BASED ON A SURVEY BY THE 50TH BATCH

MBBS ; ROLL NUMBERS 1-17

 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
 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
 Carbon monoxide Carcinogenic
chemicals
Produced by
incomplete Arsenic
combustion of tobacco Nickel
Cadmium
200 times more Chromium
affinity for hemoglobin
acetaldehyde
than oxygen and
decreases oxygen Phenol
delivery to tissues

Irritants
Cilia toxins
Nitrogen dioxide
Hydrogen cyanide
Formaldehyde
 Nicotine Organ specific
carcinogens
Alkaloid from tobacco
Lung , larynx-NNK,
Readily cross BBB polonium210,
Stimulate brain Polycyclic aromatic
nicotinic receptors hydrocarbons

Produce rise in heart Esophagus –NNN

rate,force,blood
pressure,mobilisation Bladder –
of free fatty acids 4-aminobiphenyl,
Responsible for 2-naphthylamine
tobacco addiction
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, alveolar
ducts & peribronchiolar spaces
 Mild peribronchiolar fibrosis & centrilobular
emphysema
 Dyspnoea & cough
 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

Cigarette smoke
Carcinogenic chemicals Organ specific carcinogens

metaplasia
Ciliated columnar cells Stratified squamous cells

Malignant change
Carcinoma in situ Invasive carcinoma
 To
establish the relationship between
smoking and several respiratory illnesses

 Toestablish the relationship between the

intensity, duration & type of smoking with
respiratory illnesses

 Tostudy the factors that lead the patients

towards becoming smokers
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
 OTHERS:
asthma,pneumonia,bronchiectasis,post T.B.
34 out of 44 had started smoking from the age
of 15-20 years
All the patients are aware of ill effects of smoking
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

 Despitebeing aware of the hazards of smoking,

a few are still adamant to continue it
Bibliography
Robbins & cotran: pathological basis of diseases
Harrisons textbook of internal medicine