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Why Do People Smoke?

Cigarette smoking is responsible for more than 480,000 deaths in the United States each year, including 41,000 from second-hand smoke. That makes tobacco the single largest preventable cause of death and disease in the U.S. Worldwide, about 7 million deaths each year are due to tobacco use.

Smoking is associated with cancer, heart disease and stroke, gum disease, asthma, and other chronic lung conditions, and Type-2 diabetes as well as serious complications of diabetes. About 14 percent of U.S. adults smoked cigarettes in 2017, according to the CDC, and it was recently estimated that nearly 7 in 10 wanted to stop smoking.

People with depression, anxiety, and other forms of mental illness are much more likely to smoke than the general population. While smoking may be used, in part, as a coping behavior, it is not a valid treatment for any mental health condition.

Smoking is highly addictive. For more on causes, symptoms, and treatments of nicotine addiction, see our Diagnosis Dictionary.

Who Is Most at Risk for Nicotine Addiction?


An addiction to nicotine, also known as nicotine dependence or tobacco dependence, often begins in one's teens. Most people who smoke have friends or family members who also smoke. The younger a person is when he or she starts to smoke, the higher the risk of becoming addicted to nicotine, a drug found in tobacco.

In the short term, nicotine may distract from unpleasant feelings. Once smokers become dependent on nicotine, however, they experience physical and mental withdrawal symptoms that last for days or weeks, making it very difficult to quit. Many people who are addicted to nicotine continue to smoke even though they know it's bad for their health.

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What Is the Most Effective Way to Quit Smoking?


Quitting smoking at any age can improve a person’s health, and the earlier a person quits, the better. A variety of methods can help a person break the habit, ranging from cigarette substitutes to supportive therapy.

Nicotine gum, lozenges, or patches are among the FDA-approved nicotine replacement products that people who cease smoking can use to manage withdrawal symptoms after they quit. Combining such methods with behavioral treatments, which help people prepare to quit and to cope effectively with cravings and withdrawal, can make long-term cessation even more likely. These may include the consultation of self-help materials (such as those at, brief counseling with a healthcare professional, group sessions with others who are quitting, or forms of psychotherapy such as cognitive behavioral therapy.

Some medications, including bupropion and varenicline, can be prescribed to help increase the chances of continued abstinence, though the risk of side effects such as anxiety, depression, and suicidal ideation should be taken into account.

What Is Vaping?

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Some smokers use e-cigarettes or “vapes” as a substitute for regular cigarettes and other smoked tobacco products. E-cigarettes still contain nicotine, which can stunt the growth of a developing adolescent brain. E-cigarette aerosol contains fewer chemicals than the 7,000 found in regular cigarette smoke, but it is potentially harmful nonetheless.

Vaping devices contain chemicals such as diacetyl—a flavorant linked to lung disease—harmful organic compounds, fine particles that can be inhaled, and metals like nickel, tin, and lead. They come in a range of shapes and sizes, but all include a battery, a place to hold the liquid being vaped, and some kind of heating component. While typically used with nicotine, they can also deliver marijuana or other drugs.

Vaping devices are considered especially unsafe for teens and pregnant women.

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