Tobacco products comprise more than just cigarettes. Learn about the harmful side effects of chewing tobacco, smoking shisha and e-cigarettes.
Most people will immediately think of cigarettes whenever tobacco is mentioned. However, there are many other tobacco products out in the market. But as they are not as commonly seen and publicised, many people are unaware of the dangers associated with these products.
Related: Smoking - Casual Habit or Addiction?
Cigarettes lead to the deaths of about half its users, a staggering number given that there are more than a billion smokers in the world . Cigarettes are simply sticks of tobacco blend wrapped in paper. So what actually makes a cigarette so dangerous to your health?
Cigarettes contain over 7,000 chemicals. Some of the ingredients in cigarettes include toxic substances like :
Related: Kick Smoking for Good
Some cigarette companies offer brands on the market promoted as safer alternatives to regular cigarettes. These safer alternatives are marketed as low-yield cigarettes (also known as "lights") with enhancements such as filters claimed to trap tar.
However, there is no convincing evidence to prove that switching to low-yield cigarettes can drastically reduce the likelihood of smoking-induced diseases.
Related: Benefits of Quitting
Cigars are tightly rolled bundles of fermented tobacco wrapped in tobacco leaves, grown in countries like Cuba, Brazil and Indonesia.
The amount of tobacco in cigars is generally several times more than cigarettes. A large cigar can be up to 7 inches in length. Some premium cigars contain the tobacco equivalent of an entire pack of cigarettes and can take between 1 to 2 hours to smoke .
While many believe that cigars are less harmful since cigar smokers normally do not inhale cigar smoke as it is too acrid, this is a myth. Cigar smokers still risk exposure of their lips, tongue and throat to cigar smoke and cancer-causing chemicals. Individuals who exclusively smoked cigars still have a higher risk of developing tobacco related cancer, compared to never smokers [5,6]. Moreover, cigars are still addictive as nicotine can be absorbed into the body via two routes, through inhalation to the lungs and by absorption through the oral lining .
As the majority of the cigar smoke remains in the oral cavity, cigar smokers have increased risk of [5,6]:
Related: Clearing the Air
Smokers may choose to roll their own cigarettes as a cheaper alternative to buying regular cigarettes. Sometimes called ang hoon in Singapore, roll-your-own cigarettes (also known as ryo cigarettes or ryo tobacco) consist of loose dried tobacco hand-rolled by smokers in tiny papers before they are smoked.
Due to the thinner appearance of ang hoon, some smokers perceive it as a safer choice to cigarettes. However, studies have shown otherwise [7,8]:
Related: Smoking: The Puff to Diabetes
A shisha is a waterpipe, inside which flavoured tobacco is partially burned. The smoke passes through water held in the waterpipe before being inhaled by smokers through tubes attached to the pipe.
Shisha is seen as a popular social activity, especially among youths who view this as a harmless recreational activity. Contrary to popular belief, shisha smoking is dangerous (http://www.healthhub.sg/live-healthy/317/everything_shisha), the water in the shisha pipe does NOT absorb harmful substances in the smoke. . In fact, even after passing through water, shisha smoke still contains higher levels of carbon monoxide, nicotine and cancer-causing chemicals. This is because the burning of tobacco in a shisha using charcoal produces higher levels of carbon monoxide and cancer-causing chemicals than conventional cigarettes . As such, the import, distribution and sale of shisha tobacco is now prohibited by law in Singapore
In fact, during a 1-hour shisha session, a smoker will inhale 100 to 200 times the amount of smoke produced by a single cigarette .. As people smoking shisha longer and deeper puffs from the waterpipe, users may absorb a greater concentration of harmful substances in a single shisha session compared to smoking a single cigarette
Related: "Vaping is not smoking", and Other Tobacco Myths
Oral smokeless tobacco products are products that can be chewed or sucked in the mouth. These include chewing tobacco leaves and powdered tobacco (also known as "snuff"). Chewing tobacco comes in the form of a loose tobacco leaf, while snuff comes in sachets similar to a tea-bag that contains dried or moist forms of finely ground tobacco .
Users place the tobacco in the mouth and suck on it, spitting out the tobacco juices produced.
Chewing tobacco is prohibited by law in Singapore.
Consumption of oral smokeless tobacco is prevalent in the United States, Scandinavia and parts of Asia. Smokeless tobacco is not a safe substitute for cigarette smoking. Oral tobacco is a major form of tobacco addiction and can lead to the following :
Related: National Tobacco Control Programme
The electronic cigarette, or e-cigarette, is touted as the healthier alternative to cigarettes by its manufacturers. However, WHO has never officially endorsed e-cigarettes.
Electronic-cigarettes (also known as e-cigarettes or vapourisers) consists of a mouthpiece, a heating element, a rechargeable battery and is fitted with a cartridge which contains a liquid chemical mixture. The liquid chemical mixture (also known as e-liquids or vape juices) contains nicotine (a highly addictive substance found in other tobacco products), propylene glycol (a food additive but known irritant when inhaled) and many other harmful chemicals also found in conventional cigarettes. An e-cigarette also has a LED light at the end of the device which lights up to signal the process of combustion as the smoker inhales. The heating element powered by the battery vaporises the liquid chemical mixture, generating a nicotine-containing fine mist which is then inhaled.
The World Health Organisation (WHO) has declared that e-cigarettes are undoubtedly harmful to health and that they are not safer alternatives to regular cigarettes . As e-cigarettes are relatively new products, many long-term health effects of vaping are still unknown, studies have shown that vaping is associated with increased risk of developing heart and lung diseases in the short term, such as myocardial infarction, asthma and chronic obstructive pulmonary disease (COPD) .
Vapourisers expose the user to a combination of harmful chemical substances like fine particulate matter (PM), cancer causing agents such as carbonyls and volatile organic compounds. Commonly found substances include cancer-causing compounds like formaldehyde and benzene. Formaldehyde is known to cause infertility as well. Toxic metal nanoparticles like tin, lead and nickel are also derived from the e-cigarette, heating element or vapouriser device itself .
The main function of e-cigarettes is primarily to dispense nicotine - a highly addictive substance that keeps users dependent and eventually become long-term vapers. In youths, nicotine exposure negatively affects the developing brain's ability to control attention and learning, lowers youths' impulse control permanently and can lead to mood disorders. Impulse control issues refer to the failure to resist urges. Common examples include sudden physical or verbal outbursts, internet addiction, compulsive eating etc .
Vaping is illegal in Singapore. It is an offence under the Tobacco (Control of Advertisements and Sale) Act (TCASA) to use, purchase, possess, sell, import or distribute imitation tobacco products. This includes e-cigarettes and anything else that resembles a smoking device.
Singapore is not the only country that has banned vaping, around 37 countries have banned the sales or distribution of e-cigarettes, with more countries either heavily regulating or considering a ban, as the harms of vaping become increasingly known .
Consumption of tobacco, in any form, poses a health risk. There are no safer alternatives to cigarettes when it comes to tobacco products. The best way to keep you safe from the harmful effects of tobacco is to stay away entirely. You do not need tobacco products to feel good or to pass the time. Abstaining from tobacco will allow you to lead a healthier, happier life.
Join the I Quit Programme and remain smoke free for 28 days and you are 5 times more likely to quit smoking. You can nominate your loved ones as a supporter when you sign up for the programme. Validate your smoke-free status and redeem a HPB eVoucher* worth $50 at the 28th day milestone. Keep going and you'll also receive eVouchers* worth $30 and $20 at the 3rd month and 6th month milestone respectively!
*Terms and conditions apply.
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This article was last reviewed on
Tuesday, November 15, 2022
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