Cellular Changes
Cigarettes, e-cigarettes, and vaping all contain very harmful carcinogens that severely impacts our body, starting on a cellular level. Although, if a patient starts smoking cessation, some cellular changes can begin on a positive level. Cigarette smoke contains a variety of extremely hazardous metal such as cooper, mercury, lead, nickel, and zinc. Despite the public being aware of these harmful chemicals via warning on cigarette cartons, commercials, education provided from the healthcare field, it is still a habit people commonly pick up.
“Tobacco smoke is a toxic mix of more than 7,000 chemicals and compounds. These chemicals and compounds reach a person’s lungs quickly every time the person inhales. The blood then carries the toxicants to every organ in the body.” (Benjamin, 2011)
“This reaction may lead to structural damage, endothelial dysfunction, and detachment of endothelial cells from the walls of blood vessels. Mixtures of metals and oxidants may be particularly damaging to endothelial cells.” (Centers for Disease Control and Prevention, 2010)
Furthermore, smoking cigarettes disrupts the normal process our body goes through to divide and create more cells. (Wilkinson, 2017). “Cigarette smoking impacts this process by changing the mitosis process and altering the cycle of cell regeneration and division.” (Wilkinson, 2017). Once cells have died from smoking, the body starts to flush them out completely with antioxidants. From the cellular death and structural changes, it creates early aging of organs such as the heart and lungs.
Pathophysiological Issues
Chronic exposure, either first or second hand, to the toxins in cigarettes and the act of smoking will ultimately result in irreversible cellular injury and eventually cell death. “Cigarette smoking and involuntary exposure to cigarette smoke are major causes of CDH, stroke, aortic aneurysm, and PAD.” (Centers for Disease Control and Prevention, 2010) “The risk is seen both as an increased risk of acute thrombosis of narrowed vessels and as an increased degree of atherosclerosis in the blood vessels involved.” (Centers for Disease Control and Prevention, 2010) Smokers place themselves at an extremely all time high of developing COPD, and emphysema due to destruction of alveoli in the lungs and generalized cell injury. In addition, smoking puts patients at high risk for developing atherosclerosis, and cardiovascular disruption is a big precursor to getting this disease.
Physiological
Smoking cessation dramatically decreases risk for mortality and tobacco related morbidity. When a patient smoke, they will experience an excess in pulmonary secretion which leads to constriction of airways making it harder to breathe and for the exchange in oxygenation. Once smoking cessation has occurred, the inflammatory process that begins from inhaling the smoke decreases, and the overall production of those inflammatory cells will also decrease. This will significantly reduce the risk of a patient getting diagnoses heart disease, atherosclerosis, and COPD.
“Smoking cessation is associated with improved lung function and a reduction in the presence and severity of respiratory symptoms. These changes, apparent within months of quitting, are sustained with long-term abstinence.” (Bullen, 2015)
Ethnicity, Culture, and Socioeconomic Status
Aside from ethnicity, culture, and socioeconomical status, heart disease is still the number one killer in the United States. Though, socioeconomic status has quite a huge impact on a patient’s cardiovascular health and risk for diseases. “Biological, behavioral, and psychosocial risk factors prevalent in disadvantaged individuals accentuate the link between SES and cardiovascular disease (CVD).” (Schultz, W. 2018) In the Asian American population, cardiovascular disease is the number one cause of mortality, and smoking will certainly pre-dispose them to this. Huge risk factors for CVD includes cigarette smoking, drinking, obesity, hypertension, hypercholesterolemia, and lack of exercise. “Another study on smoking prevalence among California’s Asian Americans found that Korean and Vietnamese males had higher smoking prevalence rates than males in other subgroups.” (Ye, J. 2009) “While Asian-Americans are under-studied, national-level surveys have collected data on cardiovascular risk factors.” (Ye, J. 2009)
Overall, this 67-year-old Asian American gentlemen of a low socioeconomical status is at great risk for developing chronic diseases, if he hasn’t already. Though he is a light smoker, he will still have a significant amount of years’ worth of damage on his hands. This study doesn’t provide any information as to if he is additionally around or living with anyone who smokes as the secondhand smoke would increase his risk for disease. When this patient is seen, providing him with knowledge regarding risk factors is very important, in addition to community support and resources.
