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Cigarettes
-Smoke; contains >4000 different chemicals -Tar containing carcinogen -Carbon Monoxide
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Short term effects:

Tar contains chemicals which settle on lining of airways and alveoli; increasing diffusion distance. Further can cause an allergic reaction; causing smooth muscle on the walls to contract, so the lumen gets smaller restricting flow of oxygen to alveoli Destroys cilia, restricting movement of mucus further causing goblet cells to produce more mucus which collects in the airways. Bacteria and viruses that become trapped in mucus are not removed, they multiply and can block the bronchioles. Making lungs more susceptible to infection (Influenza or pneumonia)

-Nicotine

Long term effects:

Smokers cough; attempt to shift bacteria-laden mucus. Results from irritation and need to clear airways. Causing lining of airway and alveoli to become damaged. Layer of smooth muscle thickens reducing lumen and restricting flow of air permanently Increased infection inflames lining of airways and damages it (epithelium). + attracts white blood cells- release enzymes to get into airways from blood. Enzymes (elastase) digest parts of lining of lungs. Damages elastic tissue in lining, reducing elasticity. As exhale dont recoil to push air out. Bronchioles collapse, trapping air- causing alveoli to burst due to pressure.

Nicotine and carbon monoxide are chemicals which enter the lungs and pass through into the blood. In the blood they circulation. cause changes to the circulation. This leads to increased risk of cardiovascular diseases such as: Atherosclerosis, Coronary heart disease and a stroke. Carbon monoxide Enters the red blood cells and combines with haemoglobin. It combines much more readily than oxygen, and forms stable compound carboxyhaemoglobin. This reduces the oxygen-carrying capacity of the blood. (may cause raise in heart rate) Can also cause damage to lining of the arteries.

Nicotine: Causes addiction. Mimics the action of transmitter substances at the synapses between nerves- nervous system more sensitive- smoker feels more alert Causes the release of the hormone adrenaline. Increase heart rate and breathing rate as well as constriction of the arterioles raising blood pressure Makes platelets sticky, increasing risk of blood clot of formation of a thrombus.

Problems caused by change to the blood system

Atherosclerosis
The process of deposition. Caused by carbon monoxide damaging the endothelium (inner lining) or arteries and high blood pressure. Repair requires white blood cells encouraging growth of smooth muscle and deposition of fatty substances- cholesterol from Low-density lipoproteins. The deposits/ Atheromas may also include fibres, dead blood cells and platelets. Build up of Atheromas occurs under endothelium in wall of artery. May grow enough to break through. Atheroma forms a plaque sticking out into lumen= wall rougher, less flexible and reduces size of lumen reducing blood flow.

Thrombosis
A blood clot in the artery stopping blood flow in that artery. Caused by lack of smooth blood flow caused by a plaque, Sticky platelets caused by nicotine and damage to membrane covering plaque so red blood cells also stick to exposed fatty deposits.

Coronary heart Disease- CHD (Cardiovascular disease)

Coronary arteries- carry blood to heart muscles. When lumen is narrowed by plaques, reducing blood flow to heart muscles, so they receive less oxygen for respiration. Leading to CHD. Heart doesnt receive sufficient oxygen for aerobic respiration- put under strain= insufficient quantities of blood flowing to body. 3 forms; -Angina- severe pain in chest, may extend down left arm or into neck (subsides post exercise) -Heart attack or myocardial infarction- death of part of heart muscle, caused by clot on coronary artery blocking flow of blood to heart muscle. -Heart failure- Heart cannot sustain pumping action; due to blockage.

Stroke (cardiovascular disease)

Death of part of the brain tissue. Caused by loss of blood flow to that part of the brain. 2 possible causes; -Blood clot (thrombus) floating around in blood causes block in small artery leading to brain -Artery leading to brain bursts (haemorrhage) Symptoms: Numbness or weakness of limbs. Confusion, difficulty speaking, Difficulty seeing, Trouble walking, loss of balance and coordination, as well as severe headaches with no known cause.

Cardiovascular diseases Affect the heart and circulatory system -Atherosclerosis [Coronary heart disease Stroke] result from Arteriosclerosis (hardening of the artery walls making them less flexible. Caused by deposition of mineralscalcium in walls and in Atheromas. Symptoms: - High blood pressure and hypertension; narrowing of artery lumen caused by deposition of Atheroma= friction, increasing blood pressure. Less elasticity of walls. - Coronary heart disease: Hard to exercise, Severe pain in chest and arm. - Stroke: Numbness, confusion, difficulty speaking, difficulty seeing and walking with dizziness and lack of balance as well as severe headaches. Factors that increase risk of Coronary heart disease-Age Less of a problem in LEDC; different -Sex (men+) lifestyles, lower life expectancy; die -Cigarette smoking of other diseases (Aids/ malaria) -Obesity before develop CHD, more active -High blood pressure (hypertension) lifestyle, better diet, less likely to -High blood cholesterol concentration smoke heavily -Physical inactivity -Diet- high level of saturated fats and high salt intake. Absence of antioxidants -Genetic factors -Stress

Cardiovascular Diseases

Lung Cancer
Tar contains carcinogens (cancer causing compounds) Carcinogenic compounds enter the nucleus of cells of lung tissue directly affecting the genetic materialmutation. If the mutation affects the genes that control cell division, then this could cause uncontrolled cell division- Cancer (often starts at the bronchi) - Recognized by continual coughing and shortness of breath, Chest pain, and blood coughed up in sputum.

Chronic Obstructive Pulmonary disease A combination of diseases that include: Chronic bronchitis, emphysema and asthma. Chronic Bronchitis Inflammation of the Emphysema lining of the airways. The loss of elasticity in the Also damage to the alveoli causing the alveoli to cilia and burst. Lungs have reduced overproduction of surface area, as larger air spaces mucus which collects formed. So less gaseous in the lungs. exchange. Short of breath, loss Symptoms; Irritation of elasticity= harder to exhale. in lungs, continual Blood is less well oxygenated, so coughing, coughing fatigue occurs. up mucus filled with bacteria and white blood cells. Increased risk of lung infection

Evidence linking smoking to disease

During 1940/50s more took up smoking, later decades of 20th century, it became apparent to meds that certain diseases had become more common; Lung cancer (+mouth/throat), chronic bronchitis, emphysema and cardiovascular disease.

Epidemiological evidence linking smoking and disease: -Regular smoker= 3x more likely to die prematurely than non -50% of regular smokers are likely to die of smoking related diseases -More cigarettes/day, more likely to die prematurely. -Chronic obstructive pulmonary disease= rare in non- smokers -98% of people with emphysemasmokers -20% smokers have emphysema

to help spending, research, screening procedures, education/advice, and predict. Experimental evidence:

Links to lung cancer: Smoker 18x more likely to develop Lung cancer 25% smokers die of it Heavy smoker (25+/day)= 25x more likely than non to die of it Epidemiology- observing facts and figures Chance of developing it reduces to find links. (used to find out risk factors) once stop smoking. - use of animals in experimentsdogs.

Summary:
Smoking increases the risk of developing lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. Bronchitis is inflammation of the airways, often caused by pathogens breeding in mucus that collects there. Tobacco smoke contains several different substances that irritate the ciliated cells and goblet cells lining the airways, increasing mucus production and stopping cilia from working. COPD prevents the normal flow of air through the lungs. It usually involves emphysema, in which the walls of the alveoli are broken down and lose their elasticity. Lung cancer is caused by carcinogens in tar, which damage genes that control cell division. Tobacco smoke contains nicotine, an addictive neurotoxin which increases blood pressure and therisk of developing cardiovascular diseases, including CHD and stroke. Carbon monoxide in tobacco smoke combines with haemoglobin, reducing the amount of oxygen that can be carried in the blood. Much of the evidence for the effects of smoking on health consists of epidemiological data. It is difficult to do controlled experiments that directly show that smoking causes a disease in humans.