What I want my patients to know about smoking
Wednesday, March 11, 2015
According to the Centers for Disease Control, “Smoking is the leading cause of preventable death in the United States,” and is responsible for 480,000 deaths per year. I’ve compiled the facts I tell my patients daily on the dangers of smoking.
What nicotine actually does to your body – There are many chemicals in cigarette smoke. One of them is nicotine, which has multiple effects on our nervous and endocrine systems. Even though most people who use nicotine experience a calming effect, it is actually a stimulant that results in a re-energizing sensation. Nicotine increases endorphins in the brain and stimulates other neurotransmitters that enhance its addicting effects. It constricts blood vessels near the skin and the coronary arteries (the arteries of the heart) as well. Nicotine will very quickly increase the heart rate and raise the blood pressure. It remains unclear if nicotine alone promotes atherosclerosis or clotting. These problems are likely caused by other chemicals in cigarette smoke.
Smoking increases the risk of heart attack and stroke by several mechanisms. Primarily, it causes atherosclerosis, which is plaque building up in arteries restricting the blood flow to our organs and tissues. Smoking also makes the blood more likely to clot and plug up narrowed arteries, resulting in heart attacks and strokes. In addition, smoking results in coronary artery constriction, further restricting blood flow and oxygen delivery to the heart. Cigarette smoke also contains carbon monoxide, which binds strongly to hemoglobin, decreasing the oxygen carrying capacity of the blood. By raising the heart rate and blood pressure, the heart is demanded to work harder. All of these effects of smoking work together against the body.
Smoking doesn’t just cause lung cancer. Smoking increases the risk of many different cancers involving the lung, throat, mouth, esophagus, stomach, pancreas, kidney, urinary bladder, cervix, and bone marrow (leukemia). There are toxins in cigarette smoke that damage the DNA in our cells. If a certain area of the DNA gets damaged, the cells may begin to proliferate out of control. Some of these toxins also impair our ability to kill cancer cells.
Smoking also increases the incidence of other diseases. People who smoke have less bone mass than non-smokers and are more prone to fractures. Smoking causes periodontal disease by decreasing blood flow to the gums and weakening the connection of the teeth to the soft tissue and bone. The risk for complications around the time of surgery is increased in smokers. For patients undergoing abdominal surgery, the risk of developing a hernia along an incision is increased fourfold in smokers.
There is no safe way to smoke. Smoking less appears to have very little effect in reducing the damaging effects of inhaling the smoke. Chewing tobacco may provide smoke-free nicotine, but also causes significant health problems. E-cigarettes and “vaping” can also provide the addicting nicotine, but they have not really been shown to be a successful aid to smoking cessation. While some of the toxins present in cigarette smoke are absent from e-cigarettes, other carcinogenic, or cancer causing, chemicals are found in the vapor produced by these devices.
How to stop – I think the most important way to stop smoking is for the smoker to make up his or her mind to quit. For some, this requires a life-changing event, like a heart attack or stroke. For some, it takes a loving spouse. The medications and patches can be helpful, but only if the smoker is motivated to quit. If you are interested in working on smoking cessation, I would suggest talking to your primary care provider about options and their recommendations.
Second hand smoke is also being recognized as a serious health risk. About 42,000 Americans die each year as a result of inhaling the smoke from those cigarette smokers nearby.
Also, it is very difficult to stop smoking if you have a spouse who smokes, so it is best if everyone in the house can quit together.