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How will smoking kill you?

WhyQuit News - Sunday, September 25, 2005

For roughly half of adult smokers it isn't a question of if smoking will kill them but how. Ask any smoker what smoking's greatest killer is and they'll likely tell you it's lung cancer. They're wrong. The correct response would have been circulatory or cardiovascular disease.

A smoker's incorrect response to this basic question is understandable. Early on most sensed smoking's impact upon their lungs. Even as teens they knew it was depriving them of a degree of endurance, stamina and normal lung function.

They could hear the panting while trying to keep pace with other teens. Eventually the sounds of a morning cough or wheeze arrive. But smoking induced circulatory disease is a silent killer.

Smokers need to imagine damage to normal blood flow being substantially worse than any damage they sense happening within their lungs. According to the U.S. Centers for Disease Control, lung cancer is responsible for 28% of smoking related deaths while 43% are attributable to cardiovascular disease - primarily heart disease and strokes.

It's easy to appreciate that the 43 cancer causing chemicals in each and every puff are slowly building an internal time bomb. What few comprehend is that before the bomb has time to go off that it's far more likely that smoking will cause some portion of their body's blood piping to completely clog, with downstream oxygen deprived tissues suffocating and dying. But how?

Nicotine's ability to dock at millions of acetylcholine receptor sites grant it control over the flow of a host of neurochemicals including those associated with preparing the body for fight or flight, our built-in stress response.

Imagine encountering a sabertooth tiger and having to either flee or fight in order to survive. The stresses would cause these amazing bodies to release a host of chemicals and hormones. They'd trigger an increase in our rate of breathing so that our body could immediately begin taking in more oxygen.

Our heart rate would climb so that a greater volume of oxygen rich blood could be pumped from our lungs to our muscles and brain. Our blood pressure would increase. Extremity and skin surface blood vessels would constrict so as to diminish the risk of bleeding to death if cut while fighting or fleeing the tiger. Our fingers and toes would grow noticeably colder.

Our hearing would perk and our pupils would dilate. Our body would be force-fed an instant supply of energy as the liver released glucose elevating blood sugars, and stored fats were pumped into our bloodstream -- fats intended to be burned while fighting or fleeing the sabertooth tiger.

Bodily functions not needed during fight or flight would be shut down in order to redirect blood flow to muscle tissues. Nonessential functions such as digestion would stop. The liver would suspend bad cholesterol clean-up, while stored cholesterol would be released helping thicken our blood and aid in clotting if wounded during fight or flight.

That's how the body's defenses were designed to respond. But instead of a sabertooth tiger imagine the natural insecticide and teratogen nicotine being able to trigger the body's fight or flight responses. Visualize it happening puff after puff, cigarette after cigarette, pack after pack, year after year.

Picture nicotine's control over fight or flight occurring at the exact same time as the smoker is inhaling large quantities of highly toxic carbon monoxide. Inside our lungs carbon monoxide binds to hemoglobin (the oxygen carrying portion of red blood cells) with an affinity 200-250 times greater than that of oxygen.

Not only does an arriving carbon monoxide molecule have a 200 times greater chance than an oxygen molecule of entering the bloodstream, two to four hours after inhaling a large puff of carbon monoxide half is still circulating.

It not only robs the body of life-giving oxygen but its toxic properties act as a Brillo pad in grinding away the smooth delicate endothelium lining of blood vessel walls. Like eggs that begin sticking to a worn Teflon frying pan, extra fight or flight fats begin sticking, accumulating, building and hardening.

Picture the inside of once smooth coronary arteries whose job it was to feed our heart muscle oxygen instead gradually becoming narrower and narrower as they slowly fill with fight or flight fats and cholesterols. Picture the same process occurring in blood pathways to the brain.

Eventually it happens. Complete blockage occurs. All downstream tissues serviced with oxygen by the blood vessel immediately begin to suffocate and die. By far the most common site of smoker circulatory tissue death is the heart muscle (a heart attack) followed by the brain (a stroke).

The smoker's senseless self destruction need not continue. Nicotine is simply a chemical with an I.Q. of zero. Knowledge truly is power. The smoker's greatest weapon is and always has been their vastly superior intelligence but only if put to work.

How much do you know about the basics of nicotine dependency recovery? Visit WhyQuit.com and take a short 25 question quitting quiz and find out.


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Written September 25, 2005 and updated June 5, 2015 by John R. Polito