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Smoking and

Disease
AN IN-DEPTH LOOK AT THE CORRELATION
BETWEEN SMOKING AND DISEASE

Why is it such a big deal?


WHO considers smoking to be a disease.
It became popular among European men during First
World War.

Eventually in the 1940s lots of women also started


smoking.
In Pakistan, 40% of men and 12% of women smoke.
Each day, more than 1200 young people take up
smoking.

How do cigarettes adversely affect our health?


3 main components of cigarette smoke that threaten our health:
Tar: Settles on the lining of the airways in the lungs. Leads to
obstructive lung diseases and lung cancer.
Carbon monoxide: Substitutes O2, diffuses into red blood cells to
form carboxyhaemoglobin which is stable. Less O2 in blood. Less O2
supply to the heart muscle. Also damages lining of arteries.
Nicotine: Stimulates nervous system to reduce diameter of arterioles
and to release adrenaline. Results in reduction of O2 supply in far
ends of body and increase in heart rate and blood pressure. Also
makes platelets more sticky, thus increasing risk of blood clotting.

Why are our lungs susceptible to diseases?


We are constantly exposed to moving air streams which may carry
potentially harmful gases and particles.
Despite our sophisticated filtering system, very small particles can
pass through and settle in the alveoli.

These particles make our lungs vulnerable to air-borne infections


such as influenza and pneumonia and, in some people, can cause
an allergic reaction.
Chronic (long-term) diseases such as asthma, chronic bronchitis,
and emphysema prevail as a result of atmospheric pollution.

How do allergies happen?


Some particles can be allergic to some people. They trigger a
defense mechanism in our airways. If this is bad enough, it may
cause asthmatic attack in which the smooth muscles in the
airways contract.
The bodys defense mechanisms may react with the production of
more mucus and the collection of white blood cells in the airways.
This can block the airways and cause severe coughing, which can
damage the alveoli.
Continuous damage can lead to the alveolar surface being
replayed by scar tissue. This reduces surface area for diffusion.

How do allergies happen?

Are these diseases significant enough?

Lung diseases are the third most common


cause of illness and death in the UK.
One in seven children in the UK has asthma.
To further aggravate this problem, there are
no legal controls in the UK regarding tobacco
smoke.

You mentioned chronic bronchitis. What is it?


Tar in cigarette smoke stimulates secretion of mucus.
It destroys many cilia and weakens sweeping action of those that remain.
Mucus accumulates in the bronchioles.
Dirt, bacteria and viruses block the bronchioles as well.
Eventually the damaged epithalia are replaced by scar tissue and the
smooth muscles surrounding the bronchioles and bronchi become thicker,
making it more difficult for air to move in/out the lungs.
Infections can easily build up in the mucus. When this happens the linings
become inflamed, further narrowing the airways. = CHRONIC BRONCHITIS

What about emphysema?


Inflammation of infected lungs causes phagocytes to line the airways.
Phagocytes release elastase which destroys elastin in the walls of alveoli so as to make way
for them to reach the surface and remove bacteria. Elastin is responsible for the recoil of the
alveoli when we breathe out.
As a result, the bronchioles become flabby and some of the alveoli burst and form fewer
larger ones. This reduces surface area for gaseous exchange.

Chronic obstructive pulmonary disease


Chronic bronchitis and emphysema often occur together and are
collectively called chronic obstructive pulmonary disease which is
a progressively disabling disease.

Lung cancer?
Tar in tobacco smoke contains carcinogens
These react with DNA in epithelial cells to produce mutations;
malignant tumor is developed.
As the first cancer develops, it spreads through the bronchial
epithelium and enters the lymphatic tissues in the lung.
Cells may break away and spread to other organs so that
secondary tumors become established.