From Cure to Poison: The Negative Effects of Tobacco

Tobacco is a nicotine, cellulose, ammonia, and protein-containing plant whose leaves are dried and fermented to make it suitable for human consumption. Tobacco products come in many forms such as cigarettes, chewing tobacco, snuff, pipe tobacco, dissolvable, and water pipes (hookah). There are numerous chemicals found in tobacco (also created by burning it) that are very harmful. Smoking cigarettes can also worsen the condition of people with Crohn’s disease. Countries with middle and low income have the most number of deaths that are tobacco related. About 880,000,000 of the 1.1 billion smokers around the world are from such regions. In Yemen, more than 14,400 of its people are killed each year due to diseases caused by tobacco.

Nicotine is an addictive substance and is the reason why people buy tobacco products and it is why they find it hard to quit smoking or other similar methods to get nicotine in their system. Nicotine is a relaxant and it also helps increase alertness. Nicotine amplifies the heart rate and hence blood pressure, and can directly affect the formation of excess of blood clots (thrombosis) and atheroma (fatty deposits and scar tissue accumulation on the walls of arteries) in smokers. Users of tobacco products can die at relatively younger ages and they may deprive their families of income, raise the cost of healthcare, and can also delay economic development.

According to an online article by the Centers for Disease Control and Prevention, smoking products containing tobacco causes around nine out of every ten cases of lung cancer. Moreover, it causes other cancers apart from lung cancer such as liver, bronchi and trachea, bladder, colon and rectum, kidney, mouth and throat, esophagus, cervix, and blood (acute myeloid leukemia), pancreas, kidney, and renal pelvis, larynx, and stomach. WHO calls tobacco “the single greatest preventable cause of death in the world”.

Cigarette smoke contains more than four thousand chemicals and at least seventy of them or more are carcinogens (cancer-causing agents) in each breath. These chemicals move into the bloodstream where they can easily travel throughout the body with access to every organ in the body. There is a risk of some of these chemicals damaging the DNA, an important component of the human body that codes and controls the production of different substances and new cells. Damaged DNA can result in faulty codes and hence there can proliferation of cells forming a tumor. A tumor is initially benign (in one place) but over time due to excessive growth, it becomes malignant (breaks off and can spread throughout the body). Smokeless tobacco products can also cause cancer. Products like chewing tobacco cause cancers of the mouth, throat, esophagus, and pancreas. In electronic cigarettes, a liquid containing nicotine, flavoring agents, and other chemicals is heated which gives an aerosol. People who use electronic cigarettes inhale this aerosol into their lungs. Even though there is no smoke for second-hand smoking, people nearby can also inhale the aerosol when the user exhales. Hence, they can also absorb the harmful chemicals and be just as affected as the users.

As stated by WHO in a recent fact-sheet published in 2018, “tobacco kills up to half of its users” and more than seven billion people die, of which more than six billion people died due to the direct usage of tobacco, and the remaining people, about nine hundred thousand people (non-smokers) died due to exposure to secondhand smoke.

Leading producers of tobacco like China, India, and Brazil, there is a possibility that children from low-income families are often employed in tobacco farming to earn money. In India, according to the Child Labour Act, 1986, (then amended in 2016- CLPR Act) prohibits the employment of a child. It is considered to be a “cognizable criminal offense” to employ a child for any line of work. More importantly, these children apart from being employed illegally, have a hazardous jobs. These children have the risk of getting Green Tobacco Sickness (GTS) due to handling wet tobacco leaves. The nicotine in these leaves is absorbed through their skin resulting in nicotine poisoning. Children and adolescents being more sensitive to chemicals will have more serious health hazards than adults. Prolonged nicotine absorption can hinder brain development. The prefrontal cortex is one of the last parts to mature and is susceptible to stimulants. This can cause mood disorders, memory problems, issues with attention, and impulse control.

Tobacco products and its usage can definitely reduce the quality of lifestyle people live. The treatments for the diseases are expensive, the person’s health is obviously not in good condition and will not be able to live ‘normally’ and are bound to suffer. They will also hurt people around them. Unhealthy children and people between the ages of 18 to 60 (an average age range to represent the working population) will definitely affect the working population. They cannot work efficiently, are more likely to make decisions that can impact them and their company negatively, and can strain the development of that country’s economy.

There are other issues as well apart from these health hazards. For example, the illicit trade of tobacco products can result in economic and security concerns around the world. Again, according to WHO’s online fact sheet, it is estimated that one out of ten cigarettes or tobacco products consumed globally is illegal, and this illicit market is supported by small-scaled dealers to organized criminal networks.

Tax avoidance and tax evasion compromise the potency of tobacco control policies. Examples of such activities could be legal actions like buying tobacco products in regions where the tax imposed on such products is lesser (lower tax jurisdiction) or even illegal activities like manufacturing and smuggling.

There have been arguments stating that high tobacco product taxes lead to tax evasion. For instance, ITC, the largest cigarette maker in India mentioned in an article that the exchequer (treasury) loses more than Rs. 13,000 crore (1,866,930,000 USD) revenue annually due to tax evasion on cigarettes. This value does not take into account the revenue lost on other tobacco products which would increase the amount of revenue lost. The total productivity losses caused by smoking each year in the US have been estimated at US$151 billion.

Such events can affect the reputation of companies and countries which could prevent or influence trading and possible relations with other companies or countries. The GDP (Gross Domestic Product) of a country is bound to decrease, impacting the economy negatively. Poor development of the economy can lead to inflation (increase in the cost of goods but decrease in purchasing value of money) increasing the cost of living for people. Large-scale inflation may result in unemployment, prevents businesses from making big investment decisions, and promotes hoarding (in fear of prices rising) which will only lead to further increase in prices, and it may cause an imbalance in international trade as prices fluctuate. It can also impact foreign exchange rates. Due to this, it can also result in people trying to emigrate as well.

However, in spite of all these complications, tobacco has not been banned. There are reasons why tobacco products are also considered beneficial to health or economically. It has been found that patients suffering from ulcerative colitis find smoking helpful as it alleviates it. There have also been studies that say that smokers are less likely to develop Parkinson’s disease. Even if unhealthy, smoking has also been linked to weight loss as it curbs appetite and may be helpful for people who are obese which can be seen as beneficial for them. Although this reason does not come across as humane, it has been said that smoking saves costs in pension payments if there are premature deaths of smokers.

Historically, Tobacco has been used to mitigate persistent headaches, and colds, for antidiarrhoeal, pain relief, and to heal burns. There have also been instances where it has been therapeutically been used for fevers, to help digestion. It has been used as an antiseptic for ringworm, superficial ulcers, pruritus, and athlete’s foot. In an article in the British Medical Journal, in 1889, stated that smokers are less likely to get typhus and diphtheria and can generally resist infections. In another article in The Lancet in 1913, it has been mentioned experiments that show that tobacco smoke can eradicate the cholera bacteria (comma bacillus).

According to a study conducted in 2013, there is no correlation between second-hand smoke and cancer. This is seen by their comment: 'A large prospective cohort study of more than 76,000 women confirmed a strong association between cigarette smoking and lung cancer but found no link between the disease and secondhand smoke.' Similarly, in a study conducted in 2014 in Colorado states that “acute myocardial infarction incidence (due to smoking) has been decreasing dramatically, unrelated to smoke-free ordinances”.

Apart from this, tobacco sales add on to the country’s revenue. In the United States, the sales of e-cigarettes increased throughout the years, but just between 2014-2015, the unit sales for e-cigarettes grew by 14.4%! Adding on, the sales of e-cigarette liquid refills and prefilled e-cigarette cartridges also increased. Mainly in high-income countries, sales of tobacco products yield huge tax revenues and increase employment in the tobacco industry. In China, the tobacco industry is responsible for up to 7.4% of government revenue collected. In 2013, in the US, the amount generated by taxing tobacco was around US$43.9 billion. In 2018, Philip Morris International (an American multinational company) was the largest global tobacco company generating around US$29.6 billion worth of sales, showing how much economies depend on the tobacco industry which helps fund government spending.

In only 2003, there were over 100 million people working in the tobacco industry. Over the years with increased demand, the number of workers is bound to grow. As of 2013 in the US, 13,570 people worked in just the tobacco manufacturing industry. The tobacco industry provides employment and this will help in the development of a country’s economy (even if very little). Uneducated people in developing countries do not have opportunities to work a corporate job and they depend on jobs that require fewer skills and is manageable with little or no education, providing such people with a livelihood to depend on and to survive.

It can be inferred that the various risks of using tobacco products outweigh the benefits. Overall, it can be agreed upon that controlling illicit trade will benefit tobacco control and public health, also helping the government. However, this will reduce premature deaths due to the use of tobacco products and governments will need to spend on pension payments. The WHO FCTC Protocol to Eliminate the Illicit Trade of Tobacco Products can aid the reduction of usage of tobacco products and help improve people’s health. The World Bank has an article written to reduce the consumption of tobacco products and suggests that it will help the economy by increasing these products’ prices or imposing more taxes. To control usage of tobacco products, at least to start with younger generations, by increasing the legal age to 21 making it more difficult for children to access and consume products containing tobacco, a suggestion by Nicholas Hopkinson, who is a respiratory specialist at Imperial College, London. Illicit trade should be addressed well even when prices and taxes on tobacco products are raised so that tax revenues increase but the usage declines. Abruptly banning tobacco products will cause mayhem as too many people are dependent on it, it will also result in black markets for these illegal goods, giving rise to criminal organizations. By using a long-term strategy, resulting in a gradual decrease will give companies in that industry some time to move to a different market, even though people will be allowed to smoke they would probably refrain from doing so due to it no longer being a societal norm or if they are not interacted with because most other people prefer not to smoke, and it will also give the government time to cope with changes in tax revenues.