Passive Smoking: Carcinogens

Smoking and Tobacco Smoke
The WHO considers smoking to be a disease.

- Until the end of the 19th century most tobacco was smoked by men through pipes and cigars,
involving little inhalation, then came cigarettes.
- Recently, the number of smokes in developed countries has decreased while the number in
developing countries has increased.
- Smoking flavoured tobacco called shisha has become fashionable among young people,
many of them believing that it is a healthier alternative. However, the WHO has stated that
smoking shisha could be up to 200 times more harmful than smoking cigarettes. In addition,
shisha contains nicotine and carcinogens just like cigarettes. Extra source: http://
www.theguardian.com/society/2011/aug/22/shisha-smoking-how-bad-is-it
Tobacco smoke contains over 4000 different chemicals, many of which are toxic.
- The smoke is composed of mainstream smoke (from the filter or mouth end) and sidestream
smoke (from the burning tip).
- Sidestream smoke, making up about 85% of the smoke, has higher concentrations of toxins
and thus other people in the vicinity are also exposed to them. Breathing in someone else's
cigarette smoke is called passive smoking.
- The main hazardous components of cigarette smoke are:
1. Tar, which contains carcinogens : a mixture of compounds that settles on the lining of
the airway and lungs and stimulates a series of changes that may lead to obstructive
diseases and lung cancer.
2. Carbon monoxide
3. Nicotine: Both carbon monoxide and nicotine damage the cardiovascular system.
Lung Diseases
Smoking, pollution, and allergic reaction cause most lung diseases. Despite the filtering system
of the lungs, small particles can reach the alveoli and stay there on the delicate tissues of the
lungs. Because each breath fills a huge volume of tiny airways and airflow in the depths of the
lungs is very slow these particles can settle out easily. These deposits make people more likely
to catch pneumonia, influenza, and have allergic reactions leading to asthma.
Signs: The visible expression of a disease which a doctor could find by examining a patient.
Symptoms: cannot be detected by an examination, only reported by the patient.
Chronic bronchitis and emphysema are both classified under chronic obstructive pulmonary
disease (COPD).
Chronic Bronchitis:
- Cause:
Tar in cigarette smoke causes goblet cells and mucous glands to enlarge and secrete
more mucus.
Tar inhibits the cleaning action of the ciliated epithelium in the airways by destroying
many cilia and weakening the sweeping action of the rest.
Mucous accumulates in the bronchioles and smaller bronchioles may become
obstructed.
As the mucus does not move, dirt, bacteria, and viruses collect and block the
bronchioles.
The damaged epithelium is replaced by scar tissue and the smooth muscle around the
bronchioles and bronchi becomes thicker.
- Signs and symptoms:
1. Smokers cough
2. Difficulty breathing
3. Producing large quantities of phlegm (a mixture of mucus, bacteria and some white
blood cells).
- Complications: pneumonia from accumulated mucous, which can cause narrowing and
inflammation of the airway.
Emphysema:
- Cause: Due to chronic bronchitis, the lining of the lungs are constantly inflamed. This
causes phagocytes to leave the blood and line the airways. The phagocytes inadvertently
cause emphysema
How? To reach the lining of the lungs from the capillaries, phagocytes must create a
pathway for themselves by secreting the enzyme elastase, which breaks down the
elastin fibres in the walls of the lungs. Elastin is responsible for the recoil action of the
alveoli.
With smaller amounts of elastin, the alveolar walls do not teach and recoil when
breathing. Thus, the bronchioles collapse during expiration due to the negative
pressure inside the lungs, trapping air in the alveoli and causing them to burst.
Large spaces or holes appear where alveoli have burst, decreasing the surface area
for gas exchange. The number of capillaries also decrease, decreasing the amount of
oxygen absorbed into the blood.
- Signs and Symptoms:
1. Rapid breathing rate to compensate for less oxygenated blood
2. Much smaller vital capacity.
3. Blood pressure in the pulmonary artery and thus the thickness of the right ventricle
increase, to compensate for the increased resistance to blood flow in blood vessels
(which occurs to slow the flow of blood and increase time for diffusion).
4. Breathlessness and wheezing (this only becomes troublesome when about half of
the lungs are destroyed).
Emphysema and chronic bronchitis can occur together. Only very rarely is the damage
reversible. If smoking is given up when one is young, lung function can improve. In older
people, recovery from COPD is impossible. Over 60 million people suffer from COPD
worldwide. By 2030 it is expected to be the third leading cause of death worldwide. Therefore,
many countries have legal controls on emissions of pollutants, conditions in work places, and
smoking in public places.
Lung cancer:
- Cause: The carcinogens with in tar react directly or through their breakdown products with
DNA in the epithelial cells to produce mutations which lead to the formation of a tumour. As
cancer develops, it spreads through the bronchial epithelium and into the lymphatic tissues in
the lungs. Cells may break away and cause secondary tumours (metastasis). Such tumours
are known as malignant.
- Lung cancer takes 20-30 years to develop and diagnosis often comes too late. The methods
of locating tumours in lungs include bronchoscopy, chest X-ray, and CT scan.
- Signs and symptoms:

1. Weight loss
2. Coughing up blood
3. Chest pain
4. Difficulty breathing
- Treatment: If the cancer is small and in one long, then either a part of or all of the lung is
removed. If metastasis has occurred, surgery will not be enough and a variety of treatments
including chemotherapy with anti-cancer drugs or radiotherapy with X-rays (or other radiation)
is used.
Nicotine and Carbon Monoxide
These chemicals have both short-term and long-term side effects on the cardiovascular system.
Nicotine:
- It is absorbed readily in the blood and rapidly travels to the brain, stimulating the nervous
system to reduce the diameter of arterioles and release the hormone adrenaline from the
adrenal glands. In short, it is a stimulant.
- Thus, there is an increase in heart rate and blood pressure combined with a decrease in
blood supply to the extremities of the body, reducing their oxygen supply.
- Nicotine also increases the risk of blood clotting.
- Nicotine is a highly addictive drug which influences the reward centre of the brain. It
stimulates nerve endings to release the neurotransmitter dopamine which reinforces the
pleasurable experience and makes it very hard to give up smoking.
Carbon
Monoxide:
- Carbon monoxide binds to haemoglobin to form carboxyhaemoglobin (see more on the

Transport in Mammals page).
- The decreased amounts of oxygen put strain on the heart especially during exercise.
- Carbon monoxide may also damage the lining of the arteries.
Short-term effects are easily reversible for people who have not smoked for long. However, longterm smokers put their cardiovascular system at risk:
- Damage to the walls of the arteries can lead to an build up in fatty tissue and reduction in
blood flow.
- This can lead to coronary heart disease or stroke.
cardiovascular diseases are multifactorial (many factors contribute to their development).
So, smoking is among several risk factors which increase the risk of developing them.

Passive Smoking: Carcinogens

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Passive Smoking: Carcinogens

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Smoking and Tobacco Smoke

The WHO considers smoking to be a disease.

- Signs and symptoms:

- Carbon monoxide binds to haemoglobin to form carboxyhaemoglobin (see more on the

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