What are the health consequences of smoking?

Smoking causes multiple diseases. On average, one in two regular smokers dies from smoking. The only way to protect oneself is to quit smoking.

The cigarette, a "chemical factory"

Tobacco smoke is an aerosol, meaning a mixture of gases and particles. This mixture forms at a temperature of 1000° to 1500°C. Ash appears while smoke is formed. At this moment, the 2500 chemical compounds in unburned tobacco turn into over 4000 substances, many of which are toxic.

The smoke cools rapidly before reaching the smoker’s mouth. Its composition is not constant and varies depending on the type of tobacco, its drying method, applied treatments, additives, etc. It always contains nicotine, tars, and flavor agents, but many others are present, such as toxic gases (carbon monoxide, nitrogen oxide, hydrogen cyanide, ammonia) and heavy metals (cadmium, lead, chromium, mercury). Nicotine is the substance (a potent alkaloid) that causes addiction. This addiction is very strong: it appears within the first few weeks of exposure and even with low tobacco consumption.

The poster "Autopsy of a Murderer" - National League Against Cancer (2004) lists the various toxic substances produced by cigarette smoke.

"Light" cigarettes do not reduce risks

The smoke from so-called “light” cigarettes is almost identical to that of regular cigarettes. The “light” effect is mainly due to the presence of micropores in the filter. These pores allow ambient air to dilute the smoke and reduce the proportion of tar and nicotine inhaled. The effectiveness of these filters is tested on machines that “smoke” at a constant rate and power. Unlike the machine, the dependent smoker has neither a timer nor a device to measure the volume of puffs he inhales. However, he is unconsciously seeking a precise dose of nicotine. When he switches to a “light” cigarette, he quickly learns to take larger puffs of diluted smoke, and the “light” cigarette becomes a regular one. Only the taste remains “light” (due to dilution) and the false impression of reduced risks… This is why, in September 2003, the terms “light,” “mild,” or “low-tar” were banned.

Smoking is the cause of multiple diseases

Smoking is a major cause of diseases, associated with a very significant impact on the health of populations. It is the leading cause of preventable mortality, with approximately 75,000 estimated deaths in 2015, accounting for about 13% of deaths in mainland France. On average, one in two regular smokers dies from the consequences of smoking.

  • One in three cancers is caused by smoking. The most well-known is lung cancer, of which 80 to 90% of cases are linked to active smoking. But other cancers are also caused by tobacco: throat, mouth, lips, pancreas, kidneys, bladder, uterus. Esophageal cancer is more common in cases of combined tobacco and alcohol use.
  • Active smoking can also be the cause of cardiovascular diseases: smoking is one of the main risk factors for heart attacks. Strokes, lower limb arteritis, aneurysms, and high blood pressure are also partly related to tobacco smoke. Vascular damage can also cause erectile dysfunction.
  • COPD (or chronic obstructive pulmonary disease) is a chronic respiratory disease mainly caused by smoking. This disease can progress to chronic respiratory failure. At any stage of the disease, smoking is a factor that worsens the condition.
  • Other pathologies are linked to or worsened by smoking: gastritis, gastro-duodenal ulcers, type II diabetes, hypercholesterolemia, hypertriglyceridemia, eczema, psoriasis, lupus, ENT (Nose – throat – ears) and dental infections, cataracts, and AMD (Age-Related Macular Degeneration) leading to blindness. Not to mention periodontitis, a gum disease that causes gum recession and tooth loss.

Smoking can also lead to

  • Decreased sexual abilities and fertility
  • Alteration of the epidermis (wrinkles, dull complexion, yellowed fingers) because tobacco reduces skin oxygenation, making it dull and less flexible; thus wrinkles and fine lines appear prematurely
  • Gum disease, teeth staining, bad breath: tobacco yellows the teeth, causes risks of gum recession, and weakens the gums
  • Alteration of the oral and nasal mucosa, lips, and tongue, taste buds, vocal organs, salivary glands
  • Vitamin B and C deficiencies
  • Alteration of the cerebral arteries (effects on memory, vision, hearing)
  • Effects on the esophagus, stomach
There is no threshold below which smoking is not risky. For example, the risk of developing lung cancer depends on the number of cigarettes smoked per day, but also on the duration of smoking. The only effective way to reduce this risk is to quit smoking.

Smoking during pregnancy carries multiple risks

For pregnancy itself:

  • Tobacco is responsible for about 35% of ectopic pregnancies, meaning the fetus does not implant in the right place
  • The risk of miscarriage in early pregnancy is three times higher
  • Tobacco is a cause of premature birth

For the fetus’s development:

  • The more you smoke, the greater the toxicity for the fetus. In the uterus, the fetus receives oxygen through its mother’s blood. However, when she smokes, her blood becomes loaded with carbon monoxide, a particularly dangerous gas. In addition, nicotine prevents proper blood circulation. The baby therefore does not receive enough oxygen. Other chemicals in the smoke are also toxic to the fetus’s development, which can be delayed. This is called intrauterine growth retardation (low birth weight, small size, small head circumference).
  • Secondhand smoke exposure experienced by non-smoking pregnant women has consequences for the unborn child: the chemicals in the tobacco smoke breathed in by the mother pass into the mother’s blood and into the fetus’s blood
Finally, smoking can increase the time it takes to conceive. As soon as you quit smoking, everything can return to normal.

Passive smoking: an involuntary but dangerous act

Passive smoking is the inhalation of smoke emitted by one or more smokers (from the smoke emitted by cigarette combustion or that exhaled by smokers). By extension, passive smoking also refers to the exposure of the fetus to the mother’s smoking (active or passive).

Tobacco smoke contains more than 4,000 chemicals, including nicotine, irritants, toxic substances (carbon monoxide, tar), and more than 50 carcinogens. Extremely harmful to the smoker, smoke is also harmful to non-smokers.

Passive smoking, while more toxic in a closed environment, is also harmful in an open environment, especially in covered areas (patios, awnings, etc.).

Many people affected:

Passive smoking can affect:
  • the smoker’s entourage
  • people he encounters in his daily life
  • but also the fetus in the mother’s womb
It is estimated that in 2014, 15.5% of people aged 15 to 75 in employment were exposed to other people’s smoke inside their workplace premises. At home, 28.2% of 15-75 year olds reported that someone smoked inside the home. Over the past ten years, this proportion has decreased from 32.8% in 2005. Among 17-year-olds, 24.0% reported being exposed to tobacco smoke at home and 62.9% in front of their school in 2017.

Proven risks:

Passive smoking exacerbates existing conditions and creates new ones. In France, it is estimated that several hundred non-smokers die prematurely each year from diseases caused by passive smoking. Thus, it is estimated that 1,100 adults die from passive smoking each year from heart attacks, strokes, lung cancer, or chronic respiratory diseases. The longer and more intense the exposure, the higher the risk of developing cancer, although it remains lower than in active smokers. For some diseases, such as cardiovascular accidents (heart attacks, for example), the effects of passive smoking are similar to active smoking, even when the exposure to other people’s smoke is low.
Effects on the fetus
  1. In case of active smoking by the pregnant woman:
    • Increased risk of miscarriage, ectopic pregnancy, and premature birth
    • Fetal development delay
    • Smaller birth weight of the baby (for a given gestational age)
    • In-utero fetal death (47% increased risk)
    • Reduced academic and cognitive abilities
    • Development of congenital malformations
  2. In case of passive smoking experienced by non-smoking pregnant women whose partners smoke, there is a measurable effect on the child, although less significant.
Effects on the infant: smoking in the presence of an infant doubles the risk of sudden infant death.
Effects of passive smoking on young children:
  • Irritation of the eyes, nose, and throat
  • Increased frequency of rhinopharyngitis and otitis
  • Greater risk of asthma and respiratory infections (pneumonia and bronchitis)
  • Slight but significant decrease in lung development
Effects of smoking on adults
  • Heart attacks: for a non-smoker, exposure to cigarette smoke increases the risk of having a heart attack by 27%.
  • Lung cancer: the risk of developing lung cancer in a non-smoker is increased by 25% if their spouse smokes.
  • Cancer of the sinuses: passive smoking more than doubles this risk.
  • Stroke: passive smoking damages artery walls and doubles the risk of stroke.

Legal protection:

Since February 1, 2007, smoking is prohibited: In all enclosed and covered public places or workplaces In all means of collective transport On the premises of public and private schools (including open areas) and establishments intended for the reception, training, or accommodation of minors. Since January 1, 2008, smoking is prohibited in places of conviviality (bars, tobaccos, restaurants, nightclubs, and casinos).

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