smoking & its relation with resp illness

8/9/2019 Smoking & Its Relation With Resp Illness

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BASED ON A SURVEY BY THE 50TH BATCH

MBBS ; ROLL NUMBERS 1-17


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Cigarette smoking is the most common form of

tobacco usage.

Its associated with more morbidity and mortality

than any other personal, environmental or

occupational factors

Smoking not only directly cause a disease

process but also interacts with other

occupational and environmental factors in a

synergistic or additive fashion


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Coronary artery disease Cerebrovascular lesions

Aortic aneurysms

COPD

Interstitial lung disease Lung cancer

Malignancies of GIT

Malignancies of urinary tract

Malignancies of cervix

Sudden infant death syndrome

Infant respiratory distress syndrome

Low birth weight infants


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Carbon monoxide

Produced byincomplete

combustion of tobacco

200 times moreaffinity for hemoglobin

than oxygen anddecreases oxygendelivery to tissues

Carcinogenicchemicals

Arsenic

Nickel

Cadmium

Chromium

acetaldehydePhenol

Irritants

Nitrogen dioxide

Formaldehyde

Cilia toxins

Hydrogen cyanide


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Nicotine

Alkaloid from tobaccoReadily cross BBB

Stimulate brainnicotinic receptors

Produce rise in heartrate,force,blood

pressure,mobilisationof free fatty acids

Responsible fortobacco addiction

Organ specificcarcinogens

Lung , larynx-NNK,polonium210,

Polycyclic aromatichydrocarbons

Esophagus NNN

Bladder

4-aminobiphenyl,

2-naphthylamine


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Desquamative interstitial pneumonia

Arises in 4th or 5th decade

Virtually all patients are smokers

Insidious onset dyspnoea & dry cough

Clubbing & emphysema often present Alveoli contain many smokers macrophages with

dusty brown pigment

Respiratory bronchiolitis associated ILD

Smokers macrophages in resp. bronchioles, alveolarducts & peribronchiolar spaces

Mild peribronchiolar fibrosis & centrilobular

emphysema

Dyspnoea & cough


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87% of lung cancers occur in active smokers or

those who stopped recently An average smoker has 10 times more risk of

malignancy than a normal person

Malignant change

Carcinoma in situ Invasive carcinoma

metaplasia

Ciliated columnar cells Stratified squamous cells

Cigarette smoke

Carcinogenic chemicals Organ specific carcinogens


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To establish the relationship between

smoking and several respiratory illnesses

To establish the relationship between theintensity, duration & type of smoking with

respiratory illnesses

To study the factors that lead the patients

towards becoming smokers


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Two indices are used for calculaing it

no of cigarettes/ beedis smoked per day

no of years of smoking

smoking score

No of cigarettes/beedis in a pack


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OTHERS:

asthma,pneumonia,bronchiectasis,post T.B.


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34 out of 44 had started smoking from the age

of 15-20 years


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All the patients are aware of ill effects of smoking


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A large majority of the patients admitted due

to COPD, lung cancers are current or past

smokers.

Smoking can also increase the susceptibility of

a person towards many other diseases

Despite being aware of the hazards of smoking,a few are still adamant to continue it


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Bibliography

Robbins & cotran: pathological basis of diseases

Harrisons textbook of internal medicine


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