Monday, 30 May 2011

Dangers of Tobacco

Dangers of Tobacco

The following is a small list of dangers associated with tobacco !

Regardless of the tobacco product used, there is an increased risk of cancer, strokes and heart disease. Tobacco smoke that is inhaled causes lung cancer, sinus disease and chronic obstructive lung disease. Many pipe smokers state that they do not inhale, but research shows that they have a significant increase in risk of lung, larynx, throat, esophagus, pancreas, and colon-rectal cancers along with an increased risk of coronary artery disease, emphysema, chronic bronchitis and strokes.

Premature Wrinkling of Skin Tobacco use has been associated with premature aging and skin wrinkling. Before undergoing cosmetic surgery for wrinkles one should suspend tobacco use.

Nyunova, et al. (2009) found that smoking accelerates aging by damaging the same protein which is damaged in Werner's syndrome, a genetic disorder which causes premature aging.

Fires


If careless, cigarettes can cause life threatening fires. To the right is a picture of a patient who was smoking a cigarette while using home oxygen to treat his chronic obstructive lung disease. A fire and explosions ignited with extensive burns to the face and inside of the nose. A video of the patient's nasal endoscopy can be viewed below.

Cancer


Over 90% of laryngeal cancers are caused by smoking.

Lung Cancer: Smoking causes 87% of all lung cancer cases.


Oral and Esophageal Cancer: The picture is from a 77 year old patient who had a 30 pack year history of smoking. He quite smoking 26 years ago. The picture shows a large pyriform sinus cancer. The pyriform sinus is located in the hypopharyngeal between the throat and the esophagus. The cancer can be seen eating into the patient's voice box.

Stomach Cancer: It has been estimated that 14 to 28% of stomach cancer deaths are caused by smoking.

Heart Disease, High Blood Pressure, and Stroke. Nicotine, the major drug in tobacco constricts blood vessels, increasing blood pressure and the work of the heart. Constricting blood vessels also decreases blood flow to the body's tissues, resulting in decreased healing. These effects are exacerbated by diseases such as diabetes.

Chronic Hoarseness and Laryngeal Polyps Chronic smokers often develop a persistent hoarse voice with edema of the larynx and formation of vocal cord polyps. Shown in the pictures below from left to right is a normal larynx, a larynx with massive vocal cord polyps (in a heavy smoker) and the same larynx after the polyps have been surgically removed.




Poor Sex Life: Smoking is a major factor in impotence. It is also a turnoff to the opposite sex. The following is a study taken in our local high-school.

Feldman A.H. et. al (Preventative Medicine 30(4):328-38, 2000) found that Cigarette smoking almost doubled the chances of developing moderate or complete erectile dysfunction. Exposure to passive smoke also significantly increased the incidence of erectile dysfunction.

Question: Do You Want Your Boy or Girl friend to Use Tobacco Products?
A total of 23 current tobacco users and 23 non-tobacco users were surveyed. No respondent answered "YES". There was no significant difference between tobacco users and non-users.

Smoke Yes 0 No 33 Don't Care 13
Chew Yes 0 No 40 Don't Care 5


Smoking and Pregnancy: Smoking has been implicated in the risk of diabetes, obesity and mental retardation in the newborn. An increase incidence of cleft lip and palate has also been observed in maternal smokers. Maternal smoking while pregnant also causes more miscarriages and creates low-birth weight babies.

In the mother smoking during pregnancy can cause an increase chance of premature rupture of the membranes, abruptio placentae and placenta previa. In the child, maternal smoking during pregnancy increases the chances of premature delivery, still birth and sudden infant death syndrome. Smoking during pregnancy is associated with an increase in neonatal admissions to the ICU and a corresponding increase in neonatal health care costs.

In Kentucky, smoking mothers had a 66% higher chance of having a low-birth weight infant and twice the chance of having their child die of Sudden Infant Death Syndrome.

Emphysema: This is a progressive wasting of the lungs which is most commonly caused by chronic smoking. Patient's afflicted with emphysema experience a slow loss of breath. If not caught early, many patients must use home oxygen and experience a slow suffocating death.

Smokers have more training injuries. Training injuries are the number one reason marine cadets do not make the core. These injuries include: Tendonitis, stress fractures, frostbite and more foot blisters. Nicotine is a vasoconstrictor and decreases blood flow to tissues increasing their susceptibility to injury and decreases their ability to heal. Ref: USMC National Health Naval Research Center - San Diego, CA.

Smokers have less stamina than non-smokers. They can not run as fast, have les muscular endurance and there immune system is not as strong. Smokers get sicker more often especially with bronchitis and take longer to recover. Non-smokers are steadier and have better night vision. Smoking is not allowed in USMC boot camp.

Gum, Dental and Mouth Disease To the right is a picture of a hairy tongue caused by poor mouth hygiene and smoking.


Ear Infections and URI's

Smoker's Rhinitis: Tobacco smoke contains hundreds of chemicals and at least forty of which have been implicated in cancer. Smoking irritates the lining of the nose, increasing nasal secretions and swelling. The increase in secretions are caused by goblet cell hyperplasia. The cilia (microscopic hair like structures which transport fluids) in the nose has its function inhibited and the nose becomes less able to cleanse itself and more susceptible to allergens. Thus if you smoke, treatments for allergy are less likely to be effective because the nose has a reduced ability to clean itself of the allergic particles that are inhaled. Smoking and secondhand smoke is associated with significant nasal and sinus disease and symptoms.


Shown to the left, is a picture of a dry pale inside of a nose in a 100 pack/year patient with smoker's rhinitis. In my (Dr. Kevin Kavanagh's) experience, decongestants, antihistamines and nasal steroids are of little help. In my practice, I have not had a single allergic patient who smokes improve with allergy shots. Some doctors will not even allergy test patients that smoke, and for the most part I follow this practice.


Unfortunately, most patients have caused irreversible damage to the lining of their nose and quitting smoking does not improve their symptoms. Many patients experience a worsening of their symptoms since goblet cell hypertrophy takes place which increases nasal secretions. Because cillary function (micro hair structures which clean the nose) is often permanently damaged, these secretions are not cleared and the patient experiences worsening over many months of his/her symptoms. The best treatment is to quit smoking and use hypertonic saline nasal irrigations (over-the-counter buffered hypertonic nasal spray) in combination with the use of nasal steroids. However, as with patients with chronic lung disease from smoking, patients with smoker's rhinitis, seldom return to a completely normal state.

IF YOU SMOKE..QUIT!!

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