For years, tobacco has largely been associated with lung cancer. But health experts now warn that its impact stretches far beyond the lungs, quietly affecting the heart, brain, fertility, digestion, immunity and even mental wellbeing, especially among younger Indians.
What is making the situation more concerning is the rise of vaping, smokeless tobacco and social smoking culture among Gen Z and young working adults, many of whom mistakenly believe these alternatives are safer than traditional cigarettes.
Tobacco is harming far more than just the lungs
According to Dr Madhavi Nair, Consultant - Surgical Oncologist at Manipal Hospital Varthur Road, tobacco today is damaging “almost every organ system” in the body. “Tobacco has been linked to cancer for a long time, but its harm goes far beyond just the lungs,” she explains.
Dr Nair points out that newer forms of tobacco, including vaping and smokeless products, have created a dangerous illusion among young people that these habits carry lower health risks. “In fact, tobacco is quietly destroying almost every organ system, especially in young Indians,” she says.
She further adds that the effects are both “personal and far-reaching”, from oral cancers caused by chewing tobacco to the impact of second-hand smoke on children and families.
Why young Indians are increasingly vulnerable
Experts say modern lifestyle habits are making younger people more susceptible to tobacco addiction. Stress, social media influence, peer pressure, nightlife culture and work-related burnout are all contributing to early smoking and vaping habits among urban youth.
Dr Sarat Kumar Behera, Director Critical Care & Senior Consultant - Pulmonology at Manipal Hospital, Bhubaneswar, says even occasional or social tobacco use can quietly trigger long-term internal damage. “Temporary exposure to tobacco products also brings about inflammation, hormonal imbalance, infertility problems, stress, bad skin, and loss of energy,” he explains. He also warns that vaping and “social smoking among teens is a cause for worry”.
Vaping is not the ‘safe alternative’ many believe it is
One of the biggest misconceptions among younger smokers today is that electronic cigarettes are harmless compared to traditional smoking. Dr Pooja Bajaj, Consultant – Pulmonology at Manipal Hospital Kanakapura Road, says many patients in their early 20s tell doctors they switched to vaping because they consider it safer.
“Unfortunately, it is not,” she says. According to Dr Bajaj, while e-cigarettes may contain fewer carcinogenic substances, they use lipid-rich oils that get vaporised at extremely high temperatures.
“This hot lipid-rich material causes a very severe inflammatory reaction within the lungs,” she explains. The condition, known as EVALI (e-cigarette and vaping-associated lung injury), can rapidly progress to Acute Respiratory Distress Syndrome (ARDS), which is life-threatening.
“The only safe option is to not smoke altogether,” Dr Bajaj adds.
Tobacco can also affect the heart, fertility and brain
Doctors say tobacco impacts the cardiovascular system much earlier than most people realise. Dr G Vivek, Senior Consultant – Cardiology at Manipal Hospital Kanakapura Road, explains that nicotine narrows blood vessels and increases the workload on the heart, while carbon monoxide reduces oxygen supply throughout the body. “Carbon monoxide causes reduction of oxygen supply, leading to increased vulnerability to strokes and heart attacks among all age groups including the younger generation,” he says.
Beyond heart disease, tobacco has also been linked to infertility, diabetes, hormonal imbalance and sexual dysfunction. Recent studies are increasingly showing how nicotine addiction can affect reproductive health in both men and women, making it an important concern for younger adults.
Why quitting becomes so difficult
One reason tobacco addiction becomes difficult to break is that nicotine directly affects the brain’s reward system. Dr Vivek explains that nicotine triggers dopamine release, temporarily creating feelings of happiness, excitement and improved focus.
“With time, an individual becomes dependent on tobacco use, making it hard to quit,” he says. This dependency often causes withdrawal symptoms such as irritation, anxiety and nervousness when people attempt to stop smoking or vaping.
Awareness may be the biggest protection
Experts believe awareness and early prevention are now more important than ever, particularly as tobacco products continue evolving in newer forms targeted at younger consumers. Dr Madhavi Nair stresses that exposing younger generations to tobacco “in any form is a gross irresponsibility”. “In a world already drowning in pollution and increasing health concerns, exposing young people to tobacco in any form is a gross irresponsibility,” she says.
Doctors say the focus now should not only be on treating tobacco-related diseases, but also on helping younger Indians understand how deeply these habits can affect long-term health, energy, fertility and quality of life.
