In this Nexus:
🔢 Key Facts and Numbers About Smoking
🚬 My Personal Experience With Smoking
💨 The Deadly Cocktail of Smoking
🏥 Smoking and Related Diseases
😵 Nicotine Addiction
👿 ALL Tobacco Products Are BAD!
🚭 It Is Never Too Late To Quit
🎬 Documentaries Recommendation
Do you want to live shorter and die from an ugly disease that will make your life miserable? I have a solution for you – start smoking! When I started my Nexus Newsletter, I have promised one angry article about smoking. So here it comes. Be prepared, especially if you are still smoking any kind of tobacco products. Smoking remains one of the leading causes of preventable diseases and death worldwide. It affects nearly every organ in the body, severely reducing your quality of life, healthspan and longevity. Despite efforts to educate the public, tobacco use remains a global epidemic. In this Nexus I will discuss the key numbers of tobacco harm, my personal experience related to the topic, what’s in the deadly cocktail of smoking, related diseases, nicotine addiction, different tobacco products and more. At the end you will find a Netflix documentaries recommendations just to strengthen what I wrote.
Key Facts and Numbers About Smoking
If you like numbers like me, look at these. Addiction to nicotine leads to around 15% of all deaths globally (1). Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke (2). Yearly deaths account for around the same number as the population in London, or almost 3 times more than the number of citizens of Lithuania. Put it however you want, the numbers are massive.
Tobacco kills up to 50% of its users who don’t quit.
Despite these deadly numbers, in 2020, 22.3% of the world’s population used tobacco: 36.7% of all men and 7.8% of all women (2). The costs of care associated with smoking account for about 15% of the aggregate health-care expenditure in high-income countries and are estimated to be US$500 billion worldwide (3). This means that even if you are not a smoker yourself, you are paying each month a portion of your taxes to take care of the ones who are smoking tobacco.
My Personal Experience With Smoking
I am proud to say that I have never been smoking in my life. I have tried cigarettes, but I’ve never been smoking even for a couple consecutive days. But my dad is a smoker. I remember him taking me and my sister to school and smoking in a car, and in those days back in 1990’s it was still kind of normal. I hated the smell and how it remained on my hair and clothes, and maybe due to the fact, I’ve never started smoking myself.
My dad is sadly a good example of how cigarettes affects your health. It was a hot summer day 4 years ago, and we were celebrating the 90th birthday of my grandfather (he is my role model of longevity). We saw that something is not right with my dad, heat might have provoked his cardiovascular symptoms. We reacted quickly and gave him some aspirin, and afterwards we sent him to a cardiologist for a check up. Shortly after the visit he was scheduled for a vascular bypass surgery. But if he haven’t been in the family of two daughters working in healthcare, he might have died already from the stroke.
What is worst in such cases, that the shaking of being close to death or undergoing a serious surgery lasts for a very short time. And for these people, it is very hard to understand and change their behaviour…
The Deadly Cocktail of Smoking
Tobacco smoke contains more than 7,000 chemicals, with hundreds classified as toxic and at least 70 known to cause cancer. These substances creates chaos in nearly every organ in the body, making smoking responsible for many of the deadliest chronic diseases. For instance, lung cancer, the leading cause of cancer death globally, owes about 85% of its cases to smoking. But it’s not just cancer. Cardiovascular disease, chronic obstructive pulmonary disease (COPD), and stroke are all directly linked to smoking habits.
Smoking reduces life expectancy by at least 10 years.
A meta-analysis published in the New England Journal of Medicine revealed that smoking reduces life expectancy by at least ten years, and quitting before the age of 40 can cut the risk of death associated with smoking by about 90% (4).
What Does Science Say?
Smoking and Related Diseases
When you think about smoking, the first disease that comes to your mind is lung cancer. But many people do not understand that there are much more than this one of the most aggressive cancer forms. In one of the first Nexus Newsletters, I have described 10 deadliest diseases in the Western world and smoking is a risk factor of them all! See below:
So lets look at the most directly tobacco smoking associated diseases:
- Lung cancer. Lung cancer represents the primary cause of cancer-related mortality globally. However, the incidence and mortality rates of lung cancer exhibit considerable geographic variability, driven by differences in tobacco consumption, environmental exposures, and genetic predispositions. Tobacco smoking is the predominant risk factor for lung cancer, with incidence rates closely mirroring smoking trends, which differ significantly based on sex and levels of economic development. Smokers are 15 to 30 times more likely to develop lung cancer than non-smokers (5).
- COPD. Chronic obstructive pulmonary disease, often called a smoker’s disease, is characterized by difficulty breathing and irreversible lung damage. COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019 (6). Tobacco smoking is the main and most characterised cause of COPD and accounts for over 70% of COPD cases in high-income countries (7).
- Cardiovascular diseases and stroke. Smoking damages blood vessels, raising blood pressure and leading to thickened arterial walls. A study published in 2020 in the Journal of the American College of Cardiology which included over 13.000 of participants, aimed to quantify the long-term association of cigarette smoking and its cessation with the incidence of the 3 cardiovascular outcomes. The results have indicated, that all smoking measures showed significant associations with 3 major atherosclerotic diseases – peripheral artery disease (PAD), coronary heart disease (CHD) and stroke, with the strongest effect size for incident PAD. The risk due to smoking lasted up to 30 years for PAD and 20 years for CHD. These results highlight the importance of smoking prevention and early smoking cessation (8).
- Impaired immune function. Smokers are more susceptible to infections due to a weakened immune system. The wound healing process is also slower, increasing the likelihood of complications after injuries or surgeries.
- Reduced longevity. In addition to shortening life expectancy, smoking reduces healthspan, which refers to the number of years a person remains healthy and free from serious disease. Long-term smokers tend to experience frailty, physical deterioration, and cognitive decline earlier than non-smokers.
Other effects of tobacco smoking and nicotine are shown below:
Nicotine Addiction
Nicotine (C10H14N2) – is a plant alkaloid found in the tobacco plant and is the principal constituent of tobacco responsible for its addictive character (8,9). Nicotine acts in the autonomic ganglia, brain, spinal cord, neuromuscular junctions and adrenal medulla. Nicotine has dose-dependent pharmacological effects and has both stimulant and depressant action (10,11).
The effects of nicotine on the central nervous system and its peripheral stimulating effects are mediated through the release of several neurotransmitters, including acetylcholine, beta-endorphin, dopamine, norepinephrine, serotonin, and adrenocorticotropic hormone (8). Stimulant effects of nicotine include peripheral vasoconstriction, elevated blood pressure, tachycardia, and enhanced mental alertness and cognitive function (8,10,11). Depressant effects of nicotine include muscle relaxation and anxiety reduction (10,11). At higher doses, nicotine stimulates the “reward” center in the limbic system of the brain (10).
Nicotine use produces a feeling of pleasure and relaxation. In dependent smokers, the urge to smoke cigarettes correlates with a low blood nicotine level, as though smoking were a means to achieve certain nicotine level, reap the rewarding feeling associated with nicotine and avoid withdrawals. Repetitive exposure to nicotine leads to neuroadaptation and building of tolerance to nicotine’s initial effects (10).
Accumulation of nicotine in the body leads to a more substantial withdrawal reaction if cessation is attempted. Onset of withdrawal symptoms occurs within 24 h and can last for days, weeks, or longer (10). Common withdrawal symptoms include:
- Strong cravings for tobacco
- Anxiety
- Difficulty concentrating
- Irritability
- Trouble sleeping
- Increased appetite, which may result in weight gain
Tobacco smoking is a chronic condition sustained by both physiological nicotine dependence and learned behavioural patterns. Approximately 70% of individuals who smoke express a desire to cease smoking. However, on average, individuals make about six attempts to quit before achieving sustained abstinence. Evidence suggests that behavioural counselling and pharmacological interventions, such as nicotine replacement therapy, varenicline, or bupropion, are effective as standalone treatments, but their efficacy is significantly enhanced when these approaches are combined (12).
ALL Tobacco Products Are BAD!
In the tobacco industry, traditional cigarettes are no longer the only option. E-cigarettes, heated tobacco products (HTPs), and other alternatives are marketed as “safer” choices. There’s also a common belief that switching to vaping or HTPs reduces the harm to a negligible level. However, clinical data show that while these alternatives might expose users to fewer harmful chemicals than smoking cigarettes, they still pose serious health risks (1). The comparison of these products are shown below.
No tobacco product is safe! So lets look how do these products compare.
Cigarettes
Cigarettes are by far the most dangerous form of smoking. When tobacco burns, it releases thousands of harmful chemicals, including tar, carbon monoxide, and ammonia. Research shows that cigarette smoking remains the leading cause of tobacco-related deaths worldwide (2).
E-cigarettes or Vapes
The electronic cigarette, for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry. In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial. It has been reported that the heating process itself can lead to the formation of new decomposition of toxic compounds. E-cigarettes are linked to the harmful effects on respiratory system as well as the increased cardiovascular risks (13). The recent outbreak of e-cigarette, or vaping, product use-associated lung injury highlights the potential threat unregulated e-liquids pose to the increasing number of young users of e-cigarettes (14).
Heated Tobacco Products
Heated tobacco products (HTPs) are nicotine delivery devices marketed as a less harmful alternative to traditional cigarettes for both users and bystanders. However, their full impact on user health and public health remains unclear. A systematic review found differences in biomarkers related to exposure, cardiovascular, and respiratory health between smokers and HTP users. HTP users showed improvements in some markers compared to cigarette smokers. However, HTP exposure has also been linked to changes in mitochondrial function, potentially worsening airway inflammation, airway remodelling, and increasing lung cancer risk. There is also evidence that HTPs may elevate oxidative stress and the risk of respiratory infections by enhancing microbial adherence to the respiratory tract (15).
Hookah or Waterpipe
The use of hookah or waterpipe smoking has become increasingly prevalent, particularly among younger demographics. This trend is largely driven by the misconception that hookah smoking poses fewer health risks compared to cigarettes, as well as the availability of a variety of attractive flavours. However, research indicates that hookah smokers are exposed to many of the same harmful toxicants and carcinogens found in cigarette smoke, often at significantly higher levels, which may result in more severe adverse health outcomes. These risks include infectious diseases, various forms of cancer, respiratory illnesses, etc. Furthermore, due to its overlapping chemical composition with cigarette smoke, hookah smoke has similar detrimental effects on the cardiovascular system. Nicotine, a primary factor in tobacco addiction, is present in highly variable concentrations in hookah smoke, depending on the type of tobacco used, further complicating its addictive potential (16).
It Is Never Too Late To Quit
Quitting smoking, no matter how long you’ve been smoking, drastically improves your health and longevity. Within just 20 minutes of non-smoking, blood pressure and heart rate drop. After 12 hours, carbon monoxide levels in the blood return to normal, and within months, lung function improves. It was identified in the clinical research that people who quit smoking by age 30 can regain almost all the years lost to smoking. Even quitting at age 60 adds years to life expectancy (17). So it is never too late to quit!
And no, you won’t find tips in this article how to quit smoking. I am not the one to advise here as I have never gone through such experience. But if you are a smoker, I hope my article will shake you to start looking for help and treating your addiction.
Documentaries Recommendation
It has been quite some time since I recommended some book or a movie. So here is one: Big Vape. The Rise and Fall of Jull. I highly recommend it to those who think that other forms of tobacco is less harmful for you. It is just as harmful, or sometimes even worse.
Smoking is one of the most antilongevity habits that you might have. It is one of the worst things you can do to your own body, but also to the ones exposed to tobacco smoke. I hope I have reached at least one person, who will try to quit. I hope I have also reached parents, who think that e-cigarettes or waterpipes are harmless to their teenagers. Stay tuned for my next Nexus Newsletter on how to live a healthier and longer life!
