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Tobacco was first introduced to Europeans in the New World and was quickly embraced by them. It was suggested that the Amerindians used the tobacco for medicinal uses, it was used for toothaches, oral care, and for the common cold. When tobacco fields began to grow, the Europeans needed workers to tend to the fields, which is when they began to take people from the coast of Africa to be slaves. Over many years, the fields grew, and the continued to exploit Africans, which is a long term effect of tobacco, as the production of it required intense labor that came from Africans. The long term effects of slavery can be attributed to the discovery of tobacco during the Colombian Exchange

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During the Colombian Exchange, rats could easily get onto the ships used to travel to the New World, and while on the ships, they gave birth to millions of children. As Columbus reached the New World, the rats also got to explore the New World. Rats (along with the Europeans), were the cause of spreading many diseases into the Americas, as the rats could transmit the disease to people by biting them and through their fleas.The long term effect from rats coming to the Americas is the fact that the new diseases being exposed to Amerindians were so easily spread through the large population of rats, and was not easily eradicated.

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Smallpox is a disease that is characterized by small scars that appear on the body as well as a high fever that can be fatal. When Christopher Columbus came to the New World in 1492, he brought along this disease from the Old World, and as the Amerindians were not exposed to such a disease, many died in the millions. The disease had a long term impact, as it wasn't eradicated until 1980, and although some Amerindians developed an immunity, it caused their population to decrease 90% during the Colombian Exchange.