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SMOKING AND THE LUNGS
Among the hazards of cigarette smoking are lung cancer and chronic bronchitis. The link with lung cancer cannot be disputed. A man who smokes twenty cigarettes a day is ten to fifteen times more likely to die of lung cancer than a non-smoker, as first shown by Sir Richard Doll and Dr E. Ў Hammond. Heavier smoking carries an even higher risk. Some victims develop two or more cancers. Tobacco tar contains many cancer-producing substances.
Doll has carried out a long-term study of doctors in Britain. From this he drew a new and critically important conclusion: those who gave up cigarettes had a steadily decreasing risk of lung cancer. After ten years, the risk was barely different from that of a lifelong non-smoker. This finding makes it probable that the cigarette is a cause of lung cancer, not merely an association.
Chronic bronchitis is a common lung disease. Its early symptoms are cough and phlegm, worst on rising in the morning. Later it leads to obstruction of the finer air passages in the lungs. Ultimately this can cause incapacitating shortness of breath; the patient may become unable to blow out the match with which he lit his cigarette. The disability may last for many years but a seemingly mild chest infection in a patient with chronic bronchitis can give rise to a very serious combination of respiratory and cardiac failure. Dr Hammond and others have shown that smokers are at a far greater risk of lung complications following surgical operations; when time permits, an operation is deferred until several weeks after a patient has given up smoking.
Especially in the early stages, but to some extent even when chronic bronchitis is more advanced, the smoker who quits is rewarded by improved capacity for exercise and a decreased risk of death from respiratory disease.
Smokers have other risks too. They have an increased chance of developing tuberculosis of the lung. And the cancer risk in smokers is not confined to the lungs: cigarette, cigar and pipe smokers are up to ten times more prone to cancer of the lip, mouth, tongue, larynx and gullet than are non-smokers. In cigarette smokers the risk of cancer is increased even in organs remote from the air passages: these include the bladder, the pancreas and probably the kidney.
The list of hazards is still incomplete. A form of blindness, tobacco amblyopia, occurs in cigarette smokers. Duodenal ulcer and gastric ulcer are at least twice as common in those who smoke.
Babies born to mothers who have smoked throughout pregnancy are lower in weight and have greater chance of being stillborn.
The cigarette, then, is associated with many forms of disability and many fatal diseases. Recent estimates by the British Government are that 50,000 premature deaths a year are due to cigarette smoking, and that the cost of treating diseases linked with smoking, at 1977 prices, is about 85 million pounds a year – a similar amount to that spent by cigarette manufacturers in promoting their products!
No doubt all these diseases have multiple causes; and individuals presumably differ in their inherited susceptibility, e.g. to chronic bronchitis and lung cancer.
Sometimes medical scientists have to go to curious lengths to establish a point. If, a few years ago, you were at a particular restaurant in London or New York you might have unknowingly taken part in one experiment. Researchers were collecting the contents of ashtrays to measure the length of the average cigarette butt. They were seeking a reason for the finding that the British twenty-cigarette-a-day man was more likely to get lung cancer than his U.S. counterpart: it appears that the Americans, big spenders to a man, discarded their cigarettes when the stubs were far longer than the parsimonious British; hence the dose of cancer-promoting substances was proportionally less.
The dose of tobacco smoke is important – the number of cigarettes smoked, the length of the stub, the amount of smoke inhaled, and especially the duration of the habit. Hence the particular danger to those who start to smoke as children and teenagers. Smoking is an important or major cause of most of the conditions mentioned. It is a cause which need not begin; and once begun it can be stopped.
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This entry was posted on Tuesday, November 3rd, 2009 at %I:%M %p and is filed under Anti-Infectives. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.