Tobacco smoke is one of the most important factors intensifying atherosclerosis, which causes heart attacks and strokes as well as lower limb ischemia. Smoking significantly increases the risk of heart disease, including heart attack and stroke, a disease that can often lead to severe disability or death.
In addition, the constant irritation of the bronchi by the substances contained in the smoke causes an overgrowth of the mucous glands of the bronchial mucosa, which increases the secretion of mucus. These changes lead to clinical symptoms of chronic bronchitis – coughing and expectoration of sputum, which also persist beyond the period of colds. The cough is often most severe in the morning after waking up.
The smoker coughs to finally cough up the sputum, which is usually a relief – this is called “Morning toilet” of the bronchial tree. Unfortunately, these symptoms are often neglected and perceived as “a natural consequence of smoking”. However, these are pathological symptoms, clearly indicating that a chronic inflammatory process is taking place in the smoker’s bronchi. Histopathological examination would reveal in these individuals an increased number of inflammatory cells – macrophages and neutrophils – in the bronchial mucosa.
They help to protect against infections and remove foreign substances (e.g. dust particles) from the bronchi. Unfortunately, their activity also has negative consequences – they secrete enzymes that damage the structural elements of the bronchi and the surrounding lung parenchyma, and disrupt the natural balance between oxidizing substances and antioxidants that counteract them.
These processes accelerate the rate of decline in lung function. In healthy people, FEV1 deteriorates at a rate of about 30 ml / year due to the natural aging process. Tobacco smoking accelerates the rate of FEV1 decline to as much as 60-80 ml / year, which in turn may lead to the development of COPD (see: Spirometry in COPD patients).