June is No Smoking Month.
Warnings on the ill effects of cigarette smoking are posted and discussed and laws are passed to prohibit or restrict the use of tobacco, yet for some users, quitting is quite unthinkable.
What really happens when cigarette smoke gets into the lungs?
The lungs are the breathing machines of our body. We breathe in oxygen and breathe out carbon dioxide. Our body needs oxygen to burn fuel (glucose, fatty acids) in a process called combustion. This process occurs inside the body cells to produce energy for the different body processes that are important for our survival, for the brain so that it can analyze and process information, for the heart so that it can pump blood, for the kidneys so that they can cleanse the body of waste products, for the liver so that it metabolizes substances and also help detoxify the body, for the intestines to absorb the food we eat, and for the lungs so that they can perform respiratory functions.
As the body cells burn fuel, carbon dioxide is produced and this has to be breathed out.
From the nostrils, air with oxygen passes through the trachea, bronchi, bronchioles, then to air sacs inside the lungs. It is in these air sacs or alveoli where the exchange of gases occurs. Oxygen from air sacs passes through the very thin walls of small blood vessels the capillaries to go to the blood, and carbon dioxide that is dissolved in the blood goes to the air sacs to be breathed out and eliminated from the body.
When one smokes a cigarette, he takes in nicotine that has the following effects:
It causes constriction or decrease in the caliber of the terminal bronchioles or small airways in the lungs. Constriction increases resistance of airflow into and out of the lungs. What happens when there is increased resistance? Blood from the heart cannot be oxygenated, and carbon dioxide cannot be breathed out. Without oxygen, hypoxia or hypoxemia – low level of oxygen in tissues and in the blood, would occur. The person would feel air hunger, shortness of breath.
Nicotine paralyzes the cilia on the surfaces of the respiratory epithelial cells. These cilia are hair-like structures that normally beat continuously to remove excess fluids and foreign particles from the respiratory passageways.The irritating effects of the smoke itself increases fluid secretion into the air passageways in the lungs and some swelling of the epithelial linings of the airways.
The constriction, disturbance in ciliary movements, and the irritation result in the accumulation of much debris or secretions in the passageways and add further to the difficulty in breathing. Even a light smoker feels respiratory strain during maximal exercise and the level of performance may be reduced.
In chronic smoking, the following changes can develop: mild to severe emphysema. In severe emphysema, as much as 4/5 of lung membranes can be destroyed and slightest physical exertion can cause difficulty in breathing and chronic bronchitis, obstruction of the terminal bronchioles, destruction of alveolar or air sac walls. These structural changes are seen in diseases called chronic obstructive pulmonary disease. These are characterized by low levels of oxygen in the blood, difficulty in breathing, cough. There is also shortness of breath, easy fatigue. Some structural changes can also lead to lung cancer.
Whenever we make a decision whether or not to smoke a stick of cigarette, we are in effect choosing between two types of combustion.
When we decide not to smoke the cigarette, we choose combustion inside our body cells so that they can produce energy for important body functions.
When we decide to smoke the cigarette, we choose the combustion that fires up the lungs. In Covid-19, the virus that knows no one can cause inflammation in the lungs and further damage it.
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