LiveLongAgeWell

I have some good friends who still smoke, but they’re all careful and courteous smokers (as I think most are today) in that they try to keep their secondhand smoke away from non-smokers. But a research report just published in the medical journal Pediatrics suggests that smokers are generally not aware of another hazard from their cigarettes—they may be causing even non-smokers to become “third-hand smokers”. This is the first new medical term of 2009, and it’s good to know something about it as it will be talked about and maybe used as a basis for new laws aimed at smokers.

You notice this hazard for example when you enter a hotel room (especially common in certain cities, like Las Vegas) that has recently been occupied by smokers, and you are hit with that distinctive sick smell. You know there is something foul in the room, and it’s because some smoker has been there, leaving his mark, almost like a dog marking his territory. Sometimes it’s more of a feeling you get; it might be enough to prod you to march to the front desk and demand a non-smoking room. You might encounter the same in rental cars, homes and some offices. Twenty percent of the U.S. population still smokes, so it’s a persisting issue, and this research study suggests you should be concerned if you are (not of your own making) a third-hand smoker.

Particulate matter from cigarette smoke penetrates and persists in many surfaces, slowly leaking toxins to those in contact. Most at risk are pregnant or breastfeeding women and children, but everyone suffers some risk. The National Toxicology Program has identified in cigarette smoke some 250 poisonous gases, heavy metals, and other chemicals such as cyanide, carbon monoxide, butane, lead, arsenic, and even the highly radioactive and carcinogenic polonium-210 (used to kill an ex-Russian spy in London in 2006). Ten other substances in cigarette smoke are classified as Class I carcinogens (highest level). Besides these serious issues, cigarette smoke is very bad for looking good as you get older.

The research also showed that only 43% of smokers believed third-hand smoke was dangerous, yet 65% of non-smokers thought it was harmful. The good news is that when smokers become aware of the risks to others, most will change their behavior to minimize that risk. We need to keep encouraging smokers to quit, but, in the meantime, to smoke outside so at least disperse the damage so it won’t settle into our carpets and fabrics…(I think it’s rather ironic that some righteous non-smokers—I noticed this occasionally when I lived in California—will make an absolute scandal about people smoking outside, crying that they are fouling the air, and then they drive off in a Cadillac Escalade or Range Rover, causing much more collective harm than any cigarette.)

If you find yourself in a rental car or a hotel room and you notice you are about to become a third hand smoker, get out, change the car or room. Best to remember to reserve a non-smoking environment whenever you can.

If you ever wondered if restaurant and workplace indoor smoking bans have really improved the public health—beyond just clearing the air—consider this dramatic recent study from the Centers for Disease Control and Prevention (CDC). The authors found that after three years of an indoor smoking ban in Pueblo, Colorado, local heart attack hospital admissions dropped 41%. This large drop in the rate of heart attacks is surprising and unexpected, so let’s look at the study closer to see if the conclusions are accurate and reliable.

When doctors read a medical research report, particularly one with unexpected findings, they should examine how the study was done (“study design”), to see if there were any defects, and if so, how serious they were…are they enough that the conclusions can’t be trusted? Unfortunately, many medical studies have bad design, but often that fact is not reported in the media article.

Fortunately the scientists at the CDC are good, and this study was well designed. For example, the researchers studied what is called a control group at the same time they studied the people in Pueblo. The control group was two other municipal areas close to Pueblo which did not enact a smoking ban. They looked at their heart attack rates also, and found no drop as there was in Pueblo. So most likely, the smoking ban was responsible for the big drop in heart attacks.

Actually there have been eight studies before this one looking at the same issue, and all have shown a rapid drop in heart attacks following a smoking ban, but only this CDC study covered a long time period.

Often when we think of the bad effects of cigarettes, we think about lung cancer, but this study emphasizes how smoke seriously affects our hearts also. If we want to live long, one hint is to stay clear of it. Wherever you are—inside or outside—this study suggests that it’s really worthwhile to move away…

When a new patient walked into my office I would occasionally test myself, and try to guess just by looking at her face if she was a smoker or not. Usually I was right, and I could tell by looking for vertical wrinkles around the mouth, typically much more pronounced in a smoker. Why is that? Why should smokers have more wrinkles?

For skin to look good and alive, it needs to be nourished by the blood vessels that feed it. These vessels are the pipes that send fresh blood, oxygen, and nutrients to the skin, and then carry away the bad stuff. But in a smoker, the small blood vessels that feed the skin get irritated and inflamed from the cigarette toxins, and when the vessel walls get irritated, cholesterol can more easily stick to the inflamed surface. So like a pipe filled with any sort of crud, the flow of oxygen and nutrients decreases, and the skin basically loses its elasticity and slowly dies.

The same thing is happening to the smoker’s blood vessels that feed the heart and the brain, and everywhere else in the body. We just don’t see the pipe build-up problem like we do in the skin. In the heart the smoker can experience angina (heart pain) or a heart attack. In the brain, the smoker loses brain cells faster, and are more prone to a stroke. In the penis, since a firm erection depends on good blood flow to your organ, even if you aren’t impotent, your erections won’t be as good.

Besides wrinkles, a few more reasons smokers tend to age much faster:

•    The smoke slowly kills your lung capacity, so if you DO manage to get to an old age as a smoker (note that smokers live an average of 13 to 14 years less than non-smokers), you won’t be able to handle athletic activities well; even climbing stairs might become a chore. Bad lungs severely limit your ability for fun, and there’s no cure at all. Carrying an oxygen tank is a big hassle.

•    Smoking ruins your breath, stains and loosens your teeth.

•    Smokers have a much higher rate of osteoporosis and bone fracture.

•    The risk of that much advertised affliction, ED, or erectile dysfunction, is about 50% greater in smokers.

•    Smokers are twice as likely to get macular degeneration, a common form of blindness, as well as cataracts.

•    Many plastic surgeons will refuse to operate on smokers, because they heal from surgery so much worse, and have a much higher complication rate.

•    Yes, smoking can keep your weight down somewhat, but there are better ways, and is being a little thinner worth all the negatives, and let us include: a higher risk of baldness for men and for women, increased breast cancer and a two times higher risk of cervical cancer?