Smoking

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Introduction

Soon after tobacco was brought to Europe by Columbus, laws against its use were established, with whippings, beheadings, and nose slittings as punishment in countries such as Russia, China, Turkey, and India (Wagner, 1971). However, as countries realized the potential for revenue through taxation, these laws were repealed and tobacco became widely used throughout the world.

 

Cigarette smoking is now one of the leading preventable causes of death and disease. In Canada, in 1998, it was estimated to be responsible for 22% of all deaths.

 

There are few other factors as lethal, prevalent, and neglected as cigerettes.

37,000 Canadians die each year of smoking-related causes.

 

 

 

Prevalence of Smoking

 

The Canadian Tobacco Use Monitoring Survey has found that

• 19% of Canadians are current smokers
• smokers have an aveage of 15 cigarettes daily
• the highest prevalence is in ages 20-24

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What is Smoke?

over 3400 constitutents, including 43 carcinogens

• Po 210
• As, Ni, Cd, Cr
• acetaldehyde
• phenol
• HCN
• CO
• nicotine

 

Particulate matter

• tar is the toal particulate matter - minus the water content
• 3x10⁹ particles/ml (PM10 particles)

 

Gas content

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Health Effects of Smoking

Smoking is the single most preventable cause of premature illness and death.

Yousuf Lancet 2004 smoking

Stahl's Essential Psychopharmacology (2008). Tobacco is the

There are at least 24 conditions linked to tobacco (ref).

The most common cause of smoking-related death is cardiovascular disease.

It also causes many cancers, including:

• lung
• bladder
• pancreatic
• oropharyngeal
• esophageal

Nicotine causes inflammation, atherosclerosis

• peptic ulcer disease
• COPD
• thromboangitis obliterans: ulceration of extremeties, severe, refractory pain ant rest

Smoking decreases risk of

• colitis
• endometrial cancer

 

Smoking in Pregnancy

Intrauterine growth restruction is the most well-established link

placenta previa and premature membrane rupture as well.

low birth weight is doubled.

preterm delivery

may be correlations with cleft palate

3x risk of SIDS

ADHD

Some concern regarding

 

Second-hand Smoke in Children

• A large portion of the population in the U.S. is exposed to second-hand smoke. Second-hand smoke exposure causes illness and premature death in people who do not smoke. Adults with involuntary smoke exposure have an increased risk of lung cancer and cardiovascular disease. Most deaths associated with second-hand smoke are due to an increased risk of cardiovascular disease (10).

 

• Among children exposed to environmental smoke, there was a significant increase in otitis media, tympanostomy, tonsillectomy, adenoidectomy, asthma, cough, lower respiratory tract illness, fire deaths caused by smoking materials, as well as the combined end point of disease, hospitalizations, and death. It was estimated that between 136 to 212 childhood deaths per year in the U.S. were due to environmental tobacco smoke related illness, whereas 148 deaths were due to fire caused by smoking materials (15)

 

 

Neuropharmacology of smokers is different due to downregulation of nicotinic receptors.

Rapid metabolism decreases ability of smoking cessation. Metabolism is increased in pregnancy or with the oral contraceptive pill.

The brain stem trumps the cerebral cotrex: "Bathe me in nicotine or I am going to make you feel very uncomfortable."

 

 

Nicotine Withdrawal

 

 

Resources and References

Wagner, S. (1971). Cigarette Country: Tobacco in America, History and Politics. New York: Praeger Publishers.

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