DAFTAR PUSTAKA

1. Perhimpunan Dokter Paru Indonesia. 2003. Penyakit Paru obstruktif Kronik (PPOK)
Pedoman Diagnosis dan Penatalaksanaan di Indonesia. 2003. Hal 2-21.
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Diagnosis, Management, and Prevention. Pg 4-22.
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Internal Medicine. Ed 18. Vol 2: 2151-60.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672796/. Diakses pada tanggal 28 Juni
2016.
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Indonesia berdasarkan RISKESDAS 2007 dan 2013. Hal 1-9.
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Lung Cancer in New Mexico, Am.Rev.Dis 137: 1110-3.
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Smoking

Effects
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https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-effects-on-your-body.
Diakses pada tanggal 15 Juli 2016.
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http://www.abpischools.org.uk/page/modules/breathingandasthma/asthma8.cfm?
coSiteNavigation_allTopic=1. Diakses pada tanggal 15 Juli 2016.
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Media Litbangkes Vol.23 No.2 Juni 2013: 82-8.
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Paru Obstruktif Kronik. Hal 4-12.
14. Nugraha, I. Hubungan derajat berat merokok berdasarkan indeks Brinkman dengan
derajat berat PPOK.

Semua orang tahu bahwa rokok mengandung nikotin yang dapat menimbulkan
kecanduan pada merokok. Tetapi tidak banyak orang yang mengetahui dampak lain
dari zat-zat kimia yang terkandung dalam rokok, seperti dampak karsinogenik dan
efek lainnya terhadap tubuh. Rokok mengandung banyak komponen kimiawi.
Diperkirakan terdapat 7360 komponen dalam rokok, dan jumlahnya mungkin masih
dapat meningkat bila dilakukan penelitian lebih lanjut. Diantara komponen yang
terkandung, 70 zat terbukti bersifat karsinogenik pada manusia.

Lets start with an obvious chemical first, however: the non-carcinogenic nicotine. Nicotine is
a member of the alkaloid family of compounds, a family of which caffeine is also a member.
Cigarettes contain, on average, around 10mg of nicotine; when it is inhaled in cigarette
smoke, it is absorbed into the bloodstream, and when it reaches the brain it stimulates the
production of a number of neurotransmitters. Nicotine impersonates the neurotransmitter
acetylcholine (ACh), and by binding to receptors ACh would usually bind to, stimulates the
production of dopamine, which is involved in your bodys reward pathways. This leads to
the addictiveness of smoking. Nicotine is actually toxic to humans in high doses much
higher than those obtained from smoking cigarettes.
Lets take a look at some of the other organic compounds in cigarette smoke with more
harmful effects:
N-Nitrosamines
These are a large class of nitrogen-containing organic compounds. The majority of
nitrosamines that have been studied have been shown to cause DNA mutations, and
several are known human carcinogens, including some that are specific to tobacco. Of
these, NNK (nicotine-derived nitrosamine ketone) and NNN (nitrosonornicotine) are
considered to have the highest risk for carcinogenic action. Research has shown that the
amounts of tobacco specific nitrosamines varies widely, and that low tar brands tend to
exhibit lower levels of these compounds though they remain present.
Benzene
Benzene is an organic chemical that is actually formed naturally, as a result of occurrences
such as forest fires or volcanic eruptions. However, an important source of human exposure
to this compound comes from cigarettes, which are estimated to account for up to 50% of
exposure in the USA. Benzene is a proven carcinogen, based on evidence from both animal
and human studies. Its also been shown to cause changes to chromosomes in bone
marrow under laboratory conditions. Bone marrow is where new blood cells are made, so
damage to this can lead to anaemia, and low levels of other blood constituents.
Industrially, benzene is useful to make ethylbenzene, a precursor to styrene. Styrene can be
polymerised to form polystyrene.
Aromatic Amines

Aromatic amines are another family of compounds, often used in the synthesis of
pesticides, plastics, and pharmaceuticals. Theyre also found in cigarette smoke, with their
levels tending to be higher in sidestream smoke (that produced at the lit end of the
cigarette). Several of these compounds are confirmed human carcinogens, with increasing
evidence that they contribute to bladder cancer in smokers in particular.
Formaldehyde & Acetaldehyde
These two compounds are both members of the aldehyde family of compounds.
Formaldehyde is known to be a human carcinogen, whilst acetaldehyde is classified as a
confirmed carcinogen in animals and a probable carcinogen in humans. Acetaldehyde is in
fact the most abundant carcinogen in tobacco smoke, and dissolves into saliva when
smoking. Both acetaldehyde and formaldehyde cause irritation of the skin, eyes, throat,
mucus membranes, and respiratory tract.
1,3-Butadiene
1,3-butadiene is a simple hydrocarbon molecule, containing 2 double bonds. In a 2003
study (Fowles & Dybing), the risk factor of various compounds in cigarette smoke for cancer
and heart disease was considered, and 1,3-butadiene presented the highest cancer risk by
some margin. Its also a suspected human teratogen (causes deformation of embryos).
Studies on animals have shown that breathing butadiene during pregnancy can increase
the number of birth defects.
Acrolein
Acrolein is an unsaturated aldehyde (an aldehyde also containing a carbon-carbon double
bond). Its a toxic compound, and an irritant to the eyes, skin, and respiratory tract. Links
have been made between acrolein in cigarette smoke and the development of lung cancers,
though no there is no current scientific evidence that it is a carcinogen in humans. However,
it is a known DNA mutagen, and this in turn could lead to carcinogenic effects. Acrolein has
also been been linked with heart disease as a contributor, and is one of the most abundant
chemicals in cigarette smoke.
Polyaromatic Hydrocarbons
Polyaromatic hydrocarbons are a group of over 100 different organic chemicals formed by
incomplete combustion of organic compounds. Several have been identified are
carcinogenic, mutagenic, or teratogenic. Benzo-a-pyrene is one of the most potent, and

notably was the first chemical carcinogen to be isolated. High exposure to polyaromatic
hydrocarbons in the womb has been associated with lower IQ and childhood asthma, as
well as adverse post-birth effects including heart malformations and DNA damage.

http://www.compoundchem.com/2014/05/01/the-chemicals-in-cigarette-smoke-their-effects/
http://www.ncbi.nlm.nih.gov/books/NBK53014/