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Tobacco smoking is the practice of burning tobacco and ingesting the resulting tobacco smoke. The smoke may be inhaled, as is done with , or released from the mouth, as is generally done with Tobacco pipe and . The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onward but embedded itself in certain strata of several societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus. (2025). 9781903734988, Health Press Ltd.. ISBN 9781903734988
Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with additives and then combusted. The resulting smoke, which contains various active substances, the most significant of which is the addictive psychostimulant drug nicotine (a compound naturally found in tobacco), is absorbed through the alveoli in the lungs or the oral mucosa. Many substances in cigarette smoke, chiefly nicotine, trigger chemical reactions in nerve endings, which heighten heart rate, alertness and reaction time, among other things. Dopamine and are released, which are often associated with pleasure, leading to addiction.
German scientists identified a link between smoking and lung cancer in the late 1920s, leading to the first anti-smoking campaign in modern history, albeit one truncated by the collapse of Nazi Germany at the end of World War II. In 1950, British researchers demonstrated a clear relationship between smoking and cancer. Evidence continued to mount in the 1960s, which prompted political action against the practice. Rates of consumption since 1965 in the developed world have either peaked or declined. However, they continue to climb in the developing world. As of 2008 to 2010, tobacco is used by about 49% of men and 11% of women aged 15 or older in fourteen low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam), with about 80% of this usage in the form of smoking. The gender gap tends to be less pronounced in lower age groups. According to the World Health Organization, 8 million annual deaths are caused by tobacco smoking.
Many smokers begin during adolescence or early adulthood. A 2009 study of first smoking experiences of seventh-grade students found out that the most common factor leading students to smoke is cigarette advertisements. Smoking by parents, siblings, and friends also encourages students to smoke. During the early stages, a combination of perceived pleasure acting as positive reinforcement and desire to respond to social peer pressure may offset the unpleasant symptoms of initial use, which typically include nausea and coughing. After an individual has smoked for some years, the avoidance of nicotine withdrawal symptoms and negative reinforcement become the key motivations to continue.
Systematic tobacco use dates back to as early as 5000–3000 BC when the agricultural product began to be cultivated in Mesoamerica and South America; consumption later came to involve burning the plant substance, either by accident or with the intent of exploring other means of consumption. The practice worked its way into shamanism rituals. Many ancient civilizations – such as the Babylonians, the Indians, and the Chinese – burned incense during religious rituals. Smoking in the Americas probably had its origins in the incense-burning ceremonies of shamanism but was later adopted for pleasure or as a social tool. The smoking of tobacco and various hallucinogenic drugs was used to achieve trances and to come into contact with the spirit world. Also, to stimulate respiration, tobacco-smoke enemas were used.
Eastern North American tribes would carry large amounts of tobacco in pouches as a readily accepted trade item and would often smoke it in , either in sacred ceremonies or to seal bargains. Adults as well as children enjoyed the practice. It was believed that tobacco was a gift from the Creator and that the exhaled tobacco smoke was capable of carrying one's thoughts and prayers to the Great Spirit.
Apart from smoking, tobacco was used as medicine. As a pain killer, it was used for earache and toothache and occasionally as a poultice. Desert Indians regarded smoking as a cure for colds, especially if the tobacco was mixed with the leaves of the small Desert sage, Salvia dorrii, or the root of Indian balsam or cough root, Leptotaenia multifida, the addition of which was thought to be particularly good for asthma and tuberculosis.
Frenchman Jean Nicot (from whose name the word nicotine is derived) introduced tobacco to France in 1560, and tobacco then spread to England. The first report of a smoking Englishman is of a sailor in Bristol in 1556, seen "emitting smoke from his nostrils". Like tea, coffee, and opium, tobacco was just one of many intoxicants that were originally used as a form of medicine. Tobacco was introduced around 1600 by French merchants in what today is modern-day Gambia and Senegal. At the same time, caravans from Morocco brought tobacco to the areas around Timbuktu, and the Portuguese brought the commodity (and the plant) to southern Africa, establishing the popularity of tobacco throughout all of Africa by the 1650s.
Soon after its introduction to the Old World, tobacco came under frequent criticism from state and religious leaders. James VI and I, King of Scotland and England, produced the treatise A Counterblaste to Tobacco in 1604, and also introduced excise duty on the product. Murad IV, sultan of the Ottoman Empire, 1623–40, was among the first to attempt a smoking ban by claiming it was a threat to public morals and health. The Chongzhen Emperor of China issued an edict banning smoking two years before his death and the overthrow of the Ming dynasty. Later, the Manchu people rulers of the Qing dynasty would proclaim smoking "a more heinous crime than that even of neglecting archery". In Edo period Japan, some of the earliest tobacco plantations were scorned by the shogunate as being a threat to the military economy by letting valuable farmland go to waste for the use of a recreational drug instead of being used to plant food crops.
Religious leaders have often been prominent among those who considered smoking immoral or outright blasphemous. In 1634, the Patriarch of Moscow forbade the sale of tobacco, and sentenced men and women who flouted the ban to have their nostrils slit and their backs flayed. Pope Urban VIII likewise condemned smoking in holy places in a papal bull of 1624. Despite some concerted efforts, restrictions and bans were largely ignored. When James I of England, a staunch smoking opponent and the author of A Counterblaste to Tobacco, tried to curb the new trend by enforcing a 4000% tax increase on tobacco in 1604 it was unsuccessful, as suggested by the presence of around 7,000 tobacco outlets in London by the early 17th century. From this point on, for some centuries, several administrations withdrew from efforts at discouragement and instead turned the tobacco trade and cultivation into sometimes lucrative government monopolies.
By the mid-17th century, most major civilizations had been introduced to tobacco smoking and, in many cases, had already assimilated it into the native culture, despite some continued attempts on the part of rulers to eliminate the practice with penalties or fines. Tobacco, both product and plant, followed the major trade routes to major ports and markets, and then into the hinterlands. The English language term smoking appears to have entered currency in the late 18th century, before which less abbreviated descriptions of the practice such as drinking smoke were also in use.
Growth in the US remained stable until the American Civil War in the 1860s when the primary agricultural workforce shifted from slavery to sharecropping. This, along with a change in demand, accompanied the industrialization of cigarette production as craftsman James Bonsack created a machine in 1881 to partially automate their manufacture.
The anti-tobacco movement in Nazi Germany did not reach across enemy lines during the Second World War, as anti-smoking groups quickly lost popular support. By the end of the Second World War, American cigarette manufacturers quickly reentered the German black market. Illegal smuggling of tobacco became prevalent, and leaders of the Nazi anti-smoking campaign were silenced. As part of the Marshall Plan, the United States shipped free tobacco to Germany; with 24,000 tons in 1948 and 69,000 tons in 1949. Per capita yearly cigarette consumption in post-war Germany steadily rose from 460 in 1950 to 1,523 in 1963. By the end of the 20th century, anti-smoking campaigns in Germany were unable to exceed the effectiveness of the Nazi-era climax in the years 1939–41 and German tobacco health research was described by Robert N. Proctor as "muted".
In 1950, Richard Doll published research in the British Medical Journal showing a close link between smoking and lung cancer. Beginning in December 1952, the magazine Reader's Digest published "Cancer by the Carton", a series of articles that linked smoking with lung cancer.
In 1954, the British Doctors Study, a prospective study of some 40 thousand doctors for about 2.5 years, confirmed the suggestion, based on which the government issued advice that smoking and lung cancer rates were related. In January 1964, the United States Surgeon General's Report on Smoking and Health likewise began suggesting the relationship between smoking and cancer.
As scientific evidence mounted in the 1980s, tobacco companies claimed contributory negligence as the adverse health effects were previously unknown or lacked substantial credibility. Health authorities sided with these claims up until 1998, from which they reversed their position. The Tobacco Master Settlement Agreement, originally between the four largest US tobacco companies and the attorneys general of 46 states, restricted certain types of tobacco advertisement and required payments for health compensation, which later amounted to the largest civil settlement in United States history.
Social campaigns have been instituted in many places to discourage smoking, such as Canada's National Non-Smoking Week.
From 1965 to 2006, rates of smoking in the United States declined from 42% to 20.8%. The majority of those who quit were professional, affluent men. Although the per-capita number of smokers decreased, 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 smoking smoked less, while those who continued to smoke moved to smoke more light cigarettes. The trend has been paralleled by many industrialized nations as rates have either leveled-off or declined. In the developing world, however, tobacco consumption continued to rise at 3.4% in 2002. 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. In 2008, Russia (70.2%), Indonesia (65.3%), Belarus (63.6%), Ukraine (63.3%), Laos (62.5%), Greece (62.4%), Jordan (61.7%), Tonga (61.1%), China (60.8%), and North Korea (59.5%) were ranked the first by adjusted prevalence estimate of the percent of male population smoking tobacco.
As of 2025, Bangladesh, India, and Nepal are on track to achieve at least a 30% relative reduction in tobacco use, according to the WHO global report on trends in prevalence of tobacco use 2000–2024. The WHO South-East Asia Region has shown the fastest progress globally, already meeting the global reduction target by 2021 through strong policies, taxation, and cessation initiatives. Despite this success, over 322 million adults in the region continue to use tobacco, underscoring the need for continued regulation and public health action.
Common methods of consuming tobacco include the following:
The absorbed nicotine mimics nicotinic acetylcholine, which when bound to nicotinic acetylcholine receptors prevents the reuptake of acetylcholine thereby increasing that neurotransmitter in those areas of the body. These nicotinic acetylcholine receptors are located in the central nervous system and at the nerve-muscle junction of skeletal muscles; whose activity increases heart rate, alertness, and faster reaction times. Nicotine acetylcholine stimulation is not directly addictive. However, since dopamine-releasing neurons are abundant on nicotine receptors, dopamine is released; and, in the nucleus accumbens, dopamine is associated with motivation causing reinforcing behavior. Dopamine increase, in the prefrontal cortex, may also increase working memory.
When tobacco is smoked, most of the nicotine is pyrolyzed. However, a dose sufficient to cause mild somatic dependency and mild to strong psychological dependency remains. There is also a formation of harmane (an MAO inhibitor) from the acetaldehyde in tobacco smoke. This may play a role in nicotine addiction by facilitating a dopamine release in the nucleus accumbens as a response to nicotine stimuli. Using rat studies, withdrawal after repeated exposure to nicotine results in less responsive nucleus accumbens cells, which produce dopamine responsible for reinforcement.
Smoking may be up to five times more prevalent among men than women in some communities, although the gender gap usually declines with younger age. In some developed countries smoking rates for men have peaked and begun to decline, while for women they continue to climb.
As of 2002, about twenty percent of young teenagers (13–15) smoked worldwide. 80,000 to 100,000 children begin smoking every day, roughly half of whom live in Asia. Half of those who start smoking in adolescent years are projected to go on to smoke for 15 to 20 years. As of 2019 in the United States, roughly 800,000 high school students smoke.Tobaccofreekids.org/problem/tol-s
The World Health Organization (WHO) states that "Much of the disease burden and premature mortality attributable to tobacco use disproportionately affect the poor". Of the 1.22 billion smokers, 1 billion of them live in developing or transitional economies. Smoking rates have leveled off or declined in the developed world. In the developing world, however, tobacco consumption is rising by 3.4% per year as of 2002.
The WHO in 2004 projected 58.8 million deaths to occur globally, from which 5.4 million are tobacco-attributed, and 4.9 million as of 2007. As of 2002, 70% of the deaths are in developing countries. As of 2017, smoking causes one in ten deaths worldwide, with half of those deaths in the US, China, India and Russia.
Children with smoking parents are more likely to smoke than children with non-smoking parents. Children of parents who smoke are less likely to quit smoking. One study found that parental smoking cessation was associated with less adolescent smoking, except when the other parent currently smoked. A current study tested the relation of adolescent smoking to rules regulating where adults are allowed to smoke in the home. Results showed that restrictive home smoking policies were associated with a lower likelihood of trying smoking for both middle and high school students.
Behavioural research generally indicates that teenagers begin their smoking habits due to peer pressure and cultural influence portrayed by friends. However, one study found that direct pressure to smoke cigarettes played a less significant part in adolescent smoking, with also reporting low levels of both normative and direct pressure to smoke cigarettes. Mere exposure to tobacco retailers may motivate smoking behaviour in adults. A similar study suggested that individuals may play a more active role in starting to smoke than has previously been thought and that social processes other than peer pressure also need to be taken into account. Another study's results indicated that peer pressure was significantly associated with smoking behavior across all age and gender cohorts, but that intrapersonal factors were significantly more important to the smoking behavior of 12- to 13-year-old girls than same-age boys. Within the 14- to 15-year-old age group, one peer pressure variable emerged as a significantly more important predictor of girls' than boys' smoking. It is debated whether peer pressure or self-selection is a greater cause of adolescent smoking.
Psychologist Hans Eysenck (who was later questioned for implausible results
and unsafe publicationsNigel Hawkes (2019), Works by eminent psychologist who doubted smoking caused cancer are "unsafe," finds inquiry ) developed a personality profile for the typical smoker. Extraversion is the trait that is most associated with smoking, and smokers tend to be sociable, impulsive, risk-taking, and excitement-seeking individuals. (2000). 9780765806390, Transaction. ISBN 9780765806390
Some smokers argue that the depressant effect of smoking allows them to calm their nerves, often allowing for increased concentration. However, according to the Imperial College London, "Nicotine seems to provide both a stimulant and a depressant effect, and the effect it has at any time is likely determined by the mood of the user, the environment, and the circumstances of use. Studies have suggested that low doses have a depressant effect, while higher doses have a stimulant effect."
Similarly, smoking has been shown to follow distinct circadian patterns during the waking day, with the high point usually occurring shortly after waking in the morning and shortly before going to sleep at night.
Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, , chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and emphysema.
Smoking tobacco causes various types and subtypes of (particularly lung cancer, cancers of the oropharynx, Laryngeal cancer, and Oral cancer, esophageal and pancreatic cancer). Using tobacco, especially together with alcohol, is a major risk factor for head and neck cancer. 72% of head and neck cancer cases are caused by using both alcohol and tobacco. This rises to 89% when looking specifically at laryngeal cancer.
Cigarette smoking increases the risk of Crohn's disease as well as the severity of the course of the disease.Inflamm Bowel Dis. May 2009, P. Seksik, I Nion-Larmurier It is also the number one cause of bladder cancer. Cigarette smoking has also been associated with sarcopenia, the age-related loss of muscle mass and strength. The smoke from tobacco elicits carcinogenic effects on the tissues of the body that are exposed to the smoke.Dreyer, L et al. (1997) Tobacco Smoking. APMIS Inc. Regular cigar smoking is known to carry serious health risks, including increased risk of developing various types and subtypes of , respiratory diseases, cardiovascular diseases, cerebrovascular diseases, periodontal diseases, Tooth decay and Tooth loss, and malignant diseases.
Tobacco smoke is a complex mixture of over 7,000 Toxicant, 98 of which are associated with an increased risk of cardiovascular disease and 69 of which are known to be . The most important chemicals Carcinogenesis are those that produce DNA damage, since such damage appears to be the primary underlying cause of cancer. The most Carcinogenesis compounds in cigarette smoke are acrolein, formaldehyde, acrylonitrile, 1,3-butadiene, acetaldehyde, ethylene oxide, and isoprene. In addition to the aforementioned toxic chemicals, flavored tobacco contains flavorings which upon heating release toxic chemicals and carcinogens such as carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAHs), furans, phenols, aldehydes (such as acrolein), and acids, in addition to nitrogenous carcinogens, alcohols, and heavy metals, all of which are dangerous to human health. A comparison of 13 common hookah flavors found that melon flavors are the most dangerous, with their smoke containing four classes of hazards in high concentrations.
The World Health Organization estimates that tobacco caused 8 million deaths in 2004 and 100 million deaths over the 20th century. WHO Report on the Global Tobacco Epidemic, 2008 Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."" Nicotine: A Powerful Addiction ." Centers for Disease Control and Prevention. Although 70% of smokers state their intention to quit, only 3–5% are successful.
The probabilities of death from lung cancer before age 75 in the United Kingdom are 0.2% for men who never smoked (0.4% for women), 5.5% for male former smokers (2.6% in women), 15.9% for current male smokers (9.5% for women) and 24.4% for male "heavy smokers" defined as smoking more than 25 cigarettes per day (18.5% for women). Tobacco smoke can combine with other carcinogens present within the environment to produce elevated degrees of lung cancer.
The risk of lung cancer decreases almost from the first day someone quits smoking, and it drops by 50% after 10 years of smoking cessation. Healthy cells that have escaped mutations grow and replace the damaged ones in the lungs. In the research dated December 2019, 40% of cells in former smokers resembled those of individuals who had never smoked.
Rates of smoking have generally leveled off or declined in the developed world. Smoking rates in the United States have dropped by half from 1965 to 2006, from 42% to 20.8% in adults. In the developing world, tobacco consumption is rising by 3.4% per year.
Smoking alters the transcriptome of the lung parenchyma; the expression levels of a panel of seven genes (KMO, CD1A, SPINK5, TREM2, CYBB, DNASE2B, FGG) are increased in the lung tissue of smokers.
Passive smoking is the inhalation of tobacco smoke by individuals who are not actively smoking. This smoke is known as second-hand smoke (SHS) or environmental tobacco smoke (ETS) when the burning end is present, and third-hand smoke after the burning end has been extinguished. Because of its negative implications, exposure to SHS has played a central role in the regulation of tobacco products. Six hundred thousand deaths were attributed to SHS in 2004. It has also been known to produce skin conditions such as freckles and dryness. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries 26 November 2010
Smokers are at greater risk of developing psychotic disorder. Tobacco has also been described an anaphrodisiac due to its propensity for causing erectile dysfunction. There is a correlation between tobacco smoking and a reduced risk of Parkinson's disease.
By contrast, some non-scientific studies, including one conducted by Philip Morris in the Czech Republic called Public Finance Balance of Smoking in the Czech Republic and another by the Cato Institute, support the opposite position. Philip Morris has explicitly apologized for the former study, saying: "The funding and public release of this study, which, among other things, detailed purported cost savings to the Czech Republic due to premature deaths of smokers, exhibited terrible judgment as well as a complete and unacceptable disregard of basic human values. For one of our tobacco companies to commission this study was not just a terrible mistake; it was wrong. All of us at Philip Morris, no matter where we work, are extremely sorry for this. No one benefits from the very real, serious, and significant diseases caused by smoking."
Between 1970 and 1995, per-capita cigarette consumption in poorer developing countries increased by 67 percent, while it dropped by 10 percent in the richer developed world. Eighty percent of smokers now live in less developed countries. By 2030, the World Health Organization (WHO) forecasts that 10 million people a year will die of smoking-related illness, making it the single biggest cause of death worldwide, with the largest increase being among women. WHO forecasts the 21st century's death rate from smoking to be ten times the 20th century's rate ("Washingtonian" magazine, December 2007).
The tobacco industry is one of the largest global enterprises. The six largest tobacco companies earned a combined profit of $35.1 billion (Jha et al., 2014) in 2010.
The problem of smoking at home is challenging for women in many cultures (especially Arab cultures), where it may not be acceptable for a woman to ask her husband not to smoke at home or in the presence of her children. Studies have shown that pollution levels for smoking areas indoors are higher than levels found on busy roadways, in closed motor garages, and during firestorms. Furthermore, smoke can spread from one room to another, even if doors to the smoking area are closed.Mostafa RM. Dilemma of women's passive smoking. Ann Thorac Med serial 2011 cited;6:55-6. Available from: http://www.thoracicmedicine.org/text.asp?2011/6/2/55/78410
The ceremonial smoking of tobacco and praying with a Ceremonial pipe is a prominent part of the religious ceremonies of several Native American Nations. Sema, the Anishinaabe word for tobacco, is grown for ceremonial use and is considered the ultimate sacred plant since its smoke is believed to carry prayers to the spirits. In most major religions, however, tobacco smoking is not specifically prohibited, although it may be discouraged as an immoral habit. Before the health risks of smoking were identified through controlled studies, smoking was considered an immoral habit by certain Christian preachers and social reformers. The founder of the Latter Day Saint movement, Joseph Smith, recorded that on 27 February 1833, he received a revelation which discouraged tobacco use. This "Word of Wisdom" was later accepted as a commandment, and faithful Latter-day Saints abstain completely from tobacco. Jehovah's Witnesses base their stand against smoking on the Bible's command to "clean ourselves of every defilement of flesh" (2 Corinthians 7:1). The Jewish Rabbi Yisrael Meir Kagan (1838–1933) was one of the first Jewish authorities to speak out on smoking. In Ahmadiyya Islam, smoking is highly discouraged, although not forbidden. During the month of Ramadhan however, it is forbidden to smoke tobacco. In the Baháʼí Faith, smoking tobacco is discouraged though not forbidden.
In 2002, the Centers for Disease Control and Prevention said that each Cigarette pack of cigarettes sold in the United States costs the nation more than $7 in medical care and lost productivity, around $3400 per year per smoker. Another study by a team of health economists finds that the combined price paid by their families and society is about $41 per pack of cigarettes.
Substantial scientific evidence confirms that higher cigarette prices result in lower overall cigarette consumption. Most studies indicate that a 10% price increase reduces cigarette consumption by 3% to 5%. Youth, minorities, and low-income smokers are two to three times more likely to quit or smoke less than other smokers in response to price increases. While smoking is sometimes given as an example of an inelastic good, it is elastic in poorer and middle-wealth nations, and even in wealthier nations price increases do affect consumption, if not at the same rate as more elastic goods. That is to say, a large rise in price will only result in a small decrease in consumption.
Many nations have implemented some form of tobacco taxation. As of 1997, Denmark had the highest cigarette tax burden of $4.02 per pack. Taiwan only had a tax burden of $0.62 per pack. The federal government of the United States charges $1.01 per pack.
Cigarette taxes vary widely from state to state in the United States. For example, Missouri has a cigarette tax of only 17 cents per pack, the nation's lowest, while New York has the highest cigarette tax in the U.S.: $4.35 per pack. In Alabama, Illinois, Missouri, New York City, Tennessee, and Virginia, counties and cities may impose an additional limited tax on the price of cigarettes. Sales taxes are also levied on tobacco products in most jurisdictions.
In the United Kingdom, a packet of 20 cigarettes has a tax added of 16.5% of the retail price plus £5.89. The UK has a significant black market for tobacco, and it has been estimated by the tobacco industry that 27% of cigarette and 68% of handrolling tobacco consumption is non-UK duty paid (NUKDP).
In Australia, total taxes account for 62.5% of the final price of a packet of cigarettes (2011 figures). These taxes include federal excise or customs duty and Goods and Services Tax.Scollo, Michelle (2008). "13.2 Tobacco taxes in Australia" . Tobacco in Australia. Cancer Council Victoria. Retrieved 29 July 2010.
The Tobacco Advertising Prohibition Act 1992 expressly prohibited almost all forms of Tobacco advertising in Australia, including the sponsorship of sporting or other cultural events by cigarette brands.
All tobacco advertising and sponsorship on television has been banned within the European Union since 1991 under the Television Without Frontiers Directive (1989). This ban was extended by the Tobacco Advertising Directive, which took effect in July 2005 to cover other forms of media such as the internet, print media, and radio. The directive does not include advertising in cinemas and on billboards or using merchandising – or tobacco sponsorship of cultural and sporting events that are purely local, with participants coming from only one Member State European Union – Tobacco advertising ban takes effect July 31 as these fall outside the jurisdiction of the European Commission. However, most member states have transposed the directive with national laws that are wider in scope than the directive and cover local advertising. A 2008 European Commission report concluded that the directive had been successfully transposed into national law in all EU member states and that these laws were well implemented.
Some countries also impose legal requirements on the packaging of tobacco products. For example, in the countries of the European Union, Turkey, Australia Tobacco – Health warnings Australian Government Department of Health and Ageing. Retrieved 29 August 2008 and South Africa, cigarette packs must be prominently labeled with the health risks associated with smoking. Public Health at a Glance – Tobacco Pack Information Canada, Australia, Thailand, Iceland and Brazil have also imposed labels upon cigarette packs warning smokers of the effects, and they include graphic images of the potential health effects of smoking. Cards are also inserted into cigarette packs in Canada. There are sixteen of them, and only one comes in a pack. They explain different methods of quitting smoking. Also, in the United Kingdom, there have been many graphic NHS advertisements, one showing a cigarette filled with fatty deposits as if the cigarette is symbolizing the artery of a smoker.
Some countries have also banned advertisements at the point of sale. The United Kingdom and Ireland have limited the advertisement of tobacco at retailers. This includes storing of cigarettes behind a covered shelf not visible to the public. They do, however, allow some limited advertising at retailers. Norway has a complete ban on point-of-sale advertising. This includes smoking products and accessories. Implementing these policies can be challenging; all of these countries experienced resistance and challenges from the tobacco industry. The World Health Organization recommends the complete ban of all types of advertisement or product placement, including at vending machines, at airports and on internet shops selling tobacco. The evidence is as yet unclear as to the effect of such bans.
Many countries have a smoking age. In many countries, including the United States, most European Union member states, New Zealand, Canada, South Africa, Israel, India, Brazil, Chile, Costa Rica and Australia, it is illegal to sell tobacco products to minors and in the Netherlands, Austria, Belgium, Denmark and South Africa it is illegal to sell tobacco products to people under the age of 18. On 1 September 2007 the minimum age to buy tobacco products in Germany rose from 16 to 18, as well as in the United Kingdom where on 1 October 2007 it rose from 16 to 18. Underlying such laws is the belief that people should make an informed decision regarding the risks of tobacco use. These laws have lax enforcement in some nations and states. In China, Turkey, and many other countries, a child has little problem buying tobacco products because they are often told to go to the store to buy tobacco for their parents.
Several countries such as Ireland, Latvia, Estonia, the Netherlands, Finland, Norway, Canada, Australia, Sweden, Portugal, Singapore, Italy, Indonesia, India, Lithuania, Chile, Spain, Iceland, United Kingdom, Slovenia, Türkiye and Malta have legislated against smoking in public places, often including bars and restaurants. Restaurateurs have been permitted in some jurisdictions to build designated smoking areas (or to prohibit smoking). In the United States, many states prohibit smoking in restaurants, and some also prohibit smoking in bars. In provinces of Canada, smoking is illegal in indoor workplaces and public places, including bars and restaurants. As of 31 March 2008, Canada has introduced a smoke-free law in all public places, as well as within 10 meters of an entrance to any public place. In Australia, smoke-free laws vary from state to state. In New Zealand and Brazil, smoking is restricted in enclosed public places, including bars, restaurants, and pubs. Hong Kong restricted smoking on 1 January 2007 in the workplace, public spaces such as restaurants, karaoke rooms, buildings, and public parks (bars that do not admit minors were exempt until 2009). In Romania, smoking is illegal in trains, metro stations, public institutions (except where designated, usually outside), and public transport. In Germany, in addition to smoking bans in public buildings and transport, an anti-smoking ordinance for bars and restaurants was implemented in late 2007. A study by the University of Hamburg (Ahlfeldt and Maennig 2010) demonstrates that the smoking ban had, if any, only short-run effects on bar and restaurant revenues. In the medium and long run, no negative effect was measurable. The results suggest either that consumption in bars and restaurants is not affected by smoking bans in the long run or that negative revenue effects from smokers are compensated by increasing revenues from non-smokers.Ahlfeldt, G., Maennig, W. (2010), Impact of non-smoking ordinances on hospitality revenues: The case of Germany, in Journal of Economics and Statistics, 230(5), 506–521; preliminary version in: Hamburg Contemporary Discussion Papers N° 26, http://www.uni-hamburg.de/economicpolicy/hced.html .
In the United States, about 70% of smokers would like to quit smoking, and 50% report having attempted to do so in the past year. Without support, 1% of smokers will successfully quit smoking each year. Physician advice to quit smoking increases the rate to 3% per year. Adding first‐line smoking cessation medications (and some behavioral help), increased quit rates to around 20% of smokers in a year. For cessation of smoking, public participation in health campaigns are important.
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