A review evaluation of the effects on health through tobacco exposure via routes other than by smoking cigarettes

The lethal effects of cigarette smoking are extremely well known and have been thoroughly documented over the many long years since being adopted for recreational use by humans. It is now estimated that 5 million people in the world per year die from tobacco related causes making it by far the most dangerous consumer product, even though it can be simply avoided by not smoking. There is perhaps however, less general awareness of the other deleterious effects associated with tobacco such as in its cultivation, production and use through routes other than inhalation via smoking. The physiological and medical impact of tobacco on people from these other sources is evaluated where the evidence and current thinking is discussed. Approximately 33 million people world wide are employed in tobacco cultivation and the chief environmental health hazards arise from the use of pesticides. Other problems include asthma and lung inflammation resulting from inhaling tobacco dust and fungal spores as well as green tobacco sickness disease, (nicotine poisoning through contact). Also considered is the habit of chewing tobacco or use as a snuff, ('smokeless tobacco use'), as well as nicotine replacement therapy. Issues concerning the economic, environmental/pollution and ethical aspects of the tobacco industry are not discussed but it is obviously important to acknowledge these, that together with the practice of smoking they in fact constitute by far the major aspects of the debate on the serious harm to public health and the environment that is caused by tobacco.