In addition, it is estimated that each day in the United States, nearly 3,000 people under the age of 18 will start smoking. NIDA's own Monitoring the Future Study, which annually surveys drug use and related attitudes of America's adolescents, also found the prevalence rates for smoking among youth remained high. Since 1975, nicotine in the form of cigarettes has consistently been the substance the greatest number of high school students use daily. The impact of nicotine addiction in terms of morbidity, mortality, and economic costs to society is staggering. Tobacco kills more than 430,000 U.S. citizens each year - more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire, and AIDS combined.
Tobacco use is the leading preventable cause of death in the United States.
Nicotine can act as both a stimulant and a sedative. The rush of adrenaline stimulates the body and causes a sudden release of glucose as well as an increase in blood pressure, respiration, and heart rate. Nicotine also suppresses insulin output from the pancreas, which means that smokers are always slightly hyperglycemic. In addition, nicotine indirectly causes a release of dopamine in the brain regions that control pleasure and motivation. In contrast, nicotine can also exert a sedative effect, depending on the level of the smoker's nervous system arousal and the dose of nicotine taken.