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Nicotine is a powerful stimulant and is one of the main factors leading to the continued tobacco smoking. Although the amount of nicotine inhaled with tobacco smoke is quite small (most of the substance is destroyed by the heat) it is still sufficient to cause physical and/or psychological dependence. The amount of nicotine absorbed by the body from smoking depends on many factors, including the type of tobacco, whether the smoke is inhaled, and whether a filter is used. On average it takes about seven seconds for the substance to reach the brain. Although nicotine does play a role in acute episodes of some of the diseases listed, above (such as stroke, impotence, and heart disease), it does not contribute to the most serious, longer term diseases, such as cancer or emphysema, which are caused mostly by the products of the smoldering combustion process. This has enabled development of various nicotine delivery systems, such as the nicotine patch or nicotine gum, that can satisfy the addictive craving by delivering nicotine without the harmful combustion byproducts. This can help the heavily dependent smoker to quit gradually, whie discontinuing further damage to health.
Communal smoking of a sacred tobacco pipe was a universal ritual through Native America. Native Americans considered tobacco a sacred part of their religion. It was grown for ceremonial use and considered the ultimate sacred plant. Tobacco smoke was believed to carry prayers to the heavens.
In more modern times, even before the health risks of smoking were scientifically known, it was considered a filthy, harmful and immoral habit by some Christian preachers and social reformers. Tobacco was listed, along with drunkenness, gambling, cards, dancing and theater-going, in J.M. Judy's Questionable Amusements and Worthy Substitutes, which was published in 1904 by the Western Methodist Book Concern of Chicago. Judy wrote that "Tobacco dulls the mind. It does this not only by wasting the body, the physical basis of the mind, but it does it through habits of intellectual idleness, which the user of tobacco naturally forms. Whoever heard of a first-class loafer who did not eat the weed or burn it, or both?" In addition, he claimed, "Tobacco wastes the body" and "blunts the moral nature." But there was also the more direct concern that the poor would waste what little money they had on tobacco, instead of supporting their families, similar to a concern about alcohol in this era.
The Jewish leader Rabbi Yisrael Meir Kagan ( 1838- 1933) was one of the first Jewish authorities to speak out on smoking. He considered it a waste of time and saw the practice of people "borrowing" (pilfering) cigarettes from each other as morally questionable.
Most modern opposition to smoking, however, is based on health concerns rather than moral judgments. Some public interest groups, usually described as "anti-smokers", are interested in controlling smoking as a political agenda; many consist of former "reformed" smokers.
Passive smoking (also known as environmental tobacco smoke (ETS), involuntary smoking or secondhand smoke) occurs when the ambient smoke from one person's cigarette is inhaled by other people. The US Environmental Protection Agency (EPA) in 1993 issued a report estimating that 3,000 lung-cancer related deaths in the US were caused by passive smoking every year. Tobacco industry lobbyists, such as the Alexis de Tocqueville Institution, and industry-funded researchers, such as S. Fred Singer, aggressively attacked the EPA study as "junk science." In 2002, a group of 29 experts from 12 countries convened by the Monographs Programme of the International Agency for Research on Cancer (IARC) of the World Health Organization reviewed all significant published evidence related to tobacco smoking and cancer. It concluded its evaluation of the carcinogenic risks associated with involuntary smoking, with second-hand smoke also being classified as carcinogenic to humans.[5] An earlier WHO epidemiology study also found "weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS."[6] The fact that the evidence was described as "weak" has been interpreted by the tobacco industry and its supporters as evidence that the ETS-lung cancer link has been "disproven." In reality, the "weakness" of the evidence stems from the fact that the risk of ETS for individuals is small relative to the very high risk of actually smoking, making it more difficult to quantify through epidemiology. Most experts believe that moderate, occasional exposure to secondhand smoke presents a low risk to nonsmokers, but a growing body of research suggests that risks to nonsmokers may be greater than previously believed. One recent study in the British Medical Journal found that exposure to secondhand smoke increases the risk of heart disease among non-smokers by as much as 60 percent. [7]
In addition to epidemiology, however, several other types of scientific evidence (including animal experiments, chemical constituent analysis of ETS, and human metabolic studies) support the WHO and EPA conclusions. The main area of uncertainty remaining is in the strength of the dose-response relationship, relative to the intermediate biochemical mechanism involved. For individuals who smoke, the amount of tobacco smoked, the measured concentration of toxic compounds in the bloodstream, and the epidemiologically observed health risks all correlate in a reasonable fashion, strongly confirming the now almost universally held theory that smoking exposes the smoker to these toxic compounds, which cause disease. However, with respect to second-hand smoke, the epidemiological evidence of disease is consistently much greater than the biochemical measurements of exposure to toxic chemicals would predict. While the consistency of these results through various studies might cause them to just be accepted at face value, that secondhand smoke is somehow more toxic than direct smoke, this would force the conclusion that the nonsmoker is more at risk from a certain amount of smoke than the smoker is; and therefore would become safer by actually smoking a small amount than by just being in the presence of second-hand smoke. Although this would be hard to test on humans, it seems unlikely; so the question of the actual degree of risk from second-hand smoke remains open.
Risks to non-smokers would seem to be most likely to be significant if they work in an environment where cigarette smoke is prevalent. For this reason, many countries (such as Ireland) and jurisdictions (like New York State) now prohibit smoking in public buildings. Many office buildings contain specially ventilated smoking areas; some are required by law to provide them.
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