Much more than cigarette smoking

The human condition made fragile by fear of death, by affective distress, by diseases, and by aging compels human beings to search for pleasure. The use of licit or illicit drugs is a good example of this fact. Often, this occurs in such an intense way that it condemns individuals to premature death or a subjugated life. To compound this situation, Western society is continuously bombarded by advertisements that encourage the consumption of products. Consumption becomes synonymous with happiness. The tobacco industry may have been the pioneer in exploiting and addressing this aspect in cigarette advertising, (1) being responsible for inducing billions of users to dependence on the product and, consequently, to premature death and loss of quality of life, placing an unprecedented burden on health care systems worldwide. The consequence of this tobacco epidemic was the adoption of restrictive measures to reduce consumption, and this motivated the tobacco industry to search for products that would maintain nicotine dependence, despite being labeled as " less harmful to health " than typical cigarettes. In this context, products such as hookah or narghile, and, more recently, electronic cigarettes, began to be promoted as harmless, despite there being no scientific support for it. The evidence that there are fewer toxic substances in these alternative forms of tobacco than in conventional cigarettes has been used and exploited as an argument in support of the former being harmless. In fact, however, there are not sufficient data to establish that the use of these substances at lower concentrations, but in a continuous, endless way because of the presence of nicotine vapor, is harmless. At the epicenter of this discussion, this issue of the Brazilian Journal of Pulmonology features an original article by Martins et al. on experimentation with narghile, the prevalence of its use, and the level of knowledge on the subject among third-and sixth-year medical students at and 2013. Although most students recognized the potential health risk from the use of narghile, either because of the risk of contamination with bacteria and viruses or because of the very potential for nicotine dependence resulting from the use of the product, in addition to high exposure to elevated carbon monoxide levels, this knowledge did not prevent more than 40% of the male students from experimenting with it. The low prevalence of cigarette use among third-and sixth-year medical students (9.78% and 5.26%, respectively, among males, and 1.43% and …