Tobacco/nicotine (smoking, vaping)

Dried tobacco for smoking appears as small, brown strings. These are rolled into a paper with or without a filter to be smoked. Most people smoke already rolled cigarettes.

Cigars are dried, brown tobacco leaves that have been rolled together into one, stick shaped cigar.

• It gives you a little more energy and makes you feel a bit more awake
• You can concentrate better
• If you're addicted, it helps you relax
• You feel more confident
• When it stops working, you feel anxious

Duration: within a few seconds of smoking, you feel the effects of nicotine.. This effect lasts about an hour.

Tobacco can be:

• smoked
• snussed
• snorted
• chewed

All of these methods cause nicotine to come into the bloodstream.

Smoking

Tobacco is usually smoked. This can be done with a cigarette, rolling tobacco, cigar or pipe. The nicotine then ends up in the longs and from there, enters the bloodstream.

Snussing

In Scandinavia, snussing is common. With a snus, the tobacco is in a tablet or teabag that's placed under the upper lip. Through tiny blood vessels in the upper lip, the nicotine enters the bloodstream. The risk of addiction here is just as big as when you smoke it. In snus, there are no less than 28 carcinogenic substances. Snus is therefore not a safe alternative [1]. You can read more about snus here.

Snorting

Snorting tobacco is quite rare. Tobacco powder can be snorted and then through the mucus membrane in the nose, it enters the bloodstream.

Dit wordt bijna niet gedaan. Tabakspoeder wordt in de neus gesnoven en via het neusslijmvlies in het bloed opgenomen.

Chewing

Chewing is also quite rare nowadays. When chewing, the tobacco mixes with your spit. Through bloodvessels in your cheek and tongue the nicotine enters the bloodstream. The tobacco is spat out after chewing. If you swallow the tobacco, it'll make you feel nauseous. For spitting out tobacco, a 'spittoon' was commonly used. In the United States, chewing tobacco is still done, albeit rarely and only in some places. Chewing tobacco can cause mouth- and throat cancer.

Source:

1. Willemsen, C. e.a., Stimulerende middelen tabak. In Drugs en Alcohol. Gebruik, misbruik en verslaving.

Using tobacco/nicotine has risks.

Short term risks

Stamina

Smoking is bad for your stamina. You'll be out of breath faster. This is because carbon monoxide replaces the oxygen in your blood. This makes it so your organs don't get enough oxygen.

Breath

Smokers often have bad breath and everything smells like smoke. Their hair, their clothes, their house, etc.

Budget

Smoking costs a lot of money. If you smoke a pack a day (11 euros for example) then that costs €4015 per year. This is €334,58 per month. Even if you smoke only 10 cigarettes a day, it'll still cost €167,29 per month.

Addiction

When smoking, you'll get addicted very quickly. After heroin, nicotine is one of the most addictive substances known. Your body gets used to it quickly and keeps wanting more. Sometimes extra substances are added to cigarettes to make them more addictive.

Nicotine poisoning

When someone smokes for the first time, they can get mild nicotine poisoning. This can cause dizziness or nausea. With strong nicotine someone can even enter a coma. This sometimes happens if children eat cigarettes.

Second hand smoking / passive smoking

Secondhand smoking is bad for your health. 85% of cigarette smoke ends up in the air. Even if you don't smoke, you still breathe in the smoke. Every year, thousands of people die because of passive smoking, through hart disease or lung cancer for example.

Long term risks

Smoking doesn't only cause addiction, but also many diseases. Smokers on average live 10 years shorter than people who don't smoke. In the Netherlands, every day 53 people die because of smoking.

Lung disease

Smoking is bad for your lungs. The chemicals that release upon smoking, like tar, nicotine and carbon monoxide, could cause serious disease:

• Bronchitis: an infection of the airways, which causes coughing.
• COPD (Chronic Obstructed Lung Disease): This causes shortness of breath, as the lungs keep getting worse.
• Emphysema: smoking can damage the alveoli (little air sacs) which can cause shortness of breath.
• Lung cancer: smoking can cause damage to your lungs, which can lead to cancer.

Other kinds of cancer

Smoking also increases the risk of other kinds of cancer, like mouth cancer, throat cancer, bladder cancer and kidney cancer.

Cardiovascular disease (heart disease)

Smoking is bad for your heart and veins. The chemicals in cigarettes can damage the veins, which can lead to heart attack or stroke. This is because smoking clogs the veins and arteries and raises the blood pressure.

Maag- en darmproblemen

Smoking increases the risk of stomach ulcers and Crohn's disease. It can also influence your intestines. In some cases nicotine can improve the symptoms of
ulcerative colitis, but this is only true for pure nicotine, not smoking

Other disease

Smoking can also cause other disease, like:

• Diabetes type 2
• Eye problems (like cataracts)
• Osteoporosis
• Disease like Alzheimers and ALS

Bad skin and teeth

Smoking can age your skin much faster, because your skin gets less oxygen. You teeth can also become yellow and damaged because of smoking.

Vocal cords

Coughing because of smoking can damage your vocal cords, which makes your voice sound less clear.

Memory

Smoking can make your memory worse. Researchers have discovered that smokers often have a worse memory. Luckily, you can improve your memory if you stop smoking.

Pregnancy

Smoking is also harmful to an unborn child. It can slow the growth of the baby and cause it to be underweight at birth.. If you smoke while breastfeeding, the baby also receives harmful chemicals. For more info check our page 'Tobacco, sex and pregnancy'

Addiction:

• Nicotine is one of the most addictive substances known. It's comparable with heroin, for example.
• It's mentally and physically addictive.
• If you smoke a lot, you'll get withdrawal symptoms if the nicotine wears off. You'll start shaking and feeling stressed. The pleasant feeling you get from smoking is largely because smoking again stops the withdrawal symptoms.
• Nicotine makes you more likely to get addicted to alcohol or other drugs. This is because smoking affects brain chemicals related to addiction.

It's difficult to reduce the risks of tobacco and nicotine. It's best to quit. You can read more about the advantages of quitting here. You can read more about the benefits of quitting here.

• Not smoking 'into the lungs' does not help lessen the risks. You could still get throat, mouth and esophageal cancer from smoking.
• Filtered or 'light' cigarettes are not less harmful for the lungs. Often they make you inhale deeper or smoke more, which is extra harmful.
• Every cigarette increases the risk of cancer or other disease. So smoking a little is still harmful.
• Smoking e-cigarettes or vapes is less harmful than a normal cigarette. But there are other chemicals in there that are also harmful to the lungs. They also usually contain nicotine, so you can still get addicted.
• Snus, snorting and chewing tobacco are less harmful to your lungs than smoking or vaping. But you still ingest harmful chemicals from the tobacco.

In the Netherlands, there are strict rules regulating tobacco to protect everyone's health. The most important rules are;

1. Age minimum for tobacco: you must be 18 or older to buy tobacco. Stores should always ask for ID if they're unsure about your age.
2. Smoking ban in many places: in public buildings like schools, hospitals and stations, you're not allowed to smoke. In Horeca (like bars and restaurants) 'smoking rooms' are not allowed anymore. Smoking is only allowed in special outdoor smoking spaces.
3. Warning pictures and messages: The packaging for all cigarettes and other tobacco products needs to have clear warning images and messages about the dangers of smoking. These are to clearly demonstrate that smoking is bad for your health.
4. No special flavors: it's illegal to add special flavors to tobacco products, like menthol. This is to make tobacco less attractive to minors and adolescents.
5. Tobacco advertising ban: it's illegal to advertise tobacco. Tobacco brands can't advertise on TV, radio or online and they can't sponsor events.
6. Tobacco products in stores: tobacco products need to be sold in a specific way. They must be behind a door so they're not easy to see. This is to make it less attractive to buy tobacco.

These rules exist to reduce smoking in the Netherlands and to protect people's health. The goal is to make the Netherlands tobacco free in 2040.

The amount of smokers keeps going down in the Netherlands.

• In 2023, 19% of people aged 18 year and over smoked.
• In 2014, it was 25,7% of the adult population.
• 13,5% of the population smokes every day.

Down below is a table with an overview of the amount of smokers - in The Netherlands, in Amsterdam and in Gooi- en Vechtstreek. If a cell is empty, that's because there's no known data.

Netherlands

Percentage of smokers in the Netherlands

Sources:

1: Gezondheidsenquête/Leefstijlmonitor CB in samenwerking met het RIVM en het Trimbos-Instituut, 2023

2: Peilstationsonderzoek Scholieren / Leefstijlmonitor, 2023

3: Nationale Drug Monitor, editie 2024. Tabak 12.3.6 Uitgaande jongeren en jongvolwassenen - Nationale Drug Monitor. https://www.nationaledrugmonitor.nl/tabak-uitgaande-jongeren-en-jongvolwassenen/. Geraadpleegd op: 13 november 2024. Trimbos-instituut, Utrecht & WODC, Den Haag.

If you want to use alcohol, tobacco or other drugs it's important that you feel good mentally and physically. If you're sick, sad or anxious then alcohol, tobacco and other drugs can make this worse.

Smoking also influences the effect of some medicine. Tobacco causes some medicine to lose their effect faster. Anti-psychotic drugs for example are less effective when taken by smokers. Smokers sometimes need a dose of anti-psychotic medicine twice as high as non-smokers

Are you using medicine and do you still want to use alcohol or other drugs? Then carefully research if you can beforehand. You can ask your doctor or pharmacy. Or check our overview. Do you still feel uncertain? Then make sure to message us at our Question & Answer service.

Do not use alcohol, tobacco or other drugs if you are pregnant or breastfeeding. Drugs are harmful for the baby and can cause your baby to be born sick.

More info about the influence of cocaine on sex, pregnancy and breastfeeding can be found in this overview.