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    Preventing Digestive Health: About Tobacco

    One of the most common drugs in use in the United States is nicotine from tobacco. Smoking or chewing tobacco negatively affects overall nutrition and health. Every part of the body is affected. Troubling problems such as a higher risk of developing cardiovascular disease, cancer and cataracts are linked to smoking. Smoking also contributes to increased blood pressure. The toxic minerals cadmium and lead are absorbed in the lungs from cigarette smoke. Smoking has so many harmful effects on health that it has been recognized as the top preventable health problem in the developed world.

    The message is clear: If you don't smoke, don't start. If you do smoke, quitting can help prevent chronic health problems.

    Effects on the Digestive System

    Evidence from research has shown that smoking has harmful effects on the digestive system and is associated with heartburn and peptic ulcers. Smoking also increases the risk of Crohn's disease and may increase a person's risk of gallstones. Moreover, smoking appears to alter the way the liver metabolizes drugs and alcohol.

    Heartburn

    Heartburn occurs when the strong acid in the stomach rises up into the esophagus. At the base of the esophagus there is a valve called the lower esophageal sphincter, which normally protects the esophagus from the stomach acid. Smoking weakens this protective valve and the result is esophageal reflux or upward flow of stomach acid. Smoking may also directly harm the esophagus, making it more susceptible to damage from esophageal reflux.

    Peptic Ulcers

    A peptic ulcer is a sore on the inside lining of the stomach or the duodenum (the first part of the small intestine closest to the stomach). The exact cause is unknown. A link between smoking cigarettes and ulcers appears to exist. The 1989 Surgeon General's Report stated that ulcers are more likely to occur and cause death in smokers compared with nonsmokers.

    Studies have suggested that smoking may increase a person's risk of infection by Helicobacter pylori (H. pylori), a bacterium thought to be the cause of most peptic ulcers. The amount of stomach acid present plays a role in the formation of ulcers. Normally, the food a person eats serves to buffer the stomach acid. Any unbuffered acid that leaves the stomach and enters the duodenum is neutralized by sodium bicarbonate (produced by the pancreas). Some research evidence shows that smoking reduces the amount of bicarbonate produced by the pancreas and impairs the neutralization of the unbuffered acid in the duodenum. Other research shows that continuous cigarette smoking might increase the amount of acid produced by the stomach, further contributing to the problem.

    Although the cause remains unknown, research has concluded that smokers appear to be more likely to develop an ulcer, particularly a duodenal ulcer, than nonsmokers. And ulcers are less likely to heal among smokers than nonsmokers with otherwise effective treatment.

    Crohn's Disease

    Crohn's disease causes inflammation anywhere along the lining of the gastrointestinal tract. Studies have shown that smokers and past smokers have an increased risk for developing Crohn's disease compared to nonsmokers. Among people with Crohn's disease, smoking is linked to more recurring relapses, repeat surgeries and medication needs. While the reason for the increased risk of Crohn's disease is not known, it is thought that smoking may impair the defenses of the gastrointestinal tract, reduce the flow of blood to the intestines or alter the immune system, resulting in inflammation.

    Gallstones

    Much evidence from research suggests that smoking may increase a person's risk of developing gallstones. This risk may be higher in women than in men. However, more studies are needed as results of research in this area are not consistent.

    Liver Metabolism

    The liver is like a large processing center. Its main duties are metabolizing and detoxifying drugs, alcohol and other waste products to clear them from the body. Research evidence suggests that smoking negatively affects the liver's ability to process these compounds. This may affect the dose of a medication necessary to treat an illness. Some studies also suggest that smoking can worsen liver disease caused by excessive intake of alcohol.

    Depletion of Protective Antioxidants

    Smoking changes the metabolism of vitamin C in the body. Smokers have faster depletion of this (and the other important antioxidant nutrients beta-carotene, vitamin E and zinc) than nonsmokers. Low levels of these nutrients inhibit the body's ability to neutralize harmful reactive compounds known as free radicals that are found in cigarette smoke. Increased presence of free radicals can put a person at higher risk for chronic diseases such as cardiovascular disease and cancer. Some evidence suggests that smokers may require as much as 200 mg of vitamin C a day to counteract rapid depletion and maintain blood levels similar to nonsmokers.

    Beta-carotene (a precursor to vitamin A) and vitamin A levels in lung and mouth tissues exposed to chewing tobacco or cigarette or cigar smoke are low. Tissues containing adequate amounts of vitamin A appear less likely to become cancerous. Vitamin E may reduce the damage to lung tissue from outside air pollution.

    Lower zinc levels are found in smokers. Adequate amounts of zinc may reduce the risk of atherosclerosis in people who smoke. Women who smoke during pregnancy have low zinc levels in their blood and are more likely than nonsmokers to have babies deficient in zinc. These babies are at higher risk for birth defects and disease compared to babies who have received adequate amounts of this mineral.

    Second Hand Smoke

    Nonsmokers inhale both the mainstream smoke exhaled from the smoker and the sidestream smoke from the end of a burning cigarette, passively smoking twice as much tar and nicotine, three times as much benzo (a) pyrene (a cancer-causing compound), three times as much carbon monoxide and 73 times as much ammonia. These are toxic gases that remain for hours in a smoke-filled room and enter the lungs and bloodstream of the smoker and the surrounding passive smokers.

    Inhaling carbon monoxide cuts the oxygen supply to the brain, heart and other body tissues. Passive smokers (people breathing second hand smoke) experience more breathing difficulties, eye irritations, bronchitis, pneumonia and tonsil surgeries. Smoke increases symptoms of asthma and allergies. Passive smokers may protect themselves from some of the harmful effects of second hand smoke with adequate amounts of vitamin C, beta-carotene, vitamin E and zinc in their diets.


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