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The article below has been taken from our most popular posters and leaflets.

Smoking and health - looking closer at the facts

Tobacco is a killer, on a monumental scale. Globally, around 5 million people die every year from diseases caused by smoking. That's a death every 7 seconds. By the time you have read this leaflet, many more people will have died. And it's getting worse. Tobacco sales in developing countries are increasing and the tobacco industry finds new ways to recruit young and female smokers.

In the UK, tobacco kills around 106,000 people a year - that's over 300 people every day. Half of all smokers, who start smoking when young and continue to smoke, will die from a smoking related disease. Many of these will die in middle age losing up to 25 years of life.

Look at the chemicals in tobacco smoke!

There are over 4000 chemicals in cigarette smoke.
Many are poisonous, and over 60 are known to cause cancer.

Puffing poisons

Here are some of some of the chemicals with their common uses.

Carbon monoxide - Gas in car exhausts
Tar - Road surfaces
Nicotine - Pesticide
Acetone - Paint stripper
Ammonia - Cleaning agent
Arsenic - Ant killer
Benzene - Petrol fumes
Butane - Lighter fuel
Formaldehyde - Embalming fluid
Hydrogen cyanide - Poison in gas chambers
Methanol - Rocket fuel
Toluene - Industrial solvent
DDT - Insecticide
Radon - Radioactive gas
Polonium - Radioactive fallout

The main ingredients of tobacco smoke that cause disease

Tar

Tar is a mix of organic and inorganic particles in tobacco smoke. About 70% of the tar contained in the smoke ends up coating the lungs. An average smoker's lungs collect over a mug full of tar every year. When it condenses the tar forms a sticky brown substance. Tar contains many irritants and cancer causing chemicals including benzo(a)pyrene. Tar also stains the fingers and teeth a brownish yellow.

Nicotine

A powerful, fast acting and highly addictive drug. It takes about 7 seconds after smoke is inhaled for the nicotine to be absorbed into the blood stream and register an effect in the brain. Nicotine has many effects on the body. The immediate ones are an increase in heart rate and blood pressure, narrowing of the blood vessels in the skin, an increase in hormone production and changes in body metabolism. The long-term effect of nicotine when combined with the carbon monoxide is to make the blood stickier and to damage the lining of the blood vessels. This increases the risk of heart attacks, blood clots and poor circulation.

Carbon monoxide

A poisonous gas found in high concentrations in tobacco smoke. The main toxic effect it has on the body is to reduce the amount of oxygen carried in the blood to all the organs and tissues. It clings to the red cells in the blood and up to 15% of a smoker's blood may be carrying carbon monoxide round the body rather than oxygen. It combines with the nicotine to thicken the blood and clog the blood vessels. This increases the risk of coronary heart disease and circulation problems. It can cause damage to the health of an unborn baby and it reduces fitness and concentration. Smoking 'lower tar' cigarettes can increase the carbon monoxide levels as smokers inhale more deeply.

Nitrogen oxide

Cigarette smoke has high levels of nitrogen oxide. This gas causes lung damage and is thought to be responsible for emphysema.

Hydrogen cyanide and other toxins

Hydrogen cyanide and other poisons in tobacco smoke paralyse and eventually kill the cilia or small hairs that are part of the natural cleaning process of the lungs and air passages. This results in the build up of mucus and poisons in the lungs and causes 'smoker's cough' and serious lung diseases. Other poisons damaging the lungs include: ammonia, acrolein, nitrogen dioxide and formaldehyde.

Metals

Thirty metals have been found in tobacco smoke. These include nickel, arsenic, cadmium, chromium, and lead. Some of these are linked to certain cancers. Arsenic and cadmium levels have increased over recent years due to increased use of pesticides and fertilisers in growing tobacco.

Radioactive compounds

Radioactive compounds are known to cause cancer. Those found in tobacco smoke include polonium 210, potassium 40, radium 226 and 228 and thorium 228.

Looking even closer at what smoking does to the body

Smoking and the brain

The brain is like any other organ; it needs a good blood supply to work properly. Smoking causes thickening and blocking of the blood vessels and high blood pressure and these are major risks for stroke. Female smokers have an even higher risk of stroke if they use the contraceptive pill. The shortage of oxygen caused by carbon monoxide in tobacco smoke also affects concentration.
Diseases and problems: Stroke, nicotine addiction, lack of concentration

Smoking and the head

Smoking causes many problems, minor and major, in this part of your body. The throat, mouth and eyes are all affected.

Eyes

Tobacco smoke can irritate the eyes from the outside and cause serious problems from the inside. Smokers are more likely to develop cataracts. Carbon monoxide in cigarette smoke can also impair vision by reducing the amount of oxygen to the eyes. This can result in a higher risk of motor accidents to smokers.

Mouth, throat and larynx

The more cigarettes smoked the greater the risk of cancers of the mouth, throat and larynx. Smoking also increases gum disease, tooth loss and bad breath.

Facial appearance

It's not just health that suffers. Smoking doesn't do your looks any favours either. Poisons in smoke age the skin and dry it out, causing wrinkles around the eyes and the mouth. Smokers generally look older than they actually are. The skin of smokers also has a dull, leathery and grey appearance.
Diseases and problems: Cataracts and impaired vision, throat cancer, mouth cancers, gum disease, headaches, bad breath, wrinkles.

Smoking and the heart

Heart disease is the major killer in developed countries. Cigarette smoking increases the risk of heart disease. Nicotine and carbon monoxide increase the fatty deposits on the walls of the blood vessels. This makes blood vessels narrower and less elastic and more likely to block or tear. Smoking also increases blood pressure and heart rate. This increases the body's demand for oxygen but the carbon monoxide deprives the heart of oxygen, even though it has to work harder. It also leads to heart attacks and angina or chest pain. Smokers have up to eight times more risk of aortic aneurysm when the wall of the aorta leaks or tears due to a build up of fatty deposits. Diseases and problems: Coronary heart disease, angina, abnormal heart rhythms and aortic aneurysm.

Smoking and the lungs

Cancer

Lung cancer is the leading cause of cancer death in men. Smokers are about ten times more likely to die from lung cancer than non-smokers. Lung cancer is often not found until it has spread to other parts of the body such as the brain, liver or bones. The chances of survival are low.

Chronic Obstructive Pulmonary Disease

Smoking causes over 80% of deaths from chronic obstructive pulmonary disease (bronchitis and emphysema). Smoking damages the body's ability to filter the air in the lungs. Chemicals in smoke kill the small hairs or cilia that clean out the airways. Mucus builds up in the lungs causing a chronic cough and chest infections. This is chronic bronchitis. The airways become swollen and inflamed and eventually the air sacs break down. This is emphysema, an incurable and distressing condition. The chronic breathlessness can last for many years and causes disability. Diseases and problems: Lung cancer, chronic bronchitis, emphysema and smoker's cough.

Smoking and the reproductive system

Women

Smoking during pregnancy increases the possibility of miscarriage and a low weight baby. A baby born at lower-than-normal weight is more likely to suffer health problems and delays in physical and intellectual development. Babies, whose mothers smoke, have a greater risk of Sudden Infant Death Syndrome (SIDS).
Smoking can also result in infertility and lower fertility. Smoking can worsen Pre-menstrual Syndrome (PMS). Other problems include premature menopause and cancer of the cervix and uterus. Women who smoke and use oral contraceptives are more likely to suffer a heart attack or stroke.

Men

The poisons in smoke can cause damage to sperm. Both the quantity and quality of the sperm are reduced in smokers.
Smoking is linked to problems with male sexual performance. Nicotine leads to a narrowing and thickening of the blood vessels leading to the penis. Studies have shown that impotence is far more common among smokers than non-smokers.
An increased risk of cancer of the penis is also associated with smoking. Diseases and problems: Miscarriage, lower fertility, cancer of the cervix and uterus, early menopause, damaged sperm, impotence and cancer of the penis.

Smoking and the rest of the body

Cancers

The cancer-causing chemicals in tobacco smoke are passed around the body in the bloodstream. This has been shown to increase the risk of cancers in other parts of the body.
Cancer of the bladder and kidneys are higher in smokers. Smoking also contributes to, if not causes, cancer of the pancreas and stomach.

Peripheral vascular disease

Smoking causes almost all cases of peripheral vascular disease. Blockages in the blood flow can have disastrous effects on parts of the body such as the legs and feet and sometimes to the arms and hands. It can cause severe pain and gangrene may set in. The only cure for this is amputation.

Bones

Osteoporosis is a thinning of the bones, which happens later in life and is more common in women. Smoking increases the chances of developing this condition.

Peptic ulcers

Smoking affects the gastric acid secretions and this leads to higher risk of ulcers in the stomach and duodenum. Also a smoker's ulcer will take longer to heal.
Diseases and problems
Cancers of the bladder, kidney, oesophagus, stomach, pancreas, peripheral vascular disease, gangrene, amputations, peptic ulcers, osteoporosis

What one cigarette does

If someone hasn't smoked for 12 hours or more and then smokes a cigarette, these are the effects on the body:

1. Nicotine in tobacco smoke reaches the brain within 7 seconds of reaching the lungs. It reaches the muscles and the rest of the body soon after. The effects on the body are:

• Nicotine increases the heart rate. This can be measured by checking the pulse before and after the cigarette.
• Nicotine constricts blood vessels. This causes the blood pressure to increase and the blood circulation to slow down in the smaller blood vessels and a lowering of the skin temperature. These can be measured with blood pressure and skin temperature checks before and after the cigarette.
• Nicotine acts as a relaxant for some muscles and causes tension in others. This can be demonstrated by measuring hand tremors before and after the cigarette.
• Nicotine increases stomach secretions
• Nicotine changes the brain activity

2. Carbon monoxide reaches the lungs within seconds. The carbon monoxide is quickly absorbed by the red blood cells in the blood and this reduces the blood oxygen levels. Carbon monoxide is 300 times more readily absorbed by the red blood cells than oxygen. The immediate effects on the body are:

• The body is starved of oxygen and so the heart tries to make up for the shortage and has to work harder to get enough oxygen to the muscles especially during exercise.
• After smoking 20 cigarettes during the day the levels of carbon monoxide are enough to reduce concentration and co-ordination and cause visual impairment.

3. Tobacco smoke including poisons such as hydrogen cyanide, ammonia and nitrogen oxide make the airways of the lungs tighten. This increase resistance in the airways leading into the lungs and this reduces the lung capacity. This can be measured with a peak flow meter before and after a cigarette.

For more information on smoking and health

Check out the Internet, libraries or bookshops. ASH website has many fact sheets about smoking and health. It also has links to a wide range of smoking and health websites around the world - www.ash.org.uk

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