Nicotine addiction, electronic nicotine delivery systems and Shisha smoking
Tobacco smoking is highly addictive and the contents of cigarettes contain the most toxic and carcinogenic substances. Smoking is the single greatest cause of preventable illness and premature death in the world. The pharmacologic and behavioural processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. Whether e-cigarettes are safe or pose many health risks remains controversial. The US Surgeon General has concluded that e-cigarettes can expose users to several potentially harmful chemicals, including nicotine, carbonyl compounds and volatile organic compounds. In contrast with some of the above findings, the Report from Public Health England on an update of evidence on e-cigarettes indicates that e-cigarettes pose no risk of nicotine poisoning to users when used as intended. There is a proliferation of Shisha parlours in Western countries and is trendy amongst the younger generations as part of the ‘cafe culture’. There is evidence to suggest that hookah tobacco and smoke contain numerous toxic substances known to cause lung, bladder and oral cancers. Water-pipe smoking also carries many of the same health risks and has been linked to many of the same diseases caused by cigarette smoking.