ABC of Vascular Disease
Smoking
1. How does smoking cause illness?
Burning the tobacco in a cigarette generates dozens of chemical
products in the smoke that, when inhaled into the lungs, are absorbed into the
blood and distributed by the blood all around the body. One of these
chemicals is called nicotine and it is this that causes the pleasant
"buzz" that smokers get. Unfortunately, nicotine is an addictive
drug, after a while the body cannot do without it. The direct damage
caused by smoking is not from the nicotine; it is the dozens of other chemicals
in the tar that are absorbed into the body and which irritate and poison the
bodies cells. The delicate lining of the arteries is damaged by these
chemicals and over time this causes the arterial disease. These chemicals
also get into other cells and interfere with them, sometimes damaging the cell
growth regulation and resulting in uncontrolled growth: otherwise know as
cancer. Smoking is the commonest cause of lung cancer. The problem
with smoking is that, even though the smoker knows it is unhealthy, the
addiction to nicotine makes it hard to give up.
2. Who is safe to smoke?
The simple answer is no-one. However, some people are at much greater
risk of serious illness than others. If you already have symptomatic
arterial disease, or a condition that is a risk factor for arterial disease
(sugar diabetes, hyperlipidaemia, hypertension) then smoking is very, very bad
for you. Patients with respiratory disease are also at high risk (e.g.
asthma, chronic bronchitis, emphysema). The longer you smoke for and the
more you smoke the greater the cumulative damage. Occasionally you will
hear of very old people who have smoked their whole lives: these are rare
exceptions. Most people who smoke for a long period of time will die
younger and from a potentially very unpleasant smoking related disease than
someone who doesn't!
I3. If I stop smoking will the risk go away?
The good news is that, provided you don't already have a serious smoking
related disease such as lung cancer, if you stop smoking your risk gradually
returns to that of a non-smoker, but this takes about five years. The
other benefit you will get immediately is financial. Smoking is very
expensive.
4. What can I do to stop smoking?
Some people are able just to decide to stop and do so. Others need
some form of help to stop and to keep them from relapsing. Much of smoking
is a habit, and by changing the habitual behaviour it will be easier. If
other members of a household also smoke it is more difficult for one of the
household to give up. Psychological support from friends, family and
support groups can be vital to success. The craving caused by the nicotine
addiction can be eased by using nicotine replacement therapy (NRT) that
comes in the form of chewing gum, patches and cigarette-style inhalers.
NRT is now available on prescription. There is also a drug that can help
with nicotine withdrawal but this can only be used for a short period of time (3
months) and does have side effects, some of which are rare but potentially
serious (epileptic fits).
5. Where do I go for help?
Your chemist or GP practice nurse will be able to give you information leaflets
on stopping smoking. There are lots of helplines as well, such as Quitline
on 0800 00 22 00.
© S.R.Dodds 2001