Health and safety - the risks of smoking

How's this for a reality check?

If you combine the deaths in the USA caused by HIV, car crashes, alcohol abuse, drug abuse, and gun violence – smoking causes more deaths in the entire country than all of these put together! Studies conducted in the United States have shown that life expectancy will be reduced by 10 years for those who smoke¹.

There are two specific toxins found in tobacco that can have adverse health effects:

Tar: This is a brown syrupy material that sticks to the lungs and can cause breathing problems as a result.

Carbon monoxide: This is typically found in the fumes emitted by a car’s exhaust pipe but can emanate from other sources including appliances, generators and fuel-powered tools like chainsaws, lawn mowers and snow blowers. If you are exposed to carbon monoxide in large quantities, this can lead to death as it binds to haemoglobin (the molecule that transports oxygen in the blood) and prevents the body from getting the oxygen it needs in order to function.

Smoking can affect the organs in your body that play a pivotal role in your survival, for example:

The brain

Research has proven that if you are a smoker your chances of having a stroke increase by between two and fourfold. ⁽²⁾ Smoking weakens the blood vessels, which can become blocked or obstructed leading to the formation of a nodule or bulge. This is commonly referred to as a brain aneurysm. If a aneurysm ruptures, you could haemorrhage and experience brain damage or possibly even die.MyM3dPic$!

Cardiovascular system

If you are a tobacco smoker, you will be at an increased risk of developing cardiovascular diseases (CVDs). This group of conditions are the leading cause of death across the globe and more people die annually as a result of these, than any other cause. CVDs include:

• High Blood pressure (hypertension): The nicotine in cigarettes raises both blood pressure and heart rate.
• Cerebrovascular disease: This group of conditions can lead to a cerebrovascular event such as a stroke. You are at greater risk of clotting if you are a smoker. Clots are generally caused when plaque (which is made up of fat, cholesterol, calcium, fibrin (a substance involved in blood clotting) and cellular waste) increases in the blood and accumulates on the internal walls of the arteries, causing narrowing which results in diminished blood flow and increases your risk of blood clotting. A blood clot that develops in the veins or arteries is referred to as a thrombus. If a small piece of the clot breaks off and travels through the body it is referred to as an embolus and can become lodged in the lungs or brain. When lodged in the lungs, this can cause a pulmonary embolism, and when lodged in the brain, an ischemic stroke may occur, both of which can be fatal.
• Coronary heart disease: This disease develops due to an accumulation of plaque in the coronary arteries (i.e. the arteries that supply blood to the heart) which is known as atherosclerosis. Over time, this causes the arteries to harden, reducing blood flow to the heart and when this becomes significant, heart-related chest pain (known as angina) or a heart attack may occur. The development of the condition can be caused by smoking alone, but when coupled with other risk factors such as high blood pressure, physical inactivity and a tendency to clot (all of which smoking influences) and/or high cholesterol, obesity and diabetes, the chances of developing the coronary heart disease increase exponentially³.
• Heart-related chest pain: Nicotine and carbon monoxide reduce oxygen flow in the body which forces the heart to work more quickly, placing it under significant strain (this is also why smokers generally battle with exercise). This, along with atherosclerosis that develops over time, can lead to heart-related chest pain known as angina.
• Heart attack: Coronary heart disease can lead to a heart attack (myocardial infarction).

Cardiovascular disease also plays a role in the development of chronic obstructive pulmonary disease.

Lungs and airways

Not surprisingly, the lungs and airways are impacted most by smoking.  Some time may pass before any noticeable symptoms of a lung disease appear – in fact this can take years, but when they do, issues can range from chronic coughing and difficulty breathing to more serious lung diseases.

The most common known lung diseases that occur are as follows:

• Chronic obstructive pulmonary disease (COPD): Smoking has been identified as a definite trigger for chronic obstructive pulmonary disease (COPD)⁴. COPD is an umbrella term a group of progressive lung diseases including irreversible asthma, chronic bronchitis, emphysema and certain types of bronchiectasis (a condition wherein the airways of the lungs become damaged, causing mucus build-up).
• Chronic bronchitis: This is a form of COPD commonly caused by cigarette smoking wherein the airways that carry oxygen to the lungs (bronchial tubes) become inflamed. A chronic cough and difficulty breathing are instigated by the onset of an over production of mucus. Currently, there is no cure for this condition, but studies have shown that the symptoms can be reduced if you stop smoking.
• Emphysema: Over time, smoking damages the air sacs (alveoli) of the lungs which compromises lung function and causes this condition. The ability to breathe is hindered even when not taking part in a physical activity. In severe cases, people are forced to breathe with the aid of an oxygen tank and mask. At this stage, there is no known cure and the condition is irreversible.

Other lung related diseases and conditions that have been known to occur due to smoking also include asthma, TB (tuberculosis) and pneumonia.

Immune System

Your immune system acts as a defensive barrier for your body, shielding it from infection and fighting off diseases. This ‘barrier’ is interrupted and damaged by smoking which has been linked to increasing the risk of development and exacerbation of diseases like Chron’s disease⁵ and rheumatoid arthritis^6. Type 2 diabetes has even been traced back to smoking⁷.

Bones

Smoking is detrimental to bone health and especially in women who have broken bones or are susceptible to the development of osteoporosis (a medical condition wherein your bones become extremely brittle, weak and fragile).

Mouth

Halitosis, commonly referred to as bad breath, can be caused by smoking. In addition, smoking can affect the appearance of the mouth causing stained yellow teeth, loose teeth and red, inflamed gums as a result of a gum disease. Smoking can even affect your taste buds, dulling your sense of taste.

Reproduction

Smoking affects the reproductive health and increases the risk of infertility in both genders. Men who smoke may experience impotency due to damage to the blood vessels of the penis. Male smokers also generally experience lower:⁸

• Semen volume
• Total sperm count
• Sperm density
• Sperm motility
• Rate of normal morphology
• Fertilising capacity

 If you are a women wanting to conceive a child naturally and are a smoker, your chances of falling pregnant are lowered as a result. If you are pregnant and continue to smoke, your unborn child is at risk of the following:

• Miscarriage
• Stillbirth
• Premature birth
• Sudden infant death syndrome
• Low birth weight
• Infant illnesses

 Skin

Premature aging is accelerated if you are a smoker due to the lack of oxygen supply to the skin. Over time, your skin will be left looking grey and haggard. Wrinkles around the mouth and eye area are more likely to develop and can prematurely age your skin by up to 20 years.

Other risk factors and complications of smoking

Cancer

In addition to affecting various parts of the body and its systems, causing a variety of health conditions and diseases, smoking causes many types of cancer affecting each of these.

The deadliest form of cancer affecting smokers is lung cancer which can be a challenging condition to address with the currently available treatment options. There are numerous other cancers which smoking can contribute to the development of, these include:

• Cancer of the mouth
• Larynx (voice box) cancer
• Pharynx (throat) cancer
• Cancer of the oesophagus (swallowing tube)
• Kidney cancer
• Cervical cancer
• Liver cancer
• Bladder cancer
• Pancreatic cancer
• Stomach cancer
• Colon/rectal cancer
• Myeloid leukaemia (affects the blood and bone marrow)

If you feel that putting tobacco in a pipe, cigar or even chewing it is safer – think again, whichever way you look at it, there is no safe way to consume tobacco.

References

^{1.  Centers for Disease Control and Prevention. 1 December 2016. Tobacco-related mortality:
 https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/index.htm [Accessed 22.03.2018]}

^{2. US National Library of Medicine National Institutes of Health. July 2010. Smoking and stroke: the more you smoke the more you stroke: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928253/ [Accessed 22.03.2018]}

^{3. American Heart Association. 17 February 2014. Smoking & Cardiovascular Disease (Heart Disease): 
http://www.heart.org/HEARTORG/HealthyLiving/QuitSmoking/QuittingResources/Smoking-Cardiovascular-Disease_UCM_305187_Article.jsp#.WrOeQYhuaHt [Accessed 22.03.2018]}

^{4. SAGE Journals. 12 May 2011. Chronic Obstructive Pulmonary Disease and Smoking Cessation: http://journals.sagepub.com/doi/abs/10.1177/1559827611404872 
 [Accessed 22.03.2018]}

^{5.  Journal of Crohn's and Colitis. 1 August 2014. Smoking in inflammatory bowel disease: Impact on disease course and insights into the  aetiology and its effect: https://academic.oup.com/ecco-jcc/article/8/8/717/530121 [Accessed 22.03.2018]}

^{6. US National Library of Medicine National Institutes of Health. 15 December 2014. Smoking and Rheumatoid Arthritis: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284707/ [Accessed 22.03.2018]}

^{7. Centers for Disease Control and Prevention. 6 September 2012.  Smoking and Diabetes: https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html 
 [Accessed 22.03.2018]}

^{8. BioMed Central. 16 July 2013. Lifestyle factors and reproductive health: taking control of your fertility: https://rbej.biomedcentral.com/articles/10.1186/1477-7827-11-66 [Accessed 22.03.2018]}