Caitlin Whyte (Host): Welcome to BayCare HealthChat. I'm your host, Caitlin Whyte. And in this episode, we are focusing on smoking and how it affects the healing process. Joining us for this important two part discussion is Dr. Germanuel Landfair, an orthopedic surgeon with specializations in total hip and knee replacement.

Well, thank you so much for being on the show today, doctor. I am quite interested in getting into this topic. So to start us off, can you tell us a bit about smoking cigarettes in general? What chemicals do I consume when I smoke?

Dr. Germanuel Landfair: To be completely honest with you, there are so many chemicals in cigarette smoke that it would take us all day to kind of go through them and their specific effects. There are at least 70 known cancer-causing chemicals in tobacco smoke. So, one of the more popular and well-known ones is nicotine, of course, which is a colorless, poisonous chemical derived from the tobacco plant. It's a powerful drug which affects the brain and, of course, subsequently becomes very addictive.

Tar is another constituent, which is a sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer. There's carbon monoxide, which is released from burning tobacco. And when it is inhaled, it enters the bloodstream and interferes with the working of the heart and the blood vessels. Up to 15% of a smoker's blood can be carrying carbon monoxide instead of what it should be carrying, which is oxygen. There's also arsenic, which is from the pesticides used in tobacco farming in small quantities, which is also commonly found in rat poison. Don't want none of that. There is ammonia, which is commonly used in cleaning products and fertilizers, is used to boost the impact of the nicotine in manufactured cigarettes. Then, there's acetone, which we know is a solvent. For instance, nail polish remover is another solvent. So, that's another thing we don't want. And then, there's toluene, which is a highly toxic chemical. It's used in industrial situations, including rubbers, oils, resins, detergents, dyes, and explosives. There's other pesticides, of course. And then, there's this thing called Polonium 2-10, which happens to be a radioactive element used in nuclear weapons as well as atomic heat source. Methanol, of course, which is a fuel used in aviation industry.

Now, if we want to get more specific, because people are like, "Oh, I don't smoke cigarettes, right? I just vape." Okay. Vaping is definitely dangerous as well. There's acetaldehyde and formaldehyde, which are known carcinogens. Carcinogens are any chemicals that are known to cause cancer. As you know, formaldehyde is used to prepare bodies of people who are deceased. So, that's another thing you probably don't want to ingest. There's acrolein, which is a herbicide primarily used to kill weeds and it can cause irreversible lung damage. There's also diacetyl, which is a chemical linked to a lung disease called bronchiolitis obliterans. I guess a more common term for it is popcorn lung.

Host: Wow. Okay. So, there's a lot going on in cigarettes and vapes and a lot of stuff that, like you're saying, sounds like I do not want in my body. But can you break it down a bit more for us? What are these chemicals that I'm ingesting when I do smoke? What are they doing to my body?

Dr. Germanuel Landfair: Yeah. So, I mean, that actually could be another podcast within itself that would probably take at least a half a day if we were to go over all of the effects chemicals from tobacco smoking can have on your body. But I guess, you know, just to go over a few of the systems of the body and how, you know, tobacco smoke affects them. We can start probably with the most well-known, which is the respiratory system, so, you know, your lungs and your airways. Tobacco smoke has been known to cause reduced lung function, breathlessness, and this is due to swelling and narrowing of the lung airways, and also excess mucus in the lung passages. There's also impairment of the lungs' ability to clear the lung passages, leading to buildup of poisonous substances, any substance that also, you know, caused lung irritation and damage. And then, there's increased risk of lung infection and symptoms such as coughing and wheezing.

If we go on to, let's say, to another well-known system, which is the circulatory system, you know, your veins, your arteries, your blood pressure and heart rate go up. There's tightening of the blood vessels in your skin, resulting in the drop in your skin temperature. Your blood becomes "stickier," which means it's more prone to clotting, damage to the lining of your arteries. There's reduced blood flow to your fingers and toes, increased risk of stroke and heart attack due to blockages of the blood supply.

Let's move on to another system. There's the immune system. There's greater susceptibility to infections such as pneumonia and flu. There's more severe and longer-lasting illnesses. It's harder for you to actually eradicate the illness if you smoke. And then, there's lower level protective antioxidants, such as vitamin C in the blood to help you get rid of free radicals.

Now if you look at the musculoskeletal system, which is, you know, near and dear to me, there's reduced bone density, which is very important. You know, especially as we get older, people fall and then they get hip fractures. They get wrist fractures, ankle fractures, all of these things that could happen less often if your bones are more dense, right? There's tightening of certain muscles. There's decreased bone strength, basically the same as the bone density. And then, you know, like I said before, the big thing that we were trying to cut down on is that risk of what we call fragility fractures. There's a high association between smoking and increased risk of having hip fractures, spine fractures, all of these things.

We could talk about the sexual organs, right? It affects these too. For, you know, individuals born as males, there's a lower sperm count, higher percentage of deformed sperm, genetic damage to the sperm, impotence, which may be due to the effects of smoking on blood flow and damage to the blood vessels of the penis. For people who were born as females, there's reduced fertility, menstrual cycle irregularities, absence of menstruation, menopause a year or two earlier. There's also risk of cervical cancer. Now, speaking of pregnancy-related issues, there's an increased risk of miscarriage, stillbirth, and premature birth if you're a smoker.

Now, what about the baby, right? In utero, the baby is subjected to the effects of nicotine and all of the other chemicals that are in cigarette or vape smoke. They may develop weaker lungs, they have lower birth weight, which may have a lasting effect on the growth and development of the child. It's also associated with an increased risk of heart disease, high blood pressure and diabetes when the child reaches adulthood. Now, we don't want to do that to our kids, right? There’s also an increased risk, I should say, of cleft palate and cleft lip. And also, there's been some studies that show a link between smoking in utero being exposed to smoking and having an increased risk of ADHD or attention deficit hyperactivity disorder.

 Just some other things that are common, gum disease, irritation and inflammation of the stomach and intestines, painful ulcers in your GI or digestive tract, reduced ability to smell and taste, premature wrinkling of the skin, and then there is also a higher risk of blindness.

Host: Thank you for breaking that down for us. It shows that there's definitely a lot going on when we ingest these chemicals. And that is today’s episode of BayCare HealthChat. Remember, this is just part one of a two part conversation on smoking and the healing process.

 In the meantime, head over to our website at BayCare.org for more information and to get connected with one of our providers.

Please remember to subscribe, rate, and review this podcast and all of the other BayCare podcasts. For more tips and health updates, follow us on your social channels. I’m Caitlin Whyte, thanks for listening.