Tobaccosmoki ngi st hepr act i

ceofsmoki ngt obaccoandi nhal ingt obaccosmoke( consist i

ng
ofpar t
icleandgaseousphases) .(Amor ebr oaddef i
nitionmayi ncludesi mpl ytaki ngt obacco
smokei ntothemout h,andt henr eleasingit ,asi sdonebysomewi thtobaccopi pesandci gars.
)
Thepr acticeisbel ievedt ohav ebegunasear l
yas5000–3000BCi nSout hAmer ica.Smoki ngi s
themostcommonmet hodofconsumi ngt obacco, andt obaccoi sthemostcommonsubst ance
smoked.Theagr i
cul t
uralpr oducti sof t
enmi xedwi t haddi tiv
eandt hencombust ed.The
result
ingsmokei st heninhal edandt heact ivesubst ancesabsor bedt hrought heal veoliint he
l
ungsort heor al mucosaCombust i
onwast radi t
ional l
yenhancedbyaddi ti
onofpot assium or
nitr
ates.Cigarettes,Frenchf or"smal l
cigar", areapr oductconsumedt hr oughsmoki ngand
manuf acturedoutofcur edandf inelycutt obaccol eav esandr econst itutedtobacco, often
combi nedwi thot heraddi tives, whichar ethenr olledorst uff
edi ntoapaper -wrapped
cyli
nder .
Cigarettesar eigni tedandi nhaled, usual lyt hr oughacel lul
oseacet atef i
lter,intothe
mout handl ungs. Manysubst ancesi nci garet t
emoket ri
ggerchemi cal reacti
onsi nner v e
endings, whichhei ght enhear trate,alertnessandr eact iont i
me, amongot herthings.Asoft he
record,tobaccoi susedbyabout49%ofmenand11%ofwomenaged15orol deri nlow- income
andmi ddl e-
incomecount ries.wi t
habout80%oft hisusagei nt hef orm ofsmoki ng.Many
smoker sbegi ndur i
ngadol escenceorear lyadul t
hood. Duringt heear l
yst ages, acombi nationof
perceivedpleasur eact i
ngasposi ti
v ereinfor cementanddesi ret or espondt osoci al peer
pressuremayof fsett heunpl easantsy mpt omsofi nitial use,whi chtypicallyincludenauseaand
coughing.Af terani ndivi
dual hassmokedf orsomey ears, t
heav oidanceofwi t
hdr awal
sympt omsandnegat ivereinf orcementbecomet hekeymot ivationst ocont i
nue. Themost
commonf actorleadi ngst udent st osmokei sci gar et teadv erti
sement s.Smoki ngbypar ents,
sibl
ingsandf ri
endsal soencour agesst udent stosmoke.

Mostt obaccosmokersbegi
ndur i
ngadolescenceorear l
yadult
hood.Smokinghaselement sof
ri
sk-
takingandrebel
li
on,whichoftenappealtoy oungpeopl
e.Thepresenceofhigh-
status
modelsandpeer smayalsoencour agesmoking.Becauseteenager
sareinfl
uencedmor eby
thei
rpeersthanbyadult
s,attemptsbyparents,school
s,andhealt
hprofessi
onal
satpr event
ing
peoplefrom t
ryi
ngci
garett
esar enotalwayssuccessful
.

Smoker sof tenr epor tthatcigarett

eshel prel i
evef eeli
ngsofst ress.Howev er ,
thest resslevel
s
ofadultsmoker saresl ightl
yhigherthant hoseofnonsmoker s.Adol escentsmoker sreport
i
ncreasingl ev el
sofst ressast heydev el
opr egularpatternsofsmoki ng, andsmoki ngcessat i
on
l
eadst or educedst ress.Farf r
om act i
ngasanai df ormoodcont r
ol,nicot i
nedependencyseems
toexacer batest ress.Thi sisconf i
rmedi nthedai lymoodpat ternsdescr ibedbysmoker s,wit
h
normal moodsdur ingsmoki ngandwor seningmoodsbet weenci garettes.Thus, t
heappar ent
rel
axantef fectofsmoki ngonl yref
lectsther eversalofthetensi onandi rritabili
tythatdev elop
duri
ngni cotinedepl eti
on.Dependentsmoker sneedni coti
netor emai nf eelingnor mal .Smoking,
pri
marilyoft obacco, isanact ivi
tythatispr acticedbysome1. 1bill
ionpeopl e,andupt o1/3of
theadultpopul ati
on. Thei mageoft hesmokercanv ar
yconsider ably,buti sv eryof t
en
associ
at ed, especial l
yinf i
cti
on, wi
thindividualityandal oofness.Ev enso, smoki ngofci garet
te
canbeasoci al activitywhi chser vesasar einfor cementofsoci al structuresandi spartoft he
cultur alri
tualsofmanyanddi ver sesoci alandet hni cgroups.Manysmoker sbegi nsmoki ngi n
soci al sett
ingsandt heof feringandshar ingofaci garetteisof t
enani mpor tantriteofiniti
ation
orsi mpl yagoodexcuset ost artaconv ersat i
onwi thstranger sinmanyset ti
ngs; inbars,night
clubs, atwor koront hest reet.Li ght i
ngaci garet teisof tenseenasanef fectivewayofav oiding
theappear anceofi dlenessormer el oi
tering.Foradol escent s,i
tcanf unct i
onasaf ir
ststepout
ofchi l
dhoodorasanactofr ebel li
onagai nstt headul twor ld.Also,smoki ngcanbeseenasa
sortofcamar aderie.I thasbeenshownt hatev enopeni ngapacketofci garettes,orof f
eringa
cigar ettetoot herpeopl e, cani ncr easet hel evel ofdopami ne(the" happyf eeli
ng" )inthebr ain,
andi tisdoubt l
esst hatpeopl ewhosmokef ormr elati
onshi pswi t
hf ellowsmoker s,inawayt hat
onlypr oli
feratest hehabi t,particular lyi
ncount rieswher esmoki ngi nsidepubl icpl aceshasbeen
madei ll
egal.Ot hert hanr ecreat ional dr
uguse, i
tcanbeusedt oconst r
ucti dentit
yanda
dev elopmentofsel f -i
magebyassoci at
ingi twi thper sonal exper i
encesconnect edwi thsmoki ng.
Ther iseoft hemoder nant i
-smoki ngmov ementi nt helat e19thcent urydi dmor ethancr eate
awar enessoft hehazar dsofsmoki ng;itpr ov okedr eactionsofsmoker sagai nstwhatwas, and
oftenst il
li
s, perceiv edasanassaul tonper sonal fr
eedom andhascr eatedani dentit
yamong
smoker sasr ebelsorout casts, apar tfr
om non- smoker s.

Thehar mful consequencesofsmoki ngonheal t

har ewell-
document ed.Datafrom recent
studi
esconf i
rmt hequant it
ativerelationshipbet weensmoki ngandmanyheal thhazardsint he
form ofpr emat uredeat handser iousmor bidit
y.Unfor
tunately,smoki ngisont heri
seinmost
developingcount ri
es,includingPaki stan,wher easinmostdev elopedcount ri
esthereisast eady
decli
neini tsprevalence.Cigar et
tepr oductionhasbeeni ncreasingwor ldwideatanav erageof
2.2%eachy ear,outpacingt hepopul ationgrowt hrateof1.7%. AccordingtoaWor l
dHeal th
Organizati
on( WHO)r eport,tobaccousei spr edi
ctedtocause10mi lli
ondeathsannual l
ybyt he
year2030.Si ncesmoki nghasaser iousi mpactonpubl i
cheal th,pr
ev enti
onprogramshav e
beengi venhighpr ior
itytoWHOpol icies.

Nomat terhowiti ssmoked,tobaccoi sdanger oust otheheal th.Therear enosaf esubstances

i
nanyt obaccopr oducts,
from acet oneandt artoni cotineandcar bonmonox i
de.The
substancesi nhaleddon’tjustaffectl ungs,theycanaf fecty ourent ir
ebody .
Smoki ngcanl eadto
av ari
etyofongoi ngcompl i
cationsi nt hebody , aswel lasl ong-term effectsont hebody
systems.Whi lesmoki ngcani ncreaset her i
skofav arietyofpr oblemsov ersev eralyears,some
ofthebodi l
yef f
ect sarei
mmedi ate.Lear nmor eaboutt hesy mpt omsandov erallef
fectsof
smoki ngont hebodybel ow.InPaki stan, themor tali
tyratef orsmoker si sthreetimest hatof
peoplewhonev ersmoked.I nf act,thei nsti
tutessayt hatsmoki ngi sthemostcommon
"pr
ev entabl
ecauseofdeat h"inthePaki stan.Whi letheef fectsofsmoki ngmaynotbe
i
mmedi ate,t
hecompl i
cati
onsanddamagecanl astfory ears.Thegoodnewsi sthatquitti
ng
smoki ngcanr eversemanyef fects.

Oneoft hei
ngredi
entsint
obaccoisamood-al
ter
ingdrugcall
ednicot
ine.Ni
coti
nereachest
he
brai
ninmer esecondsandmakesthesmokingpersonfeelmoreenergi
zedforawhil
e.Butas
thatef
fectwearsoff,
theper
sonfeelt
ir
edandcravemor e.Ni
coti
neisextr
emelyhabit
-f
ormi
ng,
whi chiswhypeopl ef indsmoki ngsodi ff
iculttoqui t.
Phy sicalwithdrawal f
rom ni coti
necan
i
mpai rthecogni ti
vef unct i
oni ngandmakest hesmokerf eel anxi
ous, irri
tated, anddepr essed.
Wi t
hdr awal canalsocauseheadachesandsl eeppr oblems. Theef fectsofni coti
ne,li
ket hoseof
otherdr ugswi thpot entialforabuseanddependence, arecent r
allymedi ated.Thei mpactof
nicotineont hecent ral nervoussy st em isneur oregulatoryi nnature,affectingbi ochemi cal and
phy siol
ogi cal f
unctionsi namannert hatr ei
nforcesdr ug-takingbehav i
or.Dose- dependent
neur otransmi t
terandneur oendocr ineef fectsoccuraspl asmani cotinelev elsr i
sewhena
ci
gar etteissmoked.Ci rculatinglev elsofnor epinephr i
neandepi nephr ineincr ease,andt he
bioav ai
labilityofdopami nei salt
er edaswel l.Amongt heneur oendocr ineef fectsarerel easeof
argininev asopr essin, beta-endor phi n,adrenocor ti
cotropichor mone, andcor ti
sol.Notabl y,
sev eraloft heseneur ochemi calsar epsy choact iveand/ orknownt omodul at ebehav i
or .Thus,
affectivest atesorcogni tivedemandsmaybef avorablymodi fi
ed( atleastt empor ari
ly)by
nicotineint ake.Whenni cotineisi nhal ed,theneur oregulator yeff
ect sjustdescr i
bedar e
i
mmedi atelyav ail
ableandt hereinf orcingeffect softhedr ugar emaxi mized.

Whent hesmokei si nhaledasubst ancet hatistakencandamaget hel ungs.Ov ert i

me, t
his
damagel eadst oav ari
et yofpr obl ems.Al ongwi thincreasedi nfect i
ons, peopl ewhosmokear e
athigherr iskforchr onicnonr ev ersiblelungcondi ti
onssuchasemphy sema, thedest r
uctionof
theairsacsi nlungs, chronicbr onchi ti
s,per manenti nfl
ammat iont hataf fectst heliningoft he
breathingt ubesoft hel ungs, chr oni cobst ructi
vepul monar ydi sease( COPD) ,agr oupofl ung
diseasesandl ungcancer .Withdr awal f
rom t obaccopr oduct scancauset empor ar ycongest i
on
andr espiratorydi scomf ortasy ourl ungsandai rway sbegi ntoheal .I ncr easedmucus
product i
onr ightaf terqui tti
ngsmoki ngisaposi tivesignt haty ourrespi rator
ysy stem i s
recovering.Childrenwhosepar ent ssmokear emor epr onet ocoughi ng, wheezi ng,andast hma
attackst hanchi ldrenwhosepar ent sdon’ t
.Theyal sot endt ohav ehi gherr atesofpneumoni a
andbr onchi t
is.i
r r
itati
onoft het rachea( wi ndpipe)andl arynx( voicebox) .Smoki ngcauses
reducedl ungf unct ionandbr eat hlessnessduet oswel l
ingandnar rowi ngoft helungai rways
andexcessmucusi nthel ungpassages, impai r
mentoft hel ungs’cl ear ancesy stem, leadingto
thebuild-upofpoi sonoussubst ances, whi chresultsinlungi rr
itati
onanddamage, i
ncr eased
ri
skofl ungi nfect i
onandsy mpt omssuchascoughi ngandwheezi ngandper manentdamaget o
theairsacsoft hel ung.

Smoki ngdamagest heent i

recar diov ascularsy stem.Ni cotinecausesbl oodv esselstoti
ghten,
whi chrestri
ctsthef lowofbl ood.Ov ertime, theongoi ngnar r
owing, alongwi thdamaget othe
bloodv essels,cancauseper ipher alarterydisease. Smoki ngalsor aisesbl oodpr essur
e,
weakensbl oodv essel wal l
s,andi ncr easesbl oodcl ots.Toget her,thisraisesther i
skof
stroke.Thereisal sot her i
skofwor seninghear tdiseasei fsomeoneal r
eadyhadhear tbypass
surger y
,ahear tat t
ack, orast entpl acedi nabl oodv essel .r
aisedbl oodpr essureandhear tr
ate
const ri
cti
on( ti
ghtening)ofbl oodv esselsint heski n, resul t
inginadr opinski ntemper at
ure.The
l
essoxy gencar ri
edbyt hebl ooddur ingexer cise‘sticki er’blood,whi chismor epr oneto
cl
ot ti
ng.Cigarett
esmoki ngcausesdamaget ot hel i
ni ngoft hearteries,whi chisthoughttobea
cont r
ibuti
ngf actortoat heroscl erosis( t
hebui l
d-upoff attydepositsont hear t
erywal l
s)reduced
bl
oodflowtoextr
emi t
ies(f
ingersandt oes)
,increasedriskofstr
okeandheartatt
ackdueto
bl
ockagesoft
hebl oodsupply.gr
eatersusceptibil
i
tytoinfecti
onssuchaspneumoniaand
i
nfl
uenzaandlowersthelevelsofprotecti
veant i
oxidant
s( suchasvi
tami
nC) ,i
nthebl
ood.

Fingernail
sandtoenail
sar en’
timmunef rom theeffectsofsmoking.Smoki
ngincreasesthe
l
ikelihoodoffungalnai
linfect
ions.Hairisalsoaffectedbynicoti
ne.Anol
derstudyfoundit
i
ncr easeshai
rloss,bal
ding,andgr aying.
Smoki ngincreasestheri
skofmouth,thr
oat,l
ary
nx,and
esophaguscancer .Smoker salsohav ehigherrat
esofpancr eati
ccancer
.Evenpeoplewho
“smokebutdon’ tinhal
e”faceani ncreasedr i
skofmout hcancer
.

Smoki ngalsohasanef fectoninsulin,

maki ngitmoreli
kel
yt hatwhosmokescandev elop
i
nsulinresistance.Thatputsani ncreasedriskofty
pe2di abetesandi tscompli
cati
ons,whi ch
tendtodev elopataf asterrat
et haninpeopl ewhodon’tsmoke. Nicoti
neaff
ectsbl
oodf lowt o
thegenitalareasofbot hmenandwomen.Formen, t
hiscandecr easesexualper
formance.For
women, thi
scanr esultinsexualdissati
sfacti
onbydecreasinglubricat
ionandtheabil
i
tyt o
reachor gasm.Smoki ngmayal solowersexhor monelevelsinbot hmenandwomen.Thi scan
possiblyleadtodecr easedsexual desi
re.

Passi vesmoki ngi st heusual lyinv oluntar yconsumpt i

onofsmokedt obacco.Second- hand
smoke( SHS)i st heconsumpt ionwher et hebur ningendi spr esent ,env i
ronment altobacco
smoke( ETS)ort hird- handsmokei stheconsumpt ionoft hesmoket hatr emai nsaf tert he
burningendhasbeenext ingui shed.Becauseofi tsnegat ivei mpl icat i
ons, thisf orm of
consumpt ionhaspl ay edacent ral r
oleint her egulationoft obaccopr oduct s.
Li ghtingup
cigarettear oundt hef ami l
yi ncr easest hei rr i
skofdev elopi ngeari nf ect i
ons, ast hma, andot her
breathingcompl icat ions—l i
kecoughs, shor tnessofbr eat h, andev enbr onchitis.Chi ldr enwho
growupwat chingt hei rparent ssmokear eal somor el i
kel yt obecomesmoker sast eens.Bei ng
anadul t,ofcour se, doesn’ tpr otectany onef rom thedamagi ngef fect sofci gar ettes.Thel ungs
andhear t
sofal lf ami l
ymember sint hehomear eputatr iskbysecondhandsmoke, nomat ter
howwi desomeonekeepst hewi ndowsopen—orhowmanyf anshemakeuseof .Smoki ngnot
onlyimpactt hesmoker '
sheal th, butalsot heheal t
hoft hosear oundwhodon’ tsmoke.Exposur e
tosecondhandsmokecar riest hesamer iskt oanonsmokerassomeonewhodoessmoke.
Risksincludest roke, hear tat tack, andhear tdisease. Themor eobv i
oussi gnsofsmoki nginvolve
skinchanges.Subst ancesi nt obaccosmokeact ual l
ychanget hest ruct ureoft heski n.Ar ecent
studyhasshownt hatsmoki ngdr amat icallyi ncreasest her iskofsquamouscel lcar cinoma
(skincancer ).Eveni fsomeonei snotpuf fi
ngonci gar ettesi ntheof fice( orot herwor ksit
e),the
colleaguescanst i
ll bei mpact ed.Smoki ngcandecr easepr oduct ivityont hejob, plusal lt
hose
potentialmedi cal compl i
cationsl inkedt osmoki ng.Hear tdi sease, diabet es,andr educed
i
mmunef unct i
on( tonamej ustaf ew)cancauset hesmokert ot akemor et i
meof ft hananon-
smoki ngcol l
eagu. Secondhandsmokecont ainsov er7, 000chemi cal .Breat hi
ngi nsecondhand
smoke—whet heri t’sf rom anei ghbor ’
sbur ningci gar etteorf rom aci garetteout side
window—hasbeenshownt ohav ei nstantef fectsont henear byi ndi viduals.Ov ertime,
secondhandsmoket akesat ollonpeopl e’sl ungsandhasbeenf oundt oi ncreaset her i
skof
strokeint hoseexposedby20- 30%.
Col l
egest udent smi ghtwantt othinkt wi cebef or elightingaci gar et te:
anewst udyshowst hat
smoki ngdur i
ngadol escencecanaf fectcogni t
ionanddeci sion-maki ng.I
ti sf oundt hatt hepr e-
frontal cor tex, whichcont rolshighercogni tion, includingt heabi l
ityt omakegooddeci sionsand
thinkaboutf utureconsequences, wasl essact iv einadol escent swi thgreat eraddi ctionst o
nicotine, suggest ingt hatsmoki ngaf fect sbr aindev elopmentandf unct ion.Ast hepr efront al
cor t
excont inuest odev elopdur ingt hecr it
ical per i
odofadol escence, smoki ngmayi nfl
uence
thet raject oryofbr aindev elopmentandaf fectt hef unct ionoft hepr efrontal cor ex.Ifsev er ely
affect ed,st udent smi ghthav eani mpededabi li
tyt omaker ati
onal judgment s,incl udingt he
choicet ost opsmoki ng. Smoki ngnotonl yaff ectst hheal thoft hest udent ,butal sodecr eases
thef ocusancausesl ossofconcent ration.Theyr emai ninast ateofconf usionandl ethar gy.
Thisdecr easest heirefficiencyint hest udiesandhencecompr omi singthei rfut ure.Asst udent s
smoke, thel ooset heirstami naandbecomei nact i
vei nt hespor t
sandot herext r acur ri
cul ar
activities.Thi scausesadecr easei nt heirsoci al cir
cl eandact i
vit
iest hatf r
eshent hemi nd. The
habitofsmoki ngul t
imat elydr i
vest hem bachandbacandt hereisl ossoft hei rheal thand
studies. Sot heircompet encyi ntheirfieldwi llbecompr omi sedi nl ongt er ms. Student sar eal so
affect edf inanci all
yt osomeext ent.Ast heyputt heirmoneyf orbuy ingcigar ettes, theyr unout
ofmoneyandhencet heygi veupt heot herheal thydi etrypr oduct sl ikefreshj uices, mi l
ket c.
Theymaywantt oconsumet hem, butt heyr emai nnol ongerabl et oaf for dthesepr oduct s.
Mor eov er,st udentsusual lysuf f
erfrom acut ephar y ngitisandf evercausedbyi rrit
ationduet o
cigaret tesmoke.Sot heyneedt opayf ort hedr ugsf r
om t heirpocketmoneyandt hatseemst o
beanext r abur denont hem.

Healthpr of essional seducat et heirpat ientsont hehazar dsofsmoki ng.Theyusual lyserv eas
rolemodel sf orthei rpat ientsandt hepubl i
cand, theref ore, pl
ayani mpor t
antr olei n
discouragi ngpeopl ef rom smoki ng.Thepar ti
cipat i
onofHeal thpr ofessional sinpr eventionand
cessat i
oncounsel ingcoul dbepar toft hest rategiest omi nimizet obacco- relateddeat hsi nt he
future.Forheal thpr ofessi onal stoconv i
nceot hers,theyshoul dbenonsmoker s.Theycounsel
thesmoker sbyaddr essingt othem t hatdeci dingt oqui tsmoki ngi sonl yhal fthebat tl
e.
Knowi ngwher etost artont hepat htobecomi ngsmoke- freecanhel pt ot aket hel eap.Qui tti
ng
smoki ngi snotasi ngleev entt hathappensononeday ;itisaj our ney.Byqui tt
ing, aper sonwi ll
i
mpr ov ehisheal thandt hequal ityanddur ationofhi slife,aswel last helivesoft hosear ound
him.Toqui tsmoki ng,asmokernotonl yneedst oalterhi sbehav iorandcopewi tht he
withdrawal sympt omsexper i
encedf rom cut tingoutni cotine,but heal soneedt ofindot herway s
tomanagehi smoods. Wi tht her i
ghtgamepl an,asmokercanbr eakf reef rom ni cot i
neaddi ct i
on
andki ckthehabi tforgood. Ther ear esev eral way stost opsmoki ng, butul ti
mat ely,theper son
needst odeci dewhet herhei sgoi ngt oqui tabr uptly,orcont i
nuesmoki ngr i
ghtupunt il
hi squit
dateandt henst op. Her ear esom t ipst hataregi vent oasmokert ohel phim qui tt hesmoki ng.
Hei sadv isedt ot ell f
riends, f amily,andco- wor kersabouthi squi tdat e,t
hr owawayal l
cigar ettes
andasht ray s.deci dewhet herhei sgoi ngt ogo" coldtur key "oruseni cotinerepl acementt herapy ,
setupasuppor tsy stem, suchasaf ami lymembert hathassuccessf ul
lyqui tandi shappyt o
helpy ou.Br eakingt heassoci ationbet weent het r
iggerandsmoki ngi sagoodwayt ohelpy out o
fi
ghtt heur get osmoke. Theper soni saskedt ost aybusy ,beginuseofhi sNRTi fhehas
chosent ouseone, attendast op- smoki nggr ouporf oll
owasel f-hel ppl an,dr i
nkmor ewat erand
j
uice, dr inklessornoal cohol ,av oidi ndividual swhoar esmoki ng.Ont heot herhand, ni cot i
ne
gum andmostot herni cotiner epl acementv ehiclesincur rentusehav easl oweronsetofact ion,
resultingi nlessr einf orcementv alue.Recentdat asuggestt hatsmoki ngcessat ionr at esmaybe
optimi zedbyt ai loringt hedoseofni cot i
ner epl acement( forexampl e, 2or5mgofni cot inegum)
tothei ndivi
dual degr eeofni cot inedependence.I nviewoft hedy nami ci nteractionsbet ween
theneur or
egul at oryef f
ectsofni cotineandahostofenv i
ronment al condi ti
ons, nicotine
replacementt her apyi sbestcar riedouti ncombi nati
onwi thbehav iormodi fication
techni ques.NRTcanr educet hecr avingsandwi thdrawal sy mpt omst hatmayhi nder t
heat tempt
togi veupsmoki ng.NRTsar edesi gnedt oweant hebodyof fcigar et tesandsuppl ywi tha
cont rolleddoseofni cot inewhi lespar i
ngaper sonf r
om exposur et oot herchemi calsf oundi n
tobacc.Bupr opi onandv eri
nicilinear eal sousedf orthispur pose.Ri sksi nvolvedwi t
husi ng
thesedr ugsi ncl udebehav i
oral changes, depr essedmood, aggressi on, host ili
ty,andsui cidal
thought soract ions. Theemot i
onal andphy sical dependenceonsmoki ngmakesi tchal lengi ng
tost ayawayf rom ni cot ineaf terqui ttingt hesmoki ng.Toqui t
,ther ei sneedt otackl et his
dependence.Tr y ingcounsel ingser vices, self-helpmat eri
als, andsuppor tadv icescanhel pt o
gett hrought hist i
me.Asphy si cal sympt omsgetbet terov ert i
me, sowi llbeemot ional ones.
Combi ni ngmedi cat ion-suchasNRT, bupropi on, andv areni cli
ne-wi thbehav ioral suppor thas
beendemonst r at edt oi ncreaset hechancesofl ong- t
er m smoki ngcessat ionbyupt o25
percent .

Asf uturephysi
cians,medi cal studentsareconsi deredapr imar ytargetoftobaccopr ev enti
on
programs.Theycant herefore, playapositiveroleinpreventingsmoki ngamongpeopl ei ntheir
communi t
y.Theymaydel iverheal t
heducation,supportant i
-smoki ngpolici
esandi nfluence
nati
onal andglobal t
obaccocont roleff
ort
s.Previousstudiesi nPaki st
anofmedi cal student s,i
n
gover nmentcoll
eges, showedt hatsmoki ngwashi ghl
ypr evalentamongmal estudent s.This
studyaimedt odet er
mi nethepr ev al
enceofsmoki ngofmedi calstudentsattheShei khZay ed
Medi calColl
egeandassesst heassoci ati
onbet weensmoki ngandsoci odemogr aphical factor
s,
contactswithsmoker s, r
easonsf orsmokingandat t
empt stost opsmoki ngIti
shopedt hatthe
resultswouldhelpwi t
ht hepl anni ngofcorrecti
vemeasur es,asnecessar y .