¿Mi flujo vaginal es normal?

Easy to smoke but hard to forget!

Silva-Zúñiga LM¹, Serafín-Pacheco AG¹, Vega-Días EU¹, Rivera-Chávez MJ², Urzúa-González AR²

1. Students of the Bachelor General Medicine, Department of Medicine and Nutrition, Division of Health Sciences, University of Guanajuato, Mexico.
2. Coordinators of the Module of Internal Medicine of Phase II of the degree in General Medicine, Department of Medicine and Nutrition, University of Guanajuato, Mexico.

Abstract

In antiquity smoking tobacco was considered a healthy habit, it was even believed that it could cure diseases such as warts, pains, burns and more. Over time, their adverse effects were discovered, mainly as a result of studies of the twentieth century such as Framingham, where smoking is identified as the second risk factor for cardiovascular diseases and type 2 diabetes. Today it is known that not only has association with the aforementioned diseases, it also increases the risk of lung cancer, colon cancer, liver cancer, breast cancer, abortions and malformations at birth, erectile dysfunction and hypertension. Knowledge about the complications of smoking, related statistics, triggers of habit and treatment methods, are an important part in the prevention of addiction and perpetuation of it.

Keywords: Smoking, Tobacco, Death, Infarction, Cancer

Introduction

The use of tobacco is as old as the discovery of America by Cristobal Colon. The Native Americans used rolls as pipes, eventually spread to Spain, Portugal and England to become widespread throughout the world. At first it uses wasn`t only recreational, it was thought to have healing properties generating syrups, powders and ointments based on tobacco for warts, dog bites, toothaches, burns and to discharge diseases of the head like pain, dizziness or dizziness, vision impairment, fatigue or insomnia.

Over time the other side of the coin became known. In the seventeenth century King James I of England ordered his subjects to stop using tobacco arguing that it was a habit abhorrent to the eye, harmful to the nose, malignant for the brain and lungs. However, it was not until the beginning of the 20th century that solid research studies began in relation to smoking and diseases. In 1964, the United States published a report based on more than 7,000 articles that concluded that tobacco was associated with an increase in mortality with the development of lung cancer, cancer of the larynx, chronic bronchitis and asthma attacks, without leaving behind the Framingham study that since 1948 identifies it as the second risk factor for cardiovascular disease and type 2 diabetes mellitus.



The image shows two Americans from ancient civilizations smoking.

 

Smoke, get sick and die

Although it is usually assumed that if tobacco were to kill you it would be lung cancer. The reality is that cardiovascular diseases are the ones that cause more deaths of smokers per year. Even so it´s true that the risk of lung cancer is 2 or 10 times higher in smokers. This information is supported by a study by the American Cancer Society where it was also concluded that smoking was also a cause of liver cancer and colorectal cancer and that passive smokers were more likely to develop breast cancer.

So, can you only die of cancer or cardiovascular diseases if you are a tobacco user? Sadly not. It´s known that smoking cause of type 2 diabetes mellitus in addition patients have a greater progression towards kidney disease, blindness and circulatory complications that can cause amputation. The components of tobacco alter the immune system, there is an increase in pneumonia among smokers as well as risk of tuberculosis and death related to it. Including smoking is part of the causes and resistance to the treatment of rheumatoid arthritis. In man there is a great relationship between smoking and having erectile dysfunction because this is associated with vascular damage and nervous system. On the other hand, it is known that in pregnancy the complications associated with smoking are potentially fatal for the mother and the fetus without neglecting the defects at birth. In general, smokers lose more than 10 years of life quitting before age 40 reduces that loss by almost 90%.

The addiction starts early

Nicotine is a substance found in tobacco, it is absorbed quickly when smoking and reaches the brain in about 10 seconds generating a highly addictive effect. It suffices 1 cigarette per month in a teenager of 12 years for the symptoms of dependence to appear, in addition 80% of people will continue to do during adult life. The bad news is that 1 in 3 of these individuals will die prematurely (between 15 and 60 years of old) due to tobacco-related diseases.

Addiction to smoking ... kills.

 

Other factors that directly influence the attitude that leads to smoking are the presence of smokers in the family or friends, adverse experiences (violence, sexual abuse, divorce of parents), lack of efficient programs against the consumption of cigarettes, poor knowledge about the risks to which the smoker is exposed, to believe that one does not smoke too much and the advertising of the tobacco companies.

Is one nothing?

Recent studies mention that even one cigar a day is harmful and not only a little, in fact it increases the risk of arterial and venous insufficiency, of hemorrhage and cerebral ischemia and heart attacks by 30-40%, being worse for men than for women and increasing up to 3 times the risk compared to a non-smoker when 20 cigarettes are consumed per day. The good news is that quitting smoking permanently manages to eliminate the risk of these cardiovascular diseases, however it does not work with the risk of cancer or chronic obstructive pulmonary disease (COPD), which will not reverse or will take decades to do it. It should be noted that the causes of the risks do not belong to nicotine alone, in fact the main factor is the exposure to the products of combustion of the cigar and other toxic components of itself.

The image shows the mechanism by which nicotine can trigger an acute coronary syndrome (angina or infarction). This is largely due to the increase in blood pressure, cardiac output, oxidative stress and decreased oxygen in the blood.

 

Smoking cessation in 5 steps

Smokers who quit smoking reduce the risk of illness and death related to their consumption. An approach to stop smoking is the five-step algorithm that we have adapted from the article "Overview of smoking cessation management in adults" of UpToDate platform:

1. To evaluate the consumption of tobacco, Being aware of how harmful it is to our person is the first step to take, you are not alone in this process, you can seek medical help and, in the consultation, talk about your current use of tobacco, how many cigarettes per day you smoke, as well as your purpose of quitting it. Let yourself be advised, know how the cessation of this substance can have an impact on improving your current state of health and avoiding future complications. If you know all the benefits of stopping smoking you will have more sense and motivation to carry out your goal.
2. Set a date to quit smoking, having only the purpose is not enough, you need to make it happen, having a set day will help you to achieve your goal, ideally that date should be within the next two weeks to from your decision.
3. Strengthen this decision with help of friends and family, talk to your inner circle about your concern of leaving this problematic habit, having the support of your loved ones will make lighter this trip you have just started.
4. Avoid situations that induce you to relapse into tobacco, as environments that favor or where you are surrounded by it consumption, for example bars or parties, Because alcohol can cause relapse, you should consider limiting/abstaining from alcohol while quitting, eliminate all tobacco from home, car and work environment, Quitting is more difficult when there is another smoker in the household, it is very useful to encourage your housemates to quit with you or not smoke in your presence.
5. Recognize your achievements because it strengthens your commitment to stop smoking, a lapse can be used as a learning experience, if there was any relapse you should evaluate the circumstance to identify problems already encountered and anticipate challenges to avoid future encounters with the cigar, total abstinence is essential. "Not even a single smoke after the date of abandonment.".

The support of your doctor will really helpful in this process, ask your doctor about whether you are a candidate for pharmacological or only behavioral therapy, as it has been shown that the combination therapy is superior to the individual.

So, do I really get benefit from quitting smoking?

In subjects without coronary heart disease, quitting smoking can reduce the risk of presenting a cardiac event by up to 47%, these decrease as the time in which this habit was left is increased. The benefit of quitting smoking is equivalent for both the young and the elderly on the function of the endothelium (tissue that covers the blood vessels internally), since smoking impairs vasodilation (mechanism by which blood flow is increased), which causes a decrease in blood supply and increases both the incidence of coronary heart disease and mortality.

 

 

 

Conclusion

The current evidence should make us reconsider smoking due to its potential association with chronic and devastating diseases. What would be ideal is to consolidate the prevention of the first contact between a teenager and 1 cigarette, which is a constitutive event for later addiction, as well as disclosing information about each of the consequences of smoking on the population and the high probability of having a premature death associated with it. However, those designated smokers, still have the possibility of stopping the organic damage and in some cases revert it if they leave this malignant habit, that although centuries ago it was seen in a peculiar way, it was only due to the ignorance about its impact.

 

Bibliography

De Micheli, A., & Izaguirre-Ávila, R. (2005). Tabaco y tabaquismo en la historia de México y de Europa. Revista de investigación clínica, 57(4), 608-613.

Rigotti, N., Rennard, S. I., & Daughton, D. M. (2015). Overview of smoking cessation management in adults. UpToDate, Park L.

Jackson, E., & Barnes, G. (2018). Cardiovascular risk of smoking and benefits of smoking cessation. UpToDate.

Rockville. (2014). Las Consecuencias del Tabaquismo en la Salud: 50 Años de Progreso; Informe de la Dirección General de Servicios de Salud de los EE. UU. Atlanta: American Journal of Public Health.

Wendling, P. (2018). Smoking Even One Cigarette a Day Raises Cardiovascular Risk. Medscape.