Tobaccois commodity that is legalized in most of the jurisdictions,irrespective of the negative impacts that it has on health, social,and economic status of consumers. Tobacco is consumed by people inall stages of development, starting from childhood to old age. By theyear 2015, WHO (2015) estimated that more than 1.1 billion people hadstarted consuming tobacco, where more than 80 % of them lived in themiddle-income and low-income nations. Apart from the large number ofpeople who make deliberate decisions to use tobacco, there is anotherpopulation of innocent second-hand smokers who inhale tobacco smokethat is released into their surroundings. WHO (2015) stated thatabout 600,000 people in the modern world are second-hand smokers.This paper will explore the issue of tobacco use, with a focus on itsprevalence, risk factors, effects, prevention strategies, and thegateway drug theory.

Prevalenceof tobacco use

Studieson the prevalence of tobacco consumption focus on three age groups,namely children, adolescents, and adults. In total, about 46.6million (approximately 20.6 % of the total population) U.S. citizensuse different products of tobacco, where 850 people aged between 12and 17 years start smoking on a daily basis (Office of DiseasePrevention and Health Promotion, 2014). Unfortunately, most of thechildren below the age of 12 years are victims of second-handsmoking. Most of these kids are brought up by smoking caregivers orparents, who consume tobacco in the presence of innocent children.Second hand smoking is considered to be worse than the first handsmoking because the victim inhales unfiltered smoke that contains alarge number of chemicals. The high risk of second-hand smoking isconfirmed by the fact that children of the first-hand tobacco usersare at a higher risk of suffering from infections at the lowerrespiratory tract, infection in the middle ear, bronchitis, andpneumonia compared kids who are brought up by caregivers who do notconsume the product (ODPHP 2014).

Adolescenceis considered as the riskiest stage of human development because itis characterized by a high tendency to experiment with differentproducts. Although studies show that about 3,450 of the new consumersof tobacco start at the age of between 12 and 17 years, it is evidentthat the majority of them learn about the product at the onset ofadolescence, which is 13 years (ODPHP 2014). A large number of thesefirst-time smokers (about 850 young people) start consuming tobacco on a daily basis by the time they reach the climax of adolescence,which is 17 years of age (ODPHP 2014). There is also a highprobability of continuing with the same risky behavior to adulthood.The probability of consuming the product until the later stages ofdevelopment is a sign of addiction that limits the capacity of theaffected adolescents to avoid the risky behavior.

Thereis a general perception that the majority of the current populationof users of tobacco started during adolescence. However, the highprevalence of tobacco abuse among adults suggests that the largestnumber of consumers consume their first product during adulthood.This fact is confirmed by the data showing that over 46 millionAmericans are regular smokers and 16 million of them live withsmoking-related health conditions, while only 3,450 of themexperiment with tobacco during adolescence (WHO, 2015). However, thelargest proportion of adults is first-hand smokers, unlike childrenwho are victims of the second-hand smoking. More men (18.8 %) consumetobacco products than women, who represent 14 % of all smokers (CDC,2016). In terms of ethnicity, the native Americans (including theIndians) have the largest percentage of smokers (29.2 %) followed bymulti race Americans (27.9 %), non-Hispanic Whites (18.2 %), blackAmericans (17.5 %), and Hispanic Americans with a proportion of 11.2% (CDC, 2016). The rate of prevalence is also influenced byeducational attainment where adults who have attained the GEDcertificate have the highest proportion of smokers (43.0 %), whileonly 5.4 % of graduate degree holders consumer tobacco products (CDC,2016).

Riskfactors for tobacco use

Adecision to start consuming tobacco is influenced by a wide range offactors, including environmental, social, genetic, and psychologicalissues. Social factors motivate people to consume tobacco through theapproval of the product by peers. People who engage socially withsmoking peers are at a higher risk of consuming tobacco compared tothose who socialize with non-smoking peers (ODPHP 2015). Similarly,smoking guardians and parents create a family environment thatmotivates children to experiment with tobacco. Living with suchparents increases the accessibility of tobacco products to children(Kalavana, Lzarou &amp Christodoulou, 2011).

Stressis among the key psychological factors that make a significantcontribution towards an increase in the prevalence of smoking. Thisis common among the people who believe that tobacco products have thecapacity to relieve stress or help them forget the underlyingproblems. A cross sectional study of 352 adolescents at the collegelevel of education revealed that stress reduces self-esteem, whichincreases the risk of abusing substances (Uba, Yaacob, Talib,Abdullah &amp Mofrad, 2013). Stress may result from differentfactors, including workload at college or difficult exams. However,people with a higher level of self-esteem are able to overcome theeffects of stress without relying on tobacco or other type ofsubstance.

Moreover,there is a population of individuals who are predisposed to the riskof abusing tobacco by their genetic composition. Studies have shownthat genetic predisposition influences the smoking behavior throughdopamine. Dopamine is a neurotransmitter that has the capacity tobind to certain receptors in the brain and influence the rewardsystem (Hiemstra, Engels, Schayck, Barker &amp Otten, 2013).Inability of the genes to regulate the production of adequatequantities of dopamine increases the risk of abusing tobacco. This isbecause dopamine competes with the nicotine component of tobacco forthe binding sites in the brain, which means that less than normalquantities of dopamine create a craving for tobacco due to theexistence of free binding sites in the brain. This genetic deficiencyrun in families and can be indicated by the high risk of abusingtobacco when there are other relatives who have been using theproduct before.

Effectsof tobacco consumption


Theuse of tobacco has been a significant issue of concern and theleading cause of deaths that can be prevented. Most of the diseasesthat reduce the functionality of the lungs and heart are attributedto the use of tobacco products (Hiemstra et al., 2013). The abuse oftobacco has played some role in the prevalence of a wide range ofcancers, including larynx, liver, trachea, kidney, and cervicalcancer. Smoke that is inhaled by users of tobacco causes several lungdiseases, such as bronchitis, pneumonia, bronchitis, and emphysema,among others. A combination of these diseases has killed a total of20 million citizens of the United States since 1964 (ODPHP, 2015).

Second-handsmokers also suffer from many diseases that can be directlyattributed to smoke and chemicals that are released by smokers. Someof the key diseases that affect second-hand smokers includerespiratory infections, asthma attacks, infant death syndrome, andrespiratory infections (ODPHP, 2015). These health conditions affectinfants and spouses of smokers. Research has shown that about 2.5million Americans have died of second-hand smoking since 1964 (ODPHP,2015). The health effects of tobacco result from over 5,000chemicals, where about 98 of them are toxicological. Cancer diseasesare associated with chemicals (such as formaldehyde and acrolein)that lead to the degradation and a significant damage of the DNA.

Socialand environmental effects of tobacco consumption

Mostof the social effects of tobacco use are negative. The spouses andchildren of smokers endure a lot of suffering since they are forcedby circumstances to inhale smoke and live with people who smell liketobacco all the time (Novotny, Bialous, Burt, Costa, Curtis, Iqtidar,Pujari, Liu &amp Espaignet, 2015). The range of diseases and deathscaused by the abuse of tobacco every year reduce the number ofproductive members of the community. It can also result in distressamong the family members of the affected persons. Moreover, anincrease in the number of adolescents who experiment with tobaccoeach year is a worrying situation because it indicates the extent towhich members of the society can access addictive substances,including tobacco. According to Novotny etal.,(2015) the use of tobacco results in emission of about 2.6 tonscarbon dioxide and 5.2 tons of methane gas each year. Cumulatively,greenhouse gases that are emitted by smokers play a significant rolein the destruction of the ozone layer and the overall environmentaldegradation. Apart from the smoke, (ODPHP 2014) estimated that theusers of tobacco products dispose about 1.8 million tons of packagingmaterial and 175,200 tons of filters. Irresponsible disposal of thesesolid wastes results in a significant pollution of the environment.

Economicimpact of tobacco consumption

Consumptionof tobacco has both negative and positive economic effects. On thepositive side, farmers who grow tobacco earn money and considertobacco growing as a business that creates employment (Action onSmoking and Health, 2015). Companies that process tobacco intoconsumable products also earn a lot of profits every year, whichmakes it one of the most profitable cash crops in the world. Forexample, the British American Tobacco earns about $ 5,913 million perannum (Action on Smoking and Health, 2015)

Onthe negative side, the use of tobacco affects consumers, society, andtax payers. It is estimated that smokers in the U.S. spent about $3,900 in 2015 to buy premium cigarettes (Action on Smoking andHealth, 2015). Unfortunately, most of the consumers of tobaccoproducts forego the basic needs (such as food) since their addictiondemands that they spend their scarce financial resources to addressthe craving. Tobacco users also incur a lot of costs in form ofhospital bills to address the health conditions that they sufferfollowing the consumption of tobacco products over a long time.

Tobaccoconsumption affects the society in several ways. Although it isexpected that patients should pay their health bills, studies haveshown that the government spends about 90 cents for every $ 10 (atotal of $ 170 billion per year) that is spent in the health caresector to address tobacco-related medical issues (Kennedy, 2014).Besides the direct costs that are incurred in the treatment oftobacco-related medical conditions, the society has been losingthousands of productive members who die after consuming the productfor many years. This contributes towards a decline in the economicperformance.

Tobaccouse and the gateway theory

Tobaccois a legalized product that is addictive, which makes it moreaccessible. The gateway hypothesis holds that many consumers of harddrugs (such as cocaine and heroin) start abusing substances by takingtobacco first (Torabi, Jun, Martinez, Nowicke &amp Gassman, 2014).The consumption of tobacco leads to nicotine dependence. However, itreaches a point where tobacco can no longer satisfy the addictedpersons, which forces them to graduate to the consumption of harderdrugs. Therefore, the use of tobacco serves as a risk factor forconsumption of other types of drugs, which makes the product agateway to higher levels of addiction and substance abuse.

Preventionof tobacco consumption

Thegateway hypothesis justify the need for the stakeholders involved inthe war on drug to focus on reduction of new entrants and helpingtobacco addicts recover successfully. This idea is founded on thenotion that preventing the consumption of tobacco can play a criticalrole in reducing the abuse of other types of drugs (ODPHP, 2015).There are many strategies that have been proposed as effectiveapproaches for reducing the consumption of tobacco, but three of themare more convincing. First, the stakeholders assume that increasingthe price of tobacco products through measures (such as sin tax) canreduce their accessibility (ODPHP, 2015).

Secondly,the society can reduce the chances for children experimenting withtobacco by limiting the advertisement of the product through themedium that can be accessed by children. This strategy aims to reducethe exposure of children to tobacco before they gain the capacity tomake rational decisions on whether to use or to avoid the product. Bylimiting the number of people who consume tobacco, it will bepossible to reduce the population of addicts who graduate to the useof hard drugs, thus increasing the success of the war on drugs.

Third,the stakeholders will be able to rehabilitate the current populationof tobacco addicts by funding control programs fully, which should bedone at the CDC recommended levels (ODPHP, 2015). This is a capacitybuilding strategy that seeks to enable tobacco control programs reachand rehabilitate more addicts without experiencing financialconstraint.


Tobaccois among the most common types of addictive drugs in the world. Thelegalization of tobacco makes it more accessible, even to minors whoexperiment with it before trying harder drugs. The use of tobacco ismore prevalent among men than women. Risk factors for consumption oftobacco products can be classified into four categories, includingenvironmental, social, genetic, and psychological issues. Diseasesthat can be directly attributed to the use of tobacco affect the mostimportant organs, such as the heart and lungs. This increases therisk of death among tobacco consumers. The products lead toenvironmental pollution through emission of greenhouse gases anddisposal of millions of filters and tons of packaging materials.Based on the gateway theory, the war on drug can be won bycontrolling the consumption of tobacco since tobacco productsintroduce addicts to consumption of hard drugs.


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