SMOKING
 R.A.S HEMAT, MB;BCh, FRCSI, DUL.
- Cigarette smoke contains more than 4000 toxic gaseous or particular compounds.
- Tobacco smoking is the leading preventable cause of death (40%).
In 1950, it was estimated that an individual adult consumed 3500 cigarettes per year. In 1984, cigarette-initiated fires were reported in 67,000 cases in USA and resulted in 1570 deaths and 7000 serious injuries.
In the year 2000 Four million people died from illnesses related to tobacco, worldwide. By 2030, 10 million people will die each year. Peptic ulcer disease (PUD) is twice as likely to develop in smokers as in nonsmokers. Smoking one cigarette increases coronary vascular resistance and decreases coronary flow velocity. Cigarette smokers have 2-3 times more risk to develop stroke than non-smokers. Smoking increases fibrinogen and factor VII that leads to progression of atherosclerosis and acute thrombosis due to thrombogensis. Cigarette smoke contains 2-6% carbon monoxide (CO), which can cause hypoxia. The high oxygen extraction ratio of the myocardium makes it more sensitive to the hypoxia. Smoking is the major cause of bronchogenic carcinoma, it exposes the bronchial epithelium to oxygen free radicals (OFR). Smoking 20 cigarettes a day results in tissue hypoxia for most of each day. 30 minutes after smoking one cigarette, there is a mean decline in subcutaneous oxygen tension of 32%. Smokers can have raised carboxyhaemoglobin levels for up to 4 hours after smoking, causing false pulse oximeter readings.
Stress and smoking can cause damage to platelets. Nicotine inhibits the function of erythrocytes, fibroblasts, and macrophages. Nicotine causes a release of adrenal catecholamines resulting in vasospasm and subcutaneous hypoperfusion with a simultaneous increased oxygen demand. Nicotine creates tolerance, physical dependence, and withdrawal symptoms.
Nicotine withdrawal symptoms include craving, irritability, anxiety, difficulty concentrating, increased appetite, and sleep disturbances. Smoking cessation may take 3-4 attempts before successful abstinence is maintained.
The age of onset of smoking is earlier in alcoholics than in moderate drinkers. Tobacco smoking, which is very often associated with alcohol consumption, also produces free radicals and thus participates in the generation of oxidative stress.
Passive smoke causes detrimental effects on the health of both children and adults. Non-smokers living with smokers have an excess risk of developing ischaemic heart disease of 26%. Passive smoking is the third leading preventable cause of death after active smoking and alcohol. Passive smoke exposure is associated with increased severity of symptoms in children with asthma. Asthma is twice as common in the children of smokers. Passive smoking increases the risk of lower respiratory tract infections, e.g., bronchitis, and increases the risk of otitis media in children of parents who smoke.
July, 2001
Note: The information in this article has been excerpted from the following books: urotext-ebook simplifying urology, Principles of modern urology, Air, Principles of Orthomolecularism by Dr. R.A.S HEMAT. Permission is granted to copy and redistribute this document electronically as long as it is unmodified. This article may not be sold in any medium, including electronic, CD-ROM, or database, or published in print, without the explicit, written permission of Dr. R. A. S. Hemat.
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Dr. R.A.S HEMAT declares no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, stock holdings, gifts, or honoraria.
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