Addiction
Tobacco Use Disorder

What Is Tobacco
Use Disorder?

According to the World Health Organization, tobacco addiction—also referred to as tobacco use disorder—is characterized by the following core features:

• Impaired control over tobacco use;
• Giving higher priority to tobacco use than to other activities;
• A strong urge to use nicotine despite harm or negative consequences;
• Reduced effects of nicotine over time (tolerance);
• Withdrawal symptoms following the reduction or cessation of nicotine use;
• Continued tobacco use despite recurrent social or interpersonal problems caused or exacerbated by tobacco use (for example, arguments with others related to tobacco use);
• Recurrent tobacco use in potentially hazardous situations (for example, smoking in bed);
• Recurrent tobacco use resulting in failure to fulfill major responsibilities at work, school, or home (for example, interference with work performance).

According to the World Health Organization’s criteria, a diagnosis of tobacco use disorder may be made when an individual has used tobacco regularly for at least one month and exhibits the associated symptoms.

The most common tobacco products include cigarettes, roll-your-own tobacco products, pipes, cigars, hookah tobacco products, snuff, and chewing tobacco.

What Is Tobacco Withdrawal?
Nicotine, a toxic dark-colored substance naturally found in tobacco, has highly dependence-producing effects. Withdrawal symptoms may begin within 90 to 120 minutes after nicotine use stops. These symptoms are often most severe during the first day following cessation, but they generally decrease over time and gradually subside.

During the cessation process, individuals may experience difficulties such as managing withdrawal symptoms and coping with cravings. Professional support may help make the process more manageable.

Common withdrawal symptoms may include:
1. irritability or anger,
2. dizziness,
3. increased appetite,
4. muscle tension or cramps,
5. low blood pressure,
6. sleep disturbances,
7. depressed mood,
8. intense nicotine cravings.

What Is Passive Smoking or Exposure to Second-Hand Tobacco Smoke?
Tobacco use can cause serious health problems not only for people who use tobacco products, but also for those exposed to tobacco smoke. Toxic substances and carcinogenic chemicals released from burning tobacco products contaminate the air and create a harmful environment for others. As a result, exposure among non-users is also a major public health concern. This is referred to as passive smoking or exposure to second-hand tobacco smoke. Second-hand tobacco smoke refers to the smoke that accumulates indoors when tobacco products such as cigarettes or hookahs are used. Inhaling this smoke is known as passive smoking.

According to the World Health Organization (2020), exposure to second-hand tobacco smoke can have particularly serious health consequences, especially during early childhood. Globally, nearly half of all children breathe air polluted by tobacco smoke, contributing to serious health problems.

The harms associated with passive smoking include:
1. Smoke from a burning cigarette contains approximately 4,000 chemicals and toxic substances, 50 of which are known carcinogens.

2. A cigarette burns for approximately 12 minutes, while active inhalation lasts for only about 30 seconds. The remaining smoke is inhaled by others nearby.

3. Second-hand smoke is more harmful than directly inhaled smoke because it forms and spreads at a lower temperature.

4. Children exposed to tobacco smoke are at greater risk of respiratory conditions such as asthma, bronchitis, common colds, middle ear disease, and reduced lung function.

5. Approximately two-thirds of the smoke from a burning cigarette is released into the surrounding air.

By addressing tobacco use, we help protect not only our own health but also the health of those around us. We can help create a cleaner and healthier environment for children and young people.

Health Problems Caused by Tobacco Use Disorder
Tobacco use contributes to the development of a wide range of diseases, including:

1. Cancers (including lung, stomach, skin, cervical cancers, and others)
2. Cardiovascular diseases
3. Diabetes
4. Respiratory diseases
5. Gastritis and peptic ulcers
6. Dental and periodontal diseases
7. Pregnancy-related complications such as premature birth, miscarriage, developmental disorders in children, and reduced breast milk production

Tobacco use is a major public health concern and contributes significantly to the global burden of disease. According to the World Health Organization’s 2019 European Tobacco Use Trends Report, smoking increases the risk of premature death. The report also identifies tobacco use as one of the leading causes of premature mortality worldwide, accounting for approximately 18% of all deaths.

If Your Child Smokes
1. Children often model parental behavior. Therefore, as a parent, demonstrating positive role-modelling can strengthen the effectiveness of support provided during cessation.
2. If a child is found smoking, the cigarette pack may be calmly removed, and household or school rules regarding tobacco use may be reinforced.
3. A consistent response to each incident is important to ensure clear messaging and to establish appropriate boundaries.
4. Adherence to household rules by adults, and ensuring that children do not observe adults smoking, is a critical component of prevention.
5. Rather than using a directive or instructive tone, discussions on the effects of tobacco may be conducted in a way that facilitates access to accurate and evidence-based information.

Effects of Tobacco Use on Children and Adolescents
Tobacco use is widely recognized as a global public health issue affecting all population groups. However, its impact is particularly pronounced during childhood and adolescence, when long-term behavioral patterns are established.

1. Childhood and adolescence represent a developmental period in which experimentation with health-risk behaviors, including tobacco and other illicit psychoactive substances, may occur.
2. Tobacco use during childhood and adolescence is associated with a higher likelihood of continued use into adulthood.
3. Tobacco use during childhood and adolescence increases the risk of asthma in the short term and significantly elevates the risk of cardiovascular diseases, respiratory illnesses, and cancer in later life.
(Health at a Glance: Europe 2020 Report)

Did You Know?
1. Tobacco use negatively affects psychological, physical, and social well-being and increases the risk of premature mortality.
2. Exposure to second-hand smoke also poses serious health risks for non-users and is associated with cardiovascular disease, cancer, and other chronic conditions.
3. Tobacco companies generate an estimated USD 700 billion annually.
4. Approximately 7 million people die each year due to tobacco use worldwide.
5. Around 19,100 people die every day from tobacco-related diseases.
6. A person consuming approximately half a pack of cigarettes per day is exposed to an estimated 300 nicotine stimulations to the brain daily.
7. In Türkiye, approximately 83,100 people die annually due to tobacco-related causes, while an estimated 252,000 children and 14.5 million adults use tobacco products.

Electronic Cigarettes Are Harmful to Health
In recent years, new-generation tobacco and nicotine products have been incorporated into tobacco control discussions. According to the World Health Organization (2019), these products are referred to as Electronic Nicotine Delivery Systems (ENDS). Common types include e-cigarettes, vape devices or vape pens, e-hookahs, e-pipes, and e-cigars.

Although the tobacco industry markets these products as less harmful alternatives that may help people quit smoking, the World Health Organization stated in 2020 that they pose health risks similar to those associated with other tobacco products.

Children and adolescents are particularly vulnerable. Because brain development continues into the mid-twenties, early exposure to these products may negatively affect brain development. E-cigarette use is also associated with increased risks of cardiovascular and respiratory diseases. These products may also pose risks during pregnancy by affecting fetal development.

Exposure to the chemicals released by e-cigarettes may also result in second-hand exposure, similar to exposure to tobacco smoke. Second-hand exposure is associated with increased risks of cardiovascular disease, lung and bladder cancer, asthma attacks, childhood respiratory illnesses, sudden infant death syndrome, and respiratory failure.

In addition, e-cigarettes carry risks such as cartridge leakage, accidental nicotine exposure, unintended high-dose nicotine intake, as well as explosions, burns, and injuries.

It Is Never Too Late to Quit Tobacco!
The body begins to recover immediately after quitting smoking, provided there is no further exposure to tobacco smoke. Heart rate and blood pressure return to normal levels, and the risk of coronary heart disease gradually declines.

1. Quitting in your 30s can increase life expectancy by up to 10 years.
2. Quitting in your 40s can increase life expectancy by up to 9 years.
3. Quitting in your 50s can increase life expectancy by up to 6 years.
4. Quitting in your 60s can increase life expectancy by up to 3 years.

Quitting Is Possible!
You may think quitting smoking will be difficult and may choose to postpone the process. However, once you take the first step and seek professional support, the process can become significantly easier.

The improvements in your health and physical functioning shortly after quitting smoking can help you stay committed to the process.

Psychological support and pharmacological treatment play a critical role in smoking cessation interventions. For information on cessation methods and available support, you can contact the Green Crescent Counseling Center (YEDAM) through the 115 hotline. Specialist psychologists at YEDAM provide support to individuals, families, and communities, and respond to questions related to addiction. YEDAM offers counseling services for individuals aged 15 and over who wish to quit tobacco use.

Health Improvements After Smoking Cessation
Significant physiological improvements occur following smoking cessation:

After:
1. 20 minutes: heart rate and blood pressure decrease.
2. 12 hours: carbon monoxide levels in the blood return to normal.
3. 2 weeks to 3 months: circulation improves and lung function increases.
4. 1 to 9 months: coughing and shortness of breath decrease.
5. 1 year: risk of coronary heart disease is reduced by approximately 50% compared to smokers.
6. 5 years: stroke risk decreases significantly, approaching that of non-smokers.
7. 10 years: risk of death from lung cancer is reduced by approximately 50% compared to smokers.
8. Risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.
9. 15 years: risk of coronary heart disease approaches that of a non-smoker. (World Health Organization, 2020)

10 Steps to Quit Smoking
• Set a quit date.
• Remove cigarettes, lighters, matches, and ashtrays from your environment.
• Set small, achievable goals.
• Engage in activities to distract yourself.
• Brush your teeth frequently and take showers.
• Maintain a balanced diet and drink plenty of water.
• Avoid triggers that increase the urge to smoke.
• Chew gum or herbal tea to manage cravings.
• Spend time outdoors and remain physically active.
• Take 10 deep breaths when experiencing cravings.

YEDAM Counseling Hotline (115)
Calls to the YEDAM hotline are answered by trained specialists. Individuals may ask questions about addiction and quitting tobacco and receive professional support. The hotline operates daily from 09:00 to 00:00 and provides assistance to individuals with tobacco use disorder, their families, and anyone seeking information about addiction.

For more information:

tbm.org.tr
yedam.org.tr
birakabilirsin.org

References and Resources
For more information on the topics covered on this website, please see the sources below: