This document discusses the harmful effects of smoking on every system of the body. It details how smoking tobacco exposes the body to nicotine, carbon monoxide, and over 400 other toxins. Nicotine is highly addictive and causes accelerated heart rate and hardening of arteries. Carbon monoxide reduces oxygen in the blood and can cause vision and mental problems. Smoking increases the risks of numerous cancers, heart disease, COPD, cataracts, age-related macular degeneration and more. It also discusses the harmful effects of secondhand smoke and marijuana smoke. The document emphasizes that quitting smoking can significantly reduce health risks over time.

1. Smoking Guns
by Dr. D. J. Griffith
Consultant Ophthalmologist
Where There Is No Vision,
The People Perish.

2. Smoking Guns
☻‘Smoking Gun’ was originally, and still
is primarily, a reference to an object
or fact that serves as conclusive
evidence of a crime or similar act
☻Originated in the Sherlock Holmes
story ‘The Gloria Scott (1893)’
☻The effects of smoking is conclusive
evidence

3. Smoking Guns
☻Tobacco smoke
primarily
☻Brief mention of
marijuana smoke
☻Some say you can
as well put a gun to
your head

4. Smoking Guns
Chemical Components

5. Smoking Guns
Nicotine
☻Nicotine is a powerful insecticide
☻Poisonous for the nervous system
☻Enough (50mg) in four cigarettes to
kill a man in just a few minutes if it
were injected into the bloodstream
☻Fatalities have occurred with
children after they had swallowed
cigarettes or cigarette butts

6. Smoking Guns
Nicotine
☻When diluted in smoke, nicotine reaches
the brain in just seven seconds
☻It stimulates brain cells and then blocks
the nervous impulse
☻This is where addiction to tobacco arises
☻It causes accelerated heart rate, leads to
contracting and hardening of arteries
☻Resulting in twice as many coronary attacks

7. Smoking Guns
Nicotine
☻Nicotine also increases the
consumption of lipids (hence having a
wt loss effect)
☻Induces temporary hyperglycemia
(hence the appetite suppressing
effect)

8. Smoking Guns
Carbon Monoxide
☻This is the asphyxiating gas produced by
cars
☻Makes up 1.5% of exhaust fumes
☻However, smokers inhaling cigarette smoke
breathe in 3.2% carbon monoxide
☻And directly from the source
☻Carbon monoxide attaches itself 203 times
more quickly to haemoglobin than oxygen
does

9. Smoking Guns
Carbon Monoxide
☻The oxygen is displaced
☻Resulting in asphyxiation
☻Hence, cardiovascular problems result:
narrowing of arteries, blood clots,
arteritis, gangrene & heart attack
☻Also results in loss of reflexes and visual
and mental problems
☻It takes between 6 to 24 hours for carbon
monoxide to leave the blood system

10. Smoking Guns
Other Components
☻Also radioactive compounds like nickle,
polonium & plutonium
☻No less than 400 irritating, suffocating,
dissolving, inflammable, toxic, poisonous,
carcinogenic gases and substances
☻Others include benzopyrene,
dibenzopyrene, benzene, isoprene, toluene,
naphthylamines, arsenic, cadmium, carbon
dioxide, methane, ammonia, nitric oxide,
nitrogen dioxide, hydrogen sulphide, methyl
alcohol, ethanol, glycerol, glycol,
acetaldehyde, acetone, prussic acid &
nitrosamines

11. Smoking Guns
Marijuana Smoke
☻Used in medical treatment for thousands
of years
☻Removed in the 1940’s from the US
Pharmacopeia as a result of political
pressures
☻Compounds used to treat pain & nausea
☻Refers to dried flowers, leaves, stem &
seeds of the Cannabis sativa plant
☻Contains at least 60 types of cannaboids

12. Smoking Guns
Marijuana Smoke
☻THC (delta-9-tetrahydrocannabinol) is the main
component
☻THC is responsible for the mind altering effect
☻Cannabinol & cannabidiol have similar properties of
THC but cause less psychoactive effects
☻Dronabinol (Marinol) is a man-made version of THC
available by prescription
☻Dronabinol is used to prevent nausea & vomiting
after cancer chemotherapy & to increase appetite
in people with AIDS

13. Smoking Guns
Marijuana Smoke
☻When smoked, reaches peak levels in
minutes, lasting up to 1 ½ hours
☻When eaten, can take several hours
to reach peak levels, lasting for hours
☻Dronabinol (as an oral capsule) takes
effect in 30 mins, continuing to
stimulate appetite for more than a
day

14. Smoking Guns
Marijuana Smoke
☻ Medical uses include:
A. Nausea
B. Glaucoma – decreases IOP
not well understood
CB1 receptors in the eye
C. Pain – analgesic effect
enhances effects of opiates
D. Multiple Sclerosis - treat tremors,
muscle spasms & pain

15. Smoking Guns
Marijuana Smoke
☻Federal Law in Us recognizes
marijuana as a Schedule 1 drug
☻This classifies it as one of “the most
dangerous drugs that has no
recognized medical use”
☻Hence if caught with it, a small fine
or prison sentence

16. Smoking Guns
Marijuana Smoke
☻Health risks include impaired thinking,
problem-solving skills & memory
☻Reduced balance & coordination
☻Increased risk of heart attack
☻Heightened risk of chronic cough &
respiratory infection
☻Potential hallucination & withdrawal
symptoms
☻Increased risk of cancer of the lungs and
respiratory tract

17. Smoking Guns
Secondhand Smoke
☻Known as environmental tobacco smoke given off
by the burning end of a cigarette, pipe or cigar
(sidestream) & smoke exhaled from the lungs of
smokers (mainstream)
☻Causes premature death & diseases in children and
in adults who do not smoke
☻SIDS, acute respiratory infections, ear problems
& more severe asthma
☻Heart disease, lung cancer, breast cancer, LBW
babies
☻There is no safe level of secondhand smoke

18. Smoking Guns
Immune System Effects
☻Affects antibodies
☻AML strongly
associated with
smoking
☻Affects cells that
attack foreign
bodies

19. Smoking Guns
Digestive System Effects
☻Increases the risk
of developing
stomach ulcers,
rectal, pancreatic &
liver cancers
☻More likely to have
problems with
heartburn

20. Smoking Guns
Nervous System Effects
☻This system is continuously
developing
☻Therefore, it is sensitive to the toxic
substances in cigarette smoke
☻Smoking can make several diseases
of the nervous system worse
☻It also increases the risk of
developing some of these diseases,
eg. Multiple sclerosis

21. Smoking Guns
Female Reproductive
System
☻Early menopause & reduction in bone
density
☻Increased risk of hip fractures in older
females
☻Increased risk of cervical & vulval cancer
☻Increased risk of infertility
☻During pregnancy, increased risk of
miscarriage, premature delivery &
increased risk if SIDS

22. Smoking Guns
Male Reproductive System
☻Increased risk of erectile
dysfunction
☻Decreased sperm count
☻Increased chances of developing
cancer of the penis
☻Increased risk of hip fractures in
older men

23. Smoking Guns
Mental Health Effects
☻Increased rates of
depression,
anxiety,
schizophrenia &
drug abuse

24. Smoking Guns
Endocrine System
☻Decrease female
hormones
☻Alters hormonal
regulation of body
weight and
distribution of
body fat

25. Smoking Guns
Skeletal System
☻Nicotine, carbon
monoxide and
hydrogen cyanide
harm bone
☻Increases the risk
of osteoporosis
☻Delays bone healing

26. Smoking Guns
Respiratory System
☻Increased risk of developing
respiratory infections such as
bronchitis & pneumonia, COPD,
emphysema and lung cancer
☻More than 80% of lung cancers are
caused by smoking; 23 times higher
for men and 13 times higher for
women who smoke compared with non-
smokers

27. Smoking Guns
Muscular System
☻Increased risk of
developing RA,
lupus and MS

28. Smoking Guns
Circulatory System
☻Smoking kills more than 400,000 Americans each
year
☻About 180,000 of these die from diseases of the
heart or arteries, such as heart attacks or
strokes
☻Risk of dying of coronary heart disease is 70%
higher for smokers than for non-smokers
☻Risk of having a heart attack is 2-6 times higher
☻Smoking-related coronary heart disease can
contribute to heart failure
☻Associated with sudden cardiac death
☻Risk of heart disease drops dramatically after 12
months of quitting smoking
☻Smoking raises blood pressure, thus increasing the
risk of developing atherosclerosis
☻Complications of atherosclerosis include: heart

29. Smoking Guns
Urinary System
☻Increases the risk
of developing
cancer of the
kidney and bladder

30. Smoking Guns
Effects On Skin
☻Dry, irritated,
discolored, leathery,
worn appearance
☻Wrinkles around eye
and mouth develop
sooner & more
pronounced
☻Increased risk of skin
cancer
☻Yellow discoloration of
hands and fingernails

31. Smoking Guns
Senses
☻More susceptible to hearing loss due to ear
infection & loud noise
☻Effects on blood vessels decrease blood flow to
the inner ear
☻Smoking around children increases their risk of
ear infections
☻Decreases the sense of smell
☻Related to cancer of the nasal cavity and sinus
☻Yellowish discoloration of teeth, tooth decay, bad
breath & gum disease
☻Chewing and swallowing related to mouth cancer
☻Affects sense of taste
☻50% of cancer of the pharynx, larynx &
oesophagus caused by smoking

32. Smoking Guns
Eyes
☻Smoke irritation
☻2-3 times higher
risk of developing
cataracts
☻Four times
increased risk of
developing ARMD
☻Increased risk of
developing optic
neuropathy; risk
increased more
when coupled with
the use of alcohol

33. Smoking Guns
Cataracts
☻ Strongly associated with
nuclear & PSC cataracts
☻ Dose dependent
relationship between pack-
years of use & degree of
opacification
☻ A 13yr f/u from Physicians
Health Study,
demonstrated smoking
cessation reduced risk
primarily by limiting
cumulative dose & smoke
related damage

34. Smoking Guns
ARMD
☻Leading cause of blindness in the developed
world
☻Increases long term risk of incident late,
but not early ARMD
☻And possibly a greater effect in persons
with low HDL cholesterol, high ratio of
total to HDL cholesterol & low fish
consumption
☻Siblings of ARMD patients are at high risk
of developing the condition, suggesting
ARMD is a genetic disease

35. Smoking Guns
Tobacco Amblyopia
☻Cigarette smoke commonly releases
cyanide
☻Smokers of tobacco have a mean blood
cyanide level of 0.4 mcg/ml (2.5 times
greater than non-smokers)
☻Cyanide exists in many different forms
(fruits, vegetables like cassava and certain
lima beans as cyanide glycosides)
☻As a gas, liquid or solid
☻Mostly toxic to CNS & myocardium

36. Smoking Guns
Tobacco Amblyopia
☻Long-term low-dose cyanide poisoning is
thought to be the cause of tobacco
amblyopia
☻Also associated with Leber hereditary
optic atrophy
☻Antidotes are hydroxocobalamin (Europe)
& dicobalt acetate (Great Britain)
☻Hydroxocobalamin used in France since
1996
☻Only approved in US by FDA in 2006

37. Smoking Guns
Hydroxocobalamin
☻Hydroxocobalamin is also known as
vitamin B12a
☻It chelates & fixes cyanide to form
cyanocobalamin (vitamin B12)
☻Excreted in urine

38. Smoking Guns
What About Quitting?
☻Also, emphasis has been placed upon the
optician and attending doctor to enquire if
their patients smoke, and to refer them
for help to quit
☻In June, 2007 legislation passed a bill
banning smoking in public places in the UK
☻Smoking Leaflet
☻Nicotine patches and gums
☻Support services?