- Cigarettes and Other Tobacco Products DrugFacts | National Institute on Drug Abuse
- How do people use tobacco?
- How does tobacco affect the brain?
- What are other health effects of tobacco use?
- How does tobacco use lead to addiction?
- How can people get treatment for nicotine addiction?
- Behavioral Treatments
- Nicotine Replacement Therapies
- Other Medications
- Can a person overdose on nicotine?
- Learn More
- What’s in a cigarette?
- Carbon Monoxide
- What ingredients in cigarettes cause cancer?
- Low tar, 'light' and filtered cigarettes are not safer options
- How do chemicals in tobacco smoke lead to cancer?
- Some chemicals in tobacco smoke damage DNA.
- Chemicals in tobacco smoke are even more dangerous as a mix.
- Chemicals in tobacco smoke harm the cleaning system that our bodies use to remove toxins
- It’s never too late to stop smoking
- 5 Vaping Facts You Need to Know
- 1: Vaping Is Less Harmful Than Smoking, but It’s Still Not Safe
- 2: Research Suggests Vaping Is Bad for Your Heart and Lungs
- 3: Electronic Cigarettes Are Just As Addictive As Traditional Ones
- 5: A New Generation Is Getting Hooked on Nicotine
- Statistics about Cigarette Use
- FDA Regulation of Cigarettes
- Manufacturing Cigarettes
- Retail Sales of Cigarettes
- Importing Cigarettes
- Reporting Adverse Experiences and Product Violations
Cigarettes and Other Tobacco Products DrugFacts | National Institute on Drug Abuse
Tobacco leaves drying in a row.
Tobacco is a plant grown for its leaves, which are dried and fermented before being put in tobacco products. Tobacco contains nicotine, an ingredient that can lead to addiction, which is why so many people who use tobacco find it difficult to quit. There are also many other potentially harmful chemicals found in tobacco or created by burning it.
How do people use tobacco?
People can smoke, chew, or sniff tobacco. Smoked tobacco products include cigarettes, cigars, bidis, and kreteks. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip, and snus; snuff can also be sniffed.
How does tobacco affect the brain?
The nicotine in any tobacco product readily absorbs into the blood when a person uses it. Upon entering the blood, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline).
Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with drugs such as cocaine and heroin, nicotine activates the brain’s reward circuits and also increases levels of the chemical messenger dopamine, which reinforces rewarding behaviors.
Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain.
What are other health effects of tobacco use?
Although nicotine is addictive, most of the severe health effects of tobacco use comes from other chemicals. Tobacco smoking can lead to lung cancer, chronic bronchitis, and emphysema.
It increases the risk of heart disease, which can lead to stroke or heart attack. Smoking has also been linked to other cancers, leukemia, cataracts, Type 2 Diabetes, and pneumonia. All of these risks apply to use of any smoked product, including hookah tobacco.
Smokeless tobacco increases the risk of cancer, especially mouth cancers.
Electronic cigarettes, also known as e-cigarettes or e-vaporizers, are battery-operated devices that deliver nicotine with flavorings and other chemicals to the lungs in vapor instead of smoke.
E-cigarette companies often advertise them as safer than traditional cigarettes because they don't burn tobacco. But researchers actually know little about the health risks of using these devices.
Read more about e-cigarettes in our Electronic Cigarettes (e-Cigarettes) DrugFacts.
Pregnant women who smoke cigarettes run an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Smoking while pregnant may also be associated with learning and behavioral problems in exposed children.
People who stand or sit near others who smoke are exposed to secondhand smoke, either coming from the burning end of the tobacco product or exhaled by the person who is smoking. Secondhand smoke exposure can also lead to lung cancer and heart disease.
It can cause health problems in both adults and children, such as coughing, phlegm, reduced lung function, pneumonia, and bronchitis.
Children exposed to secondhand smoke are at an increased risk of ear infections, severe asthma, lung infections, and death from sudden infant death syndrome.
How does tobacco use lead to addiction?
The Surgeon General’s Report on Smoking Cessation, released in January 2020, offers evidence that smoking cessation is beneficial at any age, improves health status and enhances quality of life. It also reduces the risk of premature death and can add as much as a decade to life expectancy.
For many who use tobacco, brain changes brought on by continued nicotine exposure result in addiction. When a person tries to quit, he or she may have withdrawal symptoms, including:
- problems paying attention
- trouble sleeping
- increased appetite
- powerful cravings for tobacco
How can people get treatment for nicotine addiction?
Both behavioral treatments and medications can help people quit smoking, but the combination of medication with counseling is more effective than either alone.
The U.S. Department of Health and Human Services has established a national toll-free quitline, 1-800-QUIT-NOW, to serve as an access point for anyone seeking information and help in quitting smoking.
On May 5, 2016, the FDA announced that nationwide tobacco regulations now extend to all tobacco products, including
- e-cigarettes and their liquid solutions
- hookah tobacco
- pipe tobacco
This ruling includes restricting sale of these products to minors. For more information, see the FDA's webpage, The Facts on the FDA's New Tobacco Rule.
In December 2019, the federal government raised the legal minimum age of sale of tobacco products from 18 to 21 years, and in January 2020, the FDA issued a policy on the sale of flavored vaping cartridges.
Behavioral treatments use a variety of methods to help people quit smoking, ranging from self-help materials to counseling. These treatments teach people to recognize high-risk situations and develop strategies to deal with them. For example, people who hang out with others who smoke are more ly to smoke and less ly to quit.
Nicotine Replacement Therapies
Nicotine replacement therapies (NRTs) were the first medications the U.S. Food and Drug Administration (FDA) approved for use in smoking cessation therapy.
Current FDA-approved NRT products include chewing gum, transdermal patch, nasal sprays, inhalers, and lozenges. NRTs deliver a controlled dose of nicotine to relieve withdrawal symptoms while the person tries to quit.
Bupropion (Zyban®) and varenicline (Chantix®) are two FDA-approved non-nicotine medications that have helped people quit smoking. They target nicotine receptors in the brain, easing withdrawal symptoms and blocking the effects of nicotine if people start smoking again.
Can a person overdose on nicotine?
Nicotine is poisonous and, though uncommon, overdose is possible. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death.
Nicotine poisoning usually occurs in young children who accidentally chew on nicotine gum or patches used to quit smoking or swallow e-cigarette liquid. Symptoms include difficulty breathing, vomiting, fainting, headache, weakness, and increased or decreased heart rate.
Anyone concerned that a child or adult might be experiencing a nicotine overdose should seek immediate medical help.
The Food and Drug Administration has alerted the public to hundreds of reports of serious lung illnesses associated with vaping, including several deaths. They are working with the Centers for Disease Control and Prevention (CDC) to investigate the cause of these illnesses.
Many of the suspect products tested by the states or federal health officials have been identified as vaping products containing THC, the main psychotropic ingredient in marijuana. Some of the patients reported a mixture of THC and nicotine; and some reported vaping nicotine alone.
No one substance has been identified in all of the samples tested, and it is unclear if the illnesses are related to one single compound. Until more details are known, FDA officials have warned people not to use any vaping products bought on the street, and they warn against modifying any products purchased in stores.
They are also asking people and health professionals to report any adverse effects. The CDC has posted an information page for consumers.
- Tobacco is a plant grown for its leaves, which are dried and fermented before being put in tobacco products. Tobacco contains nicotine, the ingredient that can lead to addiction.
- People can smoke, chew, or sniff tobacco.
- Nicotine acts in the brain by stimulating the adrenal glands to release the hormone epinephrine (adrenaline) and by increasing levels of the chemical messenger dopamine.
- Tobacco smoking can lead to lung cancer, chronic bronchitis, and emphysema. It increases the risk of heart disease, which can lead to stroke or heart attack. Smoking has also been linked to other cancers, leukemia, cataracts, and pneumonia. Smokeless tobacco increases the risk of cancer, especially mouth cancers.
- Secondhand smoke can lead to lung cancer and heart disease as well as other health effects in adults and children.
- For many who use tobacco, brain changes brought on by continued nicotine exposure result in addiction.
- Both behavioral treatments and medication can help people quit smoking, but the combination of medication with counseling is more effective than either alone.
- Nicotine overdose is possible, though it usually occurs in young children who accidentally chew on nicotine gum or patches or swallow e-cigarette liquid.
- Anyone concerned that a child or adult might be experiencing a nicotine overdose should seek immediate medical help.
For more information about tobacco products and nicotine, visit:
This publication is available for your use and may be reproduced in its entirety without permission from NIDA. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.
What’s in a cigarette?
A cigarette is much more than chopped up tobacco leaves wrapped in paper. Cigarettes release thousands of dangerous chemicals when they burn.
Roll-up tobacco cigarettes are not any safer. They contain the same cancer-causing chemicals as manufactured cigarettes.
Tar is a sticky-brown substance that collects in the lungs when you breath in cigarette smoke. It can stain fingers and teeth a yellow-brown colour.
Tar contains cancer-causing chemicals. But it can cause more than just lung cancer. It also increases the risk of other lung diseases. This includes emphysema and chronic obstructive pulmonary disease (COPD).
Cigarette smoke contains a poisonous gas called carbon monoxide. You can’t smell, see or taste it.
Carbon monoxide stops your blood from carrying as much oxygen. This means your heart must work harder, and your organs don’t get the amount of oxygen they need. This increases your risk of heart disease and stroke.
Nicotine is a very addictive drug. Most people who smoke regularly don't do so choice – it’s because they have a nicotine addiction.
Some people associate smoking with feeling less stressed and anxious. But this is only because it reduces the unpleasant symptoms of nicotine withdrawal for a short time.
But nicotine is harmless compared to other substances in tobacco smoke. And studies have shown that nicotine replacement therapy (NRT) doesn't cause cancer.
NRT helps people deal with cravings when they are trying to cut down or stop smoking. It comes in many forms including patches, lozenges or gum.
Find out more on our how do I stop smoking page.
What ingredients in cigarettes cause cancer?
Up to 70 of the chemicals found in tobacco smoke cause cancer. Many of these cancer-causing chemicals in tobacco smoke have other surprising uses.
- 1,3-Butadiene is used in rubber manufacturing
- Arsenic is a poison
- Benzene is an industrial solvent, refined from crude oil
- Beryllium is used in nuclear reactors
- Cadmium is used in batteries
- Chromium is used to manufacture dye, paints and alloys
- Formaldehyde is used as a preservative in science laboratories and mortuaries
- Polonium-21 is a highly radioactive element
- Polycyclic aromatic hydrocarbons are a group of dangerous DNA-damaging chemicals, including benzo(a)pyrene
Low tar, 'light' and filtered cigarettes are not safer options
There is no such thing as safe tobacco.
Smoking filtered, low-tar, or ‘light’ variations of cigarettes doesn't reduce overall risk of disease.
And since 2003 it's been against the law to call tobacco products ‘light’, ‘mild’ or ‘low-tar’ versions. Using these words can make people wrongly believe that they are safer or healthier options.
How do chemicals in tobacco smoke lead to cancer?
Each cigarette you smoke can lead to DNA damage. And it is the build-up of damage in the same cell that leads to cancer.
Here are some of the ways that harmful chemicals in tobacco smoke can cause damage in the body:
Some chemicals in tobacco smoke damage DNA.
The DNA in all our cells controls how they grow and behave. If DNA is damaged, things can go wrong.
Some chemicals in cigarette smoke cause damage to parts of the DNA that normally protect our cells from cancer. And this can lead to cancer cells growing control.
Chemicals in tobacco smoke are even more dangerous as a mix.
This is because there are chemicals in tobacco smoke that can make other harmful chemicals stick more strongly to DNA.
There are also chemicals that stop our cells from repairing DNA damage. This makes it even more ly that damaged cells will turn cancerous.
Chemicals in tobacco smoke harm the cleaning system that our bodies use to remove toxins
For example, chemicals in cigarette smoke kill cilia. Cilia are the little hairs which usually keep our airways clear from dirt and infections.
This means people who smoke are less able to handle toxic chemicals than those with healthy lungs and blood.
It’s never too late to stop smoking
If you smoke, the best thing you can do for your health is to stop – it could even save you thousands of pounds each year. The NHS has a calculator to work out how much you could save by stopping smoking.
Stopping can be difficult, but it is possible. And the number of people who have stopped smoking is increasing.
Using prescription medicine with support of a free, local stop smoking service, is most ly to help you to stop for good. But how you chose to quit is up to you.
Read more on how to stop smoking.
5 Vaping Facts You Need to Know
Mens Health Heart Health Know Your Heart Risks
If you have thought about trying to kick a smoking habit, you’re not alone. Nearly 7 of 10 smokers say they want to stop. Quitting smoking is one of the best things you can do for your health — smoking harms nearly every organ in your body, including your heart. Nearly one-third of deaths from heart disease are the result of smoking and secondhand smoke.
You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all.
But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Can e-cigarettes help you to stop smoking once and for all? Michael Blaha, M.D., M.P.H.
, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping.
1: Vaping Is Less Harmful Than Smoking, but It’s Still Not Safe
E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we don’t know exactly what chemicals are in e-cigarettes, Blaha says “there’s almost no doubt that they expose you to fewer toxic chemicals than traditional cigarettes.”
However, there has also been an outbreak of lung injuries and deaths associated with vaping. As of Jan. 21, 2020, the Centers for Disease Control and Prevention (CDC) confirmed 60 deaths in patients with e-cigarette, or vaping, product use associated lung injury (EVALI).
“These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing tetrahydrocannabinol (THC),” explains Blaha.
The CDC has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E acetate is a thickening agent often used in THC vaping products, and it was found in all lung fluid samples of EVALI patients examined by the CDC.
The CDC recommends that people:
- Do not use THC-containing e-cigarette, or vaping, products
- Avoid using informal sources, such as friends, family or online dealers to obtain a vaping device.
- Do not modify or add any substances to a vaping device that are not intended by the manufacturer.
2: Research Suggests Vaping Is Bad for Your Heart and Lungs
Nicotine is the primary agent in both regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is also a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the lihood of having a heart attack.
Is vaping bad for you? There are many unknowns about vaping, including what chemicals make up the vapor and how they affect physical health over the long term. “People need to understand that e-cigarettes are potentially dangerous to your health,” says Blaha.
“Emerging data suggests links to chronic lung disease and asthma, and associations between dual use of e-cigarettes and smoking with cardiovascular disease.
You’re exposing yourself to all kinds of chemicals that we don’t yet understand and that are probably not safe.”
3: Electronic Cigarettes Are Just As Addictive As Traditional Ones
Both e-cigarettes and regular cigarettes contain nicotine, which research suggests may be as addictive as heroin and cocaine.
What’s worse, says Blaha, many e-cigarette users get even more nicotine than they would from a tobacco product — you can buy extra-strength cartridges, which have a higher concentration of nicotine, or you can increase the e-cigarette’s voltage to get a greater hit of the substance.
Vaping and e-cigarettes are sometimes promoted as ways to help cigarette smokers quit. But what about the reverse? Can vaping lead to regular cigarette smoking later on?
Although they’ve been marketed as an aid to help you quit smoking, e-cigarettes have not received Food and Drug Administration approval as smoking cessation devices. A recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes.
In the light of the EVALI outbreak, the CDC advises adults who use e-cigarettes for smoking cessation to weigh the risks and benefits and consider use of other FDA-approved smoking cessation options.
5: A New Generation Is Getting Hooked on Nicotine
Among youth, e-cigarettes are more popular than any traditional tobacco product. In 2015, the U.S. surgeon general reported that e-cigarette use among high school students had increased by 900%, and 40% of young e-cigarette users had never smoked regular tobacco.
According to Blaha, there are three reasons e-cigarettes may be particularly enticing to young people. First, many teens believe that vaping is less harmful than smoking. Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal to younger users.
Both youths and adults find the lack of smoke appealing. With no smell, e-cigarettes reduce the stigma of smoking.
“What I find most concerning about the rise of vaping is that people who would’ve never smoked otherwise, especially youth, are taking up the habit,” says Blaha. “It’s one thing if you convert from cigarette smoking to vaping. It’s quite another thing to start up nicotine use with vaping. And, it often leads to using traditional tobacco products down the road.”
There’s a strong link between smoking and cardiovascular disease, and between smoking and cancer. But the sooner you quit, the quicker your body can rebound and repair itself. Talk to your doctor about what smoking cessation program or tools would be best for you.
One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.
On this page:
The basic components of most cigarettes are tobacco, chemical additives, a filter, and paper wrapping. Cigarettes are responsible for the vast majority of all tobacco-related disease and death in the United States.
Smokers are exposed to a toxic mix of over 7,000 chemicals when they inhale cigarette smoke.1 The harmful chemicals in cigarette smoke can damage nearly every organ in the body.
2 Nonsmokers are exposed to many of these same chemicals through secondhand smoke.
Statistics about Cigarette Use
- Every day, on average, about 1,500 youth aged 12-17 smoke their first cigarette and more than 200 youth under aged 12-17 become daily smokers.3
- Nationwide, 4.6 percent of high school students (710,000 ) and 1.6 percent of middle school students (190,000) currently smoke cigarettes.4
FDA Regulation of Cigarettes
FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of cigarettes, including components, parts, and accessories, under the Federal Food, Drug, and Cosmetic Act (FD&C Act) and its implementing regulations.
Learn more about federal requirements limiting the sale, distribution, and marketing of cigarettes.
In July 2017, the FDA announced a comprehensive plan for tobacco and nicotine regulation that will serve as a multi-year roadmap to better protect kids and significantly reduce tobacco-related disease and death, including pursuing lowering nicotine in cigarettes to a minimally addictive or non-addictive levels. In April 2021, FDA announced that it plans to propose tobacco product standards to ban menthol as a characterizing flavor in cigarettes.
“Heated tobacco products” and “heat-not-burn tobacco products” are colloquial terms that do not appear to have universally agreed upon definitions and seem to be used interchangeably.
For FDA’s purposes, if a tobacco product meets the legal definition of a cigarette but the tobacco is not heated to a temperature high enough to cause combustion, the product would be currently categorized as a “non-combusted cigarette” and regulated as a cigarette.
If you make, modify, mix, manufacture, fabricate, assemble, process, label, repack, relabel, or import cigarettes, you must comply with these requirements for manufacturers.
CTP’s Office of Small Business Assistance can answer specific questions about requirements of small businesses and how to comply with the law. This office also provides online educational resources to help regulated industry understand FDA regulations and policies.
Retail Sales of Cigarettes
If you sell cigarettes, please read this summary of federal rules that retailers must follow. In addition, our website provides more information on regulations, guidance and webinars for retailers.
Tobacco products imported or offered for import into the United States must comply with all the applicable requirements under the Federal Food, Drug, and Cosmetic Act (FD&C Act). You can find more information on the Importing and Exporting webpage.
You can also learn more about the importation process in the FDA Regulatory Procedures Manual, Chapter 9, Import Operations and Actions.
If you have questions about importing a specific tobacco product, please contact the FDA district into which your product will be imported.
Reporting Adverse Experiences and Product Violations
If you have experienced an unexpected health or safety issue with a specific tobacco product, you can report your adverse experience to FDA. Knowledge about adverse experiences can help FDA identify health or safety issues beyond those normally associated with product use.
If you believe these products are being sold to minors, or you see another potential violation of the FD&C Act or FDA’s tobacco regulations, report the potential violation.
1. U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S.
Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.2. U.S. Department of Health and Human Services (USDHHS).
How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S.
Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.3. Substance Abuse and Mental Health Services Administration. (2020).
Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
4. Gentzke AS, Wang TW, Jamal A, et al. Tobacco Product Use Among Middle and High School Students — United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1881–1888.