Smokers Lungs - An Overview

Introduction:

Smokers lungs refer to the lungs of a person who smokes. The lungs are one of the most important parts of the respiratory system, which takes oxygen inside and removes carbon dioxide. Though several factors or diseases may affect lung function, like genetic diseases, environmental factors, and infections, smoking remains one of the most common and dangerous causes. Over time, smoking decreases lung capacity and makes lungs more susceptible to infections. The structure and function of the lungs are altered, making it more difficult to breathe and increasing the risk of numerous medical conditions. Smoking is considered the undoubtful cause of lung cancer in many patients. As per the survey, smoking causes 80 % of people affected with lung cancer.

What Are the Changes in Smokers Lungs?

The physical appearance of the lungs is changed due to the effects of smoking. The change in the color, size, presence, or absence of inflammation is observed. In addition, muscle loss in the diaphragm is observed. The color of the affected lungs may vary from pink to gray or black. The discoloration is due to black-pigmented tar (particulate matter that is produced when burning tobacco) when puffing a cigarette. The affected lungs become hyperinflated (larger in size). There are patches of inflammation in the affected lungs. Smoking not only causes physical changes but also causes changes in the function of the lung. The duration that is taken to cause changes differs individually.

What Are the Symptoms of Smokers Lungs?

There are several symptoms that interfere with normal breathing. Symptoms include-

• Increased Mucus Production: Smoking stimulates the lungs to produce more mucus secretion. It causes damage to the epithelial cells lining the airways. Hence, due to damage to epithelial cells, the inflammatory cells build up, resulting in goblet cell formation and leading to increased mucus secretion. The quantity and consistency of mucus vary from person to person. But in a smoker's lungs, moderate to large amounts of thick mucus are produced.

• Coughing: One of the commonest symptoms of smokers is frequently coughing and an increased risk of developing a chronic cough. This is because smoking causes damage to the cilia. Cilia are small hair-like projections in the airways that help to clear or filter the dirt or irritants out of the lungs. Due to smoking, the cilia are completely damaged or partially paralyzed and allow irritants to get into the airways. Without cilia, the toxins and chemicals in the cigarette and other infectious organisms can easily reach the lungs and cause smoking-related illnesses. Therefore, the chronic cough caused due to the absence of cilia is called smokers cough.

• Clogged Airways: Inflammation of the airways may result in respiratory illnesses. Chronic obstructive pulmonary disorder (COPD) occurs as a result of chronic inflammation of the bronchi.

• Emphysema: Smoking also causes emphysema. During breathing activity, the air sacs called alveoli in the lungs are stretched when the air is inhaled and exhaled. As a result of smoking, these air sacs lose their elasticity and deflate, making it harder for the body to breathe air in and out of the lungs. Therefore, the capacity of the air sacs reduces lung capacity or the amount of air that a person is able to inhale. The reduced oxygen intake puts added strain on the heart resulting in cardiovascular diseases and heart attacks.

• Wheezing and Chest Tightness: In smoking people, the chemicals in cigarettes may irritate and damage the tissues of the lungs, which leads to inflammation. Lung inflammation leads to the narrowing of air passages which causes wheezing and chest tightness.

• Shortness of Breath: All these changes, including destroyed cilia, damage to epithelial cells that line airways, and increased mucus production, makes breathing difficult. Even mild physical exertion may cause breathlessness.

Why Does Smoking Affect the Lungs?

There are more than 7,000 chemicals present in cigarette smoke, and these include -

• Nicotine.

• Acetaldehyde.

• Ammonia.

• Carbon monoxide.

These chemicals are potential carcinogens that can irritate the lungs and may cause cancer in humans. The risk of developing cancer is 25 times greater in men and 25.7 times greater in women. According to survey reports, nine out of ten causes of lung cancer death are due to smoking. In other ways, these chemicals can cause scarring or inflammation and damage to cells and blood vessels.

What Are Smoking-Related Lung Diseases and the Changes Involved in the Lungs?

There are many chances of lung disease that are caused once a person starts to smoke regularly. Some of the common lung diseases due to smoking are:

• Chronic Bronchitis - The inflammatory immune cells infiltrate the subepithelium, epithelium, and glandular tissue in bronchitis, including the macrophages, neutrophils, CD8 positive (CD8+) and CD4 positive (CD4+) T lymphocytes, and B cells that are part of adaptive inflammatory immune responses. Due to the continuous intake of tobacco, the inflammation consisting of enlargement of mucous glands and remodeling of walls of bronchi results in dysregulation of the tissue healing process. In addition, the elastase from the polymorphonuclear neutrophils stimulates the secretion of mucus by epithelial goblet cells.

• Chronic Obstructive Pulmonary Disease - Smoking is also a trigger for chronic obstructive pulmonary disease (COPD) flare-ups. This is because it damages the air sacs, airways, and the lining of the lungs. In addition, long-term exposure to lung irritants like secondhand smoking also triggers chronic obstructive pulmonary disease (COPD).

Long-term inflammation causes remodeling of the airway structure and subsequent restriction in respiratory airflow. The airflow restriction is irreversible even after removing the risk factors. Following are the noticeable changes in the affected lungs:

• Damage to the structure of the air duct wall.

• Damage to the septum of the alveolar wall.

• Interstitial fibrosis (lung disease that causes scarring or fibrosis of the lungs).

• Aggravates the progression of lung lesions.

• Smoking Stimulates Reactive Oxygen Species (ROS) - It leads to an imbalance in oxidation and antioxidant systems, resulting in cell dysfunction and inducing cell apoptosis.

What Are the Benefits of Quitting Smoking?

Quitting smoking minimizes the damage to the lungs and allows the body to heal gradually. The lung and cilia begin to function normally between a month or year after quitting smoking. Other impaired functions like shortness of breath and chronic coughing also get reduced after quitting.

Conclusion:

Cigarette smoking is the primary cause of several lung diseases. There are a number of cessation strategies available that vary from using medication to gaining strength from support groups and therapy. Self-awareness, counseling, and behavioral approaches aid in coping with the challenges of smoking cessation. Following lifestyle strategies or modifications like exercise routines and healthy habits like drinking more water and eating nutritious food can help to replace the habit of smoking.