Ministry of Health Singapore. All Rights Reserved.
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 with enhancements such as filters.
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 and can have as much as 20 times the amount of tobacco that a cigarette has.
While cigar smokers normally do not inhale cigar smoke as it is too acrid, the risk of lung cancer of cigar smokers is still 25 times higher than that of non-smokers.
As the majority of the cigar smoke remains in the oral cavity, cigar smokers also have increased risk of:
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, available data indicate otherwise:
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. But Shisha smoking is dangerous. The water in the shisha pipe does NOT absorb harmful substances in the smoke, contrary to popular belief. 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.
A smoker will inhale 100 to 200 times the amount of smoke produced by a single cigarette in one hr. As people tend to sit around and socialise with friends when smoking shisha, a session can easily last for 20 to 80 minutes. As people smoking shisha take more and deeper puffs from the waterpipe, a shisha smoker absorbs a greater concentration of harmful substances than a cigarette smoker.
Related: Shisha 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 and 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 causes cancer of the head, mouth, neck and throat including:
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.
E-cigarettes are devices made to resemble real cigarettes. An e-cigarette consists of a mouthpiece, a heating element, a rechargeable battery and is activated with a cartridge which contains a liquid chemical mixture. The liquid chemical mixture is composed of nicotine (a highly addictive substance found in cigarettes), propylene glycol (a known irritant when inhaled or ingested) and may also contain many other harmful chemicals found in conventional cigarettes. An e-cigarette also has a LED light at the end of the device which lights up to simulate the process of combustion when the smoker inhales.
As the user inhales through the e-cigarette, a heating element powered by a rechargeable battery is activated and vaporises the liquid chemical mixture, generating a fine heated mist. The fine mist generated contains nicotine that is inhaled and absorbed into the user's lungs.
Some marketers of e-cigarettes have claimed that their product is an effective nicotine replacement therapy and a smoking cessation aid endorsed by the World Health Organizations (WHO). However, WHO had issued a press statement in September 2008 stating that it does not support e-cigarettes as a legitimate therapy to help smokers quit as there is a lack of conclusive scientific evidence to substantiate the efficacy, safety and quality of e-cigarettes. WHO also called on marketers of e-cigarettes to immediately stop the unproven claims on e-cigarettes.
Electronic cigarettes have so far been proven to be neither safe nor effective in helping smokers quit. More research still needs to be done to establish the usefulness of e-cigarettes to help people quit smoking. Although e-cigarettes do not contain some of the harmful substances found in normal cigarettes, this does not mean that they are entirely harmless. The nicotine present still poses a health risk to users.
Users may still develop a dependence or addiction to nicotine by inhaling the fine nicotine mist produced by e-cigarettes.
Imitation tobacco products such as electronic cigarettes are prohibited by law.
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 28-Day Countdown now! Call QuitLine at 1800 438 2000 for support, and visit participating retail pharmacies for advice and products that can help you quit.
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This article was last reviewed on
Tuesday, February 18, 2020
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