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The Effects of Smoking on the Respiratory System

Although smoking has a negative impact on the overall health status of an individual, people continue this habit. Smoking is one of the main causes of respiratory conditions, which ultimately causes a high percentage of deaths.

“Tobacco smoking is one of the most potent and prevalent addictive habits, influencing the behavior of human beings for 4 centuries. Smoking is now increasing rapidly throughout the developing world and is one of the biggest threats to current and future world health. Furthermore, while the prevalence of tobacco use has declined among men in some high-income countries, it is still increasing among young people and women. Cigarette smoking is the most common type of tobacco use. On average, to date 47.5% of men and 10.3% of women are current smokers. Tobacco continues to be the second major cause of death in the world. By 2030, if current trends continue, smoking will kill 9 million people annually.”1

Psychosocial Factors Related to Smoking

“Although 88% of adult smokers initiated smoking before age 18 years, public health researchers and the tobacco industry also consider young adulthood to be a formative period for smoking patterns. Leaving the home to live independently gives youth more autonomy to make choices about their lifestyle, including healthy habits. The tobacco industry has studied young adults with the goal of making smoking socially acceptable. From 1990 to 2005, the prevalence of young adult smoking increased and then decreased; since then, it has been stable. Data from the 2000 National Youth Tobacco Survey highlight that age 18 years is still very much a transition period for smoking patterns. In that survey, 21% of 18-year-olds were established smokers who had smoked at least 100 cigarettes in their lifetime and had smoked 20 out of the past 30 days. However, an additional 11% had smoked at least 100 cigarettes in their lifetime and had smoked on 1–19 days in the past month (7%) or had not smoked in the past month (4%). Another 40% of 18-year-olds had at least experimented with cigarettes. These statistics suggest that a large proportion of young adults are at risk of becoming established smokers. More recently, data from the National Survey on Drug Use and Health (NSDUH) show that smoking initiation increased from 2002 to 2009 among those aged 18 years and older.”2

Smoking and Respiratory Conditions

Smoking increases the chances of suffering respiratory conditions, such as cancer and Constructive Obstructive Pulmonary Disease (COPD).

Smoking, along with passive smoking, is one of the most significant causes of lung cancer. Lung cancer produces tumors due to an unusually high development of cells in one or both lungs. Tumors might appear anywhere in the respiratory system.  In some cases, they begin on the main passageway into the lungs. Breathing difficulties, unusual voice changes, inflammation above the thorax area, discomfort in the upper extremities, and sudden high temperature, are some of the symptoms of lung cancer.

Aside from lung cancer, smoking can cause other types of cancer linked to the respiratory system, such as mouth cancer.

While COPD encompasses several conditions, only emphysema and chronic bronchitis are closely related to smoking. Emphysema is characterized by tiredness, dyspnea, cough, depressive disorder, unexplained reduction in weight, cardiovascular issues, and somnipathy. This disease damages the alveolus located in the lungs. Another COPD condition triggered by smoking is chronic bronchitis, which is the harm caused on the right or left bronchus.

Smoking Not Only Affects the Respiratory System

“Tobacco smoking has known adverse consequences on most human body systems. Researchers have focused more attention on the deleterious effects of smoking for high mortality diseases, such as cancer and diseases of the cardiovascular and respiratory systems, with less research attention on other body systems, such as the musculoskeletal system. The musculoskeletal system is one of the largest human body systems, comprised of bones, joints, muscles, cartilage, tendons, ligaments, and other connective tissues. An intact and functioning musculoskeletal (locomotor) system is necessary to perform activities of daily living and maintain quality of life. Several studies have investigated the association between smoking and musculoskeletal disorders. According to the recent Surgeon General report, the causal relationship between tobacco smoking and rheumatoid arthritis, periodontitis, and hip fractures has been confirmed; however, there is inconclusive evidence to support causality between smoking and many other musculoskeletal disorders.”3

Smoking may also have an impact on mental health. “The high co-occurrence of smoking and mental illness is a major public health concern, and smoking accounts for much of the reduction in life expectancy associated with mental illness. Many studies report a positive association between smoking and mental illness, with smoking rates increasing with the severity of the disease. Individuals with mental illness also tend to start smoking at an earlier age, smoke more heavily, and are more addicted to cigarettes than the general population. For example, a recent survey suggests that 42% of all cigarettes consumed in England are consumed by those with mental illness, although this includes substance use disorders. Additionally, while cigarette consumption in the general population has shown a sustained decrease over the past 20 years, consumption among smokers with mental illness has remained relatively unchanged. There is, therefore, a pressing need to understand the mechanisms underlying the high rate of smoking in people with mental illness.”4

Other Conditions Related to Smoking

“Cigar smoking produces numerous adverse health effects. Cigar smoke contains many of the same toxic constituents as cigarette smoke, and cigar smoke has been shown to have higher levels of tobacco-specific nitrosamines (TSNAs) than cigarette smoke due to the curing and fermentation process for cigar tobacco. Many of these TSNAs such as N-Nitrosonornicotine (NNN) and nicotine-derived nitrosamine ketone (NNK) are known carcinogens. Cigar smoke has also been found to have higher levels of carbon monoxide and nitrogen oxide than cigarette smoke. The International Agency of Research on Cancer (IARC) has previously concluded in 2004 that cigar and/or pipe smoking is causally connected to cancers of the lung and upper aerodigestive tract, including the oral cavity, oropharynx, hypopharynx, larynx and esophagus. They also found evidence that cigar and/or pipe smoking are causally associated with cancers of the pancreas, stomach, and urinary bladder. A recent analysis of the population health effects of cigar smoking found that regular cigar smoking is responsible for at least 9,000 deaths each year in the US and that the total number of deaths may be higher due to potential increases in cigar smoking relative risks over time, perhaps due to more diverse cigar products and changes in inhalation patterns, as well as the possibility of deaths due to other causes that have not been previously linked to cigar smoking”5 

Environmental Tobacco Smoke (ETS)

Although you abstain from smoking, environmental tobacco smoke poses a major risk to your condition and those around you, especially to the cardiovascular and respiratory systems.

Two forms of smoke compose environmental tobacco smoke:

  1. Mainstream smoke exhaled from a smoking person.
  2. Sidestream smoke that comes out from the lighted end of tobacco products

“Secondhand smoke (SHS) increases the risk of heart disease by 30%, 1–7 accounting for at least 35.000 deaths annually in the United States. Protection of nonsmokers through smoke-free environments leads to a decrease in heart disease mortality through a combination of reduced exposure to SHS and an environment that makes it easier for smokers to stop smoking. The California Tobacco Control Program that stressed smoke-free policies has been associated with preventing 59.000 deaths resulting from heart disease between 1989 and 1997. An evaluation of a geographically isolated community (Helena, Mont) showed that the number of hospital admissions resulting from acute myocardial infarction decreased after the implementation of a law ending smoking in public and workplaces, an effect that partially reversed when enforcement of the law was suspended by a lawsuit. The effects observed in epidemiological studies are both larger and faster than one would expect if there were a simple linear dose-response relationship between the level of smoke exposure in passive smokers and active smokers. Despite the fact that the dose of smoke delivered to active smokers is 100 times or more than delivered to a passive smoker, the relative risk of coronary heart disease for smokers is 1.78,5 compared with 1.31 for passive smokers. Rapidly accumulating evidence, however, indicates that many important responses of the cardiovascular system (Table 1) are exquisitely sensitive to the toxins in SHS. These mechanisms, rather than isolated events, interact with each other to increase the risk of heart disease.”6 


Table 1. Effects of SHS on the Cardiovascular System
Table 1. Effects of SHS on the Cardiovascular System

ETS Affects Both Adults and Children

Children are also exposed to ETS, since it is in the air, and are prone to cot death when living in contact with ETS. If children (and adults) are exposed to ETS, they will probably experience cough, a distressing feeling in the thorax, and excess mucus in the respiratory tract.

“Some studies have reported correlations between passive smoking and hearing loss prenatally, and in infants, children, and adolescents. Exposure to environmental tobacco in childhood is suggested to affect the cochlear physiology by affecting the outer hair cells which can be measured through a decreased response in transient evoked otoacoustic emissions (TEOAE). The reported PTA threshold measured after exposure to tobacco is around 20−25 dBHL, indicating that passive smoking is related to mild or minimal sensorineural hearing loss. There are few available studies conducted in adults, but these report that passive exposure to tobacco is more likely to result in hearing loss. However, these studies defined hearing loss with a speech-in-noise test or included former smokers into the category of passive smokers.”8 

How Smoking Cessation Benefits You

Even though quitting smoking can be difficult, it brings numerous advantages to your health and daily life, including:

  • Diminishing the development of chronic or acute disorders in the respiratory and cardiovascular system
  • Reducing the harm pulmonary diseases cause if you suffered from prior lung conditions

Smoking cessation can also enhance your daily life by:

  • Lessening your expenditure on tobacco products
  • Helping you recover your gustation and olfaction senses
  • Removing cigarette marks and odor from your body and garments

 Smoking cessation can reverse some effects that cigarette has caused on your body and increase your quality of life. “The possible biological mechanisms responsible for the observed association of smoking with various diseases and global mortality are numerous and, in spite of many attempts to find causative relationships, are still unclear. It is a great scientific task to unravel exact pathways through which smoking affects human health. Although the effects of smoking on inflammatory markers may persist for many years, a majority of the adverse health effects of smoking are reversible. Therefore, quitting smoking avoids much of the excess health-care risk associated with smoking and allows increasing life expectancy”9

Multiple strategies are available if you want to quit smoking; however, consult with a physician which is the most effective treatment or therapy depending on your age, mental and physical health status, and other related factors.



 (1,9) Systemic Effects of Smoking. Yanbaeva, D.G., Dentener, M.A., Creutzberg, E.C., Wesseling, G. & Wouters, E.F.M. Chest Journal. 2007. (p.1,2,8) 

 (2) Are Tobacco Control Policies Effective in Reducing Young Adult Smoking? Farrelly, M.C., Loomis, B.R., Kuiper, N., Han, B., Gfroerer, J., Caraballo, R.S., Pechacek, T.F. & Couzensa, G.L. Journal of Adolescent Health. 2014. 

 (3) The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review. AL-Bashaireh, A.M., Haddad, L.G., Weaver, M., Lynch Kelly, D., Chengguo, X. & Yoon, S. Journal of Environmental and Public Health. 2018. 

 (4) The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Fluharty, M., Taylor, A.E., Grabski, M. & Munafò, M.R. Nicotine & Tobaco Research. 2016.

 (5) Systematic review of cigar smoking and all cause and smoking related mortality. Chang, C.M., Corey, C.G., Rostron, B.L. & Apelberg, B.J. BMC Public Health. 2015.

 (6, 7) Cardiovascular Effects of Secondhand Smoke: Nearly as Large as Smoking. Barnoya, J. & Glantz, S.A. Circulation. 2005. 

 (8) Effect of Cigarette Smoking and Passive Smoking on Hearing Impairment: Data from a Population–Based Study. Jiwon Chang, J., Ryou, N., Jin Jun, H., Hwang, S.Y., Song, J.J & Chae, S.W. PLOS ONE. 2016. 


María Laura Márquez
13 October, 2018

Written by

María Laura Márquez, general doctor graduated from The University of Oriente in 2018, Venezuela. My interests in the world of medicine and science, are focused on surgery and its breakthroughs. Nowadays I practice my more:

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