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Smoking DIseases

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Biology
Smoking refers to the act of substance inhalation, typically tobacco, followed by bloodstream absorption. Other commonly used substances include cannabis, methamphetamine and heroin. Smoking remains a severe health risk. It increases the likelihood of substance addiction and misuse and can also increase the risk of lung cancer, affecting the smoker and those immediately around them. The World Health Organisation (WHO) describes this as a tobacco epidemic that has claimed the lives of more than 8 million individuals a year.

Smoking Diseases and Causes of Smoking

Smoking is highly addictive due to the substances people inhale in the process, such as nicotine. Nicotine is rapidly absorbed into our bloodstream, and it triggers the secretion of dopamine and adrenaline, hormones that instil feelings of relaxation and pleasure. The rewarding effects of the addictive drug often leave smokers regularly consuming tobacco products, but what causes them to smoke in the first place?

Dopamine is a soluble hormone released by neurones and is associated with the reward pathway in the brain. Adrenaline is similarly a hormone, but it is released from the adrenal glands and plays an essential role in the fight-or-flight response.

The causes of smoking are multi-factorial, but some of the leading reasons include:

  • Anxiety and stress
  • Depression
  • Media and peer influence

Individuals often turn to smoking to relieve stress, anxiety and mental health issues, such as depression. The rewarding feeling of relaxation caused by hormones transiently improves mood, but, as we will learn later, dependence and addiction increase the likelihood of adverse health risks that may enhance stress.

In addition to mental health stresses, media has been used as a powerful tool to glamorise smoking habits. Outlets such as shop advertisements and filmstars significantly influence young individuals into thinking smoking is fashionable and popular. Peer influence and pressure may also lead individuals into trying tobacco products.

Physicians must understand that there is no single cause for smoking and that often individuals take up the habit due to traumatic experiences and personal issues. Approximately 2 out of 3 smokers state they want to quit but have had very little success. Fortunately, there have been campaign and regulation efforts implemented to alleviate smoking.

These campaigns include regulations such as:

  • Banning tobacco advertisements
  • Publishing health warnings on cigarette packs
  • Preventing the display of tobacco products in shops

Dangers and Risks of Smoking

Smoking gives rise to many adverse effects on an individual's health and those around them. Just some of the risks associated with smoking include:

  • Appetite loss
  • Fertility issues
  • Premature ageing
  • Gum disease
  • Second-hand smoking
  • Cardiovascular disease
  • Pulmonary disease
  • Cancers

Appetite Loss and Infertility

It has been long-known that smokers tend to be more underweight; this was even part of the cultural aesthetic during the early 1900s that was advertised to women, especially. Research has shown that nicotine, the addictive component of tobacco smoke, acts on particular nicotinic receptors that suppress and dull the appetite when activated. This pheneomenon predisposes individuals to develop nutrient deficiencies and often eating disorders.

Tobacco products additionally impair both male and female fertility. In males, smoking can increase the rate of sperm DNA damage, decrease sperm motility and decrease sperm count. Meanwhile, for females, the toxins in smoke can damage eggs, impede egg maturation and increase the likelihood of ectopic pregnancies.

Ectopic pregnancies occur when a fertilised egg implants in tissues outside of the uterus, including the fallopian tubes, ovaries, or the cervix.

Ectopic pregnancies are major risks for females as the tissues implanted in the egg become damaged, often leading to internal bleeding. Approximately 12,000 women are diagnosed with ectopic pregnancies each year, but this is most likely a significant underestimate as many women may never be diagnosed.

Premature Ageing and Gum Disease

One of the dermatological effects of tobacco smoke is premature ageing, in which collagen production is impaired, and certain enzymes are synthesised that degrade collagen. Collagen is an important protein for skin health, and its degradation accelerates the ageing of the skin.

The enzymes known to degrade collagen are called matrix metalloproteinases (MMP).

Additionally, smokers are four times more likely to develop gum disease and periodontal issues. These issues occur because the toxins in tobacco smoke damage the connective tissue in your teeth, making them prone to structural loss and deterioration.

Second-hand Smoking

Not only does smoking inflict consequences upon the smoker, but also those around them that inhale the tobacco smoke. Research has shown that the risk of developing adverse effects of smoking increases to 30% for those who inadvertently inhale smoke. The WHO states that of the 8 million lives that die each year due to tobacco smoking, over 1.2 million individuals have been exposed to second-hand smoke.

Other Diseases

Cardiovascular disease, pulmonary complications and cancers are the leading causes of smoking-related deaths worldwide, with lung cancer being the leading disease caused by smoking. We will explore each disease type in the following section.

Diseases and Long-term Effects of Smoking

Many still take up the habit despite efforts to discourage individuals from smoking. This, unfortunately, predisposes these individuals to develop long-term complications and life-threatening diseases that are largely preventable if they quit smoking.

Smoking can increase the risk for cardiovascular diseases, which affect the heart and its associated blood vessels, including atherosclerosis. Meanwhile, respiratory diseases affect the respiratory system, including conditions such as emphysema and chronic obstructive pulmonary disease (COPD). The number one cause of death by smoking is cancer, and it has been estimated that one-third of all cancer deaths are attributed to tobacco use. The most common types of cancers include lung, liver and kidney cancer.

Smoking cessation is the single most effective solution to prevent the onset of these morbidities. By quitting habitual tobacco use, individuals can prevent premature death, reduce the chances of developing life-threatening diseases and improve their overall health.

Cardiovascular Diseases

Smoking increases the burden of cardiovascular diseases, such as atherosclerosis. This disease refers to the build-up and hardening of plaque made of substances such as cholesterol and calcium in the vascular system. Tobacco use induces and augments the effects of atherosclerosis through two main mechanisms:

  • Endothelium damage
  • Increased cholesterol levels

Endothelial dysfunction is known as the key initiator for atherosclerosis pathogenesis. Evidence has shown that the toxins in tobacco smoke can induce endothelial cell apoptosis and necrosis. In addition to this, proteins known as inflammatory cytokines are secreted upon smoke exposure, which augments endothelial damage and dysfunction.

The endothelium refers to the inner lining of blood vessels. Apoptosis describes programmed cell death, while necrosis refers to uncontrolled cell death.

The mechanisms of atherosclerosis are highly intricate and complex. Other processes involved include inflammation, insulin resistance and changes in lipid metabolism.

Respiratory Diseases

Respiratory diseases, or pulmonary diseases, detrimentally affect lung function. This includes COPD, which refers to conditions that make it difficult to break as respiratory structures have been damaged or are dysfunctional. One such COPD is emphysema. This condition occurs when your alveoli, the air sacs of the lungs, become destroyed and permanently enlarged. As a result, the gaseous exchange of oxygen and carbon dioxide in the alveoli is dramatically reduced. In addition to this, cigarette smoke triggers the hypersecretion of mucus, which exacerbates lung obstruction.

The clinical manifestations of emphysema include:

  • Chronic cough
  • Excessive mucus secretion
  • Shortness of breath

Once emphysema develops, the pathophysiological effects cannot be reversed because the alveoli become permanently dilated!

Cancer

Carcinogens, which are agents capable of promoting cancer development, are abundantly present in tobacco smoke, and they include aldehydes, aromatic amines and benzene. Tobacco smoke can contain over 7000 chemicals, of which there are 73 known carcinogens, meaning each puff delivers a cocktail of harmful substances. This can lead to cancers in different organs, most commonly the lungs in chronic smokers.

One of the known mechanisms concerning how tobacco smoke promotes cancer development is through the production of molecules called epoxides, an extremely toxic substance. These epoxides can interact covalently with DNA, bind to DNA and cause DNA replication errors due to complementary base pairing complications. Changes to the nucleotide sequence of DNA are called mutations, and if these mutations occur in oncogenes, cell growth and proliferation can become uncontrolled and lead to tumour development.

Mutations refer to changes in the nucleotide sequence of DNA. Oncogenes are genes that are involved in the cell cycle and growth regulation.

Smoking Diseases - Key Takeaways

  • The causes of smoking include anxiety, depression and media influence. Legal steps have been taken to mitigate these influences, such as anti-smoking campaigns and advertisement bans.
  • The health risks of smoking include premature ageing, fertility complications and gum disease.
  • Smokers have an increased risk of developing life-threatening diseases such as cardiovascular diseases (e.g., atherosclerosis), respiratory diseases (COPD) and cancer.
  • Mutations in oncogenes caused by tobacco smoke are a known cancer development mechanism.

Smoking DIseases

Smoking can cause respiratory diseases, such as emphysema, a type of COPD. This condition occurs when the alveoli of the lungs become damaged. This reduces gaseous exchange and triggers mucus hypersecretion. 

By quitting smoking, you can prevent premature death, reduce the chances of developing life-threatening complications and improve your overall health. This is the best solution to prevent the onset of health complications caused by smoking. 

The number one leading disease caused by smoking is lung cancer.

Tobacco smoke contains harmful toxins that promote endothelial dysfunction and damage. This initiates processes such as apoptosis, lipid metabolism changes and inflammation which trigger the pathogenesis of cardiovascular diseases, such as atherosclerosis.

Individuals smoke for a variety of reasons, but some of the main causes include anxiety, depression and media influence. 

Final Smoking DIseases Quiz

Question

What substances can individuals smoke?

Show answer

Answer

Tobacco, cannabis, methamphetamine, heroin.

Show question

Question

Identify the 2 hormones that nicotine triggers the release of. 

Show answer

Answer

Adrenaline. Dopamine.

Show question

Question

What are the main causes of smoking?

Show answer

Answer

The main causes of smoking include anxiety, stress, depression, media influence and peer influence. 

Show question

Question

What fertility complications can tobacco smoke trigger?

Show answer

Answer

Males can have reduced sperm motility, sperm count and increase sperm DNA mutations. 


In females, tobacco smoke increases the likelihood of an ectopic pregnancy and interrupts the egg maturation process.

Show question

Question

Briefly describe ectopic pregnancies. 

Show answer

Answer

Ectopic pregnancies occur when a fertilised egg implants in tissues outside of the uterus and this includes the fallopian tubes, ovaries or the cervix.

Show question

Question

Identify the important protein needed for skin health.

Show answer

Answer

Collagen.

Show question

Question

How does smoking increase the chances of gum disease?

Show answer

Answer

Toxins in tobacco smoke damage the connective tissue in your teeth, making them prone to structural loss and deterioration.

Show question

Question

Identify three types of diseases caused by smoking.

Show answer

Answer

Any suitable answer is sufficient. Examples include atherosclerosis, COPD, emphysema, cancer, bronchitis, gum disease etc.

Show question

Question

Identify key processes in atherosclerosis pathogenesis.

Show answer

Answer

Any suitable answer is sufficient. Examples include: endothelial damage/dysfunction, increased cholesterol levels, inflammation, insulin resistance, changes in lipid metabolism etc.

Show question

Question

What are the clinical symptoms of emphysema?

Show answer

Answer

Chronic cough, excessive mucus secretion, shortness of breath.

Show question

Question

Define carcinogens. 

Show answer

Answer

Chemical agents that are capable of promoting cancer development.

Show question

Question

What are oncogenes?

Show answer

Answer

Oncogenes are genes that are involved in cell cycle and growth regulation.

Show question

Question

What would happen if significant mutations occur in oncogenes?

Show answer

Answer

The regulation of the cell cycle and growth will become uncontrollable. This contributes to cancer development.

Show question

Question

Identify the hormone involved in the fight-or-flight response. 

Show answer

Answer

Adrenaline. 

Show question

Question

Define mutations. 

Show answer

Answer

Mutations are changes in the nucleotide sequence of DNA.

Show question

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