Complications of smoking

Basically, the major complications of smoking are lung and cardiovascular disease.

Intro

• Cigarettes have literally thousands of chemical components, at least 400 of which are toxic. Its tar component can cause lung cancer, its gas can cause pulmonary disease and its carbon monoxide and nicotine significantly increase your risk of cardiovascular disease.
• incidence of smoking in patients suffering from post traumatic stress disorder, bipolar disorder, major depression and other mental illnesses twofold or fourfold higher than the general population, and smoking incidence among patient with schizophrenia is as high as 90 percents

Heart

• UK studies show that smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers.

• Tobacco contributes to the hardening of the arteries(Atherosclerosis), which can then become blocked and starve the heart of bloodflow, causing the attack.
• Inflammation of the artery wall and the development of blood clots can obstruct blood flow and cause heart attacks or strokes.
• Often, smokers who develop this will require complex and risky heart bypass surgery.
• Smoking also increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.
• Smoking decreases HDL (good) cholesterol.
• If you smoke for a lifetime, there is a 50% chance that your eventual death will be smoking-related - half of all these deaths will be in middle age
• Smoking also increases the risk of having a stroke due to high blood pressure and tendency of the blood to clot.
• Smoking-related coronary heart disease may contribute to congestive heart failure.

Cancer

• The primary health risk associated with smoking are lung cancer
• Lung cancer commonly follows or accompanies COPD
• There are three forms of lung cancer that are associated with smoking.
• The most common is squamous-cell carcinoma. In its early stage, basal cells of the bronchial epithelium multiply, and the ciliated pseudostratified columnar epithelium transforms into the stratified squamous type. As the dividing epithelial cells invade the underlying tissues of the bronchial wall, the bronchus develops bleeding lesions. Dense swirled masses of keratin appear in the lung parenchyma and replace functional respiratory tissue.f
• Cancer-causing agents (carcinogens) in tobacco smoke damage important genes that control the growth of cells, causing them to grow abnormally or to reproduce too rapidly.
• For smoking-attributable cancers, the risk generally increases with the number of cigarettes smoked and the number of years of smoking, and generally decreases after quitting completely.
• Smoking cigarettes that have a lower yield of tar does not substantially reduce the risk for lung cancer.
• Smoking also increases the risk of oral, uterine, liver, kidney, bladder, stomach, and cervical cancers, and leukaemia.
• Cigarette smoking is a major cause of esophageal cancer in the United States.

Respiratory

• Smoking damages airways and alveoli of the lung
• Another health problem associated with tobacco is emphysema, which, when combined with chronic bronchitis, produces chronic obstructive pulmonary disease.
• Chronic bronchitis and emphysema can exacerbate asthma symptoms in adults and children.
• In 2001, chronic obstructive pulmonary disease (COPD) was the fourth leading cause of death in the United States, resulting in more than 118,000 deaths. More than 90% of these deaths were attributed to smoking.
• According to the American Cancer Society’s second Cancer Prevention Study, female smokers were nearly 13 times as likely to die from COPD as women who had never smoked. Male smokers were nearly 12 times as likely to die from COPD as men who had never smoked. (p. 500)
• Smokers are more likely than nonsmokers to have upper and lower respiratory tract infections, perhaps because smoking suppresses immune function
• In general, smokers’ lung function declines faster than that of nonsmokers

Pregnancy

• Research has shown that women’s smoking during pregnancy increases the risk of pregnancy complications, premature delivery, low-birth-weight infants, stillbirth, and sudden infant death syndrome (SIDS).
• The nicotine in cigarettes may cause constrictions in the blood vessels of the umbilical cord and uterus, thereby decreasing the amount of oxygen available to the fetus. Nicotine also may reduce the amount of blood in the fetal cardiovascular system. Nicotine is found in breast milk.
• Babies of mothers who smoked during pregnancy have lower birth weights. Low birth weight is a leading cause of infant deaths.
• Mothers’ smoking during pregnancy reduces their babies’ lung function.

Contributed by Lawrence Oh