Smoking Effects

Smoking Effects

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  • 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

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  • 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

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  • Short-term effects of smoking

    • Bad breath

    • Fatigue and decrease in energy

    • Reduction in senses of taste and smell

    • Coughing

    • Shortness of breath

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  • 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

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  • Neurological effects

    • Brain: Smoking destroys grey matter, thinner cerebral cortex

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

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  • 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

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  • Physical effects of smoking

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

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

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  • 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

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  • Cardiovascular system

    • Toxins from cigarette smoke enter bloodstream and other organs

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

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  • 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

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  • 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

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  • 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

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  • 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

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  • 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

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  • 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

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  • 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

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  • Nicotine and opiates activate dopamine transmission

    • Basal ganglia

    • Prefrontal cortex

    • Ventral tegmental area

    • Nucleus accumbens

    • Amygdala

    • Dopamine

    • GABA

    • Glutamate

    • Nicotinic acetylcholine receptor

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  • 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

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  • 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.

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  • 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

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  • 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

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  • 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

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