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Smoking



NICOTENE
rapidly absorbed
most addictive chemical in smoke
cotinine is most important metabolite, can be detected in blood or urine
polycyclic hydrocarbons are the primary carcinogens
smokeless still is addictive and cancer causing

SECONDHAND/PASSIVE INHALATION
worst impact on kids
more resp and middle ear infx
worse asthma

BENEFITS OF QUITTING
risk of CV dz and lung CA approaches that of nonsmoker after 15 years
risk of stroke approaches nonsmoker after 5-15 years
reduced risk of CA of the mouth, larynx, esophagus, pancreas, urinary bladder
inproved pulmonary function
reduced risk of pneumonia, influenza, bronchitis

RISK TO FETUS INSIDE SMOKER MOM
growth retardation
low birth weight

SYSTEMIC EFFECTS ASSOCIATED WITH TOBACCO USE
CV: more MIs, sudden death, peripheral vasc dz, HTN
CNS: more strokes, intracerebral or subarachnoid hemorrhage
GI: oropharyngeal, esophageal, pancreatic CA, reflux dt relaxation of LES, delayed PUD healing
General: decreased activation of neut adhesion mols, decr ascorbic acid and beta-carotene conc
GU: cervical CA (SCC), decr test/est by gender, kidney CA (RCC), bladder CA (transitional CC)
Integument: wrinkling incr
MS: osteoporosis dt decr est in female, test in male
Resp: laryngeal CA (SCC) COPD (bronchitis, emphysema), Lung CA (SCC, small cell, adenocarc)
Special senses: decr smell and taste sense, macular degeneration-->blindness, cataracts

NERVOUS SYSTEM HOOK IN
there are two types of cholinergic receptors in the body: nicotinic and muscarinic
Nicotinic receptors exist in these locations:
autonomic ganglia
sympathetic and parasympathetic ganglia
adrenal medulla
neuromuscular junctions

DRUGS THAT INHIBIT
hexamethonium inhibits the ganglia
tubocuranine inhibits the motor endplate receptors
(atropine inhibits muscarinic receptors)

Comments

machmed
Aug. 1st, 2009 06:50 am (UTC)
Well, here's the main study which, after reading, motivated me to consider smoking cessation as a way to lower my cortisol:

http://www.psychosomaticmedicine.org/cgi/content/full/68/2/299#R11-18

Here's an article that I found less reliable and much more confusing, but I think it's conclusion is similar:

http://www.medscape.com/viewarticle/496223_4

And here's another publication that discusses the subject, but is only available in full for subscribers to the site:

http://www.springerlink.com/content/g55w7r6p83w86t58/

I'm surprised there isn't more research in this area. I'm also surprised that the only research that I've found has been done by scientists not directly related to naturopathic medicine, as it was only the naturopathic doctors that were willing to consider cortisol as a cause of my insomnia in the first place (which, to be sure, was an incredibly helpful step in the right direction for me, even if those doctors weren't able to identify smoking as the underlying culprit).

Once I can afford it, I do plan on having my cortisol tested again to confirm what I believe is going on here. But after having dealt with this for such long time, I can confidently say that my smoking cigarettes was somehow increasing my cortisol and subsequently causing my insomnia.
liveonearth
Aug. 1st, 2009 02:13 pm (UTC)
smoking kicks adrenals into high gear
Awesome links! Thanks. I am hereby more educated than I was.

Smoking acutely elevates not just cortisol from the adrenal zona fasciculata, but also catecholamines (dopa-->norepi-->epi) from the adrenal medulla and DHEA production from the zona reticularis. I had no idea that cigs were responsible for such adrenal overstimulation. It kind of makes sense esp when I think of smokers I know who crave that very first morning cigarette the most. Because they need the kick to get their adrenals working! Cool.

There is also a relaxing effect of cigs, that has something to do with the binding of nicotinic receptors. Know anything about that?

I have to focus on other matters for a few days, I will be interested to hear the results of your cortisol test! The fact that you are sleeping better is pretty convincing. I bet your levels have already normalized.

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