The huff and puff of smoking

He has not touched even a single cigarette in the last two years. Paul Jacob, a 32-year-old entrepreneur from Bengaluru, profoundly yearns for a smoke, even if it is second-hand smoking. But the moment he sees someone smoking, he resists his urge and walks away, daunted by the side effects of smoking.

Jacob recalls his first puff from his friend’s cigarette back when he was studying in class 12. His habit started because of peer pressure and the need to smoke to be part of his friends’ group. “I remember my first cigarette where I kept coughing for every puff. I wanted to look cool in front of my friends. Then I started smoking alone to overcome the cough as I didn’t want to be made fun of,” he says.

It started with two cigarettes a day. “I moved to New York for my master’s degree and worked there for two more years. The cold weather made me smoke more and when I returned, I realised that I was smoking a pack a day. But I always took a break and gave up smoking and drinking during the lent season (a religious observance). This helped a lot with my self-control when I decided to quit,” he says.

Experts say that a single puff from a cigarette carries hundreds of toxins which can damage the lungs. “Cigarette smoking is harmful as it contains multiple toxins and chemicals such as nicotine and tar, which when inhaled affect the lining of the lungs and the smaller airways called alveoli which help in breathing,” says Dr Nimish Shah, consultant pulmonologist, Jalsok Hospital, Mumbai.

How does smoking affect the lungs?

Dr Shah says that smoking causes the paralysis of the cilia which are tiny hair-like particles that help keep foreign particles out of the lungs. “As the paralysis of the cilia prevents the mucous from being cleared from the lungs, it results in cough and an accumulation of mucous. Smoking also causes damage to the elasticity of the lung membranes (alveoli) which leads to an impairment in lung function and makes you more susceptible to infections. This also affects the oxygenation in the body and the body will not be able to effectively exchange oxygen,” he says.

“Smoke from tobacco carries more than 7,000 chemicals of which 70 are known to cause cancer,” says Dr Navneet Sood, clinical lead and senior consultant, pulmonology, Dharamshila Narayana Super Speciality Hospital, Delhi.

The effects of smoking are almost instant

Dr Sood says that a single puff can start damaging the lungs because of the hundreds of toxins it carries. “Since the main function of the lungs is to provide oxygen to the body; this entire function is slightly or severely hampered and the function of other organs is also affected; this can lead to a variety of diseases. The harmful effects of tobacco smoking on the lungs are almost instant,” says Dr Sood.

Jacob proudly remembers the last puff he had a day before lent began in February 2020. My wife who was worried asked me if I could quit. Every year I used to give up smoking for 40 days during lent and I felt that it wasn’t impossible. Knowing all the harmful effects of smoking, I made up my mind and quit,” he says.

Why it should bother you if someone next to you lights up

Passive smoking is nothing but breathing in another person’s tobacco smoke. Dr Sood says that it increases the risk of respiratory illnesses such as asthma, bronchitis and pneumonia among children. “If you live with someone who smokes, you also have a higher risk of smoke-related diseases like lung cancer, heart disease and stroke. When a person smokes at home or in the car, the family members including children would be in direct contact with the smoke. Inhaling the fumes could also lead to chronic obstructive pulmonary disease (COPD) and the risk of lung cancer,” he says.

Jacob says that even now, he has the urge to smoke, especially when he gets the whiff of cigarettes from another person. “I fight the urge every time I step out with my friends who smoke. Even in public places, I get the urge. But as soon as I smell the second-hand smoke, I walk away,” he says. He did not opt for any therapy to quit smoking or use nicotine patches for smoking cessation; it was due to sheer willpower that he was able to quit smoking.

Experts tell Happiest Health that passive smoking can be prevented by stepping away from smokers and not allowing anyone to smoke inside their car or their house. Adults as well as children can be taught to stay away from smokers and not to inhale second-hand smoke.

The many perils of smoking

Bone health

The National Institute of Health, UK, states that cigarette smoking was first identified as a risk factor for osteoporosis decades ago. Studies have shown a direct relationship between tobacco use and decreased bone density. Studies have also suggested that smoking increases the risk of developing a fracture and has a negative impact on bone healing, post fracture.

Cancer risk

Dr Sood says that lung cancer is an unusual expansion or uncontrolled growth of cells that results in lumps, masses or tumours. “It can start in the lining of the bronchi or other areas of the respiratory system. Smoking, including passive smoking, is the main cause of lung cancer. Smoking increases the risk of mouth and lung cancer along with other respiratory cancers such as nose, sinuses, larynx and throat,” he says.

Heart matters

A research study on smoking and cardiovascular disease points out that smoking has been associated with a two-to four-fold increased risk of coronary heart disease, a greater than 70 per cent excess rate of death from coronary heart disease and an elevated risk of sudden death.

Other effects

Dr Shah says, “COPD, strokes, bladder cancer and oesophageal cancer are some of the risks of smoking. Other effects include reduced fertility, low sperm count, long-term memory loss, certain immune disorders like arthritis, increased risk of TB and premature and/or low birth weight in babies.”

 If one already has asthma or other breathing problems, smoking or tobacco usage can make their condition worse, adds Dr Sood. He points out that the usage of frequent tobacco leaves has irreversible effects on the lungs. “Any small obstruction in breathing or a slight discomfort in the respiratory tract leaves deeper health implications because proper breathing is a prerequisite for living a healthy life,” he says.

Are cigars better? No

Dr Sood says that cigars cause the same, if not greater, risk of oral cancers as cigarettes. “Smokers who smoke five cigars a day may have a similar risk of lung cancer as smokers who smoke one cigarette a day. Second-hand smoke from cigars contains toxins and cancer-causing substances (carcinogens) similar to that of second-hand cigarette smoke but in higher concentrations. A tobacco user’s respiratory health is always at risk,” he points out.

Quit today

Dr Shah says that stopping smoking can halt the decline in lung function and stops the damage to the lungs. “Doctors offer various medications and counselling for stopping smoking. This includes nicotine replacement tools such as gums and patches, e-cigarettes, behavioural therapy and other cessation medications,” he says.

For Jacob, quitting smoking was not an easy task, but he says that it is all about the mind. “I had to find distractions to keep myself away from smoking and I would find different things to do. I started working out to keep myself fit. To overcome the urge, I would hit the gym twice a day for four to five months which helped a lot,” he says.

Quit tobacco and reap the benefits  

Dr Sood lists out the benefits of quitting tobacco:

• Quitting smoking improves health and enhances the quality of life
• It can reduce the risk of premature death and can add ten years to one’s life expectancy
• Reduces the risk of developing poor reproductive health, cardiovascular diseases, COPD and cancer
• It benefits people who are already diagnosed with coronary heart disease or COPD.