPs, they produce a heated aerosol that is then inhaled. The difference is that HTPs heat up tobacco, and ENDS heat up liquids in cartridges.

Excessive Nicotine Exposure

One of the primary concerns of ENDS use is the excessive nicotine exposure. Nicotine is well known to have serious adverse effects, in addition to being highly addictive.  As shown in various studies, the biological effects of nicotine are extensive, affecting all systems of the body, including the cardiovascular, respiratory, renal, and reproductive systems. Nicotine suppresses the immune response by impairing key immune system processes. The inhalation of nicotine through heated aerosols also affects pulmonary sensitivity and enhances lung inflammation, as well as lung injury. Thus, there are increasing grounds to believe that, regardless of whether nicotine is consumed with cigarettes, HTPs or ENDS, it plays an adverse role on pulmonary health and one may be at an increased risk for bacterial and viral infections, such as from COVID-19.

Harm to Cognitive Balance and Adolescent Health

A review of recent literature showed that nicotine induces free radicals, depletes antioxidant defence mechanisms, and increases markers of oxidative stress in neural cells, making it particularly toxic to the neurodevelopment of young children. Other studies show that nicotine consumption can worsen irritability, anxiety and impulsivity. More recent research also states that developing adolescent brains exposed to nicotine may derange the normal course of brain maturation and may include adverse effects such as attention deficit, enhanced anxiety and fear, as well as having an increased risk of developing psychiatric disorders and cognitive impairment. Therefore, drugs containing nicotine have potentially severe consequences for teen addiction, cognition and emotional regulation.


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