What tobacco includes

Tobacco comes from the tobacco plant. Common forms used in sub-Saharan Africa include cigarettes, hand-rolled tobacco, cigars, pipes, shisha (hookah or waterpipe), snuff and chewing tobacco.

Tobacco contains nicotine, which is highly addictive. Tobacco smoke also contains many toxic chemicals that can damage the lungs, heart, blood vessels and other organs. Smokeless tobacco is also harmful and can damage the mouth, gums and overall health.

How tobacco harms the body

When tobacco is smoked, harmful chemicals enter the lungs and then the bloodstream. These chemicals travel through the body and slowly damage tissues and organs.

The damage may build up over years, but even early tobacco use can cause cough, poor exercise tolerance, gum disease and dependence. Long-term use greatly increases the risk of severe illness and early death.

Effects on the lungs and breathing

1. Lung Damage

Smoking damages the airways and lung tissue. Over time, a person may develop chronic cough, excess mucus, wheezing and shortness of breath.

• Chronic cough
• Excess mucus production
• Wheezing
• Shortness of breath

2. Chronic Obstructive Pulmonary Disease (COPD)

Long-term tobacco use is a major cause of COPD, a long-lasting lung disease that makes breathing difficult and limits daily activities. In settings where access to inhalers, oxygen or specialist care may be limited, prevention and quitting are especially important.

3. Lung Cancer

Smoking is a leading cause of lung cancer. The risk increases with the number of years a person uses tobacco and the amount used.

Effects on the heart and blood vessels

Tobacco increases the risk of heart disease and stroke by:

• Raising blood pressure
• Increasing heart rate
• Damaging blood vessels
• Reducing oxygen delivery to the body

As a result, people who use tobacco are more likely to develop heart attack, stroke and peripheral artery disease. Secondhand smoke also increases cardiovascular risk.

Effects on the mouth and teeth

Tobacco affects oral health and may cause:

• Bad breath
• Tooth discolouration
• Gum disease
• Tooth loss
• Delayed healing after dental treatment

It also increases the risk of cancers of the mouth, tongue, throat and voice box.

Effects on fertility and pregnancy

Tobacco can reduce fertility in both men and women. In men, it may reduce sperm quality and increase the risk of erectile dysfunction. In women, it may reduce fertility and increase the risk of miscarriage, poor fetal growth and placental complications during pregnancy.

Tobacco and cancer

Tobacco use is linked to many cancers, including cancers of the lung, mouth, throat, oesophagus, pancreas, kidney and bladder. The longer a person uses tobacco, the greater the risk.

The longer a person uses tobacco, the greater the risk of developing tobacco-related cancers.

The dangers of secondhand smoke

Secondhand smoke is the smoke breathed in by people near someone who is smoking or using a tobacco product that gives off smoke.

Children and adults exposed to secondhand smoke may have asthma attacks, respiratory infections, ear infections, heart disease and lung cancer. There is no safe level of exposure.

There is no safe level of exposure to secondhand smoke.

Why this matters in sub-Saharan Africa

Tobacco remains a growing public health threat in the WHO African Region. Although average prevalence is still lower than in some other regions, rapid population growth, aggressive tobacco industry marketing and the rise of new and emerging nicotine products create serious risks. Shisha and smokeless tobacco are also common in some communities and are often misunderstood as safer than cigarettes.

Across Africa, tobacco control has improved, but cessation services are still limited in many countries. This means prevention, patient education, smoke-free homes and early support for quitting remain especially important.

Benefits of quitting tobacco

The body starts to recover soon after a person stops using tobacco. Benefits of quitting include:

• Improved breathing and less coughing
• Better heart and blood vessel health
• Lower risk of cancer over time
• Better circulation
• Improved sense of taste and smell
• Better health for family members because they are less exposed to smoke

Quitting can be difficult because nicotine is addictive, but support helps. Patients can speak with a doctor, nurse, pharmacist or counsellor about a quit plan, practical coping methods and medicines if available.