section_path: Abstract
section_name: Abstract
paragraph_text: Smoking is a practice in which a substance is combusted and the resulting smoke is typically inhaled to be tasted and absorbed into the bloodstream of a person. Most commonly, the substance used is the dried leaves of the tobacco plant, which have been rolled with a small rectangle of paper into an elongated cylinder called a cigarette. Other forms of smoking include the use of a smoking pipe or a bong.
  
  Smoking is primarily practised as a route of administration for psychoactive chemicals because the active substances within the burnt dried plant leaves vaporize and can be airborne-delivered into the respiratory tract, where they are rapidly absorbed into the bloodstream of the lungs and then reach the central nervous system. In the case of tobacco smoking, these active substances are a mixture of aerosol particles that includes the pharmacologically active alkaloid nicotine, which stimulates the nicotinic acetylcholine receptors in the brain. Other notable active substances inhaled via smoking include tetrahydrocannabinol (from cannabis), morphine (from opium) and cocaine (from crack).
  
  Smoking is one of the most common forms of recreational drug use. Tobacco smoking is the most popular form, being practised by over one billion people globally, of whom the majority are in the developing countries. Less common drugs for smoking include cannabis and opium. Some of the substances are classified as hard narcotics, like heroin, but the use of these is very limited as they are usually not commercially available. Cigarettes are primarily industrially manufactured but also can be hand-rolled from loose tobacco and rolling paper. Other smoking implements include pipes, cigars, bidis, hookahs, and bongs.
  
  Smoking has negative health effects, because smoke inhalation inherently poses challenges to various physiologic processes such as respiration. Smoking tobacco is among the leading causes of many diseases such as lung cancer, heart attack, COPD, erectile dysfunction, and birth defects. Diseases related to tobacco smoking have been shown to kill approximately half of long-term smokers when compared to average mortality rates faced by non-smokers. Smoking caused over five million deaths a year from 1990 to 2015. Non-smokers account for 600,000 deaths globally due to second-hand smoke. The health hazards of smoking have caused many countries to institute high taxes on tobacco products, publish advertisements to discourage use, limit advertisements that promote use, and provide help with quitting for those who do smoke.
  
  Smoking can be dated to as early as 5000 BCE, and has been recorded in many different cultures across the world. Early smoking evolved in association with religious ceremonies; as offerings to deities; in cleansing rituals; or to allow shamans and priests to alter their minds for purposes of divination or spiritual enlightenment. After the European exploration and conquest of the Americas, the practice of smoking tobacco quickly spread to the rest of the world. In regions like India and Sub-Saharan Africa, it merged with existing practices of smoking (mostly of cannabis). In Europe, it introduced a new type of social activity and a form of drug intake which previously had been unknown.
  
  Perception surrounding smoking has varied over time and from one place to another: holy and sinful, sophisticated and vulgar, a panacea and deadly health hazard. In the last decade of the 20th century, smoking came to be viewed in a decidedly negative light, especially in Western countries.