Tobacco has been used for a very long time in the Americas and some of the adjacent countries due to its intense effects on the central nervous system and the feeling of excitement brought about by it. Tobacco is a type of agricultural crops that contains a chemical that is required for the production of cigarettes and chewed tobacco products. Within the tobacco leaf, there is a specific chemical known as nicotine, which is an ingredient that leads to addiction and causes tobacco abuse. This is why many people who smoke cigarette (intake of nicotine) will get addicted and will not easily quit tobacco use, thus developing a condition known as tobacco abuse or tobacco dependence. Tobacco abuse or tobacco dependence can be defined as an addiction to the use of tobacco products due to the intake of nicotine substance. For this reason, nicotine is the chemical that is responsible for the cause of this addiction or abuse. There is no safe level of tobacco use. Our body will become dependent on nicotine psychologically or physically. Once you start using tobacco, you will find it very difficult to stop using it. This is because the body has developed a tolerance to the effects of nicotine. In addition, tobacco use cannot be stopped abruptly as it will interrupt with the normal body functions for someone who relies on it to kick start the day.

1. EAP 2
Speech Outline
Faculty of Medicine
MBBS Batch 9
Topic: Tobacco Abuse
Name Matrix Number
YEE SHERMAINE QIUP-201805-002351
CHUN WAI KAH QIUP-201805-002352
CHAN QIAN ZIE QIUP-201805-002353
CHOOI WEN HAN QIUP-201805-002356
CHIN CHUNG YEE QIUP-201805-002357

2. Introduction
Tobacco has been used for a very long time in the Americas and some of the adjacent countries due to its
intense effects on the central nervous system and the feeling of excitement brought about by it. Tobacco
is a type of agricultural crops that contains a chemical that is required for the production of cigarettes and
chewed tobacco products. Within the tobacco leaf, there is a specific chemical known as nicotine, which
is an ingredient that leads to addiction and causes tobacco abuse. This is why many people who smoke
cigarette (intake of nicotine) will get addicted and will not easily quit tobacco use, thus developing a
condition known as tobacco abuse or tobacco dependence. Tobacco abuse or tobacco dependence can be
defined as an addiction to the use of tobacco products due to the intake of nicotine substance. For this
reason, nicotine is the chemical that is responsible for the cause of this addiction or abuse. There is no
safe level of tobacco use. Our body will become dependent on nicotine psychologically or physically.
Once you start using tobacco, you will find it very difficult to stop using it. This is because the body has
developed a tolerance to the effects of nicotine. In addition, tobacco use cannot be stopped abruptly as it
will interrupt with the normal body functions for someone who relies on it to kick start the day.
When nicotine is absorbed into our bloodstream, a typical hormone known as epinephrine will increase
the level of dopamine (a chemical messenger produced by the brain), which will reinforce a rewarding
behaviour. This explains why nicotine is sometimes known as a “Nervous System Stimulant”.
Epinephrine that is released into the bloodstream can affect your heart, blood sugar levels, and blood
vessels. This explains why the adverse effects of tobacco include stroke and hypertension.
In the contemporary society, there are many ways that people could use tobacco. For an instance, tobacco
can be processed into many different types of products for the consumers, such as cigarettes, cigars,
kreteks, bidis or clove cigarettes. Furthermore, tobacco can also be consumed in the form of smoke or
smokeless, for example, a hookah or chewing tobacco.

3. Consequently, people get to choose their favourite form of tobacco use to increase their need for tobacco
intake. Tobacco will not only cause addiction but it will also contribute to various chronic health
conditions such as lung cancer, stroke and emphysema. In addition, tobacco use could also impair our
physical appearance like stained teeth and bad breathe which may lead to bad impression and it will also
affect the society with second hand smoke which is an indirect way of devastating the health of the
society – one of the main cause of increasing mortality (death rate).
Last but not least, even though tobacco abuse is starting to become more and more prevalent in the
modern societies, however there is still a wide range of treatment available for the abuser. Where there is
a will, there is a way, tobacco abuse can be treated either in the form of medication or counselling.
However, the process may not be quick and carried out in a short period. In order to becoming a normal
functioning human again, they must go through a lot of obstacles and persistence is strictly required for
the treatment to complete. This explains why many tobacco abusers are reluctant to undergo treatment.
Tobacco is a narcotic that can bring about addiction to the user, over consumption of tobacco will expose
many risks to the user, symptoms of tobacco abuse can be seen easily as tobacco is relatively poisonous,
but the good news is, there is a wide range of treatment available for tobacco abusers.

4. Content
People who uses tobacco are more prone to develop diseases such as cancers that may affect the individual’s
health and organs of the body. In individuals who smoke, almost every organ in their body will be impaired.
Tobacco use will also cause many diseases as well as affect the health of the person and those who are
exposed to second-hand smoke. Tobacco smoking increases the risk of heart disease, it may lead to heart
attack or stroke. Besides that, it may also increase the chance of the person to get lung cancer, emphysema
as well as chronic bronchitis. Smoking may cause other cancer such as leukemia, cataracts, and pneumonia.
All these risks apply to the usage of any tobacco products, including using smokeless tobacco. Smokeless
tobacco will increase the risk of cancer, especially mouth cancers. Tobacco abuse will also affect the
individual’s brain. When a person uses tobacco in any form, the nicotine in tobacco will be absorbed into
the person’s bloodstream. Once it enters the circulation, it will instantly stimulate the adrenal glands of the
individual to release adrenaline hormone or in other terms as epinephrine. Epinephrine will trigger the CNS
to increase blood pressure, heart rate and the breathing rate of the user. Some of the chemicals in tobacco
such as acetaldehydes might boost this mechanism in the brain which may increase the level of chemical
messenger known as dopamine to reinforce the rewarding behaviors. Pregnant mothers who smoke may
have the risk of having their children born with learning and behavioral problem. This will also lead to an
increase on risk of stillborn, miscarriage, premature infants or infants with low birth weight.
Misuse of tobacco might be a marker for emotional wellness issues, such as melancholy and uneasiness
issue. Tobacco use may represent a means of self-treating symptoms that are often associated with these
disorders. Contingent upon the populace thinks about, 55% to 90% of people with mental issue smoke,
contrasted and around 20% all in all populace. (Tammy H. Sims, 2009) Researchers at King's College
London have found that people who suffer from psychosis are about three times more likely to be smokers.
Inclination issue, nervousness, and other substance utilize related turmoil might be more typical in people
who smoke than in the individuals who are previous smokers and the individuals who never smoked.
(Tammy H. Sims, 2009) This is because most smokers believe that smoking can help them release stress.
So when they do not smoking in one day, they will be very stress.

5. Tobacco smoking reduces the function of the lungs due to impairments towards lung growth. Smokers
cough more frequently and are prone to have severe respiratory illnesses compared to non-smokers.
Smokers have less physical continuance and tend to encounter shortness of breath even with insignificant
effort contrast with a non-smoker. Exposure to second-hand smoke will also lead to heart disease and lung
cancer. It might cause the health problem in both children and adults, such as reduced lung function,
bronchitis, coughing and increase lung infections. The main function of lungs is respiration which exchange
the carbon dioxide gas and oxygen gas. Since lungs will be affected due to tobacco, the ability of lungs to
exchange will be affected. Thus, people who taking tobacco has higher risk in lung infection.
Tobacco smoking can lead to addiction. Nicotine which is addictive substance found in tobacco. It acts as
stimulant which leads to high blood pressure, tachycardia and contributes to heart diseases and stroke. It is
a substance which causes physiological or psychological dependence. Psychological dependence can be
defined as emotional needs while physical dependence is changes in body when the additional drug which
is nicotine found in tobacco is removed as time passed. For example, individual will feel anxious or stress
when he or she does not taking tobacco smoke per day. But once they smoke they would not control
themselves to stop smoking. According to statistic, one person can smoke more than 8 cigarettes per day.
For who smokes more than average 3 or 4 ziggurats considered as addicted to nicotine. That’s why tobacco
can let people rely on it which known as addictive.
Tobacco will lead to infertility in both genders. As mentioned earlier, nicotine can be found in tobacco.
For male, sperm production will be lesser and testicle becomes smaller. A healthy man will produce
millions of sperm per day. For man who smokes, the concentrations of sperm in the semen will be
reduced and the shape of sperm will be changed. A number of studies have reported an association
between tobacco smoking and male infertility .A review of observational studies on smoking and semen
parameters found that 20 of the 25 studies reported an increased risk of lower sperm concentration in
smokers compared to non-smokers. On average, sperm concentration was 13% lower in smokers
compared tenon-smokers. Smoking men also had a lower average proportion of sperm that were motile
and morphologically normal , compared to non-smoking men. For female, tobacco will change cervical
mucus. This will lead to difficulty in sperm reach the egg. Moreover, men’s and women’s hormone
production will also affected. Men’s sex hormone such as testosterone and female’s sex hormones which
are oestrogen and progesterone ‘s production will be reduced due to tobacco smoking. Thus, tobacco
smoker in both gender has higher chance in infertility compared to non-smokers.

6. Apart from that, what are the symptoms of tobacco dependence? It’s certainly which including
withdrawal, tolerance and dependent behaviours. Researches clam that people who are addicted towards
tobacco will experience withdrawal symptoms unlike people who are not dependent on tobacco. When a
person stops using tobacco, he or she will experience a set of physical symptoms known as withdrawal.
Consequently, individuals who are dependent on tobacco will need to use a larger quantity of tobacco to
obtain the same effect. Accordingly, individuals who have tobacco dependence will develop dependent
behaviours. Their daily activities will be disrupted. Therefore, withdrawal, tolerance and dependent
behaviours are symptoms of tobacco addiction. There is mounting evidence that when those who are
tobacco dependent try to quit tobacco, they will experience symptoms of withdrawal such as shaky hands,
sweating, irritability or rapid heart rate. Studies have shown that adolescents who smoke only few
cigarettes per month and those who have smoked as few as 100 cigarettes can suffer physical and
psychological withdrawal symptoms when they attempt to quit using tobacco. (Sims, T.H. 2009,
November 01) . As a results, most common symptoms of withdrawal are yearning for tobacco, agitation,
drowsiness, irritability, nausea, restlessness, headaches, depressed mood and difficulty in concentrating.
Thus, people who are addicted to tobacco cannot stop smoking or chewing gum even if they tried to quit.
Individuals who are dependent on tobacco will continue to smoke despite knowing and understanding that
using or smoking tobacco is harmful to oneself or others. In short, people who are dependent on tobacco
tend to shun themselves from activities or events that restrict smoking.
What is more, tobacco dependence will also lead to attention deficit hyperactivity disorder (ADHD). A
recent study found that beyond the traditional side effects of tobacco reliance (e.g. withdrawal, resilience
and dependent behaviours), individual psychological well-being elements may assume a pivotal job.
Specifically, stress and Attention Deficit Hyperactivity Disorder (ADHD) manifestations are two
conceivably vital benefactors that speak to recognizable focuses for intercessions. Besides,
epidemiological examinations have demonstrated that people presented to elevated amounts of tobacco
report that more elevated amount of stress after a couple of years. Nonetheless, engagement in smoking is
frequently credited to stress by people themselves. Undoubtedly, smoking is accounted for to be a way to
ease pressure and nervousness manifestations for a short period. This is organically conceivable since
intense nicotine changes cerebrocortices neuroactive steroids and plasma corticosterone focuses. But for a
long terms view, smoking will increase stress and anxiety symptoms. Yet, stress and smoking may
likewise have basic hereditary and natural vulnerabilities. Strangely, females might be more inclined to
smoking and more susceptible to ADHD than men when in a long period. To illustrates how tobacco

7. dependence lead to ADHD, there is some evidence that while tobacco smoking is naturally a modifiable
conduct, the very addictive intensity of nicotine makes smoking discontinuance an overwhelming
assignment. Tobacco commencement and fixation, similar to various wellbeing hazard practices, settle
down for the most part amid puberty and youthful adulthood. On top of that, the self-prescription theory
may clarify the example of the expansive assemblage of writing concentrating on the ADHD-tobacco
interface, understudies with large amounts of ADHD manifestations smoked at altogether higher rates and
at heavier dimensions than those with low dimensions of ADHD side effects since people with ADHD
smoke to enhance their consideration and official working. Moreover, student life is thus a basic period
when intercessions may proficiently change the beginning of dangerous practices and along these lines
enhance future results. In this line, the Center for Disease Control has as of late exhausted the age run for
commencement counteractive action to school/college youthful grown-ups. Accordingly, stress has been
appeared to be related with tobacco use (e.g. inception, continuation and challenges to stop) in both
human and creature contemplates.
Both prevention of tobacco usage initiation among youths and young adults as well as tobacco abuse
cessation among established tobacco users are the essential key for reducing tobacco usage and the
associated negative health consequences. Among the preventive actions that can be carried out includes the
implementation of public health approaches and individual strategies in life which would help in preventing
tobacco abuse. Parents play an important role when it comes to prevention of children or adolescents from
abusing substances such as tobacco. They should be an example to their children by not smoking as children
or adolescents’ smoking status will be greatly influenced by their parents’ attitudes, opinions and feelings.
Parents can even talk to their children about the dangers of using tobacco products to prevent children from
abusing tobacco made items. Not only that, parents should also maintain a smoke-free household and
vehicles to articulate clear messages to their children that they expect them to be smoke-free. Moreover,
paediatrician plays an important role in preventing children and youths from smoking. For example,
paediatricians can use their knowledge that he or she have acquired to educate children or youths about the
consequences of tobacco use and the risks of it towards an individual’s health. In addition, individuals
should involve oneself in the preventive measures or strategies that are effective in preventing the use of
tobacco. For instance, individuals can be an active participator in smoking cessation programs held by
either the school or community.

8. Furthermore, the risk of overall mortality among adult smokers can be reduced through smoking cessation.
Health benefits can be observed in individuals who quit smoking at the age of 65 or even after the
development of a tobacco-related disease. For example, smokers who stop smoking by the age of 40 years
have the greatest mortality benefit as the risk for them to develop and die of tobacco-related disease can be
reduced by 90%. Not only that, health benefits from smoking cessation also extend to smokers over age of
70 years. Risk of developing tobacco-related disease such as cardiac disease, pulmonary disease and
cancers can be reduced in smokers who quit smoking. However, the reduction of these risks occurs at
different rates. For instance, the excess risk for former smokers to develop coronary heart disease reduces
rapidly to approximately one-half of the risk of those who continued to smoke after quitting tobacco for a
year and within 15 years, reaches the level of those who do not smoke. Moreover, after a person quits
smoking for about 5 to 15 years, he or she will be able to eliminate the excess risk of developing stroke.
Besides that, the risk of developing cardiovascular diseases for smokers with pre-existing disease decreases
rapidly when they stop using tobacco related products. For example, there is a reduced subsequent mortality
by 15% to 61% and a reduced rate of angina occurrence among those who stop smoking after myocardial
infarction. All these reasons explain why smoking cessation is greatly encouraged in smokers of all ages.
In addition, tobacco use and tobacco abuse can be reduced and prevented through public policies. Most of
the tobacco control policies are carried out by reducing the public’s demand for tobacco products. For
example, when cigarette prices are increased by increasing tobacco excise taxes and the legal age of tobacco
purchase being raised, it will reduce the supply of tobacco among youths and young adults. Besides that,
public policies such as smoke-free policies being adopted in indoor areas and printings of health warning
labels on cigarette packages are also enforced by the government. Not only that, mass media campaigns
that aims to educate the public and promote tobacco cessation are also encouraged and supported. So, with
tobacco products sold off as high-priced merchandise and smoke-free workplace laws implemented, it will
help to reduce the incidence of smoking in youths and adults as well as nip tobacco abuse in the bud.

9. Conclusion
In a nutshell, tobacco abuse is not only deteriorating for an individual, it will also bring about negative
impacts to the society. Nicotine, which is a substance found in tobacco, is a risk factor that will give rise
to many health conditions such as damaging the brain and CNS, as well as inducing emotionally-related
conditions such as depression and anxiety. Other than that, tobacco abuse will also have negative
implications on the society due to the second-hand smoke released especially when non-smokers
accidentally inhale the smoke produced by the smokers. This is because when tobacco enters the lungs,
the cells of the lung will be damaged and its effect may be irreversible. In short, tobacco abuse is not
beneficial in any aspect and will only cause harm to an individual as well as the community. However,
the symptoms of tobacco dependence are usually pretty obvious and noticeable. Since we can observe the
symptoms of tobacco dependence rather easily, we should prevent them from becoming a tobacco abuser.
Therefore, each and every one of us should play our part in helping these individuals who show the
symptoms of tobacco dependence as well as the tobacco abusers to get rid of the addiction so that they
can receive the necessary treatment as soon as possible.

10. Reference
1. Tammy H. Sims, M. M. (2009). Technical Report-Tobacco as a Substance of Abuse. The
American Academy of Pediatrics, e1046.
2. Staff, M. C. (2018, March 09). Nicotine dependence. Retrieved from MAYO CLINIC:
https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/symptoms-causes/syc-
20351584
3. NIH. (2018, June ). Retrieved from Cigarettes and Other Tobacco Products:
https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products