Long-term tobacco users are likely to develop a tolerance for nicotine’s effects, meaning they must use more tobacco to achieve the same effects as when they initially used. Similarly, there is potential for physical or psychological dependence to occur. Physical dependence occurs when the body adapts to functioning when nicotine is present, whereas psychological dependence occurs when individuals find that they feel an urge or craving to use tobacco, especially in social settings.
The list of long-term health effects linked to tobacco use is extensive. These effects may include, but are not limited to, increased risk of brain damage and/or stroke, loss of sense of smell or taste, tooth decay or staining, possible hearing loss, shortness of breath, coughing, chronic bronchitis, emphysema, heart disease, stomach ulcers, hypertension, lower fertility, early menopause, impotence, and an increased susceptibility to infection. Tobacco use has also been associated with cancers of the nose, lip, tongue, mouth, larynx, lung, stomach and bladder. External effects may include yellowing of the teeth, grey appearance and early wrinkles.