In 1976, Professor Michael Russell, a pioneer in the study of tobacco dependence, famously said, “People smoke for nicotine but die from the tar.”

It’s the thousands of chemicals contained in tobacco smoke that make tobacco use deadly.

“This toxic mix of chemicals—not nicotine—causes the serious health effects among those who use tobacco products, including fatal lung diseases, like chronic obstructive pulmonary disease (COPD) and cancer,” according to the US Food and Drug Administration (FDA), echoing Russell’s iconic words from almost half a century ago.

Collectively known as tar, these toxic substances (carbon monoxide, formaldehyde, ammonia, hydrogen cyanide, arsenic, DDT, etc.) are produced by the burning of dried tobacco leaf and are subsequently inhaled by the smoker.

Nicotine, while highly addictive, does not cause diseases associated with smoking. Similar to caffeine, it is a food-grade substance producing stimulant and sedative effects. It is also a main component prescribed by doctors to help patients quit smoking.

“It is the toxins in cigarette smoke…that cause smoking-related disease and death, not the nicotine,” according to a leaflet of nicotine replacement therapy (NRT) inhalator.

Unfortunately, there are a lot of misinformation and misconceptions about nicotine. More than 57% of respondents in the Health Information National Trends Survey (HINTS) of the US National Cancer Institute falsely agreed with the statement that “nicotine in cigarettes is the substance that causes most of the cancer caused by smoking” and even 80% of physicians falsely believe that nicotine causes cancer.

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