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
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
Short-term effects of smoking
Bad breath
Fatigue and decrease in energy
Reduction in senses of taste and smell
Coughing
Shortness of breath
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
Neurological effects
Brain: Smoking destroys grey matter, thinner cerebral cortex
Cerebral cortex crucial for thinking skills, memory, and learning
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
Physical effects of smoking
Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and COPD
Increases risk for tuberculosis, eye diseases, immune system problems
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
Cardiovascular system
Toxins from cigarette smoke enter bloodstream and other organs
Increases heart rate and blood pressure, narrows capillaries, reduces oxygen flow
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
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
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
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
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
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
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
Nicotine and opiates activate dopamine transmission
Basal ganglia
Prefrontal cortex
Ventral tegmental area
Nucleus accumbens
Amygdala
Dopamine
GABA
Glutamate
Nicotinic acetylcholine receptor
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
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.
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
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
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