Why cigarettes are so dangerous

Things are looking up, and that’s not good news: The Number of cigarette smokers in Germany is 2022 rose again for the first time in years, and that by almost five percentage points to 35.5 percent in 2022 alone. At the same time, the number of people who tried at least one smoking cessation in 2022 is falling and was just eight percent in November 2022. Although literally every child in this country knows that smoking cigarettes is bad for your health. Statistically, 15 percent of avoidable deaths in Germany are attributed to cigarettes. Smoking kills – in this country more than 127,000 people a year.

Die There are many reasons for this. Cigarettes are harmful to health in many ways. Lung cancer, larynx cancer, esophagus, stomach and colon cancer, kidney, bladder and blood cancer: Smoking is the main risk factor for many forms of cancer or promotes the development of tumors. Anyone who regularly smokes cigarettes also causes massive damage to their cardiovascular system and respiratory tract, which can even lead to chronic lung disease COPD.

Arsenic, hydrogen cyanide, tar: what smokers inhale

But while these facts are well known, there is a great deal of ignorance about the primary causes of health damage. 84 percent of cigarette users consider nicotine to be the main cause of all the diseases that can result from smoking. But what is also striking: Doctors also stubbornly cling to this opinion. In a US-Studiepublished in the Journal of General Internal Medicine in 2020, a good 80 percent of medical specialists considered nicotine to be carcinogenic and the main cause of COPD.

The medical truth, however, looks different: the vast majority of harmful substances are not in the tobacco itself, but mostly only occur when it is burned. Arsenic and ammonia, benzene and hydrocyanic acid, formaldehyde, tar, carbon monoxide and cadmium: the consumer breathes in cigarette smoke more than 4800 different substances and distributes them throughout the body via the lungs and blood. At least 250 of these substances are considered toxic or are proven to be carcinogenic. Keyword passive smoking: These dangerous substances are also still measurably present in the so-called sidestream smoke – the smoke that is exhaled and inhaled by other people in the room. Cigarettes also endanger non-smokers through passive smoking.

Smokers don’t die from nicotine

Just because the greatest risks come from burning tobacco does not mean that nicotine is harmless. The one in the tobacco Substance constricts the vessels, worsens blood circulation and thus increases the risk of heart attack and stroke. And: Nicotine has a high potential for addiction – it is the reason why chronic smokers find it so difficult to give up their cigarettes. However, nicotine is not carcinogenic.

Why is this distinction between nicotine and other toxic substances in cigarette smoke still important? Because with tobacco heaters like Iqos or Glo, e-cigarettes like Veev or Vuse or nicotine pouches (e.g. snus) there are different ways of consuming nicotine without inhaling harmful cigarette smoke. While e-cigarettes vaporize a liquid containing nicotine and inhale this vapor, tobacco heaters heat real tobacco to up to 350 degrees Celsius instead of burning it. The aerosol formed when heated contains 90 to 95 percent less toxic substances as cigarette smoke. A clinical study commissioned by British American Tobacco shows that in smokers who have completely switched to tobacco heaters, the concentration of biomarkers, which are considered early indicators of typical smoking diseases such as lung cancer or cardiovascular diseases, fell permanently.

“The enormous damage potential of tobacco smoke and the devastating consequences of smoking are caused by the combustion products of tobacco and not by the nicotine contained in tobacco smoke,” said the Munich addiction doctor Tobias Rüther in one Opinion for the Bundestag formulated. “Compared to the other ingredients in tobacco smoke, nicotine has only moderate effects on the cardiovascular system and is not on the World Health Organization’s list of carcinogenic substances.” Rüther is certain: “Smokers smoke because of the nicotine and die from the combustion products.”

The better option for hardcore smokers

The manufacturers of these products emphasize that Iqos & Co. are not suitable for children and young people, pregnant women and previous non-smokers, as they are not harmless but only reduce the risk of smoke-induced diseases. But for long-time smokers who cannot or do not want to quit this habit – and statistically this applies to every second smoker – the alternative products open up a way to reduce their health risks.

“Harm reduction” is the technical term for this type of substitution. The company Philip Morris, which grew up selling cigarettes, is now focused on this principle and has invested more than ten billion US dollars in the development of lower-risk alternatives to cigarettes and more than 400 studies on the topic of smokeless products since the 1990s initiated.

“Unsmoke the world” is Philip Morris’ new goal. The goat as a gardener? “We have great scientific expertise in tobacco products. And we know the consumers, their motivations and barriers. And that’s why we are in a very good position to drive this transformation forward,” believes Alexander Nussbaum, Head of Scientific & Medical Affairs at Philip Morris Germany. The doctor of biochemistry had researched vaccines against cancer before moving to the cigarette manufacturer. His rationale: “The available science on non-combustion alternatives for adult smokers who continue to smoke convinced me very quickly that I could make a difference at Philip Morris.”

Nicotine in a bag: Sweden is successful with it

Philip Morris’ latest coup is the acquisition of a stake in Swedish Match, manufacturers of snus, a very popular sucking tobacco in Sweden, as well as other oral tobacco products. Here the nicotine is absorbed through the oral mucosa and gets into the blood. In Sweden smoke according to one Study by research firm Lakeville now only six percent of adult men (EU average: 28 percent). As a result, significantly fewer men die in Sweden from cancer associated with smoking. According to the study, a large part of the lower death rate is due to the option to switch from cigarettes to snuff.

In other countries, even health authorities are now promoting a switch from smokers to heated tobacco products or e-cigarettes: “Great Britain, New Zealand and Canada use e-cigarettes as a main tool in the fight against tobacco consumption and have been proven to be very successful with it,” emphasizes approximately Addiction expert Prof. Dr. Heino Stoever. Even if it is still disputed among experts to what extent the smoke-free alternatives actually represent an entry point to the complete quitting of smoking, sees one Cochrane Review published in 2022 clear indications that the probability of stopping smoking completely is significantly higher when using e-cigarettes as a substitute than when trying to use nicotine-containing aids.

The harm reduction principle is not a new invention, but has already established itself in many areas of life. If you like driving fast, you can buckle up. If you like to be in the sun for a long time, you reduce your risk of skin cancer by using sunscreen. If you don’t want to do without one-night stands, protect yourself with condoms. When it comes to smoking cigarettes, many people still believe that the only options are to give up the dangerous vice altogether or to continue as before. Not knowing what is actually so dangerous about smoking is one of the reasons for this.