Smoke

Cigarette smoke is composed of over 4000

different chemicals, many of which are
toxic. Both smoke that the smoker inhales
(through the filter and the smoke from the
!urning end is incredi!ly toxic. "here are
three main components that are ha#ardous
to health.
"ar $ settles in the lungs and stimulates a
series of changes that lead to o!structive
lung disease and lung cancer
%icotine $ is the addictive element of
cigarettes, stimulates the nervous system to
reduce arteriole diameter and release
adrenaline $ increasing heart rate and !lood
pressure. Causes increased stickiness of
!lood platelets, which increases the risk of
!lood clotting.
Car!on monoxide $ com!ines irreversi!ly
with haemoglo!in meaning that oxygen
cannot !ind effectivley. "his causes a strain
on the heart muscle !ecause it must pump
more to provide the same amount of oxygen
&ung 'isease
Chronic o!structive lung diseases (asthma,
chronic !ronchitis and emphysema are now
prevalent !ecause of smoking and vehicle(
industrial emissions. &ung diseases can !e
caused !y a variety of things such as
potentially harmful gases and particles,
!eing deposited in the alveoli, and this can
enhance the risk of viruses such as
influen#a.
)llergens that cause large coughing fits,
such as those found in asthmatic attacks can
cause long term damage to the alveoli.
&ung Cancer
"o!acco smoke contains tar, and tar
contains several carcinogens. "hese can
make '%) in epithelial cells lining the lungs
mutate, which is the first step towards a
malignant tumour. "his tumour then
develops into the lymphatic system after
spreading through !ronchial epithelium and
it is here, in the lymph system where
cancerous cells can !reak away and spread
around the organ, causing secondary
tumours.
*mphysema
*mphysema is the condition in which
!ronchioles collapse, leaving large spaces
where surface area for gaseous exchange
used to !e. "his is !ecause the lungs are
constantly infected, causing phagocytes to
line the airways, and to reach them they
release a protein digesting en#yme known as
elastase $ this destroys the elastin in the
walls of the alveoli allowing the phagocytes
to enter and remove !acteria. +owever, this
elastin is vital, without it, the alveoli do not
stretch and recoil when !reathing in and
out, causing !ronchioles to collapse. "he
initial inflammation is caused !y infections
which in turn is caused !y the accumulated
mucus as a result of the tar in the lungs.
,eople with emphysema cannot oxygenate
their !lood very well, and thus !reathe
rapidly $ !lood pressure also increases as
!lood vessels in the lungs !ecome more
resistant to the flow of !lood. &ung
function will deteriorate and people with
severe emphysema may need a supply of
oxygen through a face mask to stay alive.
Chronic Bronchitis
"ar destroys and weakens cilia, inhi!iting
the cleaning of the airways. -t also
stimulates go!let cells to secrete more
mucus, making mucus accumulate in the
!ronchioles, and thus mucus starts to fill up
the holes and cannot !e moved !y the cilia.
"hus !acteria and viruses collect and !lock
the !ronchioles, causing the smoker to
cough in an attempt to move the mucus up
the airways.
"he damaged cilliated epithelial cells are
replaced !y scar tissue, thickening the
airways and making it more difficult to
move air in and out of the lungs. -nfections
also easily develop in the accumulated
mucus, inflaming the airways. "he damage
and !locking of the airways is chronic
!ronchitis.
Chronic o!structive pulmonary disease
*mphysema and chronic !ronchitis together
are known as chronic o!structive
pulmonary disease, a progressively
degenerating disease. .eversal is very rare,
the damage to the lungs can sometimes !e
reversed if smoking is given up when young.
C/,' is responsi!le for 0100,000 deaths a
year in the 23.
*vidence
*pidemiological
Cigarette smoking !egan en masse in the
!eginning of the twentieth century, and
doctors started noticing a huge increase in
cases of lung cancer from 4510 onwards,
and !y 4560s it was declared an epidemic.
7or comparison, in 4548 there were 194
lung cancer cases, and now there are over
16,000 deaths a year, an increase of nearly
400 times.
"he correlation !etween lung cancer and
cigarette smoking is plain in the chart to
the right $ it shows the 80 year :lag:
!etween the rise of cigarettes and the rise
of lung cancer. *pidemiological data links
smoking and cancer, and up to 60; of
smokers may die of smoking$related
diseases.
/ne third of cancer deaths are as a result
of cigarette smoking, and a <uarter of
smokers die of lung cancer. Chronic
o!structive pulmonary disease is very rare
in non smokers, less than 40; of victims
are non$smokers, and less than 8; of
people with emphysema are non$smokers.
/ne fifth of smokers suffer from
emphysema, and as a result deaths from
pneumonia and influen#a are twice as high
amongst smokers.
*pidemiological studies have ruled out other
factors, that is to say that they cannot find
any other factor with a close correlation
with smoking. Smoking has !een found to
have a direct link with lung cancer, as
smoking is the common fact in almost all
cases. Smoking also contri!utes to many
other cancers of the mouth, larynx,
!ladder, kidney and pancreas.
*xperimental
*pidemiological evidence is sometimes
<uestioned, as it does not :prove:
sufficiently for some that there is a definite
link !etween lung cancer and smoking.
+owever, there is also experimental
evidence to prove a direct causative link
!etween smoking and lung cancer.
-n the 45=0s, an ethically <uestiona!le
experiment was setup to investigate the
effect of cigarette smoke on lungs. /ne
group of 84 dogs were forced to smoke
filter$tipped cigarettes and did not develop
cancer, whilst 84 other dogs smoke plain
cigarettes and developed tumours similar to
those found in human lung cancer patients.
C/,' was also recognised in the plain$
cigarette dogs. "he healthy group of 84 dogs
did not develop tumours, !ut this is
thought to !e due to the relativley (to the
time a smoker may smoke in their lifetime
short time of the experiment.
Chemical analysis of cigarette smoke shows
that tar contains a wide variety of
carcinogens, and when this tar is painted on
the skins of mice, cancerous growths are
shown to develop.
Cardiovascular diseases
)ll cardiovascular disease are degenerative
diseases of the heart and(or circulatory
system, and are a ma>or cause of death in
developed countries. "hey are
multifactorial, meaning that many factors
contri!ute to the development of these
disease, and smoking is a !ig one.
)therosclerosis
)therosclerosis is a chronic inflammatory
response in the walls of arteries, in large
part due to the accumulation of
macrophage white !lood cells. "he
accumulation of fatty material in artery
walls damages the arteries, which produces
the invasion of macrophages whose
secretions stimulate the growth of muscle
cells to aid repair and the accumulation of
cholesterol.
Cholesterol is an essential !iochemical, !ut
it causes pro!lems if it is to accumulate in
tissues. "his is due to its insolu!ility $ if it
is transported in the !lood it is done so in
tiny !alls of lipid and protein known as a
lipoprotein. &ipoproteins are in two groups,
&'&s and +'&S (low and high density
respectively. "hese &'&s transport
cholesterol to the artery walls and
unfortunately deposit their cholesterol at
damaged sites, whereas +'&s transport it to
the liver to !e excreted.
"hese cholesterol deposits form pla<ues in
the arteries, causing them to !e less elastic
and providing greater resistance to the flow
of !lood. "hese pla<ues cause the !lood to
flow roughly, making it likely to clot,
forming a throm!us, disrupting !lood flow
even more. See the picture on the right for
the stages of atherosclerosis and more
detail (click to enlarge.
Strokes
Stroke is the rapidly developing loss of
!rain functions due to either a !lood vessel
in the !rain !ursting or a !locking in a
!rain artery due to atherosclerosis or a
throm!us. "hey can !e instantly fatal or
severely disa!ling to the victim $ it depends
on how much of the !rain is affected.
Coronary +eart 'isease
Coronary heart disease (C+' is also a
cardiovascular disease and is disease of the
two coronary arteries (the ones that supply
the muscles of the heart. -t is as a result of
atherosclerosis narrowing the coronary
arteries, restricting the !lood flow, forcing
the heart to work harder to force the !lood
through, raising the !lood pressure. -t can
cause anything from chest pain to a fatal
heart attack.
)ngina
)ngina is the main symptom of C+', and is
characterised !y severe chest pain during
exercise, caused !y a shortage of !lood to
the heart muscle.
+eart failure
) heart failure is the result of C+' that
does not end in a heart attack, and the
heart simply gives out due to the gradual
damage of the heart muscle $ eventually it
fails to pump efficiently and the victim dies.
+eart attack
)lso known as a myocardial infarction $ this
is when a large enough !ranch of the
coronary artery is o!structed !y a !lood
clot, and thus part of the heart is starved of
oxygen and dies. 'epending on how much of
the heart dies, this can !e fatal, and !rings
severe and sudden chest pain.
*pidemiological evidence
Coronary heart disease remains a ma>or
killer across the world in 800?, and is most
prevalent in .ussia, and least prevalent in
@apan (counting only the developed world.
Coronary heart disease death rates differ
also within countries, and !etween socio$
economic stratas $ in the 23, poor people,
certain ethnic groups and men are more at
risk. "his data tells us that people are not
e<ually at risk of developing C+'.
.isk 7actors
"here are many known C+' risk factors. Aou
can control some risk factors, !ut not
others. .isk factors you can control includeB
4. +igh !lood cholesterol and triglyceride
(tri$C&-S$er$ide levels (a type of fat found
in the !lood 8. +igh !lood pressure 1.
'ia!etes and predia!etesexternal link icon
4. /verweight and o!esity 6. Smoking =.
&ack of physical activity 9. 2nhealthy diet
?. Stress
"a!le 4B .isk
.isk
fact
or
*ffect
)lco
hol
Causes high !lood pressure, this
and high intake to increase risk of
atherosclerosis. .isk may decrease
with moderate intake.
)ge .isk increases as age increases
Bloo
d
chole
stero
l
'irect correlation !etween high
cholesterol concentration and C+'
risk
'ia!
etes
)nyone with dia!etes is at increased
risk
'iet .isk increases with high intake of
saturated fat and(or salt, since
these factors increase the risk of
atherosclerosis. 'ecreases risk for
antioxidants, solu!le fi!res and
moderate amounts of unsaturated
fats.
+ere
dity
Cenetic predisposition does exist,
and genes can cause people to
develop high !lood cholesterol
concentrations.
Cend
er
Den are at greater risk than women
&evel
of
exerc
ise
.isk decreases if more exercise is
done, aero!ic activity helps to
control !lood cholesterol and
o!esity. &owers !lood pressure.
/!es
ity
Being o!ese greatly increases risk,
puts a strain on the heart and rises
!lood pressure
Socia
l
Class
,overty increases the risk
,revention E cure
Coronary heart disease is a ma>or killer in
the 23 and is also one of the !iggest
examples of avoida!le ill health. 7or this
reason governments are encouraging people
to take more exercise, give up smoking and
reduce the fat in their diet in an effort to
reduce coronary heart disease death rates.
"reatment includes drugs to reduce !lood
clotting, lower !lood pressure and decrease
the concentration of cholesterol in the
!lood. -f these are not successful, a
coronary !y$pass may !e carried out $ this
operation takes a !lood vessel from else
where on the !ody, and attaching it to the
coronary artery, :!y$passing: the clot in the
artery !lockage. -f this does not or cannot
work, a complete heart transplant may !e
given $ !ut this is very difficult to since a
donor must !e found that matches the
recipients tissues etc. +eart transplants are
usually refused to people who have not
completely given up drink and smoking, in
an effort to improve the health of the
waiting list and to ensure that the few
hearts they do get are not then ruined.