YOUR HEALTH - MEDICINE 101

SMOKING

The question remains – given what we know about the harmful affects of tobacco … why are people still smoking?

Think about it. More than 50 years ago we got incontrovertible proof that linked smoking to carcinogens – including arsenic, phenol, butane and turpentine. About 50% of smokers die prematurely from disease caused by their smoking. Does this make a lot of sense to you? 90% of smokers begin during adolescence – and why? Well, most of them say it's a need for an enhanced self-image.

Here are some normal lungs – built to last a lifetime. These are from a pig – but they’re the same as yours if you don’t smoke. The pink colour is from the blood they contain – that’s what lungs do – they mix blood with oxygen in millions of tiny sacs called alveoli. Lungs aren’t just empty balloons, they’re more like sponges as you can see here. This is what your lungs look like if you smoke. The poor pig was exposed to cigarette smoke – the dark grey black colour comes from carbon deposited in the lung.

Faced with the daily onslaught of irritant chemicals, your poor lungs try to protect themselves. They object to the chronic inflammation by producing more mucous in these large airways, the bronchi. Soon the bronchi are filled with this thick yellow mucous and inflammation, a condition known as chronic bronchitis and the cause of smoker’s cough.

Emphysema comes next. The word is Greek for inflammation, and it refers to the destruction of the small air sacs seen with smoking. Normal lung looks like this – millions of small air hollow air sacs, leaving huge empty holes in the tissue, like this. You have so much reserve in your lung that you don’t even notice that you’re short of breath until one third of the lung tissue is gone, but then you’re breathless just walking across the room.

And then, there’s cancer of the lung. It looks like this – a dirty grey sickeningly hard mass. It’s the most common cancer in men and second in women and will kill 17,000 Canadians this year. It’s so common, we doctors call it Ca of the lung. It begins with a single cell that has been so irritated by the smoke that it begins to change, begins to grow and then won’t stop growing, a cauliflower like mass that invades the adjacent lung. It produces symptoms of breathlessness, weight loss, pain and coughing up blood. As doctors, we’re not very good with this cancer. With all our treatments – surgery, radiation, and chemotherapy only 9% of patients survive to 5 years.
So there’s no question these things aren’t good for you. If you believe that life is sweet, as I do, the only question is – why do people continue to smoke?