We have decided to investigate the damage caused by tobacco, going beyond the now well-known association with cancer. This is an excellent opportunity to talk about one of the most obvious problems affecting those who depend on cigarettes: damage to the organs that allow breathing. We discussed this topic with Dr. Michele Ciccarelli, Head of Pulmonology at Humanitas.


Doctor, what are the most obvious damages that a smoker causes to his lungs?

The idea that smoking causes lung cancer is now widely known; regardless of oncological problems, in any case, smoking causes a lot of damage to the respiratory system, even immediate and chronic types. From a functional point of view, it is necessary to explain how the lungs, just like the rest of the body, undergo an ageing process over time. Smoking, in susceptible individuals, considerably accelerates this process, with a progressive decline that can lead to chronic respiratory failure and the need for oxygen therapy.

People with bronchial asthma represent a population that suffers very negatively from the effects of smoking: they suffer from a more serious disease, that responds less favorably to pharmacological treatment and that tends to become more frequent.

One of the respiratory diseases closely related to cigarette smoking, which is the main risk factor, is chronic obstructive pulmonary disease (COPD), a disease characterized by chronic obstruction of the airways (bronchi) and the progressive alteration of respiratory function.

Also worth mentioning is idiopathic pulmonary fibrosis, a degenerative pathology of the pulmonary interstice, also linked to smoking.

Finally, for some years now it has been discovered that some of the substances contained in the particulate produced by the combustion of tobacco, once reaching the alveoli pass directly into the bloodstream, with effects that can affect the entire cardiovascular system, increasing the risk of cardiovascular diseases.


How much can smoking affect athletic performance?

All physical exercises performed by a smoker are less efficient than those of a non-smoker; physical performances depend on the supply of oxygen in the muscles. For this reason, during a physical effort, the heart rate increases: it is necessary to get more blood and, therefore, more oxygen, to the muscles.

Both carbon monoxide (CO) and many of the other substances that are released as a result of the combustion of tobacco are able to bind to red blood cells: this obviously decreases the ability of red blood cells to transport oxygen through the bloodstream. To this effect it is necessary to add the effect of vasoconstriction, which smoke determines, narrowing the blood vessels and further decreasing the supply of oxygen. The muscles of a smoker will therefore have considerably less strength and endurance.