CHRONIC MUCUS HYPERSECRETION AND CHRONIC OBSTRUCTIVE LUNG DISEASE THE MOST DISABLING HEALTH EFFECTS OF TOBACCO

 

About Authors:
Chinedu Enegide*, Mr. Kennedy I. Amagon
Department of Science Lab. Tech.
(Physiology/Pharmacology Tech.),
University of Jos, Nigeria
chinex.snow@gmail.com

Abstact
The use of tobacco have been in existence for long and have also been widely abused. Tobacco is now the leading cause of preventable death in the world today. An estimate of more than 5 million deaths  are recorded world-wide, yearly. Prediction also shows that deaths caused by tobacco may escalate to about 8 million by 2030. Statistics have shown that one out of every five deaths annually is caused by cigarette smoking. This statistics reveals about 440,000 smoking-related deaths yearly, and about 49,000 of these deaths are due to passive smoking. Both voluntary and involuntary (passive) smokers are at risk of the effects of tobacco. The effects of tobacco includes increased stress, alteration of brain cells chemistry, alteration of lipid profile, facilitation of atherosclerosis, increase in heart-rate and blood pressure, gastroesophageal reflux disease, peptic ulcer disease, micro-nutrient disorders, oxidtive damage, bronchospasm, chronic mucus hypersecretion and chronic obstructive lung disease. But however, chronic mucus hypersecretion and chronic obstructive lung disease stands out to be the most disabling effect of tobacco. As these effects are known to reduce one's physical performance, breathing capacity as well as fitness (both present and future). It is therefore advised that better measures for controlling tobacco usage especially in public places should be employed. As this will help to reduce the treat it currently posess on public health (especially the high rate of chronic mucus hypersecretion and chronic obstructive lung disease occurrence caused by tobacco).

Reference Id: PHARMATUTOR-ART-1970

Introduction
Tobacco is a product from the dried leaves of tobacco plant (Nicotiana sp.). The dried leaves are usally treated with chemicals (like carbon monoxide, ammonia, toluene, acetone, arsenic, cadmium, butane, hydrogen cyanide etc) before being converted into cigarettes. The use of tobacco have been in existence for long and have also been widely abused. Though consuption is usually by smoking, other methods include  chewing and suffing. Tobacco constituets (such as nicotine and tar) and the chemicals used in processing it are however known to ellicit a number of harmful effects in the body. [1] Tobacco is now the leading cause of preventable death in the world today. An estimate of more than 5 million deaths are recorded world-wide, yearly. Prediction also shows that deaths caused by tobacco may escalate to about 8 million by 2030. [2] Statistics have shown that one out of every five deaths annually is caused by cigarette smoking. This statistics reveals about 440,000 smoking-related deaths yearly, and about 49,000 of these deaths are due to passive smoking. [3, 4] Therefore, this inidicates that both voluntary and involuntary (passive) smokers are at risk of the effects of tobacco. Passive smokers are usually nonsmokers who are exposed to second-hand smoke from the tobacco of voluntary smokers. This may be at the places of work, shopping centres, public transports, eateries and other public places. Hence tobacco poses a serious treat to pubic health. [5] The effects of tobacco are enomous with severe implications.

Some Effects of Tobacco

1 Effect on the brain

  • Increase stress: It has been shown that smokers have increased stress levels more than non-smokers, and this is contrary to the common belief that it eases stress. A feel of relaxation felt after smoking is a mere return to the normal unstressed state of non-smokers. [6-8]
  • Alteration of brain cells chemistry: It has been proven that there are fewer dopamine receptors in the brain cells of smokers when compared to those in the brain cells of non-smokers. [8, 9]

2 Effect on the cardiovascular system

  • Alteration of lipid profile: Tobacco alters the lipid  profile due to its nicotine component. It decreases high density lipoprotein (HDL) and increases low density lipoprotein (LDL), triglyceride and cholesterol levels in the blood. This increses the risk for the ocurence of heart failure. [10]
  • Facilitates atherosclerosis: It has been shown that tobacco hastens the occurence of atherosclerosis, this have been backed-up by the increase of its occurence in smokers more than non-smokers. [10]
  • Increases heart rate and blood pressure:Literature have shown that tobacco increases heart rate and this may lead to the over-working of the heart which may lead to heart failure. [11] It has also been proven that tobacco increases blood pressure above the normal range. This increase may lead to damage in organs like the kidney. [12]

3 Effect on gastrointestinal system

  • Causes gastroesophageal reflux disease: Tobacco smoking causes an alteration in the esophageal acid-base balance (favouring acidity) in smokers. There is also loosening of the lower eophageal sphinter (which is the muscle separating the esophagus and stomach), and this allows the reflux of acidic contents in the stomach into the esophagus. These effects may lead to heart-burn, inflammation of the esophagus and barretts esophagus. [13-15] This may latter escalate into esohageal cancer. [16]
  • Causes peptic ulcer disease: Tobacco smoking increases acid seretion in the stomach and esophagus. It also decreases the secretion of mucus in this region. There is also an apparrent reduction of blood flow to the esophagus, stomach and intestines due to smoking. All these factors put together prevents wound-healing in the gastrointestinal region when it occurs. The unhealed wounds then develop into peptic ulcer if not treated. [17]
  • Halitosis (bad breath): Tobacco smoking causes bad breath, and this is also accompanied by smelling hair and teeth colouration. These effects are the  immediate, but unreactive effects of tobacco smoking. [18]

4 Effect on the metabolic system

  • Micro-nutrient disoders: Tobacco smoking interfers with the absorption of some micro-nutrients (like vitamins B, C and E) from the gastro-intestinal system leading to their deficiency. The deficincy of vitamin B may lead to prolonged diarrhea, anemia and swelling of the tongue. Deficiency of vitamin C results results to scurvey, while vitamin E deficiency causes red blood cells degradation, irreversible nerve damage and eye disease. [19]
  • Oxidative damage: Tobacco smoking alters the oxidant and anti-oxidant balance in the body. This is due to the degradative effect of tobacco on the anti-oxidants in the body. This leads to an increase in oxidative activities in the body. This can result in cell damage, blood vessels damage, heart disease and cancer. [20, 21]

5 Effect on respiratory system

  • Bronchospasm: This is the abnormal tightening of the lungs airway. This normally leads to the narrowing of the airways and this causes wheezing which is similar to that experinced in asthmatic attacks. This reaction is common with smokers even when they do not have asthma. [22] The condition is however worsened in ashtmatics when they participate voluntarily in smoking or involuntarily (passively) by inhaling second-hand cigarette smoke from the environment. [23]
  • Chronic mucus hyperseretion and chronic obstructive lung disease:
    The lungs (goblet cells) secretes mucus and its function is to filter-out toxic substances from the air passing through the lungs. Cillia (finger-like hair) present on the lung surface produces a kind of rhythmic movement which helps to clear-the mucus and the substances trapped by it. Tobacco smoke promotes the growth of the goblet cells of the lungs, leading to an increase in secretion (hypersecretion) of the mucus. [24] Tobacco smoke also immobilizes the cillia and this hinders the elimination of the mucus and the substances trapped by it. This phenomenom coupled with the hypersecretion of mucus, leads to an obstruction of the lungs airway. [25] It is usually called obstructive lung disease. When these effects are prolonged, they are now referred to as chronic mucus hypersecretion and chronic obstructive lung disease. Chronic mucus hypersecretion generally causes persistent productive cough and this is aimed at clearing the accummulated mucus and substances trapped by it from the air passing the lung.  However, chronic obstructive lung disease causes diffiulty in breathing and it is irreversible. This complication ones it escalates may lead to death. [26] Chronic obstructive lung disease is now wide spread in both developed and developing countries all over the world, and occurence have largely been attributed to tobacco use age. [27, 28, 29] Statistics have shown that about 80-90% chronic obstructive disease occurence in developed countries  are caused by tobacco. [28] Of the numerous effects caused by tobacco, chronic mucus hypersecretion and chronic obstructive lung disease are the most disabling effects of tobacco. A combination of both effects have been proven to reduce one's physical performance, breathing capacity as well as fitness (both present and future), [8] hence disabling and preventing such individual from participating in most normal life's activities.

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