Tobacco

How is tobacco used?

Tobacco is commonly smoked in cigarettes, cigars, hookahs, and pipes. Inhaling the smoke of dried tobacco leaves allows nicotine to be absorbed through your mouth and lungs.²

Tobacco can also be chewed, snorted, or held between your cheek and gums. Each of these methods allow nicotine to be absorbed through your nose and mouth. These ‘smokeless tobacco’ products include chewing tobacco, dipping tobacco, snuff, and snus.³

Smokeless tobacco products are not legally available in Australia.⁵

Nicotine can be consumed in other forms such as vapes. To find out more about the effects of nicotine through vaping, head to our vaping page for more information.

Effects of tobacco

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Tobacco affects everyone differently, based on:

• size, weight, and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug
• the environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's inhaled or chewed.

• If smoked/inhaled, the effects are felt immediately, peaking within a few minutes.⁶
• If chewed or held between your cheek and gums, the effects are felt within a few minutes, peaking within an hour or so.⁷

Effects

Effects can include:

• increased heart rate
• increased blood pressure
• headache
• dizziness
• nausea
• stomach cramps
• vomiting
• diarrhoea 
• reduced appetite
• changed sense of taste
• relaxation
• improved mood
• increased concentration and short-term memory.^8-10

People who smoke tobacco regularly may build up a tolerance to the immediate and short-term effects.

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’): 

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, someone who is stressed may feel nicotine is especially calming, while someone who is already relaxed may mainly notice a short-lived buzz or stimulation.
• Setting: the physical and social environment where you take nicotine – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting will vary based on the individual and drug they’re using. For example, being in a place where you usually use nicotine can trigger stronger cravings, and make nicotine feel more rewarding.¹¹

Being in a good state of mind, with trusted friends and a safe environment before taking nicotine reduces the risk of having a bad experience.¹¹

Overdose

Smoking tobacco rarely results in overdose effects.¹² But, consuming a large amount tobacco in other forms may in result in overdose due to high levels of nicotine.

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions):

• difficulty breathing
• rapid heartbeat
• low blood pressure
• weakness
• hallucination
• seizure.^{3, 13}

Learn more on overdose and drug-related emergencies here.

Mixing with other drugs

Mixing tobacco with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Tobacco + alcohol: can increase cravings for nicotine and might cause people who have stopped smoking to start again. You may also feel less intoxicated due to the simulant effect of nicotine, which can lead to drinking more.^{14, 15}
• Tobacco + benzodiazepines: reduced effects of benzodiazepines due to nicotine’s stimulating effects.¹⁶
• Tobacco + cannabis: increases heart rate, respiratory problems, withdrawal symptoms. Smoking tobacco and cannabis together can increase your exposure to harmful chemicals.¹⁷
• Tobacco + opioids (heroin, methadone): may increase the desire and satisfaction of smoking, and lead to smoking more.¹⁶
• Tobacco + stimulants (amphetamines, cocaine, ice): increases the stimulant effects and can make smoking feel more rewarding, which can lead to smoking more.¹⁶

The use of more than one drug at the same time, or type of drug consumed at the same time, is called polydrug use.³

Reducing harm

There are ways you can reduce the risk of harm when smoking cigarettes:

• Do not smoke cigarettes if you are pregnant or breastfeeding.
• Avoid smoking near other people, especially babies and children, those who are pregnant or breastfeeding, and people with chronic (long-term) respiratory conditions to reduce the health harms associated with passive smoking.
• Speak to your doctor about different options for reducing or stopping smoking, including nicotine replacement therapy such as gum or patches.
• Tobacco smoke has the potential to interact with several drugs and medications. Talk with a health professional before starting new medications.

Coming down

Tobacco does not cause comedowns - but nicotine can mask the effects of alcohol or other drugs, leading to using more alcohol or other drugs and experiencing a worse comedown or hangover.¹⁶

Long-term effects

Long-term effects can vary depending on how much, how often and how tobacco is consumed. Regular use may eventually contribute to::

• sixteen different types of cancers
• stroke
• aortic aneurism (bulging and weakness in the walls of the aorta)
• atherosclerosis (buildup of plaque in the arteries)
• coronary heart disease
• respiratory symptoms (shortness of breath, coughing fits, wheezing)
• Chronic Obstructive Pulmonary Disease (a group of lung conditions)
• lung infections (influenza, pneumonia, tuberculosis)
• eye diseases (blindness, cataracts, macular degeneration)
• periodontitis (bleeding gums, loose teeth)
• diabetes
• hip fractures
• rheumatoid arthritis
• reduced fertility
• ectopic pregnancy or pregnancy loss
• birth defects if the foetus is exposed to cigarettes
• reduced immune function (regular colds and flu)
• overall diminished health (ageing, back pain, slower healing wounds, mood swings)
• dependence on smoking ^{10, 18, 19}

Smoking ‘light’, ‘mild’, or ‘low tar’ cigarettes does not reduce the harmful health effects of tobacco smoke. Filtered cigarettes also do not protect against smoking-related harms.²⁰

For more information on the long-term effects, visit the Cancer Council.

Passive smoking

Passive smoking occurs when you breath in the smoke of those smoking around you. This is sometimes called second-hand smoke.  

No amount of passive smoking is safe.

Passive smoking can cause many of the health problems listed above, and it can also make them worse. It is important not to smoke near other people, especially babies, children, those who are pregnant or breastfeeding, and people with chronic (long-term) respiratory conditions.²¹

Tobacco and mental health

The relationship between tobacco and mental health is complex.

While some people report relief of their depression or psychosis symptoms when using tobacco, it can worsen symptoms over time, especially if you’re dependent.²²

And, people with diagnosed mental health conditions are more likely to use tobacco. They also report having more difficulty quitting.²²

Compared to people with diagnosed mental health conditions who continue to use tobacco, quitting is associated with improvements to mood and quality of life, and reductions in depression, anxiety and stress.²²

Tolerance

Regularly using tobacco can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.⁶

Dependence

People who regularly use tobacco may become dependent. They may feel they need to use tobacco to go about usual activities like working, studying and socialising, or just to get through the day.⁶

Adolescent brains do not stop developing until the age of 25. During this time, they can be more sensitive to nicotine’s rewarding effects, which can lead to increased tobacco use and dependence. The change in brain development and learning pathways can also increase other reward seeking behaviour and may lead to the use of other drugs or alcohol.^{23, 24}

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁵

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁵

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁵

Withdrawal Symptoms

Reducing, or stopping using tobacco after a period of regular use can lead to withdrawal symptoms, including:

• cravings
• irritability, anxiety, and depression
• restlessness and difficultly sleeping
• increased appetite
• trouble concentrating
• headaches
• coughing and sore throat
• aches and pains
• upset stomach and bowels.^{3, 26}

Withdrawal symptoms usually start within 24 hours after you last use tobacco.26  If you have been smoking for a long time, or if you smoke a lot of cigarettes, you may have withdrawal symptoms as soon as 30 minutes after you last use tobacco.³

Cutting back or stopping smoking might also affect the medications you are taking. It’s important to talk to your doctor when you’re reducing the amount of nicotine in your body.

Nicotine withdrawal may last from a few days to a few weeks. 

Pregnancy and breastfeeding

No matter what stage of pregnancy you’re in, quitting tobacco can improve outcomes for your child. Speak with your healthcare provider or reach out to one of the services in the ‘Getting help’ section below.

Before pregnancy

Tobacco use makes it more difficult to become pregnant. Female partners may have difficulty conceiving and be at risk of early onset menopause and ovary or cervical cancer. For male partners, it can make it more difficult to sustain erections. It also reduces sperm count and damages DNA in sperm, causing health problems for your baby.²⁷

If you and your partner quit using tobacco products, your chances of getting pregnant can increase. For male partners, sperm quality can take about three months to return to normal.²⁷

During pregnancy

Tobacco use during pregnancy increases the risks of miscarriage and ectopic pregnancy. It also reduces the amount of oxygen and blood flow to your baby, impacting their development and growth. This can cause low birth weight and premature (early) birth.²⁸

It can also lead to an increased risk of Sudden Infant Death Syndrome (SIDS), and cause ongoing issues for the baby once they’re born, including lung conditions and middle ear infections.²⁷

After pregnancy

Exposure to passive smoke increases your baby’s risk of ear and lung infections, vomiting, diarrhoea and increased irritability. Conditions such as childhood cancer, obesity and dental problems are also more common among children who are exposed to passive smoking. Passive smoke includes smoke on your hands, face or clothing after smoking.^{27, 28}

When breastfeeding, nicotine passes through your body to the baby. And the impacts of nicotine and other chemicals is much greater for a baby than adults. Because of this, it’s safest not to use tobacco. If you’re breastfeeding and use tobacco: 

• speak with your healthcare provider about how you may be able to reduce the risk of harms to your baby
• breastfeed before using nicotine 
• avoid using nicotine for at least 30 minutes before breastfeeding.²⁸

Getting help

It’s important to ask for help if you need it.

If your use of tobacco is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support. 

If you’re thinking about quitting, trying to quit or need help staying on track, the below services can help:

• Call Quitline on 13 78 48, visit the Quit website, or speak to your doctor about the best quitting strategies for you. These can include gradually tapering off (reducing) use, nicotine replacement therapy, prescribed e-cigarettes, and a range of other approaches.29
• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.