Many of the long-term effects of smoking are felt in the respiratory system. Cigarette smoke irritates the linings of the breathing tubes, which in time can cause the inflammatory disorder chronic bronchitis. The symptoms of this typically include shortness of breath, chest pain and a productive cough. The tar in cigarette smoke can coat the inside of the alveoli, breaking down their structure and reducing the surface area available for gaseous exchange. The result is emphysema, which causes sufferers to feel breathless. This and chronic bronchitis fall under the umbrella term chronic obstructive pulmonary disease (COPD).

Tar – and many of the other chemicals in cigarette smoke – can cause cancer, not just in the lungs, but also in other parts of the respiratory system, such as the throat and mouth. It can also affect other parts of the body, such as the kidney and liver and, as cancer does, it can spread. 

Other long-term effects of smoking include: 

• Cardiovascular issues such as stroke and heart disease 
• Circulatory disorders
• Decreased fertility and sexual function
• Gastrointestinal ulcers 
• Mental health conditions
• Brittle bones (osteoporosis)
• Premature skin ageing.