Smoking Effects

Page 3:

• Tobacco smoke

  • More than 4000 chemicals identified in tobacco smoke

  • 60 of which are considered carcinogenic

  • Chemicals end up in bloodstream

  • Cigarette increases heart rate and blood pressure temporarily

  • Carbon monoxide reduces oxygen flow, causing cold fingers and toes

Page 4:

• Tobacco burden

  • Tobacco smoking kills 8 million people worldwide each year

  • Majority in low- and middle-income countries

  • Second-hand smoking causes 1.2 million deaths per year

  • Tobacco use is a leading cause of multiple cancers

Page 5:

• Short-term effects of smoking

  • Bad breath

  • Fatigue and decrease in energy

  • Reduction in senses of taste and smell

  • Coughing

  • Shortness of breath

Page 6:

• Longer term effects

  • Skin: Smokers get wrinkles sooner, reduced blood flow and tissue damage

  • Mouth: Gum disease, oral cancer, loss of taste, stained teeth, mouth sores, bad breath

Page 7:

• Neurological effects

  • Brain: Smoking destroys grey matter, thinner cerebral cortex

  • Cerebral cortex crucial for thinking skills, memory, and learning

Page 8:

• Adding to risk

  • Unhealthy lifestyle factors combined with genetic factors increase risk of cancer and heart disease

  • Smoking contributes to mortality due to other diseases, such as cardiovascular disease

Page 9:

• Physical effects of smoking

  • Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and COPD

  • Increases risk for tuberculosis, eye diseases, immune system problems

Page 11:

• Effects of inhaled combustible nicotine on lungs

  • Hyperplasia of goblet cells, increased mucous production, reduced airway diameter

  • Destruction of cilia

  • Lungs coated in tar

  • Destruction of alveolar walls

  • Chronic inflammation

  • Pre-cancerous changes in cells

Page 12:

• Cardiovascular system

  • Toxins from cigarette smoke enter bloodstream and other organs

  • Increases heart rate and blood pressure, narrows capillaries, reduces oxygen flow

Page 13:

• Cigarette smoke is carcinogenic

  • Causes most cases of lung cancer

  • Attributed to over 80% of lung cancer in New Zealand

  • Associated with various types of lung carcinomas

Page 14:

• Contributing to cancers

  • Compounds in tobacco products cause cancer through genetic and epigenetic pathways

  • Increase expression of proteins involved in inflammation

  • Modify cell cycle, induce uncontrolled cell proliferation

Page 15:

• Promoting mutations and DNA d]amage

  • Cigarette chemicals make it harder for cells to repair DNA damage

  • Damages parts of DNA that protect from cancer

Page 16:

• Health problems caused by second-hand smoke

  • No safe level of exposure to second-hand smoke

  • Can cause immediate harm

  • Coronary heart disease, stroke, lung cancer, low birth weight

  • Sudden infant death syndrome, respiratory infections, ear infections, asthma attacks in infants and children

Page 17:

• Risks to children

  • Children of smokers are more likely to become smokers

  • Increased risk of respiratory infections, coughs, colds, wheezes

  • Increased risk of cot death, glue ear, middle ear infections, meningococcal disease

Page 18:

• Side effects of nicotine

  • Central circulation: lightheadedness, increased clotting, headache tendency, sleep disturbances, atherosclerosis, abnormal dreams, enlargement of the aorta, irritability, dizziness

  • Lungs: risk of blood restriction, bronchospasm

  • Heart: increased or decreased heart rate, tremor, increased blood pressure, pain, tachycardia

  • Hormonal: high insulin, arrhythmias, insulin resistance, coronary artery constriction

  • Joint pain, gastro-intestinal risks, infertility

Page 20:

• Smoking addiction

  • Acetylcholine is an ANS neurotransmitter

  • Acetylcholine binds to cholinergic receptors

  • Two types of cholinergic receptors: muscarinic and nicotinic

  • Nicotine binds to nicotinic acetylcholine receptors in the brain, causing addiction

Page 21:

• Nicotine and opiates activate dopamine transmission

  • Basal ganglia

  • Prefrontal cortex

  • Ventral tegmental area

  • Nucleus accumbens

  • Amygdala

  • Dopamine

  • GABA

  • Glutamate

  • Nicotinic acetylcholine receptor

Page 22:

• Smoking Addiction Addiction pathway.

• Effects of Nicotine within CNS:

  • Stimulates release of Acetylcholine.

  • Stimulates release of Dopamine.

  • Dopamine levels increase in Nucleus Accumbens.

• Nucleus Accumbens: part of mesolimbic reward and pleasure pathway.

• Increased Dopamine: associated with feelings of novelty, pleasure and reward.

• Addiction is reinforced by feelings of reward and pleasure.

• References:

  • Tiwara et al.,2020

  • Benowitz, 2010

Page 23:

• Addiction

  • The risk is greatest in those who begin to smoke at a young age and continue throughout their life.

  • Quitting at any age can make an immense difference for the user, increasing life expectancy and improving the quality of life.

  • Often other forms of nicotine are used to support smoking cessation.

Page 24:

• Smoking Cessation Vaping:

  • Vaping products contain a mix of: nicotine at varying concentrations, flavourings and humectants.

  • Vaping devices vary in make, and have varying degrees of wattage (power).

  • Vaping substances are heated and become aerosol: gas and aqueous particles.

  • These particles penetrate deeply into lung tissue.

  • Long term effects of hygroscopic substances as aerosol particles on lungs are unknown.

• Reference: 14 February 2024 24

Page 25:

• Smoking Cessation Vaping: current research suggests the following:

  • Dehydration and damage to epithelial lining of respiratory tract.

  • Localised inflammation Disruption at alveoli of:

    • gas exchange

    • mucous concentrations

    • surfactant concentrations.

  • Surface tension.

• Reference: Chaumont et al.,2018

Page 26:

• References:

  • Benowitz, N. (2010). Nicotine Addiction. N Engl J Med. 2010 June 17; 362(24): 2295–2303. https://doi:10.1056/NEJMra0809890.

  • Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2015). Lewis’s medical- surgical nursing 4th ed. Elsevier

  • Chaumont, M., van de Borne, P., Bernard, A., Van Muylem, A., Deprez, G., Ullmo, J., Starezewska, J., Briki, R., de Hemptinne, Q., Zaher, W., & Debbas, N.(2018). Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials. Am J Physiol Lung Cell Mol Physiol 316: L705–L719, 2019. https://doi:10.1152/ajplung.00492.2018.

  • Marieb, E. (2019). Human