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German scientists formally identified the link between smoking and lung cancer in the late 1920s leading the first anti-smoking campaign in modern history. The movement, however, failed to reach across enemy lines during the Second World War, and quickly became unpopular thereafter.^[5] In 1950, health authorities again began to suggest a relationship between smoking and cancer.^[6] Scientific evidence mounted in the 1980s, which prompted political action against the practice. Rates of consumption from 1965 onward in the developed world have either peaked or declined.^[7] However, they continue to climb in the developing world.^[8]

Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with other additives^[9] and then pyrolyzed. The resulting vapors are then inhaled and the active substances absorbed through the alveoli in the lungs.^[10] The active substances trigger chemical reactions in nerve endings which heightens heart rate, memory, alertness,^[11] and reaction time.^[12] Dopamine and later endorphins are released, which are often associated with pleasure.^[13] As of 2000, smoking is practiced by some 1.22 billion people. Men are more likely to smoke than women,^[14] though the gender gap declines with younger age.^[15][16] The poor are more likely to smoke than the wealthy, and people of developing countries than those of developed countries.^[8]

Many smokers begin during adolescence or early adulthood. Usually during the early stages, smoking provides pleasurable sensations, serving as a source of positive reinforcement. After an individual has smoked for many years, the avoidance of withdrawal symptoms and negative reinforcement become the key motivations to continue.

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