Nicotine is a selective binder to nicotinic cholinergic receptors (nAChRs) in the brain and other tissues. The process is said to take only 2 to 8 seconds from the time of inhalation. Nicotine readily crosses the blood-brain barrier which then promptly diffuses into the brain tissue. Inhaled nicotine escapes the first pass intestinal and liver metabolism. When tobacco smoke is inhaled, nicotine rapidly enters the bloodstream through the pulmonary circulation. It is the addictive agent which confers a much lower risk than other elements of tobacco, but it is not completely benign. Nicotine is an amine found in tobacco and tobacco products. Cigarette smoking is a leading cause of preventable diseases and premature deaths in the United States along with other countries. Most of the deaths due to tobacco use occur in low or middle-income countries. The deaths due to tobacco consumption are reported to be twice the number of deaths due to alcohol and narcotic drugs combined. There is a 50% chance that a lifelong smoker will probably die prematurely from complications of smoking. Overall, smoking causes 1 out of 5 deaths. On average, around 435,000 people in the United States(US) suffer death prematurely from smoking-related diseases each year. Tobacco use accounts for more than 5 million deaths worldwide each year. According to the age group, the smoker population represent 18.3% of adults aged 18-24 years old, 22.5% of adults aged 25-44 years old, 21.3% of adults aged 45-64 years old, and 11% of adults 65 and older. At present, newer products like nicotine gums, patches, e-cigarettes, and inhalational agents constitute around 1% of total nicotine consumption worldwide and are showing a growing trend in most countries. Around 24.8% of men and around 14.2% of women smoke cigarettes. About 14% of the population use cigarettes and the remaining 5% use cigars, smokeless tobacco or pipes, and electronic cigarettes. World Health Organization estimates that there are around 1.27 billion tobacco users in the world. In 2017, the Center for Disease Control estimates that 19.3% of the US population over 18 years old use some kind of tobacco products. The prevalence of nicotine addiction can be directly estimated from tobacco consumption which is interlinked.
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