Smoking Puts You at Risk for Serious Health Problems

Tuesday, November 16, 2004

Everyone knows the adage, If at first you don’t succeed, try, try again. When it comes to trying your first cigarette, however, this wise old saying doesn’t hold true.

Most people who inhale their first puff of a cigarette will cough, and some may even feel nauseous. Their body is “telling” them that the toxins in tobacco smoke aren’t welcome, that they should not try to take another puff, or become addicted to cigarettes, or increase their risk for a host of potential health problems.

When I see patients who smoke, they don’t need me to tell them to stop smoking—they’ve heard it over and over from family and friends. They know it’s not good for them, but they find it extremely difficult to quit. So my message isn’t geared so much to current smokers as it is to those who are curious about trying that first puff. If you don’t smoke, don’t begin the often lifelong and life-threatening habit, and don’t let anyone pressure you into trying a cigarette.

Nicotine, a chemical in tobacco, is the addictive part of the cigarette. Nicotine increases the heart rate and oxygen consumption by the heart muscle. Other effects include euphoria, increased alertness, and a sense of relaxation. When someone becomes addicted to nicotine—which may take only a few weeks—and then stops using it, they experience symptoms of withdrawal, including anxiety, irritability, restlessness, and an intense craving for nicotine. For many people, the act or habit of smoking throughout the day is also addictive.

Smoking and Disease
Cigarette smoking is the most preventable cause of premature death in this country, and is responsible for one in five deaths from all causes. Millions of other people are living with serious illnesses caused by smoking.

Smokers are far more likely to develop serious diseases than non-smokers. Cigarette smoking causes lung cancer, heart disease, emphysema, and other serious diseases. Some smokers are more sensitive to the toxins in cigarette smoke and may have a greater genetic disposition to developing smoking-related disease.

Coronary Artery Disease
Smokers face a higher risk of illness and death from coronary artery disease (CAD). Carbon monoxide, nicotine, and other substances in tobacco smoke can promote atherosclerosis (clogged arteries), the chief contributor to the high number of deaths from smoking.

CAD begins when hard cholesterol substances (plaques) are deposited within a coronary artery. Smoking causes the platelets in the blood to clump together by making blood cells more “sticky” and more likely to form clots. Clumping platelets can obstruct the flow of blood to the heart and cause a heart attack.

Smoking also can cause spasms in the coronary arteries, which can reduce the blood flow to the heart; trigger irregular heartbeats, lower the “good” cholesterol in the blood, increase blood pressure, and reduce the amount of oxygen carried by red blood cells. Cigarette smoking also is a risk factor for stroke.

Lung Cancer
Smoking is by far the most important risk factor for lung cancer—about 87% of lung cancers are thought to result from smoking or passive exposure to tobacco smoke. The longer you smoke and the more packs per day you smoke, the greater your risk.

Lung cancer is the No. 1 cancer killer in the United States for both men and women. According to the American Cancer Society, in 2004 there will be about 173,770 new cases of lung cancer in the United States, and about 160,440 people will die of this disease. Lung cancer is a life-threatening disease because it often spreads in the body before it is found. Once lung cancer is diagnosed, the five-year survival rate is only 10 to 15 percent.

Cigar smoking and pipe smoking are almost as likely to cause lung cancer as cigarette smoking. There is no evidence that smoking low-tar cigarettes reduces the risk of lung cancer. The best way to prevent lung cancer is not to smoke.

In addition to lung cancer, smoking is a major cause of many other types of cancer including cancer of the voice box, throat, and esophagus.

Emphysema is a degenerative lung disease that usually develops after many years of assault on lung tissues from cigarette smoke or other toxins that pollute the air. These toxins destroy the small air sacs in the lungs. As a result, the lungs lose their elasticity, and exhaling becomes difficult as the damaged lungs trap air and cannot effectively exchange it with fresh air. As the damage progresses, the effort needed to breathe increases and, ultimately, each breath becomes labored. Once the lungs become damaged by emphysema, the disease tends to be irreversible.

Secondhand Smoke
Smoking can also affect the health of nonsmokers. The same cancer-causing chemicals found in inhaled tobacco smoke have been found in secondhand tobacco smoke but in lower concentrations. Nonsmokers exposed to secondhand smoke are at increased risk for lung cancer and coronary heart disease, and children exposed to tobacco smoke have elevated risks of sudden infant death syndrome (SIDS), ear infections, asthma, and respiratory infections.

Effects of Quitting
Quitting smoking can reduce the risk of serious health problems and premature death. However, it may take 15 to 20 years to reduce or completely reverse the risk caused by smoking. The best way to prevent smoking-related disease is to never start smoking in the first place.

Dr. Glenn Ragalie is a pulmonologist on staff at Columbia St. Mary’s. For more information on the effects of smoking, call 414-291-1196.

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