SMOKING

Smoking is the practice of inhaling smoke from burning

plant material. Nicotine works on your brain to create a
relaxing, pleasurable feeling that makes it tough to quit.
But smoking tobacco puts you at risk for cancer, stroke,
heart attack, lunch disease and other health issues.
Nicotine replacements and lifestyle changes may help
you quit.

What is smoking?
Smoking is when you inhale and exhale smoke from
burning plant material that’s rolled into a wrapper
(cigarette). You light the end of the other end. It travels
down your airways, into your lungs and through your
bloodstream to your brain and other organs.
This piece focuses on smoking tobacco cigarettes, but
you can also smoke cigars, pipes, marijuana (weed/pot)
or herbal cigarettes.
Anatomy of a cigarette:
Commercially produced cigarettes are made up of:
 A rolling paper wrapper.
 Filter (cigarette butt). The filter traps larger bits of
the partially burned tobacco while smoke travels
through it into your mouth.
Why do people smoke?
People smoke because they find it enjoyable. And
because it’s hard to quit once you start, despite the
damaging effects of smoking on your body. This is
because of your brain’s cravings for nicotine, which make
you feel good. Smoking might make you feel:
 Relaxed and calm.
 Buzzed and energized.
 More able to focus on tasks.
Smoking is also a social activity and a part of people’s
routine, just like morning coffee. You might smoke to
have fun, to calm yourself before being around a lot of
taste or just the feeling of holding a cigarette in their
hands.
What does smoking do to your body?
Smoking affects everything from the appearance of your
skin and nails to how your tissues, organs and even your
DNA work. The effects of smoking on your body start the
moment you light up a cigarette. Thousands of chemicals
released from burning tobacco start their damaging
journey before you’ve even taken a puff.
SMOKING EFFECTS ON YOUR SKIN & NAILS

‘While you hold a cigarette, tar stains your nails.

Smoke dries out and inflames your skin, causing
wrinkles and premature aging.’
SMOKING EFFECTS ON YOUR NOSE & MOUTH

‘Smoke damages nerves in your nose. Tar stains your

teeth and coats your mouth and throat. This reduces
your sense of taste and smell and can lead to tooth
decay and gum disease.’
SMOKING EFFECTS ON YOUR EYES

‘The chemicals in cigarettes plus a lack of oxygen

damage your eyes. This can lead to macular
degeneration, cataracts and vision loss.’
SMOKING EFFECTS ON YOUR LUNCH & AIRWAYS

‘Tar and poisonous gases damage your lungs and

airways. This increases your risk of respiratory
infections and COPD. Lack of oxygen and
inflammation can make you short of breath.’
SMOKING EFFECTS ON YOUR HEART & BLOOD VESSELS

Nicotine damages your blood vessels, thickening and

narrowing them. This increases your risk for blood
clots, heart attack and stroke. It can also lead to
erectile dysfunction.
SMOKING EFFECTS ON YOUR BRAIN HEALTH

Nicotine activates “feel-good” signals in your brain.

Without cigarette, you experience withdrawal
symptoms – like anxiety, restlessness and depression
– and, eventually, nicotine dependence.
SMOKING EFFECTS ON YOUR BONE HEALTH

Nicotine reduces your body’s ability to absorb the

calcium needed to make strong bones. This can lead
to osteoporosis and increase your risk for broken
bones.
SMOKING EFFECTS ON YOUR WHOLE BODY

Chemicals from cigarettes travel throughout your

body. They damage your DNA, increase your
immune defenses and cause hormone changes.
SMOKING EFFECTS ON YOUR PREGNANCY

Restricted blood flow reduces oxygen to the fetus

and harmful chemicals pass through the placenta.
This increases the risk of miscarriage, birth defects
and developmental delays.
You light the cigarette and hold it to your mouth
The heat from burning the cigarette releases nicotine and
creates tar (tobacco residue). As you bring the cigarette
to your lips, the tar stains your nails. The smoke dries out
and inflames your skin, deepening wrinkles. Inhaling
smoke through your nose damages nerve endings. Over
time, this reduces your sense of smell.
You inhale cigarette smoke through your mouth
When you take a puff from the cigarette, it goes through
a filter. This mostly keeps you from breathing in large
particles, but tar, nicotine and other chemicals still get
through. The tar stains your teeth and coats your gums
and tongue. It damages your tooth camel, pts you at risk
for tooth decay and gum disease, and reduces your
ability to taste foods you love.
Smoke moves through your airways
The tar coats your throat and vocal cords as it moves
toward your lungs. This might make you cough. Traveling
through your airways, tar and hydrogen cyanide (a
poisonous gas) paralyze your cilia. Like bristles on a
broom, cilia are hair-like strands whose job is to trap and
sweep germs and other harmful particles out of your
lungs. When they’re damaged, you’re more likely to get
stick with respiratory infections.
Smoking fills your lungs and enters your bloodstream
When the smoke reaches your lungs, it travels to the
small air sacs (alveoli) and damages them.This can lead to
emphysema, a form of COPD(chronic obstructive
pulmonary disease). From your alveoli, carbon monoxide
in the smoke moves into your blood. It bumps oxygen
out of your red blood cells, starving your cells and
tissues. The lack of oxygen can make you feel short of
breath. Your cells sound the alarm to let your body know
you need more oxygen, but the causes inflammation and
mucus to form, making it even harder to breathe.
While traveling through your bloodstream, nicotine
damages the lining of your blood vessels. This thickens
and narrows them, and causes blood cells to stick them,
putting you at risk for blood clots, heart attack and
stroke. For men, deceased circulation can make it
difficult to get an erection (erectile dysfunction)
Chemicals move through your bloodstream to the rest
of your body
Once in your blood, chemicals from cigarette smoke
travel throughout your body. This damages your:
 Bones: Nicotine decreases the absorption of calcium
and the production of bone-forming cells, causing
you to have thinner, brittle bones.
 Eyes: The chemicals in cigarettes plus a lack of
oxygen damage your eyes. This can lead to macular
degeneration, cataracts and vision loss.
 Immune system: Smoking causes constant
inflammation and weakens your immune system,
this makes you more likely to get sick and develop a
autoimmune diseases.
 Hormones: Nicotine can cause hormone changes
that can affect your fertility.
  DNA: Arsenic, nickel and radioactive polonium
damage your DNA and block the tools your body
uses to repair it. DNA damage can lead to cancer and
fertility problems from damaged sperm.
Nicotine reaches your brain
From your blood, nicotine heads to your brain. There, it
activates receptors that release dopamine, adrenaline,
endorphins, serotonin and other “feel-good” signals in
your brain. This is where a nicotine “buzz” comes from.
It’s like nicotine pushing buttons to make you more
relaxed, content or energized. It’s only been seconds
since you inhaled that first puff of smoke.
You go through withdrawal
Your liver processes nicotine and you pee it out within a
few hours of smoking a cigarette. Your body misses the
buzz and craves more, encouraging you to have another
one, If you don’t, you experience symptoms of
withdrawal, like anxiety, depression, restlessness, anger
and insomnia. Your body will develop a tolerance to
nicotine and eventually need more and more to make
you feel good, leading to nicotine dependence.
If you’re pregnant, it travels to the fetus
Narrowed blood flow to the fetus. The blood that does
flow through carries carbon monoxide, nicotine and
other harmful chemicals. This can prevent the fetus from
getting enough oxygen and damage its DNA. Women
who smoke while they’re pregnant are more likely to
have a miscarriage. Babies born to someone who smokes
can have low birth weight, heart and lung issues, and
developmental delays.
What are the health effects of smoking?
People most commonly associate smoking with causing
lung cancer, but smoking can cause or increase your risk
for many health conditions in almost every part of your
body. These include:
 Cancer: See below for a full list of cancers that
smoking can cause.
 Lung disease: This includes COPD, tuberculosis,
asthma and pulmonary fibrosis.
 Heart and vascular disease: These can lead to heart
attack, stroke or heart failure.
 Eye disease: This includes cataracts, macular
degeneration, vision loss and blindness.
  Present-at-birth conditions: These include low birth
weight and congenital malformation (birth defects)
in babies born to women who smoked while
pregnant.
 Miscarriage:
 Type 2 diabetes.
 Rheumatoid arthritis (RA) and other autoimmune
diseases.
 Erectile dysfunction:
 Fertility issues:
 Premature aging:
Secondhand smoke or smoke you breathe in from
someone smoking nearby, also has significant health
risks.
Smoking and cancer
Smoking causes or increases your risk for many types of
cancer. There’s also evidence that people who smile
while getting cancer treatment have a worse outcome
(prognosis), are less likely to have the cancer come back
(recur). Smoking can cause or increase your risk for:
 Acute myeloid leukemia.
 Bladder cancer.
 Cervical cancer.
  Colorectal cancer.
 Esophageal cancer.
 Kidney cancer.
 Laryngeal cancer and other throat cancers.
 Liver cancer.
 Lung cancer.
 Oral cancer.
 Pancreatic cancer
 Stomach cancer.
Do lungs repair after smoking?
Yes, your lungs and airways can start to heal if you quit
smoking. Inflammation and mucus production calm down
in the weeks after quitting and cilia regenerate in a few
months. In fact, many of your body systems begin to heal
after you quit smoking.
How long this takes depends on how long you smoked
before quitting and how much damage it did to your
lungs. Some issues, like infertility, can start improving
quickly. And some damage may never heal conditions
like COPD and pulmonary fibrosis are irreversible. But if
you can stop smoking for several years, your risk of
cancer and other health conditions reduces or even
returns to the same level as someone who doesn’t
smoke.

How do I quit smoking?

There are many tools to help you quit smoking. You
might need a combination of different approaches before
you find a solution that works for you. Or you might need
to change your approach when one stops working. Some
options include:
 Cold turkey: This means quitting all at once, without
medications or nicotine replacements. This method
can work well for some people. But your body’s
relationship with nicotine can make it a difficult
path.
 Nicotine replacement therapy: This includes gum,
loxenges, patches, nasal sprays or inhalers.
 Medication: Your healthcare provider might
prescribe bupropion of varenicline to help with
withdrawal symptoms and cravings.
 Lifestyle changes: Getting more exercise, changing
your routine or using cognitive behavioral therapy
(CBT) can help you feel better and break the habits
you associate with smoking.
How do I take care of myself if I smoke?
It’s no secret that the best way to take care of yourself if
you smoke is to quit. But while you’re in the process of
quitting, you can help your body heal with exercise, and
by eating nutritious foods and drinking plenty of water.
Whether you currently smoke or no longer do, talk to
your healthcare provider about getting a routine lung
cancer screening. It could catch cancer early and save
your life.
A note from Cleveland Clinic
People have been smoking for social and cultural reasons
for centuries. Today, the reasons for smoking aren’t all
that different: Having a cigarette might be a routine part
of your day – or a way to take a break from it.
But now we know how harmful smoking is for your
health – and for the health of your loved ones around
you. Unfortunately, because of nicotine’s relationship
with your brain, knowing that cigarettes are dangerous
doesn’t make kicking the habit any easier. It can be
helpful to understand this relationship and know why it’s
hard to quit. And remember to be kind to yourself while
you do so. Going from smoker to make to yourself every
day.
In addition to smoking cessation tools, it can be helpful
to keep in mind how much better you’ll feel in the long
run. You may be to return to activities you used to enjoy,
taste and smell foods properly again, protect the health
of your loved ones and probably even sane some money.
Ask for support from friends, family and your healthcare
providers – let them know about the change you’re
making how they can help.
Care at Cleveland Clinic
Cleveland Clinic’s primary care providers offer lifelong
medical care. From sinus infections and high blood
pressure to preventive screening, we’re here for you.