Assessing the Consequences of Smoking

The physical and medical consequences of smoking are numerous, and the extent and seriousness of smoking-related illness are shocking. More than 450,000 Americans die each year as a result of smoking. Between 3,000 and 5,000 more die as a result of exposure to smoke in the environment (known as secondhand smoke).

Smokers get sick and die at younger ages than nonsmokers, too. According to the World Health Organization, half of regular smokers who began smoking during adolescence will die as a result of their tobacco use. Experts estimate that up to 30 percent of cancer deaths in the United States could be prevented if cigarettes were banned.

Cancer is one of the worst effects that smoking has on the body. Organs that have direct contact with tobacco smoke — the throat, lungs, and esophagus — are the most likely to develop cancer. Here are some of the other effects you are likely to experience if you continue your habit (if you aren't experiencing them already!):

• Your fingers and fingernails become discolored with tarry, mustard-hued stains that can't be scrubbed off.

• Your breath takes on the odor either of the cigarette or cigar you're smoking or of old, lingering tobacco.

• Over time, your skin takes on the appearance of advanced age, with exaggerated wrinkles, crevices, and worry lines.

• Your gums and teeth suffer, with periodontal disease, including gingivitis (painful, swollen, bleeding gums), a prominent part of the not-so-pretty smoking picture. Teeth become stained in unwelcome shades from mustard yellow to dark brown. Stained teeth are a social liability.

• Chronic tobacco users may develop tobacco amblyopia, a condition that involves difficulty with symmetric aligned eye movements.

• Smoking can cause or worsen peptic ulcers and can make them recur.

• Cigarettes are implicated in the development of osteoporosis, a thinning or weakening of the bones often associated with the elderly.

• Female smokers over the age of 35 who take oral contraceptives ("the pill") are at greater risk for heart attack, stroke, and blood clots.

• In the United States, half of all strokes are attributable to cigarette smoking.

• Peripheral vascular disease, which causes pain, a loss of sensation, and poor circulation in the legs, is a serious condition that can lead to infection and even necessitate amputation. Smoking is the primary risk factor for the development of some types of peripheral vascular disease.

• If you are overweight or have high blood pressure or diabetes, smoking will aggravate these conditions and could lead to more severe symptoms and/or greater need for treatment.

• At least one in eight cases of high blood pressure is due to smoking.

• Babies of mothers who smoke are at greater risk for SIDS (Sudden Infant Death Syndrome) and of being born at a low weight.

• Children of mothers who smoke stand a greater chance of having asthma, ear infections, and upper respiratory infections.

Smoking is also one of the major risk factors for developing cardiovascular disease, including heart disease, stroke, abdominal aortic aneurysm, and impaired circulation to the extremities — and cardiovascular disease is the number-one cause of death in the Western world.

Smoking is a major culprit in heart attacks (myocardial infarction). Studies demonstrate that your risk of dying from a heart attack is directly related to how deeply you inhale, how long you've smoked, and the number of cigarettes you smoke per day. Smokers are almost twice as likely to have a heart attack as nonsmokers are.

Insurance companies cost share, which means that they spread the wealth — or in this case, the costs of bad habits that lead to poor health — among all those who pay for insurance, including nonsmokers.

Cigarettes and cancer: A match made in heaven

Cigarette smoke contains dozens of carcinogens (cancer-causing chemical compounds), such as nitrosamines, aldehydes, and aromatic hydrocarbons. Urine samples from smokers applied to microbes in laboratories have caused genetic mutations in these organisms. Carcinogens interact with the genetic material (DNA) in cells, causing mutations in the genetic code, which then give rise to aberrant and sometimes cancerous cells.

Despite the tobacco companies' decades-long advertising crusade, there's no doubt that smoking causes lung cancer, which is the number-one cause of cancer mortality. Experts note that 90 percent of lung cancer is related to smoking.

A smoker's odds of developing lung cancer are 12 to 22 times higher than a nonsmoker's. The more you smoke (including the number of cigarettes, the depth of the inhale, and the number of years of smoking), the greater your chance of developing lung cancer.

Lung cancer isn't the only cancer caused by smoking. Cancer of the larynx is usually caused by smoking, and a lifetime of heavy alcohol use further increases the risk of acquiring this illness. Smoking is also a principal cause of oral (mouth) cancer, esophageal cancer (four out of five cases are caused by smoking), kidney cancer, and bladder cancer. Up to a third of pancreatic cancer deaths are caused by cigarette smoking, and smokers have a significantly increased chance of developing stomach cancer, cancer of the cervix (in women), and leukemia.

What nicotine does to your body

Within seconds of the first puff (or chew or sniff) of tobacco, your heart rate, blood pressure, and breathing rate increase. Your body immediately releases adrenaline, which puts it in a state of readiness for fight or flight. The stimulant action of nicotine is similar to what has been called the stress reaction. All body systems are put on high alert — a kind of physiological DefCon 4. You remain in physiological high gear, with increased heart rate and blood pressure, as long as you smoke and for some hours after, until the nicotine has left your system.

As you can imagine, a continued stress response is harmful to the body. As a result of the continued release of adrenaline, cortisol, and other stress hormones, the body's immune and other systems become overtaxed. You need to be able to wind down from this condition of tension, vigilance, and extreme alertness.

With greater amounts and a longer duration of use, nicotine exerts a sedating effect — so much so that large enough amounts can be toxic, causing nausea, vomiting, and shaking. High doses of nicotine may even prove fatal. Insecticides are made from compounds that are identical in action to nicotine. There are known cases of accidental ingestion of tobacco products by infants and children that have led to severe poisoning.

Nicotine has other immediate effects. You probably remember the very first time or two you tried to smoke, because you probably coughed, retched, or became quite nauseated. Nausea is a direct effect of nicotine.

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