The most well known smoking drug is tobacco. Although the chemical properties of other drugs which are smoked vary, the way they are absorbed into the body is the same. The most commonly smoked drugs after tobacco are cannabis, heroin and crack cocaine.



Methods of smoking

The smoke is inhaled from a cigarette, a pipe or by so called chasing the dragon during which the smoke is sucked up through a tube from heated tinfoil.

The smoke is drawn into the lungs and passes through the lining of the lungs into the bloodstream. It is then pumped through the heart and on to the brain. See the animation on the right.

This is a very efficient method of taking drugs, as the active ingredients are mixed with oxygenated blood and travel to the brain quite quickly. The effects are felt almost immediately.



The health risks of smoking.

The tissues of the mouth, airways and lungs are not meant to take in hot, noxious gases of any kind. In the long-term this may lead to problems such as cancer of the tongue, throat and larynx, and chest diseases like bronchitis, emphysema and lung cancer.

The case against smoking tobacco as a cause of all these health problems is well established but that against other smoking drugs is less clear. This may be because it is rare for other drugs to be taken as frequently and continuously as tobacco. It may also be because of the difficulties in researching populations using illegal drugs. In the case of cannabis it seems likely that adding the cannabis to tobacco in order to make up a joint will increase the risks of respiratory system diseases. There is also the added risk in this case of occasional cannabis users becoming dependent on tobacco.



Dependency risks.

The second set of risks relates to problems of dependency. Because smoking a drug delivers a very quick effect or 'hit' the doses taken are often quite small. If the drug smoked also has a fast elimination rate from the bloodstream, which is the case with the stimulant drugs tobacco and crack cocaine, then the rate of drug in the bloodstream fluctuates rapidly.

The drug effect is felt quickly and disappears quickly. This can lead to the phenomena of bingeing with a series of repeat uses of the drug to sustain the effect. The user rapidly experiences the sensation of the drug which is very quickly follwed by its absence. This leads to a sensation of craving for the drug which can be satisfied by having some more immediately.

With tobacco this is called chain smoking but it is also well known with crack cocaine. In this latter case and given the extra power of the drug, it can lead to serious problems of overstimulated, agressive or even psychotic behaviour. To make matters worse crack is very expensive if used in this way and hundreds of pounds worth of the drug can be binged in a single day.



Smoking or injecting?

In view of the above it seems reasonable to ask if smoking a drug is the most dangerous way of taking it. The answers is - it depends. If the alternative as with street heroin, is injecting then the answer must be no. Injection of a drug carries such exceptional risks that smoking, despite its problems is much less risky. There are many professionals working with heroin injectors who would much prefer their clients to smoke their drugs.

If the alternative is snorting or eating the drug as with cocaine or cannabis, then smoking it might be more risky. In the attempt to encourage heroin users to eat rather than inject their drugs there are also programmes which provide free methadone or other opioids in syrup or tablet form.



A human condition.

There is a complex web of risks associated with drug use which is overlaid by the pleasures the drug user gets from their drug. Some of the risks associated with the drug are the price the user pays in order to gain the pleasures. If this doesn't seem very sensible to you - it might not be - but it is very human. Thus about a third of the adult population of the planet smoke tobacco despite its deadly consequences. There are an estimated 110,000 tobacco related deaths in the UK every single year!