How are smoking and chronic bronchitis related? + Symptoms and risks

The question is: How are smoking and respiratory diseases, such as bronchitis, related?
How does this long-term inflammation manifest itself and what are its complications?
Get a different perspective on smoking.

The most serious and common cause of its development is a habit that can be lived without. Smoking is the cause that causes many other unpleasant and insidious diseases, such as lung cancer, in addition to chronic lung disease.

Smokers do not realise, or do not want to admit, that smoking has significant negative effects on their bodies. In addition to health, smoking is also economically burdensome. Not only in terms of the rising price of cigarettes. The main economic burden is the period when treatment for the complications of smoking begins, both for the person himself and for the state.

The treatment is expensive, the smoker becomes disabled. In the late stages, he is paralysed by shortness of breath and the inability to breathe normally. The main component of chronic obstructive pulmonary disease is chronic bronchitis, about which you will find more information in the lines below.

Chronic bronchitis

Together with emphysema, it is one of the components of chronic obstructive pulmonary disease. It can also occur in a simple form on its own, as a result of untreated, untreated or frequent acute bronchitis in childhood, but also in adulthood.

Its main cause is the repeated, frequent exposure of the lining of the airways to harmful gases and particles, which causes inflammation. In the later stages, the difficulty escalates and the simple form turns into obstructive bronchitis, which, if neglected, can cause respiratory failure, heart failure and ultimately death. Therefore, early treatment is a success to avoid complications.

Chronic bronchitis is divided into:

• Simple (non-obstructive) chronic bronchitis refers to morning coughing and coughing up mucus.
• Chronic obstructive bronchitis with dyspnoea (mainly expiratory expiratory dyspnoea). Dyspnoea is initially exertional, in later stages also at rest. All-day coughing of mucus (sputum) and purulent (due to bacterial or viral infection) is present.

The causes of chronic bronchitis are varied and are influenced by both internal and external factors:

• Internal factors, so-called endogenous, include age (people over 40), gender (men are more affected) and genetic, immunological causes.
• External factors, so-called exogenous, which include smoking, environmental pollution, the work environment and recurrent (repeated) lower respiratory tract infections (inflammation)

Prolonged exposure to external influences causes remodelling (change in epithelial type) of the lower respiratory tract mucosa, resulting in increased mucus production. Due to impaired self-cleaning function, mucus accumulation and impaired functionality of the surrounding support apparatus and contraction of the airway smooth muscle, a narrowing of the diameter (permeability) of the bronchi and bronchioles occurs.

This constriction impairs respiratory function. The accumulation of mucus results in bacterial and viral inflammation, which in turn worsens the general state of health through respiratory failure.

How chronic bronchitis manifests itself

Coughing and coughing up mucus are among the main symptoms of bronchitis. To be diagnosed with chronic bronchitis, the trouble needs to have lasted for three months in two consecutive years. If you have noticed these symptoms in that duration, a medical examination is important. Your GP will refer you for a specialist lung examination.

Symptoms of chronic bronchitis:

• Coughing with expectoration of sputum (mucus)
• hypersecretion of mucus (excessive production)
• shortness of breath (dyspnoea)
• hypoxaemia (lack of oxygen in the blood), even cyanosis (bluing of the lips, fingertips)

Diagnosis of chronic bronchitis

The diagnosis of chronic bronchitis is made on the basis of information provided by the patient. At the same time, examinations are carried out which are determined by a specialist doctor, in this case a pulmonologist, a pneumologist.

The main diagnostic methods:

• History (smoking, work environment, home environment, coughing its recurrence, coughing up mucus, shortness of breath - professionally dyspnoea)
• Examination by listening (phonendoscope - whistles, squeaks, prolongation of exhalation are heard)
• Functional examination of the lungs (spirometry)
• Blood sampling (blood gas testing)
• Sputum examination (microbial examination of sputum)
• X-ray of the lungs
• Bronchoscopy for differential diagnosis to exclude other diseases

Interestingly, more than 90% of people with bronchitis report a history of smoking. The same is true with passive smoking. In addition, the work environment with its high prevalence of dust, smoke and other chemical components in the air has a negative impact. Wood heating and its inappropriate adaptation also contribute to recurrent bronchitis.

Complications of chronic bronchitis

As already mentioned, chronic bronchitis is subsumed under chronic obstructive pulmonary disease (COPD). Its complication is not only the lung disease itself, but also has a negative systemic effect. It causes other serious diseases which, in its interaction, worsen the overall health of the patient.

Main complications of COPD:

• Lung cancer
• IHD and other cardiovascular diseases
• chronic heart failure
• pulmonary hypertension
• diabetes mellitus (diabetes) and metabolic syndrome
• anaemia
• sleep apnoea
• depression
• systemic inflammation
• skeletal muscle dysfunction and malnutrition
• osteoporosis

Smoking

According to statistics, there are 1.1 billion smokers in the world and by 2025 this number will increase by 1.6 billion people. The mortality rate related to smoking today is alarming, with 3.5 million people dying from its effects worldwide. By 2025, this is expected to be approximately 10 million.

Smoking is a health, economic and social problem. Nicotine is more addictive than hard drugs, causing unnecessary premature deaths and resulting in dozens of cardiovascular, respiratory, digestive, oral and other diseases and complications.

The truth is that more than 80% of smokers started smoking in childhood. The age of 9 is usually the first experience of smoking and children in their early teens are already smoking regularly. Addiction in childhood develops much more quickly than in adulthood, yet it only takes 5 cigarettes a day.

With a daily consumption of approximately 20-30 cigarettes per day for 30 years, life expectancy is 8 years shorter than for non-smokers. People who die as a result of smoking in middle age (35-69 years) are robbed of 20-25 years of life by smoking. This is a sad figure for a completely unnecessary death. On average, 50% of smokers die from the direct consequences of smoking.

If you are a smoker, you should also read the following data on the diseases that smoking most often causes. To give you an idea, it is also expressed in approximate percentages.

• Cancers are represented by approximately 30%. The most common cancers are lung, mouth, lip, larynx, oesophagus, stomach, pancreas, colon, rectum, liver, bladder, breast and cervix.
• For cardiovascular diseases, the representation is approximately 20%. In this case, it is atherosclerosis, coronary heart disease and ischemic disease of the lower limbs.
• Diseases such as chronic bronchitis, followed by chronic obstructive pulmonary disease (COPD), which includes emphysema, maintain the highest percentage, 75% in smokers.
• Complications within the nervous system, stroke, lowers immunity and results in a range of other diseases.
• Smoking significantly increases the consumption of vitamins A, C, E and the element selenium.

Smoking during pregnancy is a special category. It endangers pregnancy, can cause complications during childbirth. It causes low birth weight, fetal and neonatal nicotine dependence. It increases the risk of infant mortality. And it causes a number of other diseases.

Do you know what cigarette smoke contains?

Cigarette smoke contains a number of chemicals and compounds. Of the approximately 4,000 (92% gaseous and 8% solid), 100 components are cancer-causing. Carbon monoxide (CO) binds about 200 times more readily to hemoglobin in the blood, preventing oxygen from binding. This de facto impairs oxygenation of the organs.

Some dangerous chemicals in cigarette smoke:

• Dibenzanthracene
• Benspyrene
• dimethylnitrosamine
• diethylnitrosamine
• NNK (methylnitrosamino-butanone)
• NNN (nitrosonornicotine)
• vinyl chloride
• hydrazine
• arsenic
• mercury
• nickel
• lead
• polonium 210
• cadmium
• benzene
• toluene
• naphthalene
• formaldehyde
• ammonia

When a cigarette burns, two types of smoke are produced. The main (primary) smoke stream is inhaled during the puffing process. The second (secondary) smoke stream is all the more dangerous because it contains higher concentrations of hazardous substances than the primary inhaled smoke stream at lower combustion temperatures.

For example, the concentration of ammonia is 78 times higher, 52 times more dimethylnitrosamines, 16 times more naphthalene, 3.4 times more benzopyrene, 2.5 times more CO, 1.7 times more tar, and the list goes on. This is why passive smoking and exposure to smoke in an enclosed, unventilated space is dangerous.

Cigarette smoke also contains small amounts of radioactive carcinogens, such as the lead and polonium isotope 210. Edward Martell, a radiochemist at the National Center for Atmospheric Research (NCAR), has found that radioactive substances from cigarette smoke are deposited in the bronchial tubes. You can also read Cancer Research UK' s article on the polonium content of cigarette smoke.

Preventing smoking early and informing the public, and especially young people, about its risks and complications could reduce the number of smokers in the future, which is on an ever-increasing trend. According to various statistics, up to 75% of smokers would like to quit, but their addiction is stronger and they cannot cope with smoking. If you want to quit, there are various cessation practices available. Your doctor can also help you. However, if you start having problems, it is most effective to quit smoking firmly and immediately. It is best not to start.

And for motivation:

• 20 minutes to normalise blood pressure
• after 8 hours, CO levels are at half the normal level and oxygen levels rise to normal
• 48 hours means that the nicotine gets out of the body and the sense of smell and taste adjusts
• after 72 hours your energy returns and your breathing is also better
• if you hadn't smoked for 2 weeks, you would believe that your blood circulation would improve
• In 9 months, coughing subsides, lung breathing volume adjusts
• after a year of not smoking, the risk of myocardial infarction is halved
• over 5 years, you reduce your risk of stroke
• and after 10 years of not smoking, your risk of lung cancer is the same as a non-smoker