Smoking natural history, complications and prognosis

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Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Smoking may initially not cause any symptoms and is easy to give up. If not addressed smoking can lead to a vast variety of symptoms related to different organ systems. Smoking may cause carcinomas ultimately and lead to the death. Complications of smoking are not limited to a single organ system. Cardiovascular and respiratory systems are the most commonly involved. It increases the risk of coronary artery disease by 2 to 4 times. COPD is a common complication of smoking. Lung cancers are mostly attributed cigarette smoking. Cigarette smoking is the leading preventable cause of death in the United States. Smoking cessation has positive prognostic effect in lung cancer patients.

Natural History

Smoking may initially not cause any symptoms and is easy to give up. If not addressed smoking can lead to a vast variety of symptoms related to different organ systems including staining of teeth, cough, sputum production and shortness of breath. Smoking may cause carcinomas ultimately and lead to the death.

Complications

Some complications of smoking include:

Death due to Smoking

• Cigarette smoking is the leading preventable cause of death in the United States.
• It causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths.
• Cigarette smoking increases risk for death from all causes in men and women.
• The risk of dying from cigarette smoking has increased over the last 50 years in the U.S.
• 80% of all the deaths as a result of chronic obstructive pulmonary disease (COPD) are due to smoking.

Other Health Risks

Smoking has shown to increases the risk of:

• Coronary heart disease by 2 to 4 times
• Stroke by 2 to 4 times
• Men developing lung cancer by 25 times
• Women developing lung cancer by 25.7 times

Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost

Smoking and Cardiovascular Disease

• Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
• Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
• Smoking damages blood vessels and can make them thicker and grow narrower.
• A stroke may result when:
  • A clot blocks the blood flow to part of your brain
  • A blood vessel in or around your brain bursts
• Blockages caused by smoking can also diminish the blood flow to the legs and the skin.

Smoking and Respiratory Disease

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.

• Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
• Cigarette smoking causes most cases of lung cancer.
• If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
• Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Smoking and Cancer

Smoking can cause cancer almost anywhere in your body:

• Bladder
• Blood (acute myeloid leukemia)
• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea, bronchus, and lung
• Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors.
• If nobody smoked, one of every three cancer deaths in the United States would not occur.

Other Health Risks due to Smoking

Smoking harms nearly every organ of the body and affects a person’s overall health.Smoking can make it harder for a woman to become pregnant. It can also affect her baby’s health before and after birth. Smoking increases risks for:

• Preterm (early) delivery
• Stillbirth (death of the baby before birth)
• Low birth weight
• Sudden infant death syndrome (known as SIDS or crib death)
• Ectopic pregnancy
• Orofacial clefts in infants
• Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage.
• Smoking can affect bone health.
• Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.
• Smoking affects the health of your teeth and gums and can cause tooth loss.
• Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). AMD is damage to a small spot near the center of the retina, the part of the eye needed for central vision.
• Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers.
• Smoking causes general adverse effects on the body, including inflammation and decreased immune function.
• Smoking is a cause of rheumatoid arthritis.

Prognosis

Continued smoking adversely effects the prognosis of all malignancies associated with smoking. Studies have shown that smoking cessation improves the prognosis in early stages of lung cancer.