View allAll Photos Tagged Pulmonary
Old pencil sketch from my high school days. I was playing with drawing roots and just kinda got carried away!
Your heart is in my hands! I could go on and on here, but this is a shot from the pig dissection lab from my Pulmonary Physiology class.
Happy V Day (and HMM) Flickr and Facebook friends!
Seen at Beelitz, a former pulmonary clinic near Berlin. Most of the old buildings are abandoned.
Camera: Rolleiflex T
Film: Adox CHS 100 (efke)
Processing: Neofin blue
03/2012
At the mortuary for a well-attended memorial to Kathryn Merrett, who lived with the same IPF that I do. A few of the ladies were happy to see me; apparently my visiting K when she was in the hospital cheered her up a bit. Great mind on that woman.
If a relationship has to be a secret, you shouldn’t be in it.
Une paire de vieilles reliques, dans un mémorial très fréquenté dédié à Kathryn Merrett, qui vivait avec la même une fibrose pulmonaire que je fais. Quelques dames furent très contentes de me voir ; Apparemment, ma visite à K alors qu'elle était à l'hôpital lui a un peu remonté le moral. Beaucoup d'esprit pour cette femme.
Si une relation doit être secrète, vous ne devriez pas y participer.
Please, read my profile, or visit my website!
SVP, lire mon profil, ou visiter mon page sur Web!
#LGBminusTQI2Setc
On August 5, 1998, while I was Railfanning in Downtown Tampa, I stopped at Tampa Union Station to once again Photograph the Florida FUN Train, after it's grade crossing accident. Because the startup of the FUN TRAIN had been under capitalized, the dreams of the Fun Train creator, of featuring two Fun Trains, (one on each coast of Florida) were extinguished in Bankruptcy.
But of much greater interest, was the Anti-Tobacco Train seen here in these Photographs. I'm not sure who organized the Anti Tobacco Rally or funded the Train, which apparently was touring the United States to illustrate the Health Issues of Smoking, however it presented a great Photographic Opportunity for me. This particular Railcar, which is named: "FLORIDA", is a CSX Business Car. You can find further information about yhr group "truth" at:
As we all know, Smoking causes several debilitating diseases, such as Lung Cancer, Bronchitis, Chronic Obstructive Pulmonary Disease (aka: COPD) and Emphysema.
I took these photographs with my Minolta Maxxim 5000 SLR using Color Print Film, when I was just learning photograph; so they are very soft & grainy. I scanned the Negatives and used Photoshop Elements to correct the exposure and to generate these Digital Images.
Disclaimer: Since I took these photographs while I was still learning Photography, some of my original Photos are of poor quality in both Exposure and Sharpness, which I could only partially correct with Adobe Photoshop Elements™.
On August 5, 1998, while I was Railfanning in Downtown Tampa, I stopped at Tampa Union Station to once again Photograph the Florida FUN Train, after it's grade crossing accident. Because the startup of the FUN TRAIN had been under capitalized, the dreams of the Fun Train creator, of featuring two Fun Trains, (one on each coast of Florida) were extinguished in Bankruptcy.
But of much greater interest, was the Anti-Tobacco Train seen here in these Photographs. I'm not sure who organized the Anti Tobacco Rally or funded the Train, which apparently was touring the United States to illustrate the Health Issues of Smoking, however it presented a great Photographic Opportunity for me. You can find further information at:
As we all know, Smoking causes several debilitating diseases, such as Lung Cancer, Chronic Obstructive Pulmonary Disease (aka: COPD) and Emphysema.
I took these photographs with my Minolta Maxxim 5000 SLR using Color Print Film, when I was just learning photograph; so they are very soft & grainy. I scanned the Negatives and used Photoshop Elements to correct the exposure and to generate these Digital Images.
Disclaimer: Since I took these photographs while I was still learning Photography, some of my original Photos are of poor quality in both Exposure and Sharpness, which I could only partially correct with Adobe Photoshop Elements™.
Jake's regular vet just phoned me.
He said there was no real change in Jake's status since this afternoon.
His breathing is still +/- 40/min, and still has some asthma and pulmonary edema.
Due to his heart murmur he has a slight rt ventricular hypertrophy, and with this breathing strain, has stressed the heart further. (leading to the pulmonary edema.)
His hear rate and rhythm are normal.
He is on fortacor and the puffers of ventolin and flovent and iV steroids.
Still not eating or drinking.
*******The vet said he will try to remove the oxygen tube tomorrow and monitor him.
If he tolerates it and his breaths don't increase to 60 like previous, even if they stay at 40 ****He would like to send him home!!!!**** YEAH!!!!!!
He feels he may eat and do better in his own environment, and feel less anxious. He still can't predict how Jake will respond, but we'll hope for the best.
PLEASE PLEASE please continue to pray for my sweet boy.
I KNOW he feels all the love as do I. I believe in the power of prayers.
I cannot thank you all enough for all the love and support you has given us.
Through your posts, emails and cards, I have found some inner strength.
Thank you all from the bottom of my heart!
I hope tomorrow works out as planned.
****BTW.. poor guy must feel so uncomfortable with the oxygen. By posting this pic I can see the tube is sutured to Jake in 3 places!!! No wonder he feels so lousy!****
So as long as his breaths don't go above 40 and his xray is NOT worse, by this time tomorrow he may be home with us!
**********SAW JAKE & THE VET MONDAY AM.**********
The vet removed the oxygen tube from Jakey's nose, but his breathing is about the same.
Jake is still not eating or thriving in the clinic.
So the Vet will do another chest X-ray this afternoon to see if there is any change with being off the oxygen.
IF it is ok, he proposes we take Jake home where he will be more comfortable and hopefully eat.
He will be on all the meds and puffers the rest of his life.
WHEN I SAW JAKE THIS AM! HE BRGAN PURRING!!!!!!
this is the first purrs since when he was home on Friday!
Thank you all for your support and prayers for my baby.
Now if he can only come home this afternoon.....
I will keep you all posted.
@ 1300 hrs.... He WILL be coming home!!!! :-)))))
Xray still shows some pulmonary edema, but even better than yesterday's one.
Thank you all so much. Our prayers have been answered today.
One day at a time... Hopefully he will feel better being home and will eat.
Vet says his condition is still not optimal, however.
The outside of file HOSP/STAN/07/01/02/1855, a patient at Stannington Sanatorium being treated for primary Pulmonary Tuberculosis in the left lung. Read more about this file on the album description.
Date: 1947-1948.
This image is part of our Stannington Sanatorium Flickr collection of albums of patient files, as part of our Stannington Sanatorium project. They are from our archive collections at Northumberland Archives. Feel free to share them within the spirit of the Commons. If you have any enquiries or would like copies please contact collections@woodhorn.org.uk for more information.
As always this year's New England Reflections Calendar is the best ever! More importantly all the proceeds go to provide critical support for the Pulmonary Rehabilitation Program at Cheshire Medical Center in Keene, NH. To see more check out this weeks blog:
But more importantly learn where you can get a nice calendar for a great cause.
Dawn Spire, Spofford, New Hampshire
Jeff Newcomer, NEPG Member
partridgebrookreflections.com
My name is Amaris White and I want to share my personal experience with blood clots. My hope is that by sharing this information, you will learn the signs and symptoms of this potentially fatal condition and know how to protect yourself and others.
In 2012 I was an active and healthy 25-year-old. I had run two half-marathons during the past year, and I was traveling for a month with friends to Southeast Asia to celebrate my successful completion of the bar exam.
We had been traveling for a few weeks when my lower back started to ache. I didn’t think much of it and ignored it for a week, chalking it off to the uncomfortable hostel beds. On our last night in Kuala Lumpur, Malaysia, my leg started to swell and within a few hours the pain and swelling were so severe that I could no longer walk. My left leg became discolored and for the next two days my roommate and I went to different hospitals in Malaysia in order to get a diagnosis—all the while my leg grew progressively darker, the pain increasingly crippling. I had a difficult time getting a diagnosis, but ultimately I was able to have my leg and foot examined through Doppler ultrasound. These test results confirmed that I had deep vein thrombosis (DVT), a condition in which a blood clot develops in a deep vein in the body.
Here I was—10,000 miles from home and with a severe DVT. My entire left leg, through my pelvis and nearly all the way to my heart, had an enormous blood clot. My condition was so serious I could have easily lost a leg or died. To top it off, though I didn’t know it yet, part of the blood clot in my leg had already broken off and traveled through my heart and into my lungs. This complication (called “pulmonary embolism” or PE) is often fatal.
Because my prognosis was grave and I needed more medical attention, I flew from Malaysia to Tokyo. I made this decision, despite the risks, based on the recommendation of my friend’s father, an emergency room physician. When I arrived in Tokyo I was rushed into the intensive care unit and into surgery, where they confirmed the DVT and multiple PEs. To prevent more PEs, the Japanese doctors placed a special filter, called an inferior vena cava filter (IVC filter), into the vein that goes to my heart. This filter was surgically placed to prevent future life-threatening PEs by catching blood clots before they traveled into my lungs.
It is likely I had blood clots for at least three weeks but did not know it. Anyone can have DVT, but your risks increase with each risk factor present. I had just slept through three long flights to Bangkok—1 hour, 12 hours, and 7 hours long. I was exhausted and dehydrated from a weekend of celebrating the end of the bar exam. I slept the entirety of each plane ride, walking only to transfer between flights. I now know that on long-distance travel such as this, you are advised to move the legs and flex the calf muscles in order to help reduce the risk of blood clots.
I later found out that I had two other risk factors, which greatly increased my odds of developing blood clots. I was on hormonal birth control and I have a genetic condition called Factor V Leiden. Factor V Leiden is a relatively common inherited blood clotting disorder that can result in thrombophilia. Thrombophilia is a disorder in which there is an increased tendency to form blood clots that can block blood vessels.
After having DVT as extensive as mine, I was told that I wouldn’t be able to run again without excruciating pain. Determined not to let my medical history define my future, I have since trained for and run two half marathons and am currently training for three more half marathons in the spring of 2014, and the New York City marathon in November 2014.
Your body can do a lot for you. I have exceeded all my doctors’ expectations, and because of my running and physical activity, my body has compensated by creating new veins. This process is called vein collateralization. In other words, even though my deep vein is blocked off because of DVT, my body is continually developing new, collateral veins to carry my blood. Enough blood can now travel to the tissues in my leg through smaller, collateral veins that have developed to help the flow of blood. And even though my running is still painful, by keeping my blood pumping and staying active, I am running faster and longer every day.
If you have had DVT, I encourage you to stay active to improve your physical condition. Learn everything you can about your risk factors and the signs and symptoms. Protect yourself and learn more about the facts of DVT and PE by visiting here:
www.cdc.gov/ncbddd/dvt/facts.html
To learn more about deep vein thrombosis and pulmonary embolism, visit the following sites:
www.cdc.gov/ncbddd/dvt/facts.html
www.nhlbi.nih.gov/health/health-topics/topics/dvt
“This Is Serious” is a campaign that promotes awareness of how to prevent deep vein thrombosis, or blood clots, in women. For more information: www.ThisIsSerious.org
Stop the Clot is a program of the National Blood Clot Alliance, a non-profit, voluntary health organization dedicated to advancing the prevention, early diagnosis and successful treatment of life-threatening blood clots such as deep vein thrombosis, pulmonary embolism and clot-provoked stroke. For more information: www.StopTheClot.org
www.stoptheclot.org/spreadtheword
Clot Connect is an education and outreach project of the University of North Carolina at Chapel Hill Blood Clot Outreach Program. For more information: www.clotconnect.org/
Analyzed by: Carmelita Troy MA
Excavated from Ardreigh, Co. Kildare.
Photographed by: Hannah Sims, 2010
Client: Kildare County Council
Title: A matter of health, or, West Texas and its relation to pulmonary complaints
Creator: Mayo, Henry Mash, 1862-1950
Contributors: Southern Pacific
Date: ca. 1898
Part Of A matter of health, or, West Texas and its relation to pulmonary complaints
Place: New Orleans, Orleans Parish, Louisiana
Description: This pamphlet describes the suitability of the West Texas climate for sufferers of lung diseases.
Physical Description: 20 p. 15 x 9 cm
File Name: f394_f63_m396_1900z_opt.pdf
Rights: DeGolyer Library, Southern Methodist University
Digital Collection: Texas: Photographs, Manuscripts, and Imprints
For more information, see: digitalcollections.smu.edu/cdm/ref/collection/wes/id/2318
A cigarette, also known colloquially as a fag in British English, is a narrow cylinder containing psychoactive material, usually tobacco, that is rolled into thin paper for smoking. Most cigarettes contain a "reconstituted tobacco" product known as "sheet", which consists of "recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings", to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Most modern cigarettes are filtered, although this does not make them safer. Cigarette manufacturers have described cigarettes as a drug administration system for the delivery of nicotine in acceptable and attractive form. Cigarettes are addictive (because of nicotine) and cause cancer, chronic obstructive pulmonary disease, heart disease, and other health problems.
The term cigarette, as commonly used, refers to a tobacco cigarette but is sometimes used to refer to other substances, such as a cannabis cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, and paper wrapping, which is typically white. Cigar wrappers are typically composed of tobacco leaf or paper dipped in tobacco extract.
Smoking rates have generally declined in the developed world, but continue to rise in some developing nations. Cigarette smoking causes health harms and death. Nicotine is also highly addictive. About half of cigarette smokers die of tobacco-related disease[9] and lose on average 14 years of life.
Cigarette use by pregnant women has also been shown to cause birth defects, including low birth weight, fetal abnormalities, and premature birth. Second-hand smoke from cigarettes causes many of the same health problems as smoking, including cancer, which has led to legislation and policy that has prohibited smoking in many workplaces and public areas. Cigarette smoke contains over 7,000 chemical compounds, including arsenic, formaldehyde, cyanide, lead, nicotine, carbon monoxide, acrolein, and other poisonous substances. Over 70 of these are carcinogenic. Additionally, cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.
HISTORY
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).
By 1830, the cigarette had crossed into France, where it received the name cigarette; and in 1845, the French state tobacco monopoly began manufacturing them. The French word was adopted by English in the 1840s. Some American reformers promoted the spelling cigaret, but this was never widespread and is now largely abandoned.
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847. However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf. This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
Cigarettes may have been initially used in a manner similar to pipes, cigars, and cigarillos and not inhaled; for evidence, see the Lucky Strike ad campaign asking consumers "Do You Inhale?" from the 1930s. As cigarette tobacco became milder and more acidic, inhaling may have become perceived as more agreeable. However, Moltke noticed in the 1830s (cf. Unter dem Halbmond) that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes (which are both initially sun-cured, acidic leaf varieties).
The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with less than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year). By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691; implying that about 21% of the population smoked 100 cigarettes or more per year.
The adverse health effects of cigarettes were known by the mid-19th century when they became known as coffins nails.[31] German doctors were the first to identify the link between smoking and lung cancer, which led to the first antitobacco movement in Nazi Germany. During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and text-only health warnings became common on cigarette packets.
The United States has not implemented graphical cigarette warning labels, which are considered a more effective method to communicate to the public the dangers of cigarette smoking. Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands, New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Nepal and Turkey, however, have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.
LEGISLATION
SMOKING RESTRICTIONS
Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke. Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. Bhutan is currently the only country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products under the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties. The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco. Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders. New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco. Under sharia law, the consumption of cigarettes by Muslims is prohibited.
SMOKING AGE
Beginning on April 1, 1998, the sale of cigarettes and other tobacco products to people under the state purchase age has been prohibited by law in all 50 states of the United States. The purchasing age in the United States is 18 in 42 of the 50 states — but 19 in Alabama, Alaska, Utah, and Nassau, Suffolk, and Onondaga Counties in New York, and 21 in California, Hawaii, New Jersey, Oregon, Maine and more than 180 municipalities across the nation. The intended effect of this is to prevent older high school students from purchasing cigarettes for their younger peers. In Massachusetts, parents and guardians are allowed to give cigarettes to minors, but sales to minors are prohibited.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.
Since 1 October 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland) (rising from 16). It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on 1 September 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking.
Most countries in the world have a legal vending age of 18. In Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population, has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age (suffrage in Japan is 20 years old). Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.Germany raised the purchase age from 16 to 18 on the 1 September 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine. Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.
TAXATION
Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue.Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%. The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate. Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York.As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
FIRE-SAFE CIGARETTE
According to Simon Chapman, a professor of public health at the University of Sydney, the burning agents in cigarette paper are responsible for fires and reducing them would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes. Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds developed fire safe cigarettes, but did not market them.
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper. Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish. This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.
CIGARETTE ADVERTISING
Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises. In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.
WARNING MESSAGES IN PACKAGES
As a result of tight advertising and marketing prohibitions, tobacco companies look at the pack differently: they view it as a strong component in displaying brand imagery and a creating significant in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in an alternative package. Studies also show how companies have manipulated a variety of elements in packs designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.
Some countries require cigarette packs to contain warnings about health hazards. The United States was the first, later followed by other countries including Canada, most of Europe, Australia, Pakistan, India, Hong Kong, and Singapore. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging. At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette package in Canada. As of November 2010, 39 countries have adopted similar legislation.
In February 2011, the Canadian government passed regulations requiring cigarette packs to contain 12 new images to cover 75% of the outside panel and eight new health messages on the inside panel with full color.
As of April 2011, Australian regulations require all packs to use a bland olive green that researchers determined to be the least attractive color, with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style. Similar policies have since been adopted in France and the United Kingdom. In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90 and 70% of back and front packaging, respectively. This took effect on December 1, 2012.
CONSTRUCTION
Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter. While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.
PAPER
The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.
TOBACCO BLEND
The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate"). To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.
Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing: RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.
Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.
In recent years, the manufacturers' pursuit of maximum profits has led to the practice of using not just the leaves, but also recycled tobacco offal and the plant stem. The stem is first crushed and cut to resemble the leaf before being merged or blended into the cut leaf. According to data from the World Health Organization, the amount of tobacco per 1000 cigarettes fell from 2.28 pounds in 1960 to 0.91 pounds in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors.
ADDITIVES
Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings". The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[85] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette pack(s). Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules. This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.
CIGARETTE TUBE
Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from what is known as King Size (84 mm) to 100s (100 mm).
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."
CIGARETTE FILTER
A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
CIGARETTE BUTT
The common name for the remains of a cigarette after smoking is a cigarette butt. The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. They are the most numerically frequent litter in the world. Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches. It is also called a fag-end or dog-end.
In a 2013 trial the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers
LIGHTS
Some cigarettes are marketed as “Lights”, “Milds”, or “Low-tar.” These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. he majority of major cigarette manufacturers offer a light, low-tar, and/or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.
REPLACEMENT
An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco. Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper." Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. E-cigarettes are automatically activated by taking a puff; others turn on manually by pressing a button. Some e-cigarettes look like traditional cigarettes, but they come in many variations. Most versions are reusable, though some are disposable. There are first-generation, second-generation, third-generation, and fourth-generation devices. E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquids are also sold without propylene glycol, nicotine, or flavors.
The benefits and the health risks of e-cigarettes are uncertain. There is tentative evidence they may help people quit smoking, although they have not been proven to be more effective than smoking cessation medicine. There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes. Youth who use e-cigarettes are more likely to go on to smoke cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products. It is estimated their safety risk to users is similar to that of smokeless tobacco. The long-term effects of e-cigarette use are unknown. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine itself is associated with some health harms. In 2019, an outbreak of severe lung illness across multiple states in the US has been linked to the use of vaping products.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, which have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other substances. Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. E-cigarette vapor contains fewer toxic chemicals, and lower concentrations of potential toxic chemicals than cigarette smoke. The vapor is probably much less harmful to users and bystanders than cigarette smoke,although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.
WIKIPEDIA
A cigarette, also known colloquially as a fag in British English, is a narrow cylinder containing psychoactive material, usually tobacco, that is rolled into thin paper for smoking. Most cigarettes contain a "reconstituted tobacco" product known as "sheet", which consists of "recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings", to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Most modern cigarettes are filtered, although this does not make them safer. Cigarette manufacturers have described cigarettes as a drug administration system for the delivery of nicotine in acceptable and attractive form. Cigarettes are addictive (because of nicotine) and cause cancer, chronic obstructive pulmonary disease, heart disease, and other health problems.
The term cigarette, as commonly used, refers to a tobacco cigarette but is sometimes used to refer to other substances, such as a cannabis cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, and paper wrapping, which is typically white. Cigar wrappers are typically composed of tobacco leaf or paper dipped in tobacco extract.
Smoking rates have generally declined in the developed world, but continue to rise in some developing nations. Cigarette smoking causes health harms and death. Nicotine is also highly addictive. About half of cigarette smokers die of tobacco-related disease[9] and lose on average 14 years of life.
Cigarette use by pregnant women has also been shown to cause birth defects, including low birth weight, fetal abnormalities, and premature birth. Second-hand smoke from cigarettes causes many of the same health problems as smoking, including cancer, which has led to legislation and policy that has prohibited smoking in many workplaces and public areas. Cigarette smoke contains over 7,000 chemical compounds, including arsenic, formaldehyde, cyanide, lead, nicotine, carbon monoxide, acrolein, and other poisonous substances. Over 70 of these are carcinogenic. Additionally, cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.
HISTORY
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).
By 1830, the cigarette had crossed into France, where it received the name cigarette; and in 1845, the French state tobacco monopoly began manufacturing them. The French word was adopted by English in the 1840s. Some American reformers promoted the spelling cigaret, but this was never widespread and is now largely abandoned.
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847. However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf. This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
Cigarettes may have been initially used in a manner similar to pipes, cigars, and cigarillos and not inhaled; for evidence, see the Lucky Strike ad campaign asking consumers "Do You Inhale?" from the 1930s. As cigarette tobacco became milder and more acidic, inhaling may have become perceived as more agreeable. However, Moltke noticed in the 1830s (cf. Unter dem Halbmond) that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes (which are both initially sun-cured, acidic leaf varieties).
The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with less than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year). By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691; implying that about 21% of the population smoked 100 cigarettes or more per year.
The adverse health effects of cigarettes were known by the mid-19th century when they became known as coffins nails.[31] German doctors were the first to identify the link between smoking and lung cancer, which led to the first antitobacco movement in Nazi Germany. During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and text-only health warnings became common on cigarette packets.
The United States has not implemented graphical cigarette warning labels, which are considered a more effective method to communicate to the public the dangers of cigarette smoking. Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands, New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Nepal and Turkey, however, have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.
LEGISLATION
SMOKING RESTRICTIONS
Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke. Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. Bhutan is currently the only country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products under the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties. The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco. Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders. New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco. Under sharia law, the consumption of cigarettes by Muslims is prohibited.
SMOKING AGE
Beginning on April 1, 1998, the sale of cigarettes and other tobacco products to people under the state purchase age has been prohibited by law in all 50 states of the United States. The purchasing age in the United States is 18 in 42 of the 50 states — but 19 in Alabama, Alaska, Utah, and Nassau, Suffolk, and Onondaga Counties in New York, and 21 in California, Hawaii, New Jersey, Oregon, Maine and more than 180 municipalities across the nation. The intended effect of this is to prevent older high school students from purchasing cigarettes for their younger peers. In Massachusetts, parents and guardians are allowed to give cigarettes to minors, but sales to minors are prohibited.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.
Since 1 October 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland) (rising from 16). It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on 1 September 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking.
Most countries in the world have a legal vending age of 18. In Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population, has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age (suffrage in Japan is 20 years old). Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.Germany raised the purchase age from 16 to 18 on the 1 September 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine. Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.
TAXATION
Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue.Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%. The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate. Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York.As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
FIRE-SAFE CIGARETTE
According to Simon Chapman, a professor of public health at the University of Sydney, the burning agents in cigarette paper are responsible for fires and reducing them would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes. Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds developed fire safe cigarettes, but did not market them.
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper. Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish. This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.
CIGARETTE ADVERTISING
Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises. In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.
WARNING MESSAGES IN PACKAGES
As a result of tight advertising and marketing prohibitions, tobacco companies look at the pack differently: they view it as a strong component in displaying brand imagery and a creating significant in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in an alternative package. Studies also show how companies have manipulated a variety of elements in packs designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.
Some countries require cigarette packs to contain warnings about health hazards. The United States was the first, later followed by other countries including Canada, most of Europe, Australia, Pakistan, India, Hong Kong, and Singapore. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging. At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette package in Canada. As of November 2010, 39 countries have adopted similar legislation.
In February 2011, the Canadian government passed regulations requiring cigarette packs to contain 12 new images to cover 75% of the outside panel and eight new health messages on the inside panel with full color.
As of April 2011, Australian regulations require all packs to use a bland olive green that researchers determined to be the least attractive color, with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style. Similar policies have since been adopted in France and the United Kingdom. In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90 and 70% of back and front packaging, respectively. This took effect on December 1, 2012.
CONSTRUCTION
Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter. While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.
PAPER
The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.
TOBACCO BLEND
The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate"). To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.
Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing: RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.
Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.
In recent years, the manufacturers' pursuit of maximum profits has led to the practice of using not just the leaves, but also recycled tobacco offal and the plant stem. The stem is first crushed and cut to resemble the leaf before being merged or blended into the cut leaf. According to data from the World Health Organization, the amount of tobacco per 1000 cigarettes fell from 2.28 pounds in 1960 to 0.91 pounds in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors.
ADDITIVES
Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings". The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[85] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette pack(s). Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules. This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.
CIGARETTE TUBE
Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from what is known as King Size (84 mm) to 100s (100 mm).
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."
CIGARETTE FILTER
A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
CIGARETTE BUTT
The common name for the remains of a cigarette after smoking is a cigarette butt. The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. They are the most numerically frequent litter in the world. Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches. It is also called a fag-end or dog-end.
In a 2013 trial the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers
LIGHTS
Some cigarettes are marketed as “Lights”, “Milds”, or “Low-tar.” These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. he majority of major cigarette manufacturers offer a light, low-tar, and/or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.
REPLACEMENT
An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco. Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper." Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. E-cigarettes are automatically activated by taking a puff; others turn on manually by pressing a button. Some e-cigarettes look like traditional cigarettes, but they come in many variations. Most versions are reusable, though some are disposable. There are first-generation, second-generation, third-generation, and fourth-generation devices. E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquids are also sold without propylene glycol, nicotine, or flavors.
The benefits and the health risks of e-cigarettes are uncertain. There is tentative evidence they may help people quit smoking, although they have not been proven to be more effective than smoking cessation medicine. There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes. Youth who use e-cigarettes are more likely to go on to smoke cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products. It is estimated their safety risk to users is similar to that of smokeless tobacco. The long-term effects of e-cigarette use are unknown. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine itself is associated with some health harms. In 2019, an outbreak of severe lung illness across multiple states in the US has been linked to the use of vaping products.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, which have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other substances. Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. E-cigarette vapor contains fewer toxic chemicals, and lower concentrations of potential toxic chemicals than cigarette smoke. The vapor is probably much less harmful to users and bystanders than cigarette smoke,although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.
WIKIPEDIA
Arequipa, Peru.
**I lost my dear hat inside a Bolivian outhouse in the salt flats soon afterwards. It was one of those reversible cutie hats with big pom pom ties.
Oh... this is a long shot, but should anyone visit Peru in the near future... I'd love a replacement hat just like this one. It was the most comfy 'n warm 'n cozy hat... and it matched my alpaca wool llama-print socks perfectly! What to do... what to do...
Altitude sickness
From Wikipedia, the free encyclopedia
Altitude sickness, also known as acute mountain sickness (AMS), altitude illness, or soroche, is a pathological condition that is caused by acute exposure to low air pressure (usually outdoors at high altitudes). It commonly occurs above 2,400 metres (approximately 8,000 feet).[1] Acute mountain sickness can progress to high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE).[2]
The cause of altitude sickness is still not understood. [3] It occurs in low atmospheric pressure conditions but not necessarily in low oxygen conditions at sea level pressure. Although treatable to some extent by the administration of oxygen, most of the symptoms do not appear to be caused by low oxygen, but rather by the low CO2 levels causing a rise in blood pH, alkalosis. The percentage of oxygen in air remains essentially constant with altitude at 21 percent, but the air pressure (and therefore the number of oxygen molecules) drops as altitude increases.[4] Altitude sickness usually does not affect persons traveling in aircraft because modern aircraft passenger compartments are pressurized.
A related condition,[citation needed] occurring only after prolonged exposure to high altitude, is chronic mountain sickness, also known as Monge's disease.
An unrelated condition, although often confused with altitude sickness, is dehydration, due to the higher rate of water vapor lost from the lungs at higher altitudes.
Introduction
High altitude or mountain sickness is defined when someone feels sick at high altitudes, such as in the mountains or any other altitude-related sicknesses. It is hard to determine who will be affected by altitude-sickness as there are no specific factors that compare with this susceptibility to altitude sickness. However, most people can climb up to 2500 meters (8000 feet) normally.
Generally, different people have different susceptibilities to altitude sickness. For some otherwise healthy people, Acute Mountain Sickness (AMS) can begin to appear at around 2000 meters (6,500 feet) above sea level, such as at many mountain ski resorts, equivalent to a pressure of 80 kPa. AMS is the most frequent type of altitude sickness encountered. Symptoms often manifest themselves 6-10 hours after ascent and generally subside in 1 to 2 days, but they occasionally develop into the more serious conditions. Symptoms include headache, fatigue, stomach illness, dizziness, and sleep disturbance. Exertion aggravates the symptoms.
High altitude pulmonary edema (HAPE) and cerebral edema (HACE) are the most ominous of these symptoms, while AMS, retinal hemorrhage, and peripheral edema are less severe forms of the disease. The rate of ascent, altitude attained, amount of physical activity at high altitude, as well as individual susceptibility, are contributing factors to the onset and severity of high-altitude illness.
Altitude sickness usually occurs following a rapid ascent and can usually be prevented by ascending slowly.[5] In most of these cases, the symptoms are temporary and usually abate as altitude acclimatisation occurs. However, in extreme cases, altitude sickness can be fatal.
The word "soroche" came from South America and originally meant "ore", because of an old, incorrect belief that it was caused by toxic emanations of ores in the Andes mountains.
Signs and symptoms
Headache is a primary symptom used to diagnose altitude sickness, although headache is also a symptom of dehydration. A headache occurring at an altitude above 2,400 meters (8000 feet = 76 kPa), combined with any one or more of the following symptoms, can indicate altitude sickness:
* Lack of appetite, nausea, or vomiting
* Fatigue or weakness
* Dizziness or light-headedness
* Insomnia
* Pins and needles
* Shortness of breath upon exertion
* Persistent rapid pulse
* Drowsiness
* General malaise
* Peripheral edema (swelling of hands, feet, and face).
Symptoms that may indicate life-threatening altitude sickness include:
* pulmonary edema (fluid in the lungs):-
o persistent dry cough
o fever
o shortness of breath even when resting
* cerebral edema (swelling of the brain):-
o headache that does not respond to analgesics
o unsteady gait
o increased vomiting
o gradual loss of consciousness.
Severe cases
The most serious symptoms of altitude sickness are due to edema (fluid accumulation in the tissues of the body). At very high altitude, humans can get either high altitude pulmonary edema (HAPE), or high altitude cerebral edema (HACE). The physiological cause of altitude-induced edema is not conclusively established. It is currently believed, however, that HACE is caused by local vasodilation of cerebral blood vessels in response to hypoxia, resulting in greater blood flow and, consequently, greater capillary pressures. On the other hand, HAPE may be due to general vasoconstriction in the pulmonary circulation (normally a response to regional ventilation-perfusion mismatches) which, with constant or increased cardiac output, also leads to increases in capillary pressures. For those suffering HACE, dexamethasone may provide temporary relief from symptoms in order to keep descending under their own power.
HAPE occurs in ~2% of those who are adjusting to altitudes of ~3000 m (10,000 feet = 70 kPa) or more. It can progress rapidly and is often fatal. Symptoms include fatigue, severe dyspnea at rest, and cough that is initially dry but may progress to produce pink, frothy sputum. Descent to lower altitudes alleviates the symptoms of HAPE.
HACE is a life threatening condition that can lead to coma or death. It occurs in about 1% of people adjusting to altitudes above ~2700 m (9,000 feet = 73 kPa). Symptoms include headache, fatigue, visual impairment, bladder dysfunction, bowel dysfunction, loss of coordination, paralysis on one side of the body, and confusion. Descent to lower altitudes may save those afflicted with HACE.
Prevention
Avoiding alcohol ingestion
As alcohol tends to dehydrate, avoidance in the first 24 hours at a higher altitude is optimal.
Strenous activity
People with recurrent AMS note that by avoiding strenuous activity such as skiing, hiking, etc in the first 24 hours at altitude reduces their problems.
Altitude acclimatization
Altitude acclimatisation is the process of adjusting to decreasing oxygen levels at higher elevations, in order to avoid altitude sickness. Once above approximately 3,000 meters (10,000 feet = 70 kPa), most climbers and high altitude trekkers follow the "golden rule" - climb high, sleep low.[6] For high altitude climbers, a typical acclimatization regime might be to stay a few days at a base camp, climb up to a higher camp (slowly), then return to base camp. A subsequent climb to the higher camp would then include an overnight stay. This process is then repeated a few times, each time extending the time spent at higher altitudes to let the body adjust to the oxygen level there, a process that involves the production of additional red blood cells. Once the climber has acclimatised to a given altitude, the process is repeated with camps placed at progressively higher elevations. The general rule of thumb is to not ascend more than 300 metres (1,000 feet) per day to sleep. That is, one can climb from 3,000 (10,000 feet = 70 kPa) to 4,500 metres (15,000 feet = 58 kPa) in one day, but one should then descend back to 3,300 metres (11,000 feet = 67.5 kPa) to sleep. This process cannot safely be rushed, and this explains why climbers need to spend days (or even weeks at times) acclimatising before attempting to climb a high peak. Simulated altitude equipment that produce hypoxic (reduced oxygen) air can be used to acclimate to altitude, reducing the total time required on the mountain itself.
Altitude acclimatization is necessary for some people who rapidly move from lower altitudes to more moderate altitudes, usually by aircraft and ground transportation over a few hours, such as from sea level to 7000 feet of many Colorado, USA mountain resorts. Stopping at an intermediate altitude overnight can reduce or eliminate a repeat episode of AMS.
Drugs
Acetazolamide may help some people to speed up the acclimatisation process when taken before arriving at altitude, and can treat mild cases of altitude sickness. A typical dose is 250mg twice daily starting the day before moving to altitude.
A single randomized controlled trial found that sumatriptan may help prevent altitude sickness.[7]
For centuries, indigenous cultures of the Altiplano, such as the Aymaras, have used coca leaves to treat mild altitude sickness.
Oxygen enrichment
In high-altitude conditions, oxygen enrichment can counteract the effects of altitude sickness, or hypoxia. A small amount of supplemental oxygen reduces the equivalent altitude in climate-controlled rooms. At 3,400 m (67 kPa), raising the oxygen concentration level by 5 percent via an oxygen concentrator and an existing ventilation system provides an effective altitude of 3,000 m (70 kPa), which is more tolerable for surface-dwellers.[8] The most effective source of supplemental oxygen at high altitude are oxygen concentrators that use vacuum swing adsorption (VSA) technology.[neutrality disputed] As opposed to generators that use pressure swing adsorption (PSA), VSA technology does not suffer from performance degradation at increased altitude. The lower air density actually facilitates the vacuum step process.
Other methods
Drinking plenty of water will also help in acclimatisation[9] to replace the fluids lost through heavier breathing in the thin, dry air found at altitude, although consuming excessive quantities ("over-hydration") has no benefits and may lead to hyponatremia.
Oxygen from gas bottles or liquid containers can be applied directly via a nasal cannula or mask. Oxygen concentrators based upon PSA, VSA, or VPSA can be used to generate the oxygen if electricity is available. Stationary oxygen concentrators typically use PSA technology, which has performance degradations at the lower barometric pressures at high altitudes. One way to compensate for the performance degradation is to utilize a concentrator with more flow capacity. There are also portable oxygen concentrators that can be used on vehicle DC power or on internal batteries, and at least one system commercially available measures and compensates for the altitude effect on its performance up to 4,000 meters (13,123 feet). The application of high-purity oxygen from one of these methods increases the partial pressure of oxygen by raising the FIO2 (fraction of inspired oxygen).
Treatment
The only reliable treatment and in many cases the only option available is to descend. Attempts to treat or stabilise the patient in situ at altitude is dangerous unless highly controlled and with good medical facilities. However, the following treatments have been used when the patient's location and circumstances permit:
* Oxygen may be used for mild to moderate AMS below 12,000 feet and is commonly provided by physicians at mountain resorts. Symptoms abate in 12-36 hours without the need to descend.
* For more serious cases of AMS, or where rapid descent is impractical, a Gamow bag, a portable plastic pressure bag inflated with a foot pump, can be used to reduce the effective altitude by as much as 1,500 meters (5,000 feet). A Gamow bag is generally used only as an aid to evacuate severe AMS patients not to treat them at altitude.
* Acetazolamide may assist in altitude aclimatisation but is not a reliable treatment for established cases of even mild altitude sickness.[10][11]
* Some claim that mild altitude sickness can be controlled by consciously taking 10-12 large, rapid breaths every 5 minutes, (hyperventilation) but this claim lacks both empirical evidence and a plausible medical reason as to why this should be effective.[citation needed] If overdone, this can remove too much carbon dioxide causing hypocapnia.
* The folk remedy for altitude sickness in Ecuador , Peru and Bolivia is a tea made from the coca plant. See mate de coca.
* Other treatments include injectable steroids to reduce pulmonary edema, this may buy time to descend but treats a symptom, it does not treat the underlying AMS.
See also
* Mountain climbing
* Cabin pressurization
* Secondary polycythemia
* Altitude training
* High altitude pulmonary edema
* High altitude cerebral edema
References
1. ^ K Baillie and A Simpson. "Acute mountain sickness". Apex (Altitude Physiology Expeditions). Retrieved on 2007-08-08. - High altitude information for laypeople
2. ^ AAR Thompson. "Altitude-Sickness.org". Apex. Retrieved on 2007-05-08.
3. ^ The High Altitude Medicine Handbook 3rd Edition, Andrew J Pollard and David R Murdoch.
4. ^ K Baillie. "Living in Thin Air". Apex. Retrieved on 2007-12-17.
5. ^ high-altitude.org: High Altitude Medicine
6. ^ Muza, SR; Rock, PB; Zupan, M; Miller, J; Thomas, WR (2003). "Influence of Moderate Altitude Residence on Arterial Oxygen Saturation at Higher Altitudes.". US Army Research Inst. of Environmental Medicine Thermal and Mountain Medicine Division Technical Report (USARIEM/TMMD-T03-1). Retrieved on 2008-09-30.
7. ^ Jafarian S, Gorouhi F, Salimi S, Lotfi J (2007). "Sumatriptan for prevention of acute mountain sickness: randomized clinical trial". Ann. Neurol. 62 (3): 273–7. doi:10.1002/ana.21162. PMID 17557349.
8. ^ West, John B. (1995), "Oxygen Enrichment of Room Air to Relieve the Hypoxia of High Altitude", Respiration Physiology 99(2):230.
9. ^ Dannen, Kent; Dannen, Donna (2002). Rocky Mountain National Park. Globe Pequot, 9. ISBN 0762722452. "Visitors unaccustomed to high elevations may experience symptoms of Acute Mountain Sickness (AMS)[...s]uggestions for alleviating symptoms include drinking plenty of water[.]"
10. ^ Cain, SM, Dunn JE, 2nd. Low doses of acetazolamide to aid accommodation of men to altitude. J Appl Physiol 1966; 21:1195
11. ^ Grissom, CK, Roach, RC, Sarnquist, FH, Hackett, PH. Acetazolamide in the treatment of acute mountain sickness: Clinical efficacy and effect on gas exchange. Ann Intern Med 1992; 116:461
External links
* Information on high altitude medicine from the Institute for Altitude Medicine in Telluride, Colorado.
* The tutorial on altitude illness from the International Society for Mountain Medicine
* Merck Manual entry on altitude sickness
* High Altitude Pathology Institute
* University of Buffalo Reporter article on research into the cause of altitude sickness
* Mountain sickness
* Base Camp MD: Guide To High Altitude Medicine
* Altitude Illness Clinical Guide for Physicians
* General information about Altitude sickness by the Prince Leopold Institute of Tropical Medicine
* An online calculator to show the effects of high altitude on oxygen delivery
* An online calculator to compute altitude from air pressure
On August 5, 1998, while I was Railfanning in Downtown Tampa, I stopped at Tampa Union Station to once again Photograph the Florida FUN Train, after it's grade crossing accident. Because the startup of the FUN TRAIN had been under capitalized, the dreams of the Fun Train creator, of featuring two Fun Trains, (one on each coast of Florida) were extinguished in Bankruptcy.
But of much greater interest, was the Anti-Tobacco Train seen here in these Photographs. I'm not sure who organized the Anti Tobacco Rally or funded the Train, which apparently was touring the United States to illustrate the Health Issues of Smoking, however it presented a great Photographic Opportunity for me. There were three CSX Business Cars in the Anti-Tobacco Train. Of these two, only the "Kentucky" Name is readable in my lousy photograph. There are also two CSX Locomotives in this Anti-Tobacco Train: CSX #5942, a GE B40-8, however I couldn't identify the second Locomotive. The third Car, Named: "FLORIDA", is shown in the third picture in this series. You can find further information about the group "truth" at:
As we all know, Smoking causes several debilitating diseases, such as Lung Cancer, Bronchitis, Chronic Obstructive Pulmonary Disease (aka: COPD) and Emphysema.
I took these photographs with my Minolta Maxxim 5000 SLR using Color Print Film, when I was just learning photograph; so they are very soft & grainy. I scanned the Negatives and used Photoshop Elements to correct the exposure and to generate these Digital Images.
Disclaimer: Since I took these photographs while I was still learning Photography, some of my original Photos are of poor quality in both Exposure and Sharpness, which I could only partially correct with Adobe Photoshop Elements™.
Día Mundial de la Enfermedad Pulmonar Obstructiva Crónica
World Day for Chronic Obstructive Pulmonary Disease
( 17/11/2010 día mundial de la Epoc. / World COPD day.)
Español
BENEFICIOS AL DEJAR DE FUMAR
20 minutos después de abandonar el hábito: su frecuencia cardiaca, así como su presión arterial, baja.
12 horas después de abandonar el hábito: el nivel de monóxido de carbono en la sangre se reduce hasta el valor normal.
De 2 semanas a 3 meses después de abandonar el hábito: su circulación mejora y su función pulmonar aumenta.
De 1 a 9 mesesdespués de abandonar el hábito: disminuyen la tos, la congestión nasal, el cansancio y la dificultad para respirar; los cilios (estructuras parecidas a vellos pequeños que eliminan el moco de los pulmones) recuperan su función normal en los pulmones, lo que aumenta su capacidad para controlar las mucosidades, limpiar los pulmones y reducir el riesgo de las infecciones.
1 año después de abandonar el hábito: el riesgo excesivo de presentar una insuficiencia coronaria se reduce a la mitad del que tienen los fumadores.
5 años después de abandonar el hábito: de 5 a 15 años después de haber dejado el cigarrillo, el riesgo de sufrir un derrame cerebral se reduce al nivel de una persona que no fuma.
10 años después de abandonar el hábito: el índice de mortalidad debido al cáncer del pulmón se reduce a casi la mitad del que afronta una persona que fuma. Disminuye el riesgo de contraer cáncer de la boca, la garganta, el esófago, la vejiga, el cuello uterino y el páncreas.
15 años después de abandonar el hábito: el riesgo de padecer de insuficiencia coronaria es el mismo que el de una persona que no fuma.
*La Nicotina es un alcaloide (altamente adictiva)
*Una persona que fuma inhala sólo un 15 por ciento del humo total que su cigarrillo produce mientras que el 85 por ciento restante va al ambiente que todos respiramos.
*Si una persona permanece una hora en un ambiente contaminado por humo es como si se fumara activamente dos o tres cigarrillos.
*Los hijos de padres fumadores tienen un 20 por ciento más de riesgo de padecer asma, infecciones respiratorias (30 por ciento ), otitis (50 por ciento ), catarros frecuentes, tos persistente, etc.
English
BENEFITS OF QUITTING
20 minutes after quitting: Your heart rate and blood pressure low.
12 hours after quitting: The carbon monoxide level in blood drops to normal.
From 2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.
1 to 9 months after of quitting: Coughing, sinus congestion, fatigue and difficulty breathing; the cilia (small hair-like structures that remove mucus from the lungs) regain normal function in lungs, increasing their ability to handle mucus, clean lungs and reduce the risk of infections.
1 year after quitting: The excess risk of coronary heart disease is reduced to half that of a smoker.
5 years after quitting: 5 to 15 years after quitting smoking, the risk of stroke is reduced to that of a nonsmoker.
10 years after quitting, the mortality rate due to lung cancer is reduced to almost half that of a smoker. Reduces the risk of cancer of the mouth, throat, esophagus, bladder, cervix and pancreas.
15 years after quitting: The risk of coronary heart disease is the same as that of a nonsmoker.
* Nicotine is an alkaloid (highly addictive)
* A smoker inhales only 15 percent of the total smoke produced his cigarette while the remaining 85 percent goes to the atmosphere we all breathe.
* If a person is an hour in a smoke-contaminated environment is as if two or three actively smoke cigarettes.
* The children of parents who smoke are 20 percent higher risk of asthma, respiratory infections (30 percent), otitis (50 percent), frequent colds, coughing, etc.
© IVAN PAWLUK promysalud.blogspot.com/
Analyzed by: Carmelita Troy MA
Excavated from Ardreigh, Co. Kildare.
Photographed by: Hannah Sims, 2010
Client: Kildare County Council
FILE OBIT-
Brendan Anderson, 41, pirate Captain Jack Sparrow, impersonator, makes a visit to the University of Minnesota Amplatz Children’s Hospital in Minneapolis, Minn., on Saturday October 16, 2010 to visit Nicholas Koenig, 3. Nicholas was the son of Erik and Shannon Koenig, of Richmond, Minn. Nicholas was born with Pulmonary Atresia, underwent open heart surgery at less than one month old, and was diagnosed and at age 2 with acute Myloid Leukemia. Young Nicholas is a huge fan of the Disney, “Pirates of The Caribbean” movies, and especially the main character, pirate Captain Jack Sparrow.
Nicholas Koenig, 4, died of complications from his illnesses on Tuesday, August 16, 2011.
Brendan Anderson had the opportunity to grant a final wish for the young Nicholas the previous week before his death. Anderson went for a final boat ride on Lake Minnetonka, in Minneapolis, Minn. with Nicholas. Anderson described it as, "Nicholas wanted one last boat ride with his hero, and I was honored to be a part in granting his wish. I remember patting him on the head as we braved the “high seas” together. I also used a line from one of the movies, which was "Not all treasure is silver and gold, mate!""
(AP PHOTO/THE COUNTRY TODAY/PAUL M. WALSH)
Editor Note: The spelling of the hospital name is Amplatz is correct.
Nicholas Paul Koenig (2007-2011)
Gentle son, precious grandson
Nicholas Paul Koenig, 4
Richmond
April 6, 2007 – August 16, 2011
Mass of Christian Burial will be 11:00 a.m. Saturday, August 20, 2011 at Sts. Peter & Paul Catholic Church in Richmond, MN for Nicholas Paul Koenig, age 4, who died Tuesday at his home in the arms of his loving parents after a 2 ½ year battle with Acute Myeloid Leukemia. A private burial will be in the Sts. Peter & Paul Parish Cemetery.
Relatives and friends may call from 4:00 p.m. – 8:00 p.m. Friday at the Wenner Funeral Home in Richmond. Parish prayers will be at 4:00 p.m. Visitation will continue from 9:30 – 10:30 a.m. Saturday morning at the funeral home.
Nicholas was born at the St. Cloud Hospital to Erik and Shannon (Barthel) Koenig. He loved pirates, superheroes, SpongeBob, going to the park, golf cart rides, and football, especially the Minnesota Vikings. Most of all Nicholas loved making his friends, family, doctors and nurses laugh with his best friend Bernie the bear.
Survivors include his parents; sister Maggie; grandmother Sharon Steinhofer Gertken; grandmother Mary Jo Koenig; grandfather William Koenig; great-grandmother JoRita Senta; great-grandmother Shirley Steinhofer; great-grandparents Robert and Patricia Koenig; many aunts, uncles and cousins.
He was preceded in death by his great-grandfathers, Louis Senta and Norbert Steinhofer.
Thank you to the doctors, nurses and staff at the University of Minnesota Amplatz Children's Hospital, the St. Cloud Hospital, and CentraCare Clinic for taking such wonderful care of our Nicholas.
In honor of Nicholas' love of the Vikings we ask that friends and family come to the visitation and funeral wearing Vikings apparel or something purple.
My mother committed suicide in January after a protracted battle with idiopathic pulmonary fibrosis (IPF). It's a disease that attacks and scars the lungs, and there is no cure. She was drowning in slow motion and finally took charge in the only way possible.
We had a memorial service in Gainesville and had her cremated; in June we traveled to Kansas to bury some of her ashes in a family plot next to her parents. It's a small, rural church nestled against a corn field.
I take my pictures with a camera my mom gave me for Christmas. I'll probably not visit Kansas again.
COPD (Chronic Obstructive Pulmonary Disease) is a chronic respiratory disorder, mostly due to smoking, and can be as bad as cystic fibrosis (CF). CF is a rare genetic condition that fills up the lungs with fluid only curable by lung transplantation. I think it ironic that this guy is lighting up next to this poster. Both take your breath away.
The church dates back to 1050, with the nave, chancel arch and lower part of the tower being the original pre-Norman parts. The windows are Early English and Perpendicular, but the stonework of the old Norman windows is noticeable on the outside of the building. The present spire and nave roof were built when the old thatch roof caught fire on 26th October 1875. The font was destroyed in the fire when part of the roof fell on it, but some of the stonework survived. The remains are in the churchyard near the south porch. The present Rhenish helm tower was built after the fire and is similar to that of St Mary's Church in Sompting, Sussex.
Private Alfred Henry "Harry" Hook V.C. (1850-1905) is buried in the churchyard.
Born in Churcham, he served as a private in B Company, 2nd Battalion, 24th Regiment of Foot. On 22nd January 1879, during the Zulu attack on the British post at Rorke's Drift, Pte Hook was one of the patients in the camp hospital. As the Zulus advanced into the compound through a room wall of the hospital, Pte Hook with a few others defended the hospital until their ammunition ran out. Although being wounded, he then was instrumental in bringing eight patients with him out to the safety of the inner defenses. For gallantry in the face of the enemy he was awarded the Victoria Cross by Sir Garnet Wolseley, GOC South Africa on 3rd August 1879. He died of pulmonary tuberculosis at the age of 54 in Gloucester. For the movie "Zulu" (1964) Pte Hook was portrayed by actor James Booth.
The church was locked when we visited.
Women in Nova Scotia with COPD will soon be able to breathe a little easier with the development of virtual and in-person gender-specific pulmonary rehabilitation program options.
Pulmonary hypertension associated with pulmonary hemangiomatosis. A muscular pulmonary artery surrounded by angiomatous vessels exhibits marked intimal and adventitial thickening.
Hydrophilic polymers are widely used as surface coatings on vascular medical devices including guidewires, introducer and delivery sheaths, implantable stents and coils as well as cardiac, central and peripheral catheters. These polymers can fragment and embolize to various organs, most commonly the lungs. If they originate from the left side of the heart, embolization throughout the systemic circulation may occur. Their microscopic appearance is that of intravascular, coiled, worm-like structures. They can produce ischemic changes and infarction.
Diese Klinik wurde im Jahre 1910 als Heilstätte für Tuberkulosekranke erbaut und in den Vorkriegsjahren um weitere Häuser erweitert. Nach Beseitigung der Schäden des 2. Weltkriegs kam ein Schwesternwohnheim hinzu. Mit der starken Rückläufigkeit der Tuberkuloseerkrankungen wurde die Klinik zu einem pneumologischen Fachkrankenhaus umgebaut. Vor dem endgültigen Ende durch Insolvenz im Jahre 2010 diente die ehemalige Lungenheilstätte als Seniorenheim für schwere und schwerste Pflegefälle. Seit der Schließung der Klinik, gelegen in einem wunderschönen Wald, fiel sie nach und nach dem Vandalismus zum Opfer. Der Innenbereich der Klinik wurde fast vollkommen zerstört. Die Fotos zeigen den Zustand der Klinik, nach dem der Schrott durch den Vandalismus fast vollständig entfernt wurde. Ich hoffe, dass dieser ehemals wunderschöne Gebäudekomplex nicht abgerissen, sondern restauriert und einer sinnvollen Nutzung zugeführt wird.
Und an alle, die solche Gebäude betreten, appelliere ich:
Nehmt nichts mit außer Fotos – hinterlasst nichts außer Fußabdrücken.
This clinic was built in 1910 as a sanatorium for tuberculosis patients and was expanded in the years before the Second World War with more houses. After repairing the damages of the Second World War, a nurses home was added. With the strong decrease of the tuberculosis disease, the hospital was converted to a pulmonary specialist hospital. Before the final end caused by bankruptcy in the year 2010 , the former sanatorium served as a retirement home for heavy and very heavy nursing cases. Since the closure of the clinic, located in a beautiful forest, it became victim of vandalism. The interior of the clinic was almost completely destroyed. The photos are showing the condition of the hospital, after the scrap, caused by vandalism, was almost removed. I hope that this former beautiful complex of buildings will not be demolished, but restored and supplied to a meaningful use.
And to all, who enter such building, I appeal:
Take nothing, except photos – leave nothing, except footprints.
Title: A matter of health, or, West Texas and its relation to pulmonary complaints
Creator: Mayo, Henry Mash, 1862-1950
Contributors: Southern Pacific
Date: ca. 1898
Part OfA matter of health, or, West Texas and its relation to pulmonary complaints
Place: New Orleans, Orleans Parish, Louisiana
Description: This pamphlet describes the suitability of the West Texas climate for sufferers of lung diseases.
Physical Description: 20 p. 15 x 9 cm
File Name: f394_f63_m396_1900z_opt.pdf
Rights: DeGolyer Library, Southern Methodist University
Digital Collection: Texas: Photographs, Manuscripts, and Imprints
For more information, see: digitalcollections.smu.edu/cdm/ref/collection/wes/id/2318
Analyzed by: Carmelita Troy MA
Excavated from Ardreigh, Co. Kildare.
Photographed by: Hannah Sims, 2010
Client: Kildare County Council
David Bock is shown here enjoying time with his wife Lauren. David survived a life-threatening pulmonary embolism, a complication of deep vein thrombosis.
David’s story: I was seriously injured several years ago when I slipped and fell in Upland, California. I was rushed to the emergency room (ER), where the ER doctor determined that I had multiple fractures of my left leg and ankle. While in the ER, my leg was set in a soft splint and I was then sent directly home to Arizona where I could receive further care.
After seeing an orthopedic specialist, I was advised that I needed surgery to receive plates and pins to provide stability to my left leg and ankle. However, while waiting for the date of my surgery, I became increasingly ill and then began to experience noticeable and unexplained difficulty breathing. I was taken immediately by ambulance to the closest ER.
After many tests were conducted, I was told I had a blood clot, known also as deep vein thrombosis (DVT), that had formed in the deep vein of my left leg. A piece of this blood clot then broke off and traveled to my lungs, resulting in a complication of DVT called pulmonary embolism. I later learned that a sign of pulmonary embolism is unexplained difficulty in breathing.
I was immediately admitted to the intensive care unit for treatment of the pulmonary embolism. My condition worsened to the point where I became unresponsive and stopped breathing. Fortunately I responded after resuscitation and was treated with special drugs designed to dissolve blood clots. Later I had an inferior vena cava (IVC) filter placed in my vein in order to prevent any more blood clots in my legs from traveling to my lungs.
I am telling my story about my experience with a traumatic injury because I want to help inform others about the risks of blood clots. I would like you to know that if you experience a traumatic injury, such as a fracture, and your legs become immobilized, you are at increased risk for blood clots. By talking to your healthcare team to learn more about your risks for blood clots, you become a stronger advocate for your own healthcare.
Diese Klinik wurde im Jahre 1910 als Heilstätte für Tuberkulosekranke erbaut und in den Vorkriegsjahren um weitere Häuser erweitert. Nach Beseitigung der Schäden des 2. Weltkriegs kam ein Schwesternwohnheim hinzu. Mit der starken Rückläufigkeit der Tuberkuloseerkrankungen wurde die Klinik zu einem pneumologischen Fachkrankenhaus umgebaut. Vor dem endgültigen Ende durch Insolvenz im Jahre 2010 diente die ehemalige Lungenheilstätte als Seniorenheim für schwere und schwerste Pflegefälle. Seit der Schließung der Klinik, gelegen in einem wunderschönen Wald, fiel sie nach und nach dem Vandalismus zum Opfer. Der Innenbereich der Klinik wurde fast vollkommen zerstört. Die Fotos zeigen den Zustand der Klinik, nach dem der Schrott durch den Vandalismus fast vollständig entfernt wurde. Ich hoffe, dass dieser ehemals wunderschöne Gebäudekomplex nicht abgerissen, sondern restauriert und einer sinnvollen Nutzung zugeführt wird.
Und an alle, die solche Gebäude betreten, appelliere ich:
Nehmt nichts mit außer Fotos – hinterlasst nichts außer Fußabdrücken.
This clinic was built in 1910 as a sanatorium for tuberculosis patients and was expanded in the years before the Second World War with more houses. After repairing the damages of the Second World War, a nurses home was added. With the strong decrease of the tuberculosis disease, the hospital was converted to a pulmonary specialist hospital. Before the final end caused by bankruptcy in the year 2010 , the former sanatorium served as a retirement home for heavy and very heavy nursing cases. Since the closure of the clinic, located in a beautiful forest, it became victim of vandalism. The interior of the clinic was almost completely destroyed. The photos are showing the condition of the hospital, after the scrap, caused by vandalism, was almost removed. I hope that this former beautiful complex of buildings will not be demolished, but restored and supplied to a meaningful use.
And to all, who enter such building, I appeal:
Take nothing, except photos – leave nothing, except footprints.
November 24th, 2013
Chestnut Hill Cemetery behind the Baptist church on Victory Highway in Exeter, RI
There is a fantastic write-up on the legend by Jeff Belanger: www.ghostvillage.com/legends/2003/legends20_06142003.shtml
Some excerpts:
"'There are such beings as vampires, some of us have evidence that they exist. Even had we not the proof of our own unhappy experience, the teachings and the records of the past give proof enough for sane peoples,' said Dr. Seward's diary in Bram Stoker's Dracula. It was Bram Stoker who took the vampire of folklore and made him beautiful, powerful, and sexy. There were cases of vampires all over the world before, during, and even after Dracula both seduced and frightened us -- one of these cases was Mercy Brown, the Rhode Island vampire.
Mercy Brown has the distinction of being the last of the North American vampires -- at least in the traditional sense. Mercy Lena Brown was a farmer's daughter and an upstanding member of rural Exeter, Rhode Island. She was only 19 years old when she died of consumption on January 17, 1892. On March 17, 1892, Mercy's body would be exhumed from the cemetery because members of the community suspected the vampire Mercy Brown was attacking her dying brother, Edwin.
During the 1800s, consumption, or pulmonary tuberculosis, was credited with one out of four deaths. Consumption could kill you slowly over many years, or the disease could come quickly and end your life in a matter of weeks. The effects were devastating on families and communities. Dr. Bell explained that some of the symptoms of consumption are the gradual loss of strength and skin tone. The victim becomes pale, stops eating, and literally wastes away. At night, the condition worsens because the patient is lying on their back, and fluid and blood may collect in the lungs. During later stages, one might wake up to find blood on one's face, neck, and nightclothes, breathing is laborious, and the body is starved for oxygen.
Dr. Bell feels there is a direct connection between vampire cases and consumption. He said, 'The way you look personally is the way vampires have always been portrayed in folklore -- like walking corpses, which is what you are, at least in the later stages of consumption. Skin and bones, fingernails are long and curved, you look like the vampire from Nosferatu.'
Consumption took its first victim within the Brown family in December of 1883 when Mercy's mother, Mary Brown, died of the disease. Seven months later, the Browns' eldest daughter, Mary Olive, also died of consumption. The Browns' only son, Edwin, came down with consumption a few years after Mary Olive's death and was sent to live in the arid climate of Colorado to try and stop the disease. Late in 1891, Edwin returned home to Exeter because the disease was progressing -- he essentially came home to die. Mercy's battle with consumption was considerably shorter than her brother's. Mercy had the "galloping" variety of consumption -- her battle with the disease lasted only a few months. Mercy was laid to rest in Chestnut Hill Cemetery behind the Baptist church on Victory Highway.
After Mercy's funeral, her brother Edwin's condition worsened rapidly, and their father, George Brown, grew more frantic. Mr. Brown had lost his wife and two of his daughters, and now he was about to lose his only son. Science and medicine had no answers for George Brown, but folklore did. For centuries prior to Mercy Brown there have been vampires. The practice of slaying these "walking dead" began in Europe -- some of the ways people dealt with vampires was to exhume the body of the suspect, drive a stake through the heart, rearrange the skeletal remains, remove vital organs, or cremate the entire corpse. All of these rituals involve desecrating the mortal remains. The practice happened with enough regularity that the general population felt it could cure, or at the very least help, whatever evil was overwhelming them.
So much death had plagued the Brown family that poor George Brown probably felt he was cursed in some way. It wouldn't take too many chats with those empathizing with George's plight to come up with a radical idea to stop the death. Maybe the Brown family was under vampire attacks from beyond the grave. Was Mercy Brown the vampire, or was it Mercy's mother or sister? George Brown was willing to dig up the body of his recently deceased daughter, remove her heart, burn it, and feed the ashes to his son because he felt he had no other choice.
Mercy Brown died before embalming became a common practice. During decomposition, it is possible for bodies to sit up, jerk -- even sounds can emit from them because bloating can occur, and if wind escapes by passing over the vocal chords, there could be groans.
We don't know exactly what position her body was in on that day in March when George Brown, and some of his friends and family, came to examine Mercy's body. We do know that she looked "too well preserved."
'There's a suggestion in the newspaper that she wasn't actually interred in the ground," Dr. Bell said. "She was actually put in an above-ground crypt, because bodies were stored in the wintertime when the ground was frozen and they couldn't really dig. When the thaw came, they would bury them. So it's possible that she wasn't even really interred.'
Her visual condition prompted the group to cut open her chest cavity and examine her innards. Dr. Bell said, "They examined her organs. The newspaper said her heart and liver had blood in it. It was liquid blood, which they interpreted as fresh blood." Bell explained how forensics can clarify how blood can coagulate and become liquid again, but at the time, the liquid was taken as evidence that Mercy was indeed a vampire and the one draining the life from Edwin and possibly other consumption victims in the community.
Dr. Bell said, 'They cut her heart out, and as Everett said, they burned it on a nearby rock. Then according to the newspaper, they fed them [the ashes of the heart] to Edwin.' The folklore said that destroying the heart of a vampire would kill it, and by consuming the remains of the vampire's heart -- the spell would be broken and the victim would get well.
The community's vampire slaying had failed to save Edwin -- he died two months later, but maybe it helped others in the community? Dr. Bell's view on Mercy Brown is that she was the scapegoat author Paul Barber discussed. Dr. Bell said, 'She basically absorbs the ignorance, the fears, and in some cases the guilt that people have because their neighbors, friends, and family are dying, and they don't understand why and they can't stop it.'
Mercy Brown is arguably North America's most famous vampire because she is also the most recent. The event caused such a stir in 1892 because newspapers like the Providence Journal editorialized that the idea of exhuming a body to burn the heart is completely barbaric in those modern times.:
SOURCE: www.ghostvillage.com/legends/2003/legends20_06142003.shtml
Asymptomatic 87 year old male with a lesion detected in the right lower lobe. Core biopsy performed. Negative immunostains: AE1/AE3, CAM 5.2, SMA, Actin, Desmin, CD34, CD117, BCL-2, S100, CD56, Chromogranin A, HMB45, CD68. Positive immunostains: FLI-1, CD99 (focally +), Ki-67 (focally + <5%).Molecular studies for synovial sarcoma and Ewing's sarcoma were negative. No significant past medical history and no evidence of extrapulmonary involvement. This sarcoma could not be subtyped. Primary pulmonary sarcomas are very rare accounting for approximately 0.2% of primary pulmonary malignant neoplasms. Metastatic sarcomas are seen far more frequently.
Asymptomatic 87 year old male with a lesion detected in the right lower lobe. Core biopsy performed. Negative immunostains: AE1/AE3, CAM 5.2, SMA, Actin, Desmin, CD34, CD117, BCL-2, S100, CD56, Chromogranin A, HMB45, CD68. Positive immunostains: FLI-1, CD99 (focally +), Ki-67 (focally + <5%).Molecular studies for synovial sarcoma and Ewing's sarcoma were negative. No significant past medical history and no evidence of extrapulmonary involvement.
This sarcoma could not be subtyped. Primary pulmonary sarcomas are very rare accounting for approximately 0.2% of primary pulmonary malignant neoplasms. Metastatic sarcomas are seen far more frequently.
Viagra is a brand-name prescription drug that is approved to treat erectile dysfunction (ED) and pulmonary arterial hypertension. It is taken by mouth or by injection into a vein. The active ingredient is sildenafil, which works by enlarging the blood vessels, allowing the blood to flow more easily to the affected areas. Its chemical formula is C22H30N6O4S.
Source: Licensed from stock.adobe.com/
I’ve never wore this dress before…I was always kind of self-conscious to wear it.. kind of felt like a “sausage“… But I was going through the closet, deciding what to wear to the movie and dinner… And I came across it… I thought to myself “I better hurry up and wear this dress before I die… Because I’ll be damned if I die without ever having worn it!” ha ha ha… True story
A cigarette, also known colloquially as a fag in British English, is a narrow cylinder containing psychoactive material, usually tobacco, that is rolled into thin paper for smoking. Most cigarettes contain a "reconstituted tobacco" product known as "sheet", which consists of "recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings", to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Most modern cigarettes are filtered, although this does not make them safer. Cigarette manufacturers have described cigarettes as a drug administration system for the delivery of nicotine in acceptable and attractive form. Cigarettes are addictive (because of nicotine) and cause cancer, chronic obstructive pulmonary disease, heart disease, and other health problems.
The term cigarette, as commonly used, refers to a tobacco cigarette but is sometimes used to refer to other substances, such as a cannabis cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, and paper wrapping, which is typically white. Cigar wrappers are typically composed of tobacco leaf or paper dipped in tobacco extract.
Smoking rates have generally declined in the developed world, but continue to rise in some developing nations. Cigarette smoking causes health harms and death. Nicotine is also highly addictive. About half of cigarette smokers die of tobacco-related disease[9] and lose on average 14 years of life.
Cigarette use by pregnant women has also been shown to cause birth defects, including low birth weight, fetal abnormalities, and premature birth. Second-hand smoke from cigarettes causes many of the same health problems as smoking, including cancer, which has led to legislation and policy that has prohibited smoking in many workplaces and public areas. Cigarette smoke contains over 7,000 chemical compounds, including arsenic, formaldehyde, cyanide, lead, nicotine, carbon monoxide, acrolein, and other poisonous substances. Over 70 of these are carcinogenic. Additionally, cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.
HISTORY
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).
By 1830, the cigarette had crossed into France, where it received the name cigarette; and in 1845, the French state tobacco monopoly began manufacturing them. The French word was adopted by English in the 1840s. Some American reformers promoted the spelling cigaret, but this was never widespread and is now largely abandoned.
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847. However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf. This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
Cigarettes may have been initially used in a manner similar to pipes, cigars, and cigarillos and not inhaled; for evidence, see the Lucky Strike ad campaign asking consumers "Do You Inhale?" from the 1930s. As cigarette tobacco became milder and more acidic, inhaling may have become perceived as more agreeable. However, Moltke noticed in the 1830s (cf. Unter dem Halbmond) that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes (which are both initially sun-cured, acidic leaf varieties).
The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with less than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year). By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691; implying that about 21% of the population smoked 100 cigarettes or more per year.
The adverse health effects of cigarettes were known by the mid-19th century when they became known as coffins nails.[31] German doctors were the first to identify the link between smoking and lung cancer, which led to the first antitobacco movement in Nazi Germany. During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and text-only health warnings became common on cigarette packets.
The United States has not implemented graphical cigarette warning labels, which are considered a more effective method to communicate to the public the dangers of cigarette smoking. Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands, New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Nepal and Turkey, however, have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.
LEGISLATION
SMOKING RESTRICTIONS
Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke. Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. Bhutan is currently the only country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products under the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties. The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco. Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders. New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco. Under sharia law, the consumption of cigarettes by Muslims is prohibited.
SMOKING AGE
Beginning on April 1, 1998, the sale of cigarettes and other tobacco products to people under the state purchase age has been prohibited by law in all 50 states of the United States. The purchasing age in the United States is 18 in 42 of the 50 states — but 19 in Alabama, Alaska, Utah, and Nassau, Suffolk, and Onondaga Counties in New York, and 21 in California, Hawaii, New Jersey, Oregon, Maine and more than 180 municipalities across the nation. The intended effect of this is to prevent older high school students from purchasing cigarettes for their younger peers. In Massachusetts, parents and guardians are allowed to give cigarettes to minors, but sales to minors are prohibited.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.
Since 1 October 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland) (rising from 16). It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on 1 September 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking.
Most countries in the world have a legal vending age of 18. In Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population, has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age (suffrage in Japan is 20 years old). Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.Germany raised the purchase age from 16 to 18 on the 1 September 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine. Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.
TAXATION
Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue.Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%. The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate. Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York.As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
FIRE-SAFE CIGARETTE
According to Simon Chapman, a professor of public health at the University of Sydney, the burning agents in cigarette paper are responsible for fires and reducing them would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes. Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds developed fire safe cigarettes, but did not market them.
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper. Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish. This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.
CIGARETTE ADVERTISING
Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises. In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.
WARNING MESSAGES IN PACKAGES
As a result of tight advertising and marketing prohibitions, tobacco companies look at the pack differently: they view it as a strong component in displaying brand imagery and a creating significant in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in an alternative package. Studies also show how companies have manipulated a variety of elements in packs designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.
Some countries require cigarette packs to contain warnings about health hazards. The United States was the first, later followed by other countries including Canada, most of Europe, Australia, Pakistan, India, Hong Kong, and Singapore. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging. At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette package in Canada. As of November 2010, 39 countries have adopted similar legislation.
In February 2011, the Canadian government passed regulations requiring cigarette packs to contain 12 new images to cover 75% of the outside panel and eight new health messages on the inside panel with full color.
As of April 2011, Australian regulations require all packs to use a bland olive green that researchers determined to be the least attractive color, with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style. Similar policies have since been adopted in France and the United Kingdom. In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90 and 70% of back and front packaging, respectively. This took effect on December 1, 2012.
CONSTRUCTION
Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter. While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.
PAPER
The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.
TOBACCO BLEND
The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate"). To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.
Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing: RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.
Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.
In recent years, the manufacturers' pursuit of maximum profits has led to the practice of using not just the leaves, but also recycled tobacco offal and the plant stem. The stem is first crushed and cut to resemble the leaf before being merged or blended into the cut leaf. According to data from the World Health Organization, the amount of tobacco per 1000 cigarettes fell from 2.28 pounds in 1960 to 0.91 pounds in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors.
ADDITIVES
Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings". The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[85] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette pack(s). Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules. This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.
CIGARETTE TUBE
Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from what is known as King Size (84 mm) to 100s (100 mm).
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."
CIGARETTE FILTER
A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
CIGARETTE BUTT
The common name for the remains of a cigarette after smoking is a cigarette butt. The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. They are the most numerically frequent litter in the world. Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches. It is also called a fag-end or dog-end.
In a 2013 trial the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers
LIGHTS
Some cigarettes are marketed as “Lights”, “Milds”, or “Low-tar.” These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. he majority of major cigarette manufacturers offer a light, low-tar, and/or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.
REPLACEMENT
An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco. Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper." Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. E-cigarettes are automatically activated by taking a puff; others turn on manually by pressing a button. Some e-cigarettes look like traditional cigarettes, but they come in many variations. Most versions are reusable, though some are disposable. There are first-generation, second-generation, third-generation, and fourth-generation devices. E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquids are also sold without propylene glycol, nicotine, or flavors.
The benefits and the health risks of e-cigarettes are uncertain. There is tentative evidence they may help people quit smoking, although they have not been proven to be more effective than smoking cessation medicine. There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes. Youth who use e-cigarettes are more likely to go on to smoke cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products. It is estimated their safety risk to users is similar to that of smokeless tobacco. The long-term effects of e-cigarette use are unknown. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine itself is associated with some health harms. In 2019, an outbreak of severe lung illness across multiple states in the US has been linked to the use of vaping products.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, which have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other substances. Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. E-cigarette vapor contains fewer toxic chemicals, and lower concentrations of potential toxic chemicals than cigarette smoke. The vapor is probably much less harmful to users and bystanders than cigarette smoke,although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.
WIKIPEDIA
A cigarette, also known colloquially as a fag in British English, is a narrow cylinder containing psychoactive material, usually tobacco, that is rolled into thin paper for smoking. Most cigarettes contain a "reconstituted tobacco" product known as "sheet", which consists of "recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings", to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Most modern cigarettes are filtered, although this does not make them safer. Cigarette manufacturers have described cigarettes as a drug administration system for the delivery of nicotine in acceptable and attractive form. Cigarettes are addictive (because of nicotine) and cause cancer, chronic obstructive pulmonary disease, heart disease, and other health problems.
The term cigarette, as commonly used, refers to a tobacco cigarette but is sometimes used to refer to other substances, such as a cannabis cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, and paper wrapping, which is typically white. Cigar wrappers are typically composed of tobacco leaf or paper dipped in tobacco extract.
Smoking rates have generally declined in the developed world, but continue to rise in some developing nations. Cigarette smoking causes health harms and death. Nicotine is also highly addictive. About half of cigarette smokers die of tobacco-related disease[9] and lose on average 14 years of life.
Cigarette use by pregnant women has also been shown to cause birth defects, including low birth weight, fetal abnormalities, and premature birth. Second-hand smoke from cigarettes causes many of the same health problems as smoking, including cancer, which has led to legislation and policy that has prohibited smoking in many workplaces and public areas. Cigarette smoke contains over 7,000 chemical compounds, including arsenic, formaldehyde, cyanide, lead, nicotine, carbon monoxide, acrolein, and other poisonous substances. Over 70 of these are carcinogenic. Additionally, cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.
HISTORY
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).
By 1830, the cigarette had crossed into France, where it received the name cigarette; and in 1845, the French state tobacco monopoly began manufacturing them. The French word was adopted by English in the 1840s. Some American reformers promoted the spelling cigaret, but this was never widespread and is now largely abandoned.
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847. However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf. This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
Cigarettes may have been initially used in a manner similar to pipes, cigars, and cigarillos and not inhaled; for evidence, see the Lucky Strike ad campaign asking consumers "Do You Inhale?" from the 1930s. As cigarette tobacco became milder and more acidic, inhaling may have become perceived as more agreeable. However, Moltke noticed in the 1830s (cf. Unter dem Halbmond) that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes (which are both initially sun-cured, acidic leaf varieties).
The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with less than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year). By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691; implying that about 21% of the population smoked 100 cigarettes or more per year.
The adverse health effects of cigarettes were known by the mid-19th century when they became known as coffins nails.[31] German doctors were the first to identify the link between smoking and lung cancer, which led to the first antitobacco movement in Nazi Germany. During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and text-only health warnings became common on cigarette packets.
The United States has not implemented graphical cigarette warning labels, which are considered a more effective method to communicate to the public the dangers of cigarette smoking. Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands, New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Nepal and Turkey, however, have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.
LEGISLATION
SMOKING RESTRICTIONS
Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke. Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. Bhutan is currently the only country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products under the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties. The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco. Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders. New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco. Under sharia law, the consumption of cigarettes by Muslims is prohibited.
SMOKING AGE
Beginning on April 1, 1998, the sale of cigarettes and other tobacco products to people under the state purchase age has been prohibited by law in all 50 states of the United States. The purchasing age in the United States is 18 in 42 of the 50 states — but 19 in Alabama, Alaska, Utah, and Nassau, Suffolk, and Onondaga Counties in New York, and 21 in California, Hawaii, New Jersey, Oregon, Maine and more than 180 municipalities across the nation. The intended effect of this is to prevent older high school students from purchasing cigarettes for their younger peers. In Massachusetts, parents and guardians are allowed to give cigarettes to minors, but sales to minors are prohibited.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.
Since 1 October 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland) (rising from 16). It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on 1 September 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking.
Most countries in the world have a legal vending age of 18. In Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population, has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age (suffrage in Japan is 20 years old). Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.Germany raised the purchase age from 16 to 18 on the 1 September 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine. Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.
TAXATION
Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue.Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%. The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate. Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York.As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
FIRE-SAFE CIGARETTE
According to Simon Chapman, a professor of public health at the University of Sydney, the burning agents in cigarette paper are responsible for fires and reducing them would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes. Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds developed fire safe cigarettes, but did not market them.
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper. Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish. This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.
CIGARETTE ADVERTISING
Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises. In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.
WARNING MESSAGES IN PACKAGES
As a result of tight advertising and marketing prohibitions, tobacco companies look at the pack differently: they view it as a strong component in displaying brand imagery and a creating significant in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in an alternative package. Studies also show how companies have manipulated a variety of elements in packs designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.
Some countries require cigarette packs to contain warnings about health hazards. The United States was the first, later followed by other countries including Canada, most of Europe, Australia, Pakistan, India, Hong Kong, and Singapore. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging. At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette package in Canada. As of November 2010, 39 countries have adopted similar legislation.
In February 2011, the Canadian government passed regulations requiring cigarette packs to contain 12 new images to cover 75% of the outside panel and eight new health messages on the inside panel with full color.
As of April 2011, Australian regulations require all packs to use a bland olive green that researchers determined to be the least attractive color, with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style. Similar policies have since been adopted in France and the United Kingdom. In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90 and 70% of back and front packaging, respectively. This took effect on December 1, 2012.
CONSTRUCTION
Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter. While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.
PAPER
The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.
TOBACCO BLEND
The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate"). To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.
Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing: RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.
Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.
In recent years, the manufacturers' pursuit of maximum profits has led to the practice of using not just the leaves, but also recycled tobacco offal and the plant stem. The stem is first crushed and cut to resemble the leaf before being merged or blended into the cut leaf. According to data from the World Health Organization, the amount of tobacco per 1000 cigarettes fell from 2.28 pounds in 1960 to 0.91 pounds in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors.
ADDITIVES
Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings". The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[85] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette pack(s). Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules. This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.
CIGARETTE TUBE
Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from what is known as King Size (84 mm) to 100s (100 mm).
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."
CIGARETTE FILTER
A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
CIGARETTE BUTT
The common name for the remains of a cigarette after smoking is a cigarette butt. The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. They are the most numerically frequent litter in the world. Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches. It is also called a fag-end or dog-end.
In a 2013 trial the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers
LIGHTS
Some cigarettes are marketed as “Lights”, “Milds”, or “Low-tar.” These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. he majority of major cigarette manufacturers offer a light, low-tar, and/or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.
REPLACEMENT
An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco. Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper." Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. E-cigarettes are automatically activated by taking a puff; others turn on manually by pressing a button. Some e-cigarettes look like traditional cigarettes, but they come in many variations. Most versions are reusable, though some are disposable. There are first-generation, second-generation, third-generation, and fourth-generation devices. E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquids are also sold without propylene glycol, nicotine, or flavors.
The benefits and the health risks of e-cigarettes are uncertain. There is tentative evidence they may help people quit smoking, although they have not been proven to be more effective than smoking cessation medicine. There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes. Youth who use e-cigarettes are more likely to go on to smoke cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products. It is estimated their safety risk to users is similar to that of smokeless tobacco. The long-term effects of e-cigarette use are unknown. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine itself is associated with some health harms. In 2019, an outbreak of severe lung illness across multiple states in the US has been linked to the use of vaping products.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, which have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other substances. Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. E-cigarette vapor contains fewer toxic chemicals, and lower concentrations of potential toxic chemicals than cigarette smoke. The vapor is probably much less harmful to users and bystanders than cigarette smoke,although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.
WIKIPEDIA
Asymptomatic 87 year old male with a lesion detected in the right lower lobe. Core biopsy performed. Negative immunostains: AE1/AE3, CAM 5.2, SMA, Actin, Desmin, CD34, CD117, BCL-2, S100, CD56, Chromogranin A, HMB45, CD68. Positive immunostains: FLI-1, CD99 (focally +), Ki-67 (focally + <5%).Molecular studies for synovial sarcoma and Ewing's sarcoma were negative. No significant past medical history and no evidence of extrapulmonary involvement. This sarcoma could not be subtyped. Primary pulmonary sarcomas are very rare accounting for approximately 0.2% of primary pulmonary malignant neoplasms. Metastatic sarcomas are seen far more frequently.
Microscopic image of a pulmonary corpus amylaceum with central black-brown inclusion. Corpora amylacea are large, round to oval glycoprotein structures that are found within alveoli in a variety of circumstances. They have been reported to be present in up to about 4% of autopsy lungs and are incidental findings with no known clinical significance. They should be distinguished from alveolar microlithiasis. They often contain central inclusions which may appear as black fragments, crystals or ring forms. Prominent central black inclusions said to be birefringent are seen in these structures.
Image contributed by Dr Sanjay Mukhopadhyay - @smlungpathguy
The New York State Department of Health today announced new findings of its ongoing investigation into the vaping-associated pulmonary (lung-related) illnesses that have been reported across the state, including an updated case count and information regarding the testing being conducted at the Department's Wadsworth Center Laboratory.
"The cases of pulmonary illnesses associated with vaping are continuing to rise across New York State and the country," said Health Commissioner Dr. Howard Zucker."We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue."
The Department issued a health advisory in August, alerting health care providers of this emerging health threat and listing symptoms they should look for in patients. As of September 5, 2019, the Department has received 34 reports from New York State physicians of severe pulmonary illness among patients ranging from 15 to 46 years of age who were using at least one cannabis-containing vape product before they became ill. However, all patients reported recent use of various vape products.
Laboratory test results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing. Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested.
As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses. Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin. However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.
The New York State Department of Health today announced new findings of its ongoing investigation into the vaping-associated pulmonary (lung-related) illnesses that have been reported across the state, including an updated case count and information regarding the testing being conducted at the Department's Wadsworth Center Laboratory.
"The cases of pulmonary illnesses associated with vaping are continuing to rise across New York State and the country," said Health Commissioner Dr. Howard Zucker."We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue."
The Department issued a health advisory in August, alerting health care providers of this emerging health threat and listing symptoms they should look for in patients. As of September 5, 2019, the Department has received 34 reports from New York State physicians of severe pulmonary illness among patients ranging from 15 to 46 years of age who were using at least one cannabis-containing vape product before they became ill. However, all patients reported recent use of various vape products.
Laboratory test results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing. Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested.
As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses. Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin. However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.
The New York State Department of Health today announced new findings of its ongoing investigation into the vaping-associated pulmonary (lung-related) illnesses that have been reported across the state, including an updated case count and information regarding the testing being conducted at the Department's Wadsworth Center Laboratory.
"The cases of pulmonary illnesses associated with vaping are continuing to rise across New York State and the country," said Health Commissioner Dr. Howard Zucker."We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue."
The Department issued a health advisory in August, alerting health care providers of this emerging health threat and listing symptoms they should look for in patients. As of September 5, 2019, the Department has received 34 reports from New York State physicians of severe pulmonary illness among patients ranging from 15 to 46 years of age who were using at least one cannabis-containing vape product before they became ill. However, all patients reported recent use of various vape products.
Laboratory test results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing. Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested.
As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses. Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin. However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.
Chronic Obstructive Pulmonary Disorder, or COPD, is nearly twice as common in rural areas. 3.5 million people living in rural counties have been diagnosed with COPD, while hundreds of thousands more don't know they have it.
You can learn more about risk factors for COPD at
www.nhlbi.nih.gov/BreatheBetter
Credit: National Heart, Lung, and Blood Institute, NIH
A cigarette, also known colloquially as a fag in British English, is a narrow cylinder containing psychoactive material, usually tobacco, that is rolled into thin paper for smoking. Most cigarettes contain a "reconstituted tobacco" product known as "sheet", which consists of "recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings", to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Most modern cigarettes are filtered, although this does not make them safer. Cigarette manufacturers have described cigarettes as a drug administration system for the delivery of nicotine in acceptable and attractive form. Cigarettes are addictive (because of nicotine) and cause cancer, chronic obstructive pulmonary disease, heart disease, and other health problems.
The term cigarette, as commonly used, refers to a tobacco cigarette but is sometimes used to refer to other substances, such as a cannabis cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, and paper wrapping, which is typically white. Cigar wrappers are typically composed of tobacco leaf or paper dipped in tobacco extract.
Smoking rates have generally declined in the developed world, but continue to rise in some developing nations. Cigarette smoking causes health harms and death. Nicotine is also highly addictive. About half of cigarette smokers die of tobacco-related disease[9] and lose on average 14 years of life.
Cigarette use by pregnant women has also been shown to cause birth defects, including low birth weight, fetal abnormalities, and premature birth. Second-hand smoke from cigarettes causes many of the same health problems as smoking, including cancer, which has led to legislation and policy that has prohibited smoking in many workplaces and public areas. Cigarette smoke contains over 7,000 chemical compounds, including arsenic, formaldehyde, cyanide, lead, nicotine, carbon monoxide, acrolein, and other poisonous substances. Over 70 of these are carcinogenic. Additionally, cigarettes are a frequent source of deadly fires in private homes, which prompted both the European Union and the United States to require cigarettes to be fire-standard compliant.
HISTORY
The earliest forms of cigarettes were similar to their predecessor, the cigar. Cigarettes appear to have had antecedents in Mexico and Central America around the 9th century in the form of reeds and smoking tubes. The Maya, and later the Aztecs, smoked tobacco and other psychoactive drugs in religious rituals and frequently depicted priests and deities smoking on pottery and temple engravings. The cigarette and the cigar were the most common methods of smoking in the Caribbean, Mexico, and Central and South America until recent times.
The North American, Central American, and South American cigarette used various plant wrappers; when it was brought back to Spain, maize wrappers were introduced, and by the 17th century, fine paper. The resulting product was called papelate and is documented in Goya's paintings La Cometa, La Merienda en el Manzanares, and El juego de la pelota a pala (18th century).
By 1830, the cigarette had crossed into France, where it received the name cigarette; and in 1845, the French state tobacco monopoly began manufacturing them. The French word was adopted by English in the 1840s. Some American reformers promoted the spelling cigaret, but this was never widespread and is now largely abandoned.
The first patented cigarette-making machine was invented by Juan Nepomuceno Adorno of Mexico in 1847. However, production climbed markedly when another cigarette-making machine was developed in the 1880s by James Albert Bonsack, which vastly increased the productivity of cigarette companies, which went from making about 40,000 hand-rolled cigarettes daily to around 4 million.
In the English-speaking world, the use of tobacco in cigarette form became increasingly widespread during and after the Crimean War, when British soldiers began emulating their Ottoman Turkish comrades and Russian enemies, who had begun rolling and smoking tobacco in strips of old newspaper for lack of proper cigar-rolling leaf. This was helped by the development of tobaccos suitable for cigarette use, and by the development of the Egyptian cigarette export industry.
Cigarettes may have been initially used in a manner similar to pipes, cigars, and cigarillos and not inhaled; for evidence, see the Lucky Strike ad campaign asking consumers "Do You Inhale?" from the 1930s. As cigarette tobacco became milder and more acidic, inhaling may have become perceived as more agreeable. However, Moltke noticed in the 1830s (cf. Unter dem Halbmond) that Ottomans (and he himself) inhaled the Turkish tobacco and Latakia from their pipes (which are both initially sun-cured, acidic leaf varieties).
The widespread smoking of cigarettes in the Western world is largely a 20th-century phenomenon. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with less than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. At that time, about 50% of men and 33% of women smoked (defined as smoking more than 100 cigarettes per year). By 2000, consumption had fallen to 2,092 per capita, corresponding to about 30% of men and 22% of women smoking more than 100 cigarettes per year, and by 2006 per capita consumption had declined to 1,691; implying that about 21% of the population smoked 100 cigarettes or more per year.
The adverse health effects of cigarettes were known by the mid-19th century when they became known as coffins nails.[31] German doctors were the first to identify the link between smoking and lung cancer, which led to the first antitobacco movement in Nazi Germany. During World War I and World War II, cigarettes were rationed to soldiers. During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and text-only health warnings became common on cigarette packets.
The United States has not implemented graphical cigarette warning labels, which are considered a more effective method to communicate to the public the dangers of cigarette smoking. Canada, Mexico, Belgium, Denmark, Sweden, Thailand, Malaysia, India, Pakistan, Australia, Argentina, Brazil, Chile, Peru, Greece, the Netherlands, New Zealand, Norway, Hungary, the United Kingdom, France, Romania, Singapore, Egypt, Nepal and Turkey, however, have both textual warnings and graphic visual images displaying, among other things, the damaging effects tobacco use has on the human body.
The cigarette has evolved much since its conception; for example, the thin bands that travel transverse to the "axis of smoking" (thus forming circles along the length of the cigarette) are alternate sections of thin and thick paper to facilitate effective burning when being drawn, and retard burning when at rest. Synthetic particulate filters may remove some of the tar before it reaches the smoker.
The "holy grail" for cigarette companies has been a cancer-free cigarette. On record, the closest historical attempt was produced by scientist James Mold. Under the name project TAME, he produced the XA cigarette. However, in 1978, his project was terminated.
Since 1950, the average nicotine and tar content of cigarettes has steadily fallen. Research has shown that the fall in overall nicotine content has led to smokers inhaling larger volumes per puff.
LEGISLATION
SMOKING RESTRICTIONS
Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke. Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. Bhutan is currently the only country in the world to completely outlaw the cultivation, harvesting, production, and sale of tobacco and tobacco products under the Tobacco Control Act of Bhutan 2010. However, small allowances for personal possession are permitted as long as the possessors can prove that they have paid import duties. The Pitcairn Islands had previously banned the sale of cigarettes, but it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco. Iceland is also proposing banning tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders. New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000. In March 2012, Brazil became the world's first country to ban all flavored tobacco including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and imported cigarettes. Tobacco manufacturers had 18 months to remove the noncompliant cigarettes, 24 months to remove the other forms of noncompliant tobacco. Under sharia law, the consumption of cigarettes by Muslims is prohibited.
SMOKING AGE
Beginning on April 1, 1998, the sale of cigarettes and other tobacco products to people under the state purchase age has been prohibited by law in all 50 states of the United States. The purchasing age in the United States is 18 in 42 of the 50 states — but 19 in Alabama, Alaska, Utah, and Nassau, Suffolk, and Onondaga Counties in New York, and 21 in California, Hawaii, New Jersey, Oregon, Maine and more than 180 municipalities across the nation. The intended effect of this is to prevent older high school students from purchasing cigarettes for their younger peers. In Massachusetts, parents and guardians are allowed to give cigarettes to minors, but sales to minors are prohibited.
Similar laws exist in many other countries. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine. Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18.
Since 1 October 2007, it has been illegal for retailers to sell tobacco in all forms to people under the age of 18 in three of the UK's four constituent countries (England, Wales, Northern Ireland, and Scotland) (rising from 16). It is also illegal to sell lighters, rolling papers, and all other tobacco-associated items to people under 18. It is not illegal for people under 18 to buy or smoke tobacco, just as it was not previously for people under 16; it is only illegal for the said retailer to sell the item. The age increase from 16 to 18 came into force in Northern Ireland on 1 September 2008. In the Republic of Ireland, bans on the sale of the smaller 10-packs and confectionery that resembles tobacco products (candy cigarettes) came into force on May 31, 2007, in a bid to cut underaged smoking.
Most countries in the world have a legal vending age of 18. In Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card. Turkey, which has one of the highest percentage of smokers in its population, has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age (suffrage in Japan is 20 years old). Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.Germany raised the purchase age from 16 to 18 on the 1 September 2007.
Some police departments in the United States occasionally send an underaged teenager into a store where cigarettes are sold, and have the teen attempt to purchase cigarettes, with their own or no ID. If the vendor then completes the sale, the store is issued a fine. Similar enforcement practices are regularly performed by Trading Standards officers in the UK, Israel, and the Republic of Ireland.
TAXATION
Cigarettes are taxed both to reduce use, especially among youth, and to raise revenue.Higher prices for cigarettes discourage smoking. Every 10% increase in the price of cigarettes reduces youth smoking by about 7% and overall cigarette consumption by about 4%. The World Health Organization (WHO) recommends that globally cigarettes be taxed at a rate of three-quarters of cigarettes sale price as a way of deterring cancer and other negative health outcomes.
Cigarette sales are a significant source of tax revenue in many localities. This fact has historically been an impediment for health groups seeking to discourage cigarette smoking, since governments seek to maximize tax revenues. Furthermore, some countries have made cigarettes a state monopoly, which has the same effect on the attitude of government officials outside the health field.
In the United States, states are a primary determinant of the total tax rate on cigarettes. Generally, states that rely on tobacco as a significant farm product tend to tax cigarettes at a low rate. Coupled with the federal cigarette tax of $1.01 per pack, total cigarette-specific taxes range from $1.18 per pack in Missouri to $8.00 per pack in Silver Bay, New York.As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
FIRE-SAFE CIGARETTE
According to Simon Chapman, a professor of public health at the University of Sydney, the burning agents in cigarette paper are responsible for fires and reducing them would be a simple and effective means of dramatically reducing the ignition propensity of cigarettes. Since the 1980s, prominent cigarette manufacturers such as Philip Morris and R.J. Reynolds developed fire safe cigarettes, but did not market them.
The burn rate of cigarette paper is regulated through the application of different forms of microcrystalline cellulose to the paper. Cigarette paper has been specially engineered by creating bands of different porosity to create "fire-safe" cigarettes. These cigarettes have a reduced idle burning speed which allows them to self-extinguish. This fire-safe paper is manufactured by mechanically altering the setting of the paper slurry.
New York was the first U.S. state to mandate that all cigarettes manufactured or sold within the state comply with a fire-safe standard. Canada has passed a similar nationwide mandate based on the same standard. All U.S. states are gradually passing fire-safe mandates.
The European Union in 2011 banned cigarettes that do not meet a fire-safety standard. According to a study made by the European Union in 16 European countries, 11,000 fires were due to people carelessly handling cigarettes between 2005 and 2007. This caused 520 deaths with 1,600 people injured.
CIGARETTE ADVERTISING
Many countries have restrictions on cigarette advertising, promotion, sponsorship, and marketing. For example, in the Canadian provinces of British Columbia, Saskatchewan and Alberta, the retail store display of cigarettes is completely prohibited if persons under the legal age of consumption have access to the premises. In Ontario, Manitoba, Newfoundland and Labrador, and Quebec, Canada and the Australian Capital Territory the display of tobacco is prohibited for everyone, regardless of age, as of 2010. This retail display ban includes noncigarette products such as cigars and blunt wraps.
WARNING MESSAGES IN PACKAGES
As a result of tight advertising and marketing prohibitions, tobacco companies look at the pack differently: they view it as a strong component in displaying brand imagery and a creating significant in-store presence at the point of purchase. Market testing shows the influence of this dimension in shifting the consumer's choice when the same product displays in an alternative package. Studies also show how companies have manipulated a variety of elements in packs designs to communicate the impression of lower in tar or milder cigarettes, whereas the components were the same.
Some countries require cigarette packs to contain warnings about health hazards. The United States was the first, later followed by other countries including Canada, most of Europe, Australia, Pakistan, India, Hong Kong, and Singapore. In 1985, Iceland became the first country to enforce graphic warnings on cigarette packaging. At the end of December 2010, new regulations from Ottawa increased the size of tobacco warnings to cover three-quarters of the cigarette package in Canada. As of November 2010, 39 countries have adopted similar legislation.
In February 2011, the Canadian government passed regulations requiring cigarette packs to contain 12 new images to cover 75% of the outside panel and eight new health messages on the inside panel with full color.
As of April 2011, Australian regulations require all packs to use a bland olive green that researchers determined to be the least attractive color, with 75% coverage on the front of the pack and all of the back consisting of graphic health warnings. The only feature that differentiates one brand from another is the product name in a standard color, position, font size, and style. Similar policies have since been adopted in France and the United Kingdom. In response to these regulations, Philip Morris International, Japan Tobacco Inc., British American Tobacco Plc., and Imperial Tobacco attempted to sue the Australian government. On August 15, 2012, the High Court of Australia dismissed the suit and made Australia the first country to introduce brand-free plain cigarette packaging with health warnings covering 90 and 70% of back and front packaging, respectively. This took effect on December 1, 2012.
CONSTRUCTION
Modern commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetate–based filter. While the assembly of cigarettes is straightforward, much focus is given to the creation of each of the components, in particular the tobacco blend. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns.
PAPER
The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. The papers used in tipping the cigarette (forming the mouthpiece) and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette, as well as the delivery of smoke with the presence of one or two rows of small laser-drilled air holes.
TOBACCO BLEND
The process of blending gives the end product a consistent taste from batches of tobacco grown in different areas of a country that may change in flavor profile from year to year due to different environmental conditions.
Modern cigarettes produced after the 1950s, although composed mainly of shredded tobacco leaf, use a significant quantity of tobacco processing byproducts in the blend. Each cigarette's tobacco blend is made mainly from the leaves of flue-cured brightleaf, burley tobacco, and oriental tobacco. These leaves are selected, processed, and aged prior to blending and filling. The processing of brightleaf and burley tobaccos for tobacco leaf "strips" produces several byproducts such as leaf stems, tobacco dust, and tobacco leaf pieces ("small laminate"). To improve the economics of producing cigarettes, these byproducts are processed separately into forms where they can then be added back into the cigarette blend without an apparent or marked change in the cigarette's quality. The most common tobacco byproducts include:
Blended leaf (BL) sheet: a thin, dry sheet cast from a paste made with tobacco dust collected from tobacco stemming, finely milled burley-leaf stem, and pectin.
Reconstituted leaf (RL) sheet: a paper-like material made from recycled tobacco fines, tobacco stems and "class tobacco", which consists of tobacco particles less than 30 mesh in size (about 0.6 mm) that are collected at any stage of tobacco processing: RL is made by extracting the soluble chemicals in the tobacco byproducts, processing the leftover tobacco fibers from the extraction into a paper, and then reapplying the extracted materials in concentrated form onto the paper in a fashion similar to what is done in paper sizing. At this stage, ammonium additives are applied to make reconstituted tobacco an effective nicotine delivery system.
Expanded (ES) or improved stem (IS): ES is rolled, flattened, and shredded leaf stems that are expanded by being soaked in water and rapidly heated. Improved stem follows the same process, but is simply steamed after shredding. Both products are then dried. These products look similar in appearance, but are different in taste.
In recent years, the manufacturers' pursuit of maximum profits has led to the practice of using not just the leaves, but also recycled tobacco offal and the plant stem. The stem is first crushed and cut to resemble the leaf before being merged or blended into the cut leaf. According to data from the World Health Organization, the amount of tobacco per 1000 cigarettes fell from 2.28 pounds in 1960 to 0.91 pounds in 1999, largely as a result of reconstituting tobacco, fluffing, and additives.
A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors.
ADDITIVES
Various additives are combined into the shredded tobacco product mixtures, with humectants such as propylene glycol or glycerol, as well as flavoring products and enhancers such as cocoa solids, licorice, tobacco extracts, and various sugars, which are known collectively as "casings". The leaf tobacco is then shredded, along with a specified amount of small laminate, expanded tobacco, BL, RL, ES, and IS. A perfume-like flavor/fragrance, called the "topping" or "toppings", which is most often formulated by flavor companies, is then blended into the tobacco mixture to improve the consistency in flavor and taste of the cigarettes associated with a certain brand name.[85] Additionally, they replace lost flavors due to the repeated wetting and drying used in processing the tobacco. Finally, the tobacco mixture is filled into cigarette tubes and packaged.
A list of 599 cigarette additives, created by five major American cigarette companies, was approved by the Department of Health and Human Services in April 1994. None of these additives is listed as an ingredient on the cigarette pack(s). Chemicals are added for organoleptic purposes and many boost the addictive properties of cigarettes, especially when burned.
One of the classes of chemicals on the list, ammonia salts, convert bound nicotine molecules in tobacco smoke into free nicotine molecules. This process, known as freebasing, could potentially increase the effect of nicotine on the smoker, but experimental data suggests that absorption is, in practice, unaffected.
CIGARETTE TUBE
Cigarette tubes are prerolled cigarette paper usually with an acetate or paper filter at the end. They have an appearance similar to a finished cigarette, but are without any tobacco or smoking material inside. The length varies from what is known as King Size (84 mm) to 100s (100 mm).
Filling a cigarette tube is usually done with a cigarette injector (also known as a shooter). Cone-shaped cigarette tubes, known as cones, can be filled using a packing stick or straw because of their shape. Cone smoking is popular because as the cigarette burns, it tends to get stronger and stronger. A cone allows more tobacco to be burned at the beginning than the end, allowing for an even flavor
The United States Tobacco Taxation Bureau defines a cigarette tube as "Cigarette paper made into a hollow cylinder for use in making cigarettes."
CIGARETTE FILTER
A cigarette filter or filter tip is a component of a cigarette. Filters are typically made from cellulose acetate fibre. Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke.
CIGARETTE BUTT
The common name for the remains of a cigarette after smoking is a cigarette butt. The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. They are the most numerically frequent litter in the world. Cigarette butts accumulate outside buildings, on parking lots, and streets where they can be transported through storm drains to streams, rivers, and beaches. It is also called a fag-end or dog-end.
In a 2013 trial the city of Vancouver, British Columbia, partnered with TerraCycle to create a system for recycling of cigarette butts. A reward of 1¢ per collected butt was offered to determine the effectiveness of a deposit system similar to that of beverage containers
LIGHTS
Some cigarettes are marketed as “Lights”, “Milds”, or “Low-tar.” These cigarettes were historically marketed as being less harmful, but there is no research showing that they are any less harmful. The filter design is one of the main differences between light and regular cigarettes, although not all cigarettes contain perforated holes in the filter. In some light cigarettes, the filter is perforated with small holes that theoretically diffuse the tobacco smoke with clean air. In regular cigarettes, the filter does not include these perforations. In ultralight cigarettes, the filter's perforations are larger. he majority of major cigarette manufacturers offer a light, low-tar, and/or mild cigarette brand. Due to recent U.S. legislation prohibiting the use of these descriptors, tobacco manufacturers are turning to color-coding to allow consumers to differentiate between regular and light brands.
REPLACEMENT
An electronic cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without combusting tobacco. Using an e-cigarette is known as "vaping" and the user is referred to as a "vaper." Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. E-cigarettes are automatically activated by taking a puff; others turn on manually by pressing a button. Some e-cigarettes look like traditional cigarettes, but they come in many variations. Most versions are reusable, though some are disposable. There are first-generation, second-generation, third-generation, and fourth-generation devices. E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquids are also sold without propylene glycol, nicotine, or flavors.
The benefits and the health risks of e-cigarettes are uncertain. There is tentative evidence they may help people quit smoking, although they have not been proven to be more effective than smoking cessation medicine. There is concern with the possibility that non-smokers and children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. Following the possibility of nicotine addiction from e-cigarette use, there is concern children may start smoking cigarettes. Youth who use e-cigarettes are more likely to go on to smoke cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products. It is estimated their safety risk to users is similar to that of smokeless tobacco. The long-term effects of e-cigarette use are unknown. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine itself is associated with some health harms. In 2019, an outbreak of severe lung illness across multiple states in the US has been linked to the use of vaping products.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, which have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other substances. Its exact composition varies across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. E-cigarette vapor contains fewer toxic chemicals, and lower concentrations of potential toxic chemicals than cigarette smoke. The vapor is probably much less harmful to users and bystanders than cigarette smoke,although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.
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