Smoking and It's Ill Effects by Dr. Aditya Agrawal

2. Dr. Aditya Agrawal
Consultant Chest Physician
Bhatia Hospital
SMOKING & IT’S ILL
EFFECTS

3. • Formerly regarded solely as a “lifestyle choice.”
• Smoking is now recognized as a chronic, relapsing
disorder caused because of addiction.
• It has become the leading preventable cause of
mortality and morbidity over the years.
Am J Med (2008)121 (4A), S1–S2Am J Med (2008)121 (4A), S1–S2
Smoking – An epidemic

4. Tobacco
TRADITIONAL COMMERCIAL
 Smoked in a pipe for
ceremonial purposes
 Used as an offering to a
healer, elder or other person
as a sign of respect or thanks
 Medicinal tobacco was often
used as a painkiller
 Deliberate targeting of
specific consumer groups
 Premeditated and conscious
addition of chemicals that
lead to addiction
 Scarcely contains actual
tobacco
4

5. Nicotine:
10-19
seconds to
reach brain
ADDICTION

7. Approx 50 LAKHS people die from tobacco use every
year
(1 death every 6 seconds)
Tobacco kills up to half of its users.
WHO report, 2011

8. • India has about 12 crore smokers & it is ever increasing
• 32.7% of adult males and 1.4% of adult females
• 17% of males and 9% of females in 13-15 yrs age group use
tobacco.
• Smoking currently causes approx 8-10 lakh deaths per year in
India.
WHO report on the global tobacco epidemic, 2008
N Engl J Med 2008;358:1137-47.
How big is the problem of
smoking in India

9. Tobacco-Related Health Risks
Cancer

10. Respiratory
 Asthma
 Bronchitis
 COPD
 Emphysema
Cardiovascular
Aortic
aneurysm
Cardiovascular
disease
Stroke
Sudden cardiac
death
Tobacco-Related Health Risks

11. Tobacco-Related Health Risks
Reproductive
•Miscarriage/
•spontaneous
abortion
•Premature baby
•Reduced fertility
Endocrine
•Early
menopause
•Irregular
menstrual
bleeding
•Premature
wrinkling and
aging
Neonatology
•Lower birth
weight
•Sudden infant
death syndrome
(SIDS)

12. Tobacco-Related Health Risks
Infections
•Pneumonia
•Influenza
•Opportunistic
respiratory infections
Others
•Accidents
•Delayed wound
healing

13. WHO report on the global tobacco epidemic, 2008

14. THERE IS
AN EASIER WAY
OF COMMITTING SUICIDE

15. Smokeless Tobacco in India
• Only 20% of the total tobacco consumed in India is in
the form of cigarettes
• About 40% consume bidis and the remaining 40%
chew tobacco, pan masala, snuff, gutkha, masheri
and tobacco toothpaste.
• These products contain putrefied tobacco, paraffin,
areca nut, lime, catechu, and 230 permitted additives
and flavours including known carcinogens.
• India has one of the highest rates of oral cancer in the
world
• Leading cause of oral cancer, oral mucosal fibrosis,
periodontal disease, abrasion of teeth & bad
breath.
1) http://www.cpaaindia.org/activities/projects.
2) WHO
3) Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:857-864)

18. Can smoking affect vision?
• Smoking is as bad for your eyes as it is for
the rest of your body. Research has linked
smoking to an increased risk of
developing age-related macular
degeneration, cataract, and optic nerve
damage, all of which can lead to
blindness.

19. How does smoking affect bones?
• Recent studies show a direct relationship between tobacco use and decreased bone
density.
• Smoking is one of many factors—including weight, alcohol consumption, and activity
level—that increase your risk for osteoporosis
• Significant bone loss has been found in older women and men who smoke. Quitting
smoking appears to reduce the risk for low bone mass and fractures.
• In addition, smoking from an early age puts women at even higher risk for
osteoporosis. Smoking lowers the level of the hormone estrogen in your body, which
can cause menopause earlier, boosting the risk for osteoporosis.

20. How does smoking affect heart
and blood vessels?
• The chemicals in tobacco smoke harm your blood cells and damage the function of
your heart. This damage increases your risk for:
• Atherosclerosis,
• Aneurysms
• Cardiovascular disease (CVD), which includes:
– Coronary heart disease (CHD), narrow or blocked arteries around the heart
– Heart attack and damage to your arteries
– Heart-related chest pain
– High blood pressure
• Peripheral arterial disease (PAD)
• Stroke, which is sudden death of brain cells caused by blood clots or bleeding

21. How does smoking affect lungs
and breathing?
Smoking causes:
•Chronic obstructive pulmonary disease (COPD)
•Emphysema
•Chronic bronchitis
•Pneumonia
•Asthma
•Tuberculosis

22. Exposing an infant to
second-hand smoke
greatly increases the
child’s risk of:
• asthma
• pneumonia
• bronchitis
• fluid in the
middle ear

23. Each year, second-hand tobacco smoke is
responsible for thousands of:
• deaths from heart disease in adults
• deaths from lung cancer in adults
• deaths from other cancers in adults
• cases of lung infections, such as pneumonia
and bronchitis, in infants and young children
• Infertility, spontaneous abortion, and low birth
weight babies
Second-hand Tobacco Smoke

24. The Consequences of Second-hand
Tobacco Smoke on Health
Effects Causally Associated with Second-hand Smoke Exposure
Developmental Effects
Foetal growth: low birth weight or small for gestational age
Sudden infant death syndrome (SIDS)
Respiratory Effects
Acute lower respiratory tract infections in children (bronchitis,
pneumonia)
Asthma induction and exacerbation in children
Chronic respiratory symptoms in children
Eye and nasal irritation in adults
Middle ear infections in children

25. The Consequences of Second-hand
Tobacco Smoke on Health
Effects Causally Associated with Second-hand Smoke
Exposure (cont.)
Carcinogenic Effects
Lung cancer
Nasal sinus cancer
Cardiovascular Effects
Heart disease mortality
Acute and chronic coronary heart disease morbidity

26. The Consequences of Second-hand
Tobacco Smoke on Health
Effects With Suggestive Evidence of a
Causal Association With Second-hand Smoke Exposure
Developmental Effects
Spontaneous abortion
Adverse impact on cognition and behavior
Respiratory Effects
Exacerbation of cystic fibrosis
Decreased pulmonary function
Carcinogenic Effects
Cervical cancer

29. When Smokers Quit

30. Risks from Environmental
Tobacco Smoke (ETS)
– Mainstream—smoke drawn through tobacco while
inhaling
– Sidestream—smoke from the burning end of a
cigarette or smoke exhaled by a smoker
– Contains 2 times more tar and nicotine, 5 times
more carbon monoxide, and 50 times more
ammonia than mainstream smoke
– Causes more deaths a year than any other
environmental pollutant

31. The Wrinkles
The Lie The Truth

32. A smoker’s risk of
heart attack is more
than twice that of
nonsmokers.
Cigarette smoking is
the biggest risk factor
for sudden cardiac
death.

33. Smoking and Strokes
• Cigarette smoking doubles the risk of a stroke.
• Smoking damages the cardiovascular system.
• Cigarette smoke makes clotting more likely.
• Smoking cessation today would significantly cut
risk of stroke within two years.

34. Smoking & Reproduction
• Women smokers have greater risks of:
– Primary and secondary infertility
– Miscarriage and premature delivery
– Stillbirth, neonatal deaths, and sudden infant death
syndrome (SIDS)
– Danger to the mother, eg, bleeding
– Menstrual problems
– Premature menopause + osteoporosis

36. Women who plan to have children need
to know that smoking is associated with:
• Reduced fertility
• Early menopause
• Increased likelihood of delayed pregnancy
• Complications of pregnancy
• Reduced oxygen to placenta

37. Women
who take
birth
control pills
and smoke
are:
39 times more
likely to have a
heart attack
22 times more
likely to suffer
from certain
forms of stroke

45. EFFECTS OF TOBACCO ON HEALTH
Tobacco affects all parts of the body from head to toe
Skin Premature aging
Skin creasing and
Skin cancers
Teeth Staining
Wearing off of teeth
Receding gum line
Mouth Oral cancer
Submucosal fobrosis
Vocal cords Cancer
Eyes Visual problems – cataracts, premature
blindness
Brain Addiction
Strokes
Brain hemorrhage
Heart Heart attacks
Aneurysms
Sudden death

46. Blood vessels Hardening and bloackage
leading to gangrene
Lungs Chronic bronchitis
Emphysema
Infections
Chronic obstructive lung
disease
Cancer
Bladder/ Kidney Cancer
Male impotence
Esophagus/ stomach/ pancreas Cancer
Reproductive system Male impotence
Female infertility
Abortions
Premature birth
Osteoporosis
Bones Thining and risk of fractures

47. Is smoking a risk factor for
autoimmune diseases?
• Smoking compromises the immune system, making smokers more likely to have
respiratory infections.
• Smoking also causes several autoimmune diseases, including Crohn’s disease and
rheumatoid arthritis.
• It may also play a role in periodic flare-ups of signs and symptoms of autoimmune
diseases.
• Smoking doubles your risk of developing rheumatoid arthritis.
• Smoking has recently been linked to type 2 diabetes, also known as adult-onset
diabetes. Smokers are 30% to 40% more likely to develop type 2 diabetes than
nonsmokers.

48. DEPARTMENT OF PULMONARY
MEDICINE