Social This section requires expansion with: information expanding the effects of tobacco on cultural practices. (January 2009) Smoking in public was for a long time something reserved for men, and when done by women was sometimes associated with promiscuity.[citation needed] In Japan, during the Edo period, prostitutes and their clients often approached one another under the guise of offering a smoke. The same was true in 19th-century Europe. Following the American Civil War the usage of tobacco, primarily in cigars, became associated with masculinity and power, and is an iconic image associated with the stereotypical capitalist. Today, tobacco is often rejected; this has spawned quitting associations and anti-smoking campaigns. Bhutan is the only country in the world where tobacco sales are illegal. [edit]Demographic Main article: Prevalence of tobacco consumption Research is limited mainly to tobacco smoking, which has been studied more extensively than any other form of consumption. As of 2000, smoking is practiced by some 1.22 billion people, of which men are more likely to smoke than women (however the gender gap declines with age), poor more likely than rich, and people in developing countries or transitional economies more likely than people in developed countries. As of 2004, the World Health Organization (WHO) reports that of the 58.8 million deaths occurring globally, 5.4 million are tobacco-attributed. [edit]Health Data from The Lancet suggests tobacco is ranked the 3rd most addictive and 14th most harmful of 20 commonly-used drugs. Main article: Health effec

s of tobacco See also: List of additives in cigarettes The harms thought or known to caused by using tobacco include diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), emphysema, and cancer (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancers). The World Health Organization estimates that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide." Rates of smoking have leveled off or declined in the developed world. Smoking rates in the United States have dropped by half from 1965 to 2006, falling from 42% to 20.8% in adults. In the developing world, tobacco consumption is rising by 3.4% per year. When the market for tobacco reduced in the West, the industry looked to India and China for 'emerging markets'. In response, various activists in these markets have campaigned against tobacco products. China is the world's largest manufacturer of cigarettes, producing about 2.4 trillion per year or 40 percent of the world's total. Changes have been made to eliminate advertising, post health warnings, and ban smoking from public buildings. However, recent studies have shown that smoking, more specifically nicotine, has been linked to lower Parkinson's Disease and later onset of Alzheimer's Disease.