Smoking – To Die For!

Lesson Objectives:
State that tobacco smoking can cause-
Emphysema, bronchitis, cancer and heart
disease.
Describe how cigarette smoke effects
ciliated epithelial cells and how this is
linked to “smoker’s cough”
 Facts:
Fewer than 10% of lung cancer patients survive five years after diagnosis.
 Smokers who smoke between 1 and 14 cigarettes a day have eight times the risk of dying from
lung cancer compared to non-smokers.  Smokers who smoke more than 25 cigarettes a day
have 25 times this risk compared to non-smokers.
Smoking leads to an earlier menopause: on average women smokers go through the menopause
up to 2 years earlier than non-smokers and are at a greater risk of developing osteoporosis.
Smoking has been associated with increased sperm abnormalities and with impotence in men. 
 Giving up smoking can reduce the risk of developing many of these problems.  Within 10-15
years of giving up smoking, an ex-smoker's risk of developing lung cancer is only slightly greater
.
than that of a non-smoker.  A young smoker suffering from bronchitis or emphysema who gives
up may see some improvement in lung function  as a result: damage to lungs caused by years of
smoking is permanent but quitting smoking prevents it worsening.

It is estimated that several hundred cases of lung cancer and several thousand cases of
heart disease in non-smokers in the UK every year are caused by passive smoking.
 Tobacco use kills around 120,000 people in the UK every year, about 330 every day - as if a
plane crashed every day and killed all its passengers,  around 20% of all deaths.
 Smoking causes at least 80% of all deaths from lung cancer, around 80% of all deaths from
bronchitis and emphysema and around 17% of all deaths from heart disease. About half of all
regular cigarette smokers will eventually be killed by their habit.
 Diseases
We are going to look at the main types of
diseases which you can get from smoking,
which are:
Bronchitis
Emphysema
Heart disease
cancer
 Bronchitis
What is chronic bronchitis?

Chronic bronchitis is a chronic

inflammatory condition in the lungs
that causes the respiratory passages
to be swollen and irritated, increases
the mucus production and may
damage the lungs. The symptoms are
coughing and breathlessness, which
will get worse over the years.

The definition of chronic bronchitis is

chronic cough or mucus reproduction
for at least three months in two
successive years when other causes
have been excluded.
 Emphysema
Effects the alveoli
The smokers cough weekens the walls of
the alveoli, therefore the lungs can not
take in enough oxygen which leads to
breathlessness.
 Cancer
Increased risk of developing lung
cancer
Number of cigarettes smoked per day
Annual death rate per 100,000 men
010-14 (8 times that of non-smokers)
15-25 (13 times that of non-smokers)
25 or more25 (25 times that of non-
smokers)
 Lung Cancer
Lung cancer kills more people than any other type of cancer and at
least 80% of these deaths are caused by smoking. In 1999, 29,406
people in England and Wales died of lung cancer.[
It is the tar in the `cigarettes which contain the carcinogenic “cancer
causing” substances
Not only are you susceptible to lung cancer, but also: mouth, throat,
stomach cancer. Cigarette tars contain some of the most
carcinogenic chemicals known to man.  Consider this when
watching people smoking and exhaling only 10% of the tars they
actually take in.  Not only are these chemicals being painted into the
lung, but smoker are also constantly painting them up on their lips,
tongue, larynx, swallowing some and thus painting it in the
esophagus and throughout the digestive tract.  Smokers have
increased incidents of cancer in all of these exposed sites.
 Heart Disease
The role of smoking in Coronary Heart Disease
Inhaling tobacco smoke causes several immediate
responses within the heart and its blood vessels.  Within
one minute of starting to smoke, the heart rate begins to
rise: it may increase by as much as 30 percent during
the first 10 minutes of smoking.
Nicotine raises blood pressure: blood vessels constrict
which forces the heart to work harder to deliver oxygen
to the rest of the body.  Meanwhile,
carbon monoxide in tobacco smoke exerts a negative
effect on the heart by reducing the blood’s ability to carry
oxygen.
 Heart Disease
Smoking tends to increase blood
cholesterol levels. 
Carbon monoxide attaches itself to
haemoglobin (the oxygen-carrying pigment
in red blood cells) much more easily than
oxygen does.  This reduces the amount of
oxygen available to the tissues. This again
will put pressure on the heart!
 Cilia and smoking
The following series of slides
illustrate microscopic changes
that happen when a person
smokes.  The first slide is
showing an illustrated blow-up
of the normal lining of the
bronchus. On the top we see
the cilia, labeled (H).  They are
attached to columnar cells,
labeled (I).  The cilia sweep
the mucous produced in the
goblet cells, labeled (J) as well
as mucous coming from
deeper glands within the lungs
and the particulate matter
trapped in the mucous.  The
bottom layer of cells, labeled
(L) are the basal cells.
 Cilia and smoking
Below we start to see the
changes that occur as people
begin to smoke.  You will see
that the columnar cells are
starting to be crowded out and
displaced by additional layers
of basal cells. 
Not only are fewer cilia present
but the ones that are still
functioning are doing so at a
much lower level of efficiency. 
Many chemicals in tobacco
smoke are toxic to cilia, first
slowing them down, soon
paralyzing them all together
and then destroying them.
 Cilia and smoking
As you see with the cilia actions being
diminished, mucous starts to build up
in the small airways making it harder
for the smoker to breathe and causing
the characteristic smokers cough in
order to clear out the airways.
Eventually though, the ciliated
columnar cells are totally displaced. 
As can be seen below ominous
changes have taken place.  Not only is
the smoker more prone to infection
from the loss of the cleansing
mechanism of the cilia, but these
abnormal cells (O) are cancerous
squamous cells.  These cells will
eventually break through the basement
membrane wall and invade into
underlying lung tissue and often
spread throughout the body long
before the person even knows they
have the disease.
 Cilia and smoking
If a smoker quits before cancer actually starts, even if
the cells are in a precancerous state, the process is
highly reversible. 
.  Cilia regeneration starts in about 3 days once smoking
stops.  Even if cilia has been destroyed and not present
for years, the lining tissue of the windpipe will start to
repair. 
Even the precancerous cells will be sloughed off over
time, reversing the cellular process to the point where
the lining tissue goes back to normal.  But if a smoker
waits too long and cancer starts, it may be too late to
save his or her life.
 Healthy Lungs
You can see how the
lung looks without the
effects of inhalation of
smoke.
Note black specks
throughout indicative
of carbon deposits
from pollution.
 Lung after smoking
Smokers lung with
cancer.  White area
on top is the cancer,
this is what killed the
person.  The
blackened area is just
the deposit of tars
that all smokers paint
into their lungs with
every puff they take.
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