Pathology of Smoking-Related Lung Disease - A Comprehensive Review

Introduction:

Patients with respiratory illnesses may experience some severe complications. Chronic smokers are more likely to develop lung disorders, which can have negative effects on their health. There are various neoplastic and non-neoplastic lung diseases associated with smoking. These diseases include diseases with airflow limitation, vascular alterations, and interstitial lung disease. Smoking-related non-neoplastic lung diseases are as follows:

• Obstructive lung disease.

• Emphysema (a lung condition causing shortness of breath).

• Alteration of large airways.

• Small airway disease.

• Pulmonary hypertension.

• Interstitial lung disease (a group of diseases causing fibrosis of the lungs).

• Respiratory bronchiolitis (associated interstitial lung disease).

• Desquamative interstitial pneumonia (a chronic lung inflammation).

• Eosinophilic granuloma (a rare non-cancerous bone tumor).

What Are the Risks Associated With Smoking?

Smoke damage can cause serious long-term lung diseases. Along with the lungs, it can affect vital organs of the body. Risks of lung diseases from smoking include:

1) Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease. Bronchitis is long-term inflammation of the large airways of the lungs. These airways are called bronchi. It shows the following symptoms:

• Shortness of breath.

• Cough along with mucus, which lasts for weeks or months.

2) Emphysema: This is also a type of chronic obstructive pulmonary disease. Emphysema affects the alveoli, which are air sacs in the lungs. It shows the following symptoms:

• Shortness of breath.

• Cough.

• Tiredness.

• Sleep disturbances.

• Heart issues.

• Weight loss.

• Depression.

3) Asthma: Fundamentally, asthma is a heightened sensitivity to or response to stimuli. The narrowing of the airways, or bronchoconstriction, is one of the defining characteristics. The stimuli can be in the form of dust, pollen, fur from animals, or a particular diet or medication. The immune system is triggered by these damaging stimuli. This causes airways to narrow, which is followed by allergic reactions. Immunoglobulin E, an antibody that targets certain cell types, and plasma cells, or mast cells, make up most of the immune system's components. Cytokines are a class of cells made of protein. Histamine is the substance that widens blood vessels and produces allergic reactions, including a runny nose, itchy eyes, and sore throat. Leukotrienes and prostaglandins can trigger an inflammatory response and create mucus. They can cause anaphylaxis, a severe reaction that can be fatal.

4) Chronic Obstructive Pulmonary Disease: The lungs' primary function is to breathe in air. The windpipe transports this air to the bronchial tube. It then travels through tiny, thin tubes called bronchioles to the alveoli, which are air sacs. There are capillaries all around these air sacs. Oxygen and carbon dioxide are exchanged through these capillaries. Lung tissue loses flexibility as the air entering and leaving the lungs decreases. The air sacs are damaged, and their walls become inflamed and thickened. Mucus production that is increased causes the tubes to clog. Mucus-removing cilia, a hair-like structure, become less effective when mucus production rises. Due to the mucus being retained, this causes continuous coughing. Below are some of the signs and symptoms of chronic obstructive pulmonary disease:

• Persistent cough.

• Shortness of breath or dyspnea.

• Blue fingernails.

• Respiratory tract infections.

• Fatigue.

• Wheezing.

• Tightness in the chest.

• In severe cases, swollen faces and weight loss.

• If the symptoms flare up, it can lead to exacerbation and emergency conditions.

5) Fibrosis: The presence of injury and scarring in the lung tissue is called fibrosis. The exchange of oxygen becomes challenging as a result. As a result, the lungs operate less effectively. Some of the symptoms it exhibits are shortness of breath, a dry cough, weariness, weight loss, and soreness in the muscles and joints. It is primarily caused by a reaction to industrial risks, such as inhaling silica, asbestos, coal, or hard metal dust, radiation damage from chemotherapy, and long-term use of pharmaceuticals such as Methotrexate for cancer, Amiodarone for heart disease, some antibiotics, and anti-inflammatory medications.

6) Sarcoidosis: Granulomas, or masses of inflammatory cells, start developing in this condition. Fibrosis results from the resulting inflammation and scarring.

7) Pulmonary Hypertension: Blood pressure rises as the lungs' blood arteries constrict, obstruct, or are destroyed. It exhibits signs like cyanosis, chest tightness, weariness, dizziness, edema, and palpitations. The pulmonary artery can become more constricted, and left-sided cardiac disease, valve malfunction, or blood clots can cause lung hypertension.

8) Cancer: Cancer involves the abnormal growth of cells. Cancer presents with lumps, masses, or tumors. Smoking increases the risk of cancer of the nose, sinus, voice box, and throat. It also increases the risk of other cancers, like cancer of the gastrointestinal, urinary, and female reproductive systems. In lung cancer, this growth of cells starts in the lining of the airways and spreads to the other part of the lungs. Smoking is the leading cause of lung cancer. Lung cancer presents with no symptoms until it advances to further stages. Lung cancer presents with symptoms as follows:

• Cough.

• Chest pain.

• Shortness of breath.

• Recurring lung infections.

What Are the Dangers of Secondhand Smoke?

Smoke that is exhaled by smokers is known as secondhand smoke. It is also smoke from burning cigarettes, cigars, or pipes. It can cause several lung conditions and heart disease. Children exposed to tobacco smoke are likely to have ear infections and asthma. Secondhand smoke presents with the following symptoms:

• Eye, nose, and throat irritation.

• Cough.

• Excessive mucus production.

• Chest discomfort or pain.

What Are the Cancer Risks of Cigar Smoking?

Cigar smokers who do not inhale the smoke are at risk for oral, throat, and esophageal cancers. At the same time, cigar smokers who do inhale are at risk for oral, esophageal, or laryngeal cancer. Cigar smoke causes the emission of carcinogens (substances that cause cancer and are known as carcinogens) into the air. These substances are more prevalent in cigar smoke than in cigarette smoke.

What Are the Benefits of Quitting Smoking?

People who quit smoking can decrease the risk of lung damage. Other benefits may include the following:

• Decreased risk for lung and heart disease.

• Decreased risk for cancer.

• No teeth stains and healthy gums.

• Decreased cough and shortness of breath.

• No foul breath, clothes, or hair.

How to Quit Smoking?

Quitting smoking can be difficult. There can be withdrawal symptoms seen. Tapering the quantity can help. Following are some methods that will make quitting easier:

• Find a motto or goal that will help quit smoking.

• Set a date and time when one is in a relaxed and stress-free state and environment.

• Look for motivation from friends and family.

• Indulge in routine physical exercises.

• Maintain a healthy diet and lifestyle balance.

• Join a program or support group that encourages one to quit smoking.

There are treatments proven to help quit smoking. Medicines reduce nicotine cravings. A combination of medicines and counseling can help to quit smoking faster. Over-the-counter medicines are available, which include:

• A nicotine patch delivers nicotine to the body through the skin.

• Nicotine-chewing gums help deliver nicotine through oral tissues.

• Nicotine lozenges are candies containing nicotine.

Prescription medicines are also available; these include:

• Nicotine nasal spray.

• Nicotine inhaler.

• Bupropion is an antidepressant medicine. It can help to decrease cravings for nicotine.

• Varenicline tartrate decreases the discomfort of withdrawal.

Conclusion:

Patients with respiratory illnesses may experience some severe complications. Lung conditions are more common and have a negative influence on health. The connection between the patient and the clinician, the assessment, and the treatment plan is essential for managing lung illnesses. Comprehensive tobacco cessation and control among youths and young adults will help eliminate smoking-related lung diseases.