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Health Effect of Smoking

Introduction

Addiction is an extremely complex condition arising from multiple pathways and manifesting in innumerable ways. It is more than just a bad habit that can be stopped through willpower. Addiction can be considered as a medical state that causes some changes in the brain. Smoking is a good example of such addictions. All tobacco products contain nicotine, which is one of addictive drugs that make smoking addictive. However, some individuals do not think so. They state that they enjoy smoking; and they are not going to give it up. They use a fear of putting on weight as a reason for their argument. Such individuals are fighting against the prohibition of smoking in public places and do not consider it a serious problem to anybody. Moreover, such persons think they are right, though it does not mean it is true.

Smoking can cause a serious damage to people’s health and can lead to death. It is an addiction, which is considered an extremely complex condition arising from multiple pathways and manifesting in innumerable ways. It is more than just a bad habit that can be stopped through willpower. This addiction can be considered as a medical state that causes some changes in the brain. All tobacco products contain nicotine being one of the addictive drugs that makes smoking addictive.

Statistics Data. According to the Centers for Disease Control and Prevention in the USA (CDC), smoking is the largest preventable cause of death and disease (“Cigarette Smoking in the United States”). The data provided by the CDC show that every year only in the United States 480,000 people die from this bad habit annually. More than 41,000 of them are secondhand smokers (“Cigarette Smoking in the United States”). Moreover, illnesses caused by smoking in the USA are worth over $300 billion per year (“Cigarette Smoking in the United States”). In 2013, 42.1 million adults in the USA were current cigarette smokers (“Cigarette Smoking in the United States”). The statistic also shows that many women in the country smoke even during pregnancy (see the table 1).

Table 1

Smoking Status - Women with recent live births, 2010

Smoked before pregnancy

23.2%

Smoked during pregnancy

10.7%

Quit smoking during pregnancy

54.3%

Smoked after delivery

15.9%

Source: “Cigarette Smoking in the United States,” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Oct. 2015, Web, 4 Nov. 2015.

Everybody knows how dangerous and harmful the smoking is. Despite all the health effects, people still carry on smoking and cannot give up as easy as they thought it would be. They cannot give up this bad habit even if they are below or at the poverty level (see table 2).

Table 2

Poverty status and smoking

Income Status

Prevalence

Below poverty level

29.2%

At or above poverty level

16.2%

Source: “Cigarette Smoking in the United States,” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Oct. 2015, Web, 4 Nov. 2015.

The Centers for Disease Control and Prevention in the USA demonstrates an interesting statistic. It shows the dependence of smoking and the level of education (“Cigarette Smoking in the United States”). According to this statistic, the highest level of smokers is among the GED group (see the table 3).

Table 3

Smoking and education level

Education Level

Prevalence

Less than high school

24.2%

GED

41.4%

High school graduate

22.0%

Some college

20.9%

Associate degree

17.8%

Undergraduate degree

9.1%

Postgraduate degree

5.6%

Source: “Cigarette Smoking in the United States,” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Oct. 2015, Web, 4 Nov. 2015.

The Reasons of Smoking

People start smoking at different ages. According to the statistic, the majority of smokers in 2005-2013 were between 22 and 24 years old (“Cigarette Smoking in the United States”). It is obvious that people of different age groups have different reasons for starting smoking.

Teenagers Reasoning of Smoking. Many individuals start smoking while they are still at school. According to the statistic from the Centers for Disease Control and Prevention in the USA in 2014, 24.6 % of high school students and 7.7% middle school students used various tobacco products (“Cigarette Smoking in the United States”). Teenagers often begin smoking because they rebel and want to look cool and grown up enough in front of their peers. The question arises as to why this habit is cool from the teenagers’ point of view. Firstly, there is a psychological explanation. When teenagers smoke in front of their friends, they want to demonstrate that they are not mommy’s and daddy’s children. They want to depict that parents do not have control over them or that they see them as old enough to let them smoke.

The second reason of smoking attractiveness among teenagers is caused by advertisement. Due to the great amount of information about human values, a way of thinking, fashion, lifestyle, and behavior patterns are gained from life models provided by mass media, an ad of smoking has a significant effect on promoting it among the youth (Bandura 25). Even though, it is banned in many countries, the hidden advertisement of smoking is widely used in mass media. According to the data provided by the Center for Tobacco Control Research and Education, youth-rated (G/PG/PG-13) movies delivered an estimated 14.8 billion tobacco impressions in theatrical release in 2012 (Polansky, Titus, Lanning, and Glantz 6). The images of smoking in movies and various entertaining programs are the powerful socializing force among youth. This influence is particularly noticeable among adolescents, who often see media stars as behavioral models. It is often possible to see in films how a protagonist, who is a positive character, smokes to relax after accomplishing a difficult task or solving a problem. It gives children an idea that cool guys smoke, and this bad habit does not affect them. Often in various movies and TV programs it is associated with wisdom and harmony. For example, in the famous trilogy Lord of Rings, which is rated PG-13, it is seen on the example of the main character Gandalf the Grey. He is an old respectful wizard, who smokes a pipe when he is thinking or relaxing. Sometimes he makes various shapes with the smoke that looks attractive to teenage viewers. Such episodes create an image that is associated with positive qualities of smoking.

Another scenario occurs when people gather to discuss something important. With the discussion getting intense, they smoke to decrease it. Various scenarios in different movies and programs demonstrate that this habit is good for the stress relief and increasing mood. Such image gets to children’s subconsciousness. Without realizing it, they begin associate smoking with fun, relaxation, and adulthood. These associations frequently lead to the smoking addiction among youth.

The other factor that is often associated with tobacco usage among young people is parental smoking. It is a well-known fact that parents play a role of a behavioral model for their children. Thus, smoking adults increase a chance of their kids to start smoking by being an example for them. A mother’s habit during pregnancy might induce the probability that her child will smoke as well (“Cigarette Smoking in the United States”).

Adults Reasoning of Smoking. It is clear that adolescents are easy influenced by various factors while they are still shaping their personalities. However, not everybody starts smoking during childhood. Many people start doing this in their adulthood. It is obvious that adults have different in comparison with adolescents’ motives and reasons of starting using tobacco products. One of the main reasons is a belief that smoking helps to overcome stress, depression, and anxiety (“Smoking and Mental Health”). This belief is partly true. It can be explained by some biological factors that are involved in the brain’s responses to nicotine (“Smoking and Mental Health”). When an individual smokes a portion of nicotine reaches the brain in about ten minutes (“Smoking and Mental Health”). It reduces anger and stress, improves mood and concentration, decreases appetite and relaxes muscles (“Smoking and Mental Health”). These effects can be explained by the fact that nicotine helps to release dopamine. It is a neurotransmitter that produced in such areas of brain as the midbrain, substantia nigra pars compacta, and hypothalamus. Dopamine plays a significant role in memory, attention, learning, movement, inhibition of prolactin production, behavior and cognition, pleasurable reward, mood, and sleep. Low levels of dopamine might cause painful symptoms. Nevertheless, the high level of dopamine has negative effects on a human organism.

The Mechanisms of Smoking Addiction Development

People carry on smoking and harming themselves and those, who are around them. Many of them think that they can give up smoking as soon as they want. They do not think that it is so addictiveUnfortunately, they are wrong. Many people try to give up smoking, but not many of them succeed.

The Physical Mechanism of Nicotine Addiction Development. As it has been shown above, nicotine contributes to the stress relief. However, despite it, this effect does not last long. Nicotine produces the sense of relaxation, which is temporary. It is soon replaced with withdrawal symptoms and increased cravings. According to the research published by a professor Andy Parrott, smoking increases stress and irritability. He states that a relaxing effect of nicotine only reflects the reversal of stress that develops during nicotine deficiency (Parrott). In his study, Parrott claims that smokers experience significantly higher stress than non-smokers do. It is caused by cravings that smokers experience between consuming cigarettes. Nicotine withdrawal symptoms include such feelings as depression, irritability, anxiety, sleep disorders, increased appetite, as well as attention and cognitive failures. All of them may occur in several hours after the last cigarette. Thus, when smokers have it the negative feelings caused by nicotine cravings restores to normal until the level of nicotine reduces again (Parrott). It creates an illusion of stress relief. Consequently, smokers experience the above-average levels of daily stress comparing to non-smokers.

The Neurological Mechanism of the Nicotine Addiction Development. This circle of stress increases and relief creates the dependence of mood on smoking. However, it does not explain the mechanism of leading to an addiction. Smoking as any other form of dependency is a complex process that includes various neurological interactions. Breathing in some smoke produced by a cigarette separates nicotine from the tobacco in it. The small particles of smoke deliver the nicotine into lungs, where they are promptly absorbed into the pulmonary venous circulation (Benowitz). After it, nicotine gets to the arterial circulation and then immediately transfers from the lungs to the brain, where it connects with nicotinic cholinergic receptors (Benowitz). The stimulation of these receptors releases different neurotransmitters in the brain. As it has been mentioned above, one of these neurotransmitters is dopamine. The reward circuitry that spreads through several regions of the brain is called mesolimbic dopamine pathway. According to the evolutionary perspective, the forces of natural selection are aimed to stimulate the reward circuitry’s development to enhance such behaviors as food intake and having sex to survive (Thombs and Osborn 41). The mesolimbic system plays a role of neurobiological structure that is responsible for producing pleasure. Therefore, it is responsible for creating an addiction. Nicotine, as a drug, stimulates reward centers in this system.

The mesolimbic flow includes such parts of brain as the amygdala, frontal cortex, and ventral striatum (Thombs and Osborn 41). It starts in the ventral tegmental area in the brainstem and projects to the nucleus accumbens in the frontal cortex and ventral striatum (Thombs and Osborn 41). The nucleus accumbens is involved in expectations and striving for rewards (Thombs and Osborn 41). Particularly, this part of brain is responsible for a feeling of pleasure caused by drug intake. The frontal cortex is involved in the evaluation of pleasure stimuli produced by an action and in activating impulse control (Thombs and Osborn 42). The amygdala deals with the intensity of pain and pleasure. It is responsible for the association of pleasurable experiences with various stimuli (Thombs and Osborn 42).

Increased dopamine’s levels in nucleus accumbens are connected with the effects of reward caused by nicotine. In the ventral striatum, pleasurable effects of stimulants are associated with an increase of dopamine. In the brain of not addicted people, the mesolimbic system is very sensitive towards the increased level of dopamine being caused by repeated drug intake. However, its level decreases over time. It produces the deficient rewards and creates withdrawal symptoms. The probability that the use of smoking will lead to addiction directly depends on the speed and intensity of dopamine release. The more people smoke, the more addicted they become.

From a biological perspective, the purpose of the mesolimbic system is to interpose between reward and pleasure and to encourage motivation in life-sustaining tasks such as eating and reproduction (Thombs and Osborn 42). Nevertheless, this trigger has emotional and cognitive aspects. The latter ones in a form of expected strengthening appears from the previous life experiences and motivations. They are formed in the prefrontal cortex, which is connected to the nucleus accumbens. Thus, the previous experience of the temporal stress relief or relax from smoking might be preserved as a memory that motivates people to smoke again. Furthermore, this part of brain becomes exposed to the excess of dopamine during smoking. It might result in reducing the natural production of a neurotransmitter and declining of sensitivity of receptors for it. Even though many people find nicotine unpleasant in the beginning, they soon learn to ignore it and focus on the pleasant effects. As a result, they become addicted to smoking. Another fact that contributes to the development of the nicotine addiction and makes harder for people quit is alcohol. Several types of research have demonstrated the link between drinking and smoking addictions. They show that people tend to smoke more when they have some alcohol. Nicotine increases the effect of alcohol within the body (Miller 320). Thus, smokers develop an association of alcohol with smoking. It makes quitting more complicated.

Besides increasing the dopamine level, nicotine, as a mild stimulant, is able to release adrenaline. It causes increasing the blood pressure and pulse rate (Miller 320). The psychological arousal that is artificially produced by the drug overrides the arousal caused by the tensions of different life events. This fact contributes to making smokers feel less nervous in spite of stimulant effects. Richard Miller states that due to the increased level of adrenaline, smokers tend to have reduced the level of chemicals that are supplemented by antidepressant and antianxiety medicine (Miller 320).

Various experiments of examining the difference that users perceive by consuming different drugs reveal that some sensations from nicotine are very similar to amphetamine and cocaine (Miller 319). The results of the experiment published by Richard Miller show that individuals who got an injection of nicotine identified it as cocaine (319). Nevertheless, it is not the only addictive substance that is presented in a cigarette. Tobacco smoke consists over 4,000 various chemicals (Berrendero et al.). Many of them increase the addictive effects of nicotine. Some of them are addictive as well. Richard Miller points out that some individuals who want to quit smoking find themselves unable to do it despite the use of pharmaceutical nicotine (320). Thus, it is not the only substance that makes smoking addictive.

Other Reasons of the Smoking Addiction Development. Another substance, beside nicotine, that makes smoking addictive is acetaldehyde (Benowitz). It inhibits the activity of monoamine oxidase, which is another significant enzyme of brain that is involved in a breakdown of dopamine (“What Are the Medical Consequences of Tobacco Use?”). Monoamine oxidase is responsible for catalyzing the metabolism of dopamine, norepinephrine, and serotonin (Benowitz). Consequently, inhibition of monoamine oxidase contributes to the development of the smoking addiction.

Besides nicotine and acetaldehyde, modern tobacco companies have devoted a significant amount of use and inclusion of various additives in cigarettes (Rabinoff, Caskey, Rissling, and Park). The results of studies provided by several scientists from California show that modern tobacco industry uses 599 different addictive substances in the production of cigarettes (Rabinoff et al.). The majority of them are aimed to improve taste and decrease harshness (Rabinoff et al.). Among such substances are sugar, sorbitol, phyto-chemical additives, beta-carotene, ammonia, and many others (Rabinoff et al.). The main purpose of these chemicals adding is to make smoking more pleasant and, as a result, more addictive. Despite some of them might look non-harmful and healthy, their presence in a cigarette might have a negative effect (Rabinoff et al.). For example, the oral beta-carotene supplements might contribute to the development of lungs cancer (Rabinoff et al.). All these additional components make smoking more addictive and harder to quit.

The Health Effects of Smoking

Smoking is harmful. This fact is known to the majority of people. However, there is the evidence that nicotine can be useful in health care. Despite this fact, the harm caused by it to humans diminishes all its benefits.

Useful Qualities of Nicotine. Not many people know that nicotine is used in medicine. Richard Miller points out that its medical uses in the treatment of such disorders as heart pain, hernia, toothache, earache, runny nose, and vomiting (318). It also helps to deal with insects’ bites, skin and intestinal parasites, and inflammation of the colon and rectum, caused by uncreative colitis (Miller 318). Pharmaceutical nicotine might help some individuals with tics of Tourette’s syndrome. Chewing gums with this substance have a record of successful treatment finger and toe sores caused by Buerger’s disease (Miller 318). Nicotine reduces hunger pains and raises blood sugar, which helps people to eat less and, as a result, lose weight. It also raises blood pressure, but its repeated intake might cause its lowering.

The Harmful Effect of Free Radicals. In spite on useful qualities of the pharmaceutical nicotine, the usual smoking affects almost every organ in the body. It increases chances of the development for cancer of the mouth, lungs, esophagus, larynx, pharynx, cervix, esophagus, kidney, stomach, and bladder (“What Are the Medical Consequences of Tobacco Use?”). It can cause acute myeloid leukemia and heart disorders. Nicotine also contributes to the development of cataracts, pneumonia, bronchitis, asthma, emphysema, bone density, brain aneurism, and gastroesophageal reflux (Miller 319). Several types of research have proven that smoking makes changes in women’s bodies that cause premature climacteric compare to nonsmoking women (Miller 319).

The question arises as to why this bad habit causes cancer and many other disorders if nicotine is used in medicine. The answer lies in the chemical processes that are responsible for producing free radicals. These ones are atoms or molecules that have an unpaired electron in its outer orbit. They are considered highly reactive chemical elements. The human body is exposed to free radicals that are continuously formed in the regular endogenous metabolism or that have external sources such as smoking and ionizing radiation (Hemat 85). They are capable of DNA mutations and damaging of all cellular components, which include lipids, proteins, carbohydrates, and nucleic acids (Hemat 85).

Recent researches have showed that the free radicals are related to the diseases caused by smoking (Hecht). They generated by cigarette smoke not only cause lung cancer, cardiovascular and heart diseases but also contribute to premature aging (Hecht). Numerous studies have showed that some of the polycyclic aromatic hydrocarbon free radicals are direct chemical carcinogens (Hecht). Cigarette smoke generates such free radicals as nitric oxide (NO), nitric dioxide (NO2), oxygen radicals (RO.), nitrate (NO3-), alkoxyl (RO.), alkyl (R.), and alkylperoxide (ROO) (Hecht). These radicals can inactivate Alpha-1- macroglobulin proteinase inhibitor, which can be an important reason for the damage to lung tissue. Carcinogenesis is thought to occur in stages. In the initiation step of carcinogenesis, a chemical directly causes an irreversible alteration in the molecular structure of the DNA cell. In the subsequent promotion stage, tumor-promoting radicals do not react directly with the genetic material but alter the expression of genes that regulate cell differentiation and growth (Hecht). It has also been claimed that certain promoters of carcinogenesis act by the generation of oxygen radicals and resultant lipid peroxidation (Hecht). Lipid peroxidation cross-links proteins and affects all aspects of cell organization, including membrane, surface structures, and mitotic apparatus (Hecht).

In relation to atherosclerosis, some researchers suggest that oxygen free radicals might be involved in the development of atherosclerotic plaques (Hemat 85). In the subendothelial space, the low-density lipoproteins may underdo oxidation by oxygen free radicals released from arterial endothelial and smooth muscle cells (Hemat 85). Peroxidatively modified low-density lipoproteins are known to be toxic to all arterial particles. They attract macrophages from blood and convert them into lipid-laden foam cells, which can colonize as fatty streaks (Hemat 85).

There is a direct connection between free radicals produced by smoking effect and the damage of bone structure. Smoking causes the disorder of hormonal balance, which leads to decreasing of the estrogen production. Low level of this hormone can be a reason of premature aging among woman. Another factor that contributes to the bone damaging is the increased level of cortisol, which makes bones more breakable. The circulatory embarrassment and poor blood supply of oxygen caused by smoking have also a negative effect on their structure and may lead to the development of osteoporosis (Hemat 85).

Conclusion

There are many reasons why people start smoking. Some people begin this bad habit at an early age because they want to be rebellious or follow their stereotype of being cool. Other individuals start smoking in their adulthood because of different stressful situations. No matter whatever reason it might be, the majority of people when they try the very first cigarette are not going to become addicted and often think they can quit anytime. However, it is not as easy task as they think. Smoking addiction develops relatively fast. As any other dependency it causes the certain change in the brain function. This fact produces many negative effects and causes withdrawal symptoms. They make quitting more difficult. As a result, people carry on smoking. Most of smokers are aware that smoking kills but they do not know what exactly is happening in their organisms when they smoke. Understanding the reasoning of this habit, the mechanism of creating the addiction, and harmful processes within the smoker’s organism may stimulate the intention to quit.