The smoking dilemma; Smoking and Physical Health

Here's an interesting exercise I'd like for you to try. Please inhale as deeply as you can and hold your breath. Now continue holding your breath a lot I talk. I'll give you further instructions in a few min. A few seconds. Most normal persons can hold their breath for 30 to 40 seconds without any trouble. Now without letting the air out try to inhale again and again and again how does this feel. How would you like to spend the last 10 years of your life like this. OK relax and breathe normally now. What you have just experienced is quite similar to what a victim of advanced emphysema feels and lives with. I think you'll agree it's quite a high price to pay for the pleasures of smoking cigarettes. I'm Dr. Ralph grinder professor of health education at San Diego State College and this is one of a series of programs on the smoking dilemma. In the next few minutes we'll be focusing sharply on some of the damaging effects on the human body of smoking. Our guest today is Dr. John Chambers chest and heart surgeon who has seen

firsthand some of the ravaging effects of smoking. You know depending on the nature of the damage of smoking them. Precisely Dr. Chambers. I'd like to proceed in this way. I'll name a disorder or a group of disorders which are linked with cigarettes and then you describe the disorder briefly and explain how cigarettes are likely involved. I think the first one of a group to together chronic bronchitis and emphysema of which there are about a million extra cases per year. What are these disorders and how are they powered How are smoking involved both chronic bronchitis and emphysema cause shortness of breath cough production of sputum are secretions and early earlier death than would otherwise occur if these conditions were not present. Names

are caused to a large extent by irritants in the bronchial tree and smoking is one of these irritants. For example when one inhales a puff of cigarette smoke the lining of the burning fuel tree which is covered with little silly you are hairs that beat the secretions the normal secretions from the brownfield tree up to the throat where they're swallowed. These Celie are paralyzed by the cigarette smoke and this sets up an implementation in the lining of the bronchial tubes and the smaller bronchial tubes become partially obstructed so that air can get in but can't get out. And when this happens the little air sacs at the end of the bronchial tubes become distended dilated and eventually rupture pop and coalesce with other air sacs

and eventually the lung tissue is destroyed. In other words emphysema is a gradual destruction of normal spongy lung tissue. It would be fair to say that the lungs were almost literally blown out. Yes but if I go to another the sort that we hear more about than all of the others perhaps lung cancer and well with that other forms of cancer which a show increases among cigarette smokers such as cancer of the mouth Atlantics esophagus bladder cancer cancer of the kidneys all of these are associated with cigarette smoking. What is it about cigarettes and the car that's cancer. Well it's easier to see how the cancer of the. Road kill tubes cancer the lung cancer of the mouth and esophagus or gullet are related to cigarettes because that direct contact to smoke is

present. It's harder to see how other cancers are related. Nonetheless they are related. We believe that cancer of the moon occurs when this inflammation of the right fuel tubes occurs over a long period of time in the cells lining the bronchial tree become changed or altered in such a way that they grow that they grow in a wild fashion. This is what cancer is is a wild growth of the changed normal cells. And this takes place over a period of years. For example we can get positive the tumor cells from patients sputum or secretions long before cancer can be seen with an X-ray or long before it can be seen even with a lighted tube down the road kill tree. And what

about these go other cancers like cancer of the bladder cancer of the kidneys there is no direct contact with these tissues we're not absolutely sure how this happens it must be absorption of poisonous so-called carcinogenic material like cancer causing substance from the cigarettes into the bloodstream which is excreta by the kidneys which causes this. How is it that cigarettes are related to and perhaps cause the heart and blood vessel diseases. Well there's several ways that this could take place. For example there's something in in cigarette smoke we don't know what that causes increase clotting in the blood and this blood which clots can clot in small blood vessels and has the healing of this clot occurs. That blood vessel becomes hardened. This is the hardening of the arteries that you're familiar with. Also.

Cigarette smoking sometimes causes an alteration in blood pressure on alteration in the vascular hold and that's the muscle of the blood vessel wall that whether it's stretched or whether it's contract thing. And of course we know blood pressure increase blood pressure is involved in heart disease. This increase in pressure or perhaps pulse rate to over a period of time might have some damage to this one of the yes abilities. Of course cigarette smoking is only one cause of the heart and blood vessel disease or other causes too but this is one that's very easy to to take care of Blaney either not start starting smoking are stopping if you're presently smoking. It was interesting to me from the statistical studies that smokers doubled their risk of coronary heart attack. You know

if they smoke. Yes they can reduce this rather sharply within a few days if they stop. And so and so the argument that oh I've been smoking for 20 years the damage is already done. There's no point in my thumping is not true is it. Well maybe the damages is some damage is already done which is irreparable. However the more damage probably would be done if you continued smoking so you can at least keep your status at the present level. One would hope. By stopping smoking when one stops the news some of the damage repaired. As far as the lungs are concerned yes also we think so as far as the blood vessels are concerned and the heart is concerned however the evidence is less good for the lead bus blood vessels and heart disease and it is for the lungs. I think another category of disorders have to go through. There

is a three fold. Increase in death from peptic ulcers among smokers as compared to govern the number of nonsmokers. How might this be explained. Again this is hard to explain but peptic ulcers sometimes occur with it when the blood supply to the mucous membrane of the stomach is reduced and this might come from smoking. As a physician in private practice you must come in contact daily with persons who understand the dangers of smoking and who would very much like to stop. I'm sure you have some idea as to what advice might be given to people who want to stop him. I found it very difficult. Smoking is really an addiction and there are many people who cannot stop. And when I'm asked what can I do. I can't really quit doctor. Or maybe they don't face this themselves. I usually tell them that they are cessation

clinics that can be attended our Maybe they can switch from cigarettes which ordinarily a person inhales to pipe or cigars which are ordinarily not inhaled. It's important not to inhale cigars or pipe if you do decide to switch. Also filters perhaps help some. And I think it's important for older people with children to tell their children and grandchildren that I am hooked on cigarettes. And please don't. Don't you get hooked on cigarettes and I can't stop. So you see what a horrible thing it's done to me and not being able to stop it. Also I think it's important for a person to see his if he is a smoker to see his doctor at least every six months or two for a complete check up to check to see whether all servers are hard or blood vessel diseases present and of course lung disease.

X-rays of the chest can be made at six months animals and these should be. At least two different views and should be compared minute lead with the chest x rays taken six months before. Far little changes are you talking about. All smokers or dark eyed no guns in the smokers hole there say over 35 years of age. Also we know that the secretions from the bronchial tree the so-called sputum that a person can raise and in certain circumstances can be examined. The microscope and. Unusual precancerous or cancerous cells can be seen very similar to the PAP and they call our PAP smears that women get for cancer of the cervix. And these can be obtained every six months to during the routine examination by your doctor and he can pick up an early cancer even before it can be

seen on an X-ray. Also I think it's worthwhile knowing that you better keep your life insurance premiums paid up because bless them. Because six to eight years of your life will be lacking on the average. If you're over 35 and smoke a pack a day are you sobering for some insurance companies will give you a discount on your premiums instantly if you don't smoke. Well those are some very interesting suggestions from what smokers might do if they find it absolutely impossible to give up the habit. And perhaps it would help those who have been thinking about smoking. You have a little extra boost in stopping about the use of drugs to help people stop. And then there are some physicians who do prescribe various drugs to aid and withdrawing from cigarette habit.

As far as I know there are no real drugs that are of help. But I believe this is going to be covered at a later session. It I might mention a few other conditions that are related to the increased morbidity and mortality that is death and second is related to cigarettes one is accidents on the highways. How many of these are caused by people who are lighting a cigarette or get a nation there I are. Take both hands off the steering wheel to light a cigarette. Also how many people die because of fires and from cigarettes who then light it bad. I one thing we didn't mention also is sinusitis. Much time is lost and in the labor force in the United States from kohls sinusitis which is related to smoking. Also dental conditions such as. Diseases of the good news are also related to

cigarette smoking. Oh no thank you pretty frightening thank you thank you Dr. Chambers for meeting with us today. Well this has been a hurried and verbal rundown on some of the many disorder this one did with cigarette smoking and some of the techniques for perhaps encouraging people. I hope it has served them once again to underline the frightening risks that smokers take in our next program we'll explore the conditions under which young people become smokers. You have been listening to the smoking dilemma with Dr. Ralph Grell a professor of health education at San Diego State College. His guest Dr. John Chambers discuss the relationship of smoking to physical health. This program was produced by the SFM at the Radio-TV Center at San Diego State College. This is the national educational radio network.