Toxicity of cigarette smoke

(saba naseer, lahore)

According to world Health Organization, about 1.3 billion smokers were present worldwide in 2003, and there is an expectation that the number will increase to 1.7 billion by 2020. Cigarette smoking is a great risk to the population because of vast multitude of chemicals present in it. It is known that cigarette contains 599 chemicals and there are over 4,700 chemical compounds in cigarette smoke which includes 40-60 compounds known as carcinogens. It is very difficult to give all the toxic compounds that are present in cigarette but some carcinogens include Polycyclic Aromatic Hydrocarbons (PAH), N-nitrosamines compounds, Aromatic Amines and Trace metals. Among trace metals, cadmium, nickel, arsenic and polonium are mostly present. There are evidences that cigarette smoke also contains some bacteria, molds and microbial toxins (exotoxins and endotoxins) linked to the inflammation of lungs.

Cigarette smoke is divided into two groups, one is called mainstream smoke and other is called as side stream smoke. The chemical composition of these two smokes is mainly similar but difference exists in quantities of compounds that are present in them. Side stream smoke contains more compounds as compared to mainstream so it possess more risk to smoker than main stream smoke because it is more toxic. Inhalation of fresh side stream smoke is somewhat four times more toxic than main stream smoke. The compounds after burning appear in two phases, gas phase in the form of aerosols and solid phase as tar. There is 300 to 500 ppm of nitric oxide in fresh main stream and side stream cigarette smoke which converts into nitrogen dioxide. The most commonly known ingredients of cigarette are nicotine, tobacco (an addictive toxicant) and tar. Other poisonous ingredients are carbon monoxide, hydrogen cyanide, DDT and naphthalene. Besides the negative impacts of nicotine which is a major component of cigarette composition, it also has a neuroprotective effect. It is found that cigarette smoke contains a number of tumor initiating and tumor promoting agents who may provide a favorable environment for the development of cancer. The mixture of different kind of chemicals in cigarette smoke has a potential to affect almost every organ system in the body because of sufficient duration of exposure. The extent and timing of exposure is very important while assessing the toxicity of smoking. It is inferred by the research that smoking for 45 years causes 100 times more risk of lung cancer than the risk to people who had been smoking for 15 years, irrespective of the heavy or moderate doses taken.

Worldwide, the death rate of 20% is due to tobacco use which is an important and main constituent of cigarette composition. Study shows that long-term smoking greatly increases the chance of developing many other fatal conditions. Smoking affects all the systems of the body mainly including digestive and respiratory systems. Among the most problematic conditions developed in digestive tract due to cigarette smoking is decreased flow of blood to intestine, backflow movement of stomach acid from stomach to esophagus causing heartburn, damage to liver which is the main filter organ of the body. Smoking may also cause ulcer which may often become fatal . In UK one out of four cancer deaths are related to smoking. It causes five times more deaths than road accidents and other incidences.

Smoking is a principal cause of cancer and as well as death from cancer. Carcinogens that are present in inhaled cigarette smoke damage the DNA and promote uncontrolled cell growth that might be invades to the other body cells and in this way causes cancer of many organs other than lungs. It is estimated that more than 85% of lung cancers is associated with smoking. 90% of lung cancer in men, and 80% in women are due to cigarette smoking. There is about 23 times more chances to develop lung cancer in men and about 13 times in women. Approximately 171,900 new lung cancer cases occurred in 2003 and about 157,200 people died from lung cancer. Estimation shows that 57,400 new cases of bladder cancer are due to smoking.

Cigarette smoking also causes cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, uterine cervix, kidney, ureter, bladder and colon. It is also linked to Leukemia. Besides the carcinogenic effects of cigarette smoking, increased risks of cardiovascular diseases (including stroke), sudden death, cardiac arrest, peripheral vascular disease and aortic aneurysm are many serious diseases related to smoking. Irritation of the lining of the respiratory system is due to some components known as Ciliotoxic present in cigarette mainstream smoke and it results in increased bronchial mucus secretion and chronic decreases in pulmonary and mucociliary function. It is also found that a carcinogen named reactive oxygen species (ROS) cause inhibition of sodium potassium pump of the cell and disrupt the function of cell  In July 1957, smoking was recognized as a cause of lung cancer and it is realized that Environmental Tobacco Smoke (ETS) which is latest aspect of cigarette smoking is the causative factor of increased risk of lung cancer amongst exposed non-smokers. Young infants are more susceptible to increased toxicity of Environmental Tobacco Smoke. According to a report, exposure to secondhand smoke makes a way to the development of asthma in children. It is also revealed that in prematurity, the cigarette smoke affects adversely to the human airway of developing fetus. They are more susceptible to asthma as childhood respiratory disease . Environmental tobacco smoke, the mixture of about 4000 chemicals poses risk to infants due to indoor smoking . Apart from second hand smoke or ETS, there is also a third hand smoke that remains in the dust of smoker’s home for about two months if the smoker has gone from that place and it will affect the new coming residents .The results of a study show that the nicotine in the tobacco smoke get adhere to the indoor surfaces and form carcinogen tobacco compounds that are dangerous to infants .

Literature provides the link between the maternal smoking and exposure to ETS to reduced lung growth and increased risks of respiratory infections and childhood asthma. The severity of these diseases increases with the increase in exposure. A large number of other problems are also associated with it e.g., Sudden infant death syndrome, neurocognitive decrements, behavioral problems and greater rates of adolescent smoking .

The reactive oxygen species formed due to smoking damage the osteoblasts of the body and causes bones to become weak. After the inhalation of cigarette smoke, the nicotine present in the smoke reaches to the brain within 10 seconds. Some individuals are addicted to alcohol, the chronic consumption of alcohol in these individuals induced brain damages. If the same person is also used to smoking, the effect of alcohol induced brain damage goes on intensifying, specially targeting the frontal lobe of brain which is responsible for many body activities. Nuerocognition is adversely affected by the alcohol addiction compounded by smoking addiction.

In US smoking is the single leading cause of approximately 400,000 deaths. A research conducted on smokers and non-smokers to evaluate the potential of toxicity has shown that teenage addiction to smoking reduces the brain function by interfering with the development of brain in adolescence. Mostly adults start smoking between the age of 14 to 18 years and at the age of 18, they completely become addicted to this habit and it reduces their attention abilities by affecting prefrontal cortex of brain which in developing stage in adolescence.

In the world, there are about 1.3 billion smokers and deaths due to tobacco use are estimated to be 5 million persons per year. If the present trend of consumption will continue, the number of deaths because of smoking will become nearly double, approximately 10 million at the end of 2020 .It is worthy to say that not only the smoke, you inhale during smoking but the exposure to the smoke while standing near a smoker, alone is sufficient to cause harm. Carbon monoxide that is present in cigarette smoke binds to the hemoglobin and reduces the oxygen supply to the blood. Carcinogens of tobacco smoke destroy the genes and causes abnormal growth of cells. Results of many in vivo and in vitro tests show that the toxicity of cigarettes varies according to the chemical compounds present in different cigarette of different brands .Different socioeconomic status and many household policies among people have effect on their children in term of exposure to smoking . Research has shown that many tobacco companies are now trying to produce harmless tobacco products. They claim that these products have reduced exposure to smokers. In other words risk to health may be lessening by using light cigarette but there is very little knowledge about them. To save public health from potential toxicity of cigarette smoking is much in debates now days, the only need is to realize the necessity of testing and examining the possible harms to the human health before a product came to the market .

It is known that the single largest cause of cancer in the world is smoking. One out of five cancer deaths are owing to cigarette consumption. 25-40% of smokers die because of smoking in their middle ages. More deaths bring about due to smoking than from other diseases. (Cancer research UK, 2009). As a result of these facts, scientists have been trying to create safer cigarettes than they are currently present. An important part of blood system, Hemoglobin along with activated carbon is made known to lower the 90 percent of free-radicals present in smoke, but this is expensive and therefore is not efficiently coming to the market (Science news, 2012). An alternative cigarette is an “eclipse cigarette” that burns itself instead of burning tobacco. Experiments have shown that the toxicity of eclipse is relatively less as compared to conventional cigarettes (Foy, et al., 2004). Having a garlic rich diet or other supplementary foods might be an evidence to strengthen the bone matter or curing the bone fractures in smokers (Ehnerta, et al., 2012). Many countries are investing in tobacco control programs. By increasing tobacco prices and by offering affordable cessation treatments, the best results can be obtained. Smoking should be ban in public places and media can also play its role to aware the people about the consequences of smoking (Surgeon General Report, 2010). Despite of all these efforts, the only way to reduce the toxicity of cigarette smoking is to quit the smoking and to reduce the exposure to cigarette smoke to avoid the damages due to second hand smoke.
 

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