1.

Going Blind

1. Description of Eye Diseases Associated with

Smoking:
1. Age Related Macular Degeneration (AMD):
AMD begins as a loss of central vision which makes it
difficult to read and see fine details. Over time, vision loss
increases significantly. Of the two types of AMD, "dry" and
"wet," dry AMD is the most common. In dry AMD, fatty
deposits form under the light-sensing cells in the back of
the eye (retina). Vision loss in dry AMD usually gets worse
slowly. In wet AMD, tiny blood vessels under the retina
leak or break open. This changes vision and causes scar
tissue to form. Wet AMD is less common, but more quickly
harmful to vision.

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2. Glaucoma
Glaucoma causes a gradual break down of the cells that
make up the nerve in your eye that sends visual
information to your brain (optic nerve). As the nerve cells
die, vision is slowly lost, usually beginning with side vision.
Often the loss of vision is not noticeable until a large
amount of nerve damage has occurred. This is the reason
why as many as half of all people with glaucoma may be
unaware that they have it.
3. Cataract
Cataract is a clouding of the eye's naturally clear lens. It
usually gets worse as we get older. Most cataracts are
related to aging. Cataracts are very common in older
people. By age 80, more than half of all Americans either
have a cataract or have had cataract surgery.
4. Diabetic retinopathy
Diabetic retinopathy is a common complication of
diabetes. It affects the tiny blood vessels of the retina in
the eye. Retinal blood vessels can break down, leak or
become blocked and this can affect vision over time. In
some people with diabetic retinopathy, serious damage to
the eye can occur when new blood vessels grow on the
surface of the retina.
5. Dry Eye Syndrome
Dry Eye Syndrome is an eye disease that appears as
damaged blood vessels in eye

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 2.Type 2 Diabetes

WHAT YOU NEED TO KNOW ABOUT SMOKING AND

DIABETES

The 2014 Surgeon General’s Report has found that

smoking is a cause of type 2 diabetes, which is also
known as adult-onset diabetes. Smokers have a greater
risk of developing type 2 diabetes than do nonsmokers.
The risk of developing diabetes increases with the number
of cigarettes smoked per day. Diabetes is a disease that
causes blood sugar levels in the body to be too high and
puts the body at risk for many serious health conditions.
More than 25 million adults suffer from diabetes in the
United States, where the disease is the seventh leading
cause of death. It is also a growing health crisis around
the world.

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The evidence also shows that smoking is associated with
a higher risk of abdominal obesity, or belly fat. Abdominal
obesity is a known risk factor for diabetes because it
encourages the production of cortisol, a hormone that
increases blood sugar. Smokers tend to have higher
concentrations of cortisol than nonsmokers.

WHAT SMOKING MEANS TO PEOPLE WITH

DIABETES

Studies have confirmed that when people with type 2

diabetes are exposed to high levels of nicotine, insulin (the
hormone that lowers blood sugar levels) is less effective.
People with diabetes who smoke need larger doses of
insulin to control their blood sugar. Smokers who have
diabetes are more likely to have serious health problems,
including: heart and kidney disease; poor blood flow in the
legs and feet that can lead to foot infections, ulcers, and
possible amputation of toes or feet; retinopathy (an eye
disease that can cause blindness); and peripheral
neuropathy (damaged nerves to the arms and legs that
cause numbness, pain, weakness, and poor coordination)

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HOW SMOKING CAUSES TYPE 2 DIABETES

Smoking increases inflammation in the body. Inflammation

occurs when chemicals in cigarette smoke injure cells,
causing swelling and interfering with proper cell function.
Smoking also causes oxidative stress, a condition that
occurs as chemicals from cigarette smoke combine with
oxygen in the body. This causes damage to cells.
Evidence strongly suggests that both inflammation and
oxidative stress may be related to an increased risk of
diabetes.nction

CAUSE:
The dvelopment of type 2 diabetes is caused by a
combination of lifestyle and genetic factors. While
some of these factors are under personal control,
such as diet and obesity, other factors are not, such
as increasing age, female gender, and genetics. A
lack of sleep has been linked to type 2
diabetes. This is believed to act through its effect
on metabolism. The nutritional status of a mother
during fetal development may also play a role, with
one proposed mechanism being that of DNA
methylation. The intestinal bacteria Prevotella
copri and Bacteroides vulgatus have been
connected with type 2 diabetes.

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3.ERECTILE DISFUNCTION:

Male sexual function is affected when you smoke.

Tobacco causes narrowing of blood vessels all over your
body, including those that supply blood to the penis. Good
news is that quitting will make a big difference.

impotence, can be caused by a range of physical and

psychological factors. Among them is cigarette smoking.
It’s not surprising since smoking can damage your blood
vessels, and ED is often a result of poor arterial blood
supply to the penis. Fortunately, if you quit smoking, your
vascular and sexual health and performance are likely to
improve.

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Smoking and your blood vessels:

There are many health risks of smoking. Cigarette

smoking can damage just about every part of your body.
The chemicals in cigarette smoke injure the lining of your
blood vessels and affect the way they function. Those
chemicals can also harm your heart, brain, kidneys, and
other tissues throughout the body.

The risk of smoking to your erectile health is due to the

effects of cigarette chemicals on the blood vessels in the
penis. An erection results when the arteries in the penis
expand and fill with blood after receiving signals from
nerves in the penis. The nerves respond to sexual arousal
signals from the brain. Even if the nervous system is
operating well, an erection might not be physically
possible if the blood vessels are unhealthy due to
smoking.

What does the research show?

While ED tends to be more common as men get older, it

can develop at any adult age. A 2005 study in
the American Journal of Epidemiology suggests that ED is
more likely in men who smoked compared with those who
never did. But in younger men with ED, cigarette smoking
is very likely the cause.

If you are a heavy smoker, research suggests the odds of

developing ED are much higher. However, quitting
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smoking can improve ED symptoms. Your age, the
severity of your ED before quitting smoking, and other
major health problems may reduce the degree that healthy
erectile function can return.

Getting help:

The sooner you deal with ED, the sooner you’ll find a
solution. If you don’t have a primary care doctor, make an
appointment with a urologist or men’s health specialist. ED
is a very common health problem. You may, however, be
advised that one of the things you should do is quit
smoking.

If you’ve tried to quit smoking and been unsuccessful,

don’t assume quitting is impossible. Take a new approach
this time. The National Heart, Lung, and Blood
Institute recommends the following steps to help you quit
smoking:

 Make a list of the reasons you want to quit and why your
earlier attempts to quit were unsuccessful.
 Pay attention to your smoking triggers, such as drinking
alcohol or coffee.
 Get support from family and friends. It’s OK to admit that
you need assistance in overcoming a powerful addiction
like smoking.
 Talk with your doctor about prescription and over-the-
counter medications designed to help with smoking
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 cessation. If a medication seems like a good choice,
follow the medication’s instructions.
 Find new alternatives to smoking and activities that can
distract you from cigarette cravings, such as exercise or
hobbies to occupy your hands and your mind.
 Be prepared for cravings and setbacks. Just because
you slip up and have a cigarette doesn’t mean you can’t
get back on track and be successful.

4.Ectopic Pregnancy

Ectopic pregnancy is a life-threatening reproductive

complication in women that is more likely in smokers. It
occurs when a fertilized egg implants somewhere other

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than the uterus. The egg can’t survive and it puts mom's
life at serious risk.

SMOKING INCREASES RISK OFFECTOPIC

PREGNANCY

smoking increases the risk of ectopic pregnancy,

according to scientists in the UK.
They discovered that cigarette smoke reduces the
production of a fallopian tube gene known as "BAD",
which helps explain the link between smoking and ectopic
pregnancy.
Ectopic pregnancy – when the embryo implants outside
the uterus and in the fallopian tube – occurs in up to 2% of
all pregnancies and is the most common cause of
maternal death in early pregnancy.

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There is currently no way to prevent this condition, which
must be treated by abdominal surgery or, when the
ectopic is small and stable, by injection of a drug called
methotrexate.
Ectopic pregnancy results from a combination of factors
affecting the transport of the developing embryo from the
fallopian tube to the uterus and changes in the tubal
environment, which allow early implantation to occur.
Smoking is known to be a major risk factor, but how
smoking changes the environment of the fallopian tube for
an ectopic pregnancy to occur has so far remained largely
unknown.
For the study, the researchers exposed cells from the
fallopian tube to a breakdown product of nicotine called
cotinine. They then showed that cotinine had a negative
effect on genes known to be associated with cell death,
and in particular with the BAD gene. In a further study the
researchers showed that the BAD gene was reduced in
the fallopian tube of women who smoked.
Changes in the production of BAD genes are seen in the
uterus as it prepares for normal implantation of the embryo
and early pregnancy. A reduction in this gene is normally
seen in the cells of the uterus just before the embryo
implants.
The study was led by Dr Andrew Horne and Dr Colin
Duncan at the Medical Research Council (MRC) Centre
for Reproductive Health in Edinburgh, UK.

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The results of the research suggests that the reduced
production of the BAD gene in the fallopian tube leads to
an environment like that of the uterus, which encourages
and allows ectopic pregnancy to occur.
"So our research," said Dr Lorne, "may in future help
scientists find ways to prevent ectopic pregnancy,
diagnosis it better, and treat it earlier."
He went on: "The research is exciting because it provides
new scientific evidence to help understand why women
who smoke are more likely to have ectopic pregnancies. It
appears that smoking reduces the production of genes
such as BAD, which are involved in the control of cell
death and promote an environment in the Fallopian tube
which is attractive to the developing embryo.
"The information gained from this study can also be
applied to other conditions caused by smoking, and could
help us prevent or treat them better in the long-term.

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5) HIP FRACTURES:

Smokers lose bone density at a faster rate than non-

smokers which puts you at risk for breaking body parts like
your hip. Putting down the cigarettes can help slow down
this process and keep you breaking a sweat, not your
bones, on the dance floor.
Smoking and Osteoporosis
Cigarette smoking was first identified as a risk factor for
osteoporosis decades ago. Studies have shown a direct
relationship between tobacco use and decreased bone
density. Analyzing the impact of cigarette smoking on
bone health is complicated. It is hard to determine whether
a decrease in bone density is due to smoking itself or to
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other risk factors common among smokers. For example,
in many cases smokers are thinner than nonsmokers, tend
to drink more alcohol, may be less physically active, and
have poor diets. Women who smoke also tend to have an
earlier menopause than nonsmokers. These factors place
many smokers at an increased risk for osteoporosis apart
from their tobacco use.
In addition, studies on the effects of smoking suggest that
smoking increases the risk of having a fracture. As well,
smoking has been shown to have a negative impact on
bone healing after fracture.
Osteoporosis Management Strategies
Start by quitting:
The best thing smokers can do to protect their bones is to
quit smoking. Smoking cessation, even later in life, may
help limit smoking-related bone loss. Many resources are
available to help you stop smoking, some of which are
listed at the end of this fact sheet.
Eat a well-balanced diet rich in calcium and vitamin D:
Good sources of calcium include low-fat dairy products;
dark green, leafy vegetables; and calcium-fortified foods
and beverages. Supplements can help ensure that you get
adequate amounts of calcium each day, especially in
people with a proven milk allergy. The Institute of Medicine
recommends a daily calcium intake of 1,000 mg
(milligrams) for men and women up to age 50. Women

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over age 50 and men over age 70 should increase their
intake to 1,200 mg daily.
Vitamin D plays an important role in calcium absorption
and bone health. Food sources of vitamin D include egg
yolks, saltwater fish, and liver. Many people, especially
those who are older, may need vitamin D supplements to
achieve the recommended intake of 600 to 800 IU
(International Units) each day.
Exercise for your bone health:
Like muscle, bone is living tissue that responds to exercise
by becoming stronger. Weight-bearing exercise that forces
you to work against gravity is the best exercise for bone.
Some examples include walking, climbing stairs, weight
training, and dancing. Regular exercise, such as walking,
may help prevent bone loss and will provide many other
health benefits.
Avoid excessive use of alcohol:
Chronic alcohol use has been linked to an increase in
fractures of the hip, spine, and wrist. Drinking too much
alcohol interferes with the balance of calcium in the body.
It also affects the production of hormones, which have a
protective effect on bone, and of vitamins, which we need
to absorb calcium. Excessive alcohol consumption also
can lead to more falls and related fractures.
Talk to your doctor about a bone density test:

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 A bone mineral density (BMD) test measures bone
density at various sites of the body. This safe and painless
test can detect osteoporosis before a fracture occurs and
can predict one’s chances of fracturing in the future. If you
are a current or former smoker, you may want to ask your
health care provider whether you are a candidate for a
BMD test, which can help determine whether medication
should be considered.
See if medication is an option for you:
There is no cure for osteoporosis. However, several
medications are available to prevent and treat the disease
in postmenopausal women and in men. Your doctor can
help you decide whether medication might be right for you.
6.Colorectal Cancer

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Colon Cancer: The Smoking Connection“Cigarette
smoke contains many carcinogens [cancer-causing
agents], benzopyrenes being the most well-known,” says
Thomas Imperiale, MD, professor of medicine and
associate director for research for the Division of
Gastroenterology at the Indiana University School of
Medicine. “It’s believed that these carcinogens cause
damage to the DNA and, over time, the body’s ability to
repair that damage decreases.”
Colon Cancer: Does Quitting Reduce Risk?
Breaking your smoking habit is always a good idea in
terms of cancer prevention. But, while quitting can help
reduce your risk of developing colon cancer, there is a
long lag time before the risk drops, says Dr. Imperiale.
“There’s an ‘induction’ period, too,” he explains. “What’s
been strongly linked with [colon] cancer is smoking in your
teens and 20s, because there’s about a 30-year lag
between the onset of smoking and the onset of
adenocarcinomas" — pre- or early cancer. So, just as it
takes a long period for the cancer to show up, it can take
an equally long time for the body to return to the average
level of risk.
Colon Cancer: Screening for Smokers
At present, there’s no set guideline for when smokers
should be screened for colon cancer if they have no other
apparent risk factors. The American Cancer Society (ACS)

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guidelines suggest that seemingly healthy people who are
at low risk for developing colon cancer should be screened
starting around age 50; how often after that you would
have your next colonoscopy screening depends on results
of that first test.
Imperiale says that the evidence is strong enough to
indicate that the risk of colon cancer from smoking is as
high as having a first-degree relative — parent, sibling, or
child — with colon cancer. The ACS recommends that
those people begin screening at age 40, but does not
recommend the same for smokers or former smokers.
Unfortunately, “for some reason, we’ve been skirting the
issue of screening these people more aggressively,” he
says.
As more research is done on the link between smoking
and colon cancer, smoking may become recognized as a
risk factor that should prompt earlier screening. Until that
happens, if you are or were a smoker, talk to your doctor
about whether you are a candidate for earlier testing

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7.Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disease

more common in women that affects the joints in your
hands and feet. It causes painful swelling that can
eventually result in bone loss and joint deformity. Smoking
is one of the causes, and is also associated with
developing the disease at an earlier age.

Rheumatoid Arthritis:
Aching joints are common in arthritis. In rheumatoid
arthritis, the joint lining swells, invades surrounding
tissues, and produces chemical substances that
attack and destroy the joint surface.
People of all ages may be affected. The disease
usually begins in middle age.

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Rheumatoid arthritis usually affects joints on both
sides of the body in the hands and feet, as well as
the hips, knees, and elbows. Without proper
treatment, rheumatoid arthritis can become a
chronic, disabling condition.
Cause
Rheumatoid arthritis is not an inherited disease.
Researchers believe that some people have genes
that make them susceptible to the disease. People
with these genes will not automatically develop
rheumatoid arthritis. There is usually a "trigger,"
such as an infection or environmental factor, which
activates the genes. When the body is exposed to
this trigger, the immune system responds
inappropriately. Instead of protecting the joint, the
immune system begins to produce substances that
attack the joint. This is what may lead to the
development of rheumatoid arthritis.

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8.Cleft Lip and Cleft Palate

These birth defects, commonly called orofacial clefts,

occur when a baby’s lip or mouth doesn't develop properly
during pregnancy. Women who smoke during pregnancy
are more likely to have babies with orofacial clefts.

The development of the face is coordinated by

complex morphogenetic events and rapid proliferative
expansion, and is thus highly susceptible to environmental
and genetic factors, rationalising the high incidence of
facial malformations. During the first six to eight weeks of
pregnancy, the shape of the embryo's head is formed.
Five primitive tissue lobes grow:
a) one from the top of the head down towards the future
upper lip; (Frontonasal Prominence)

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b) two from the cheeks, which meet the first lobe to form
the upper lip; (Maxillar Prominence)
C) and just below, two additional lobes grow from each
side, which form the chin and lower lip; (Mandibular
Prominence)
If these tissues fail to meet, a gap appears where the
tissues should have joined (fused). This may happen in
any single joining site, or simultaneously in several or all of
them. The resulting birth defect reflects the locations and
severity of individual fusion failures (e.g., from a small lip
or palate fissure up to a completely malformed face).
The upper lip is formed earlier than the palate, from the
first three lobes named a to c above. Formation of the
palate is the last step in joining the five embryonic facial
lobes, and involves the back portions of the lobes b and c.
These back portions are called palatal shelves, which
grow towards each other until they fuse in the
middle.[22] This process is very vulnerable to multiple toxic
substances, environmental pollutants, and nutritional
imbalance. The biologic mechanisms of mutual recognition
of the two cabinets, and the way they are glued together,
are quite complex and obscure despite intensive scientific
research.
Genetics
Genetic factors contributing to cleft lip and cleft palate
formation have been identified for some syndromic cases,
but knowledge about genetic factors that contribute to the
more common isolated cases of cleft lip/palate is still
patchy.
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Many clefts run in families, even though in some cases
there does not seem to be an identifiable syndrome
present, possibly because of the current incomplete
genetic understanding of midfacial development.
A number of genes are involved including cleft lip and
palate transmembrane protein 1 and GAD1, One study
found an association between mutations in the HYAL 2
gene and cleft lip and cleft palate formation.

9.FERTILITY ISSUES:

Moms-to-be take note: Smoking can affect your ability to

conceive. It causes reduced fertility in women and can
contribute to other problems during pregnancy.
How Smoking Hurts Your Fertility

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Smoking is associated with the following fertility
problems:
 Problems with the fallopian tubes, including blockages
(preventing egg and sperm from meeting) and an
increased risk of ectopic pregnancy
 Cervical changes, specifically an increased risk of
developing cervical cancer
 Damage to the eggs as they develop in the ovaries
 Increased risk of miscarriage, possibly due to
damaged eggs, damage to the developing fetus, or
unfavorable changes in the uterine lining, which may
make healthy implantation of an embryo less likely
It's important to point out that not all of these issues are
directly caused by smoking. They may be associated with
each other.
For example, smoking probably doesn't directly cause
blocked fallopian tubes. Women who smoke are more
likely to engage in other unhealthy practices, including
unsafe sex. Risky sexual behavior can increase the risk of
pelvic infection and blocked fallopian tubes.
However, in the case of damage to the eggs in the
ovaries, this is likely a direct cause of smoking.
Smoking May Shorten Your Biological Clock
Some studies have shown that smoking can cause not
only problems with fertility while you're smoking, but lead
to lowered fertility in the future.

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Men produce new sperm throughout their lives,
but women are born with all the eggs they will ever have.
Once those eggs are damaged, there's no going back.
Smoking may decrease the total number of eggs a woman
has in her ovaries and cause the ovaries to age
prematurely.
Toxins in cigarettes may also lead to DNA damage to
the ovarian follicles, where the eggs normally develop to
maturity.
This premature aging of the ovaries and decrease in eggs
may lead to earlier menopause, as much as four
years earlier than normal.

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