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Background: One of the biggest challenges in the world of health is the problem of smoking. In 2018, there was an increase in smokers at the age of 10-18 years by 9.1% compared to 2013, which was 7.2%. It is feared that the increasing number of smokers at a young age will increase the number of non-communicable diseases (NCD) at a young age. Methods: Writing this article uses the method of literature searching from various sources of information including e-books, websites and search engines. The e-books used contain cigarette information and its effects on health, the websites used are the website of the government and WHO to search for prevalence data and other information, and the search engines used are Google Scholar and Pubmed to search information on cigarette content research and its effects on health. Discussion: The content of cigarettes can cause various side effects in almost all organs of the body. Various studies have found that smoking is a risk factor for NCD. Conclusion: Cessation of smoking can save sufferers and also save people around smokers. When a smoker starts quitting smoking, the body will undergo the process of cleaning up toxic substances of cigarettes that have entered the body. Keywords: cigarette, literature searching, NCD Latar Belakang: Salah satu tantangan terbesar dalam dunia kesehatan ialah masalah rokok. Pada tahun 2018, terjadi peningkatan perokok pada usia 10-18 tahun sebesar 9,1% dibandingkan pada tahun 2013 sebesar 7,2%. Peningkatan jumlah perokok di usia muda ini dikhawatirkan akan meningkatkan jumlah Penyakit Tidak Menular (PTM) di usia muda. Metode: Penulisan artikel ini menggunakan metode pencarian literatur dari berbagai sumber informasi berupa e-book, website dan search engine. E-book yang dipakai memuat informasi rokok dan pengaruhnya kekesehatan, website yang dipakai adalah website pemerintah dan WHO untuk pencarian data prevalensi dan informasi lainnya, dan search engine yang dipakai adalah Google Scholar dan Pubmed untuk pencarian informasi penelitian kandungan rokok dan pengaruhnya kepada kesehatan. Pembahasan: Dari hasil pencarian, kandungan pada rokok dapat menimbulkan berbagai efek samping hampir di seluruh organ tubuh. Berbagai penelitian mendapatkan bahwa kebiasaan merokok merupakan faktor risiko terjadinya PTM. Kesimpulan: Penghentian kebiasaan merokok ini dapat menyelamatkan penderitanya dan juga menyelamatkan orang di sekitar perokok. Ketika seorang perokok mulai berhenti untuk merokok, maka tubuh akan melakukan proses pembersihan dari zat racun pada rokok yang sudah masuk ke dalam tubuh. Kata kunci: rokok, PTM, pencarian literatur
Content may be subject to copyright.
SCRIPTA SCORE
Scientific Medical Journal
Literature
Review
Corresponding author: Ridwan Balatif
Corresponding author at: Faculty of Medicine, Universitas Sumatera Utara, Medan
Contact: b.ridwan2503@gmail.com
SCRIPTA SCORE Scientific Medical Journal, Vol. 2, No. 1, Agustus 2020
https://doi.org/10.32734/scripta.v2i1.1246
pISSN: 2088-8686
eISSN: 2686-0864
Cigarettes and Its Effects on Health
Ridwan Balatif1
1Faculty of Medicine, Universitas Sumatera Utara, Medan
ABSTRACT
Background: One of the biggest challenges in the world of health is the problem of smoking. In 2018,
there was an increase in smokers at the age of 10-18 years by 9.1% compared to 2013, which was 7.2%.
It is feared that the increasing number of smokers at a young age will increase the number of non-
communicable diseases (NCD) at a young age. Methods: Writing this article uses the method of
literature searching from various sources of information including e-books, websites and search
engines. The e-books used contain cigarette information and its effects on health, the websites used are
the website of the government and WHO to search for prevalence data and other information, and the
search engines used are Google Scholar and Pubmed to search information on cigarette content research
and its effects on health. Discussion: The content of cigarettes can cause various side effects in almost
all organs of the body. Various studies have found that smoking is a risk factor for NCD. Conclusion:
Cessation of smoking can save sufferers and also save people around smokers. When a smoker starts
quitting smoking, the body will undergo the process of cleaning up toxic substances of cigarettes that
have entered the body.
Keywords: cigarette, literature searching, NCD
ABSTRAK
Latar Belakang: Salah satu tantangan terbesar dalam dunia kesehatan ialah masalah rokok. Pada
tahun 2018, terjadi peningkatan perokok pada usia 10-18 tahun sebesar 9,1% dibandingkan pada tahun
2013 sebesar 7,2%. Peningkatan jumlah perokok di usia muda ini dikhawatirkan akan meningkatkan
jumlah Penyakit Tidak Menular (PTM) di usia muda. Metode: Penulisan artikel ini menggunakan
metode pencarian literatur dari berbagai sumber informasi berupa e-book, website dan search engine.
E-book yang dipakai memuat informasi rokok dan pengaruhnya kekesehatan, website yang dipakai
adalah website pemerintah dan WHO untuk pencarian data prevalensi dan informasi lainnya, dan
search engine yang dipakai adalah Google Scholar dan Pubmed untuk pencarian informasi penelitian
kandungan rokok dan pengaruhnya kepada kesehatan. Pembahasan: Dari hasil pencarian, kandungan
pada rokok dapat menimbulkan berbagai efek samping hampir di seluruh organ tubuh. Berbagai
penelitian mendapatkan bahwa kebiasaan merokok merupakan faktor risiko terjadinya PTM.
Kesimpulan: Penghentian kebiasaan merokok ini dapat menyelamatkan penderitanya dan juga
menyelamatkan orang di sekitar perokok. Ketika seorang perokok mulai berhenti untuk merokok, maka
tubuh akan melakukan proses pembersihan dari zat racun pada rokok yang sudah masuk ke dalam
tubuh.
Kata kunci: rokok, PTM, pencarian literatur
Received [24 Aug 2019] | Revised [8 May 2020] | Accepted [12 May 2020]
The problem of smoking is a challenge
in the world of health that cannot be denied.
Data from the World Health Organization
(WHO) estimates that there are 1.1 billion
smokers worldwide, 80% of whom live in
countries with lower middle income.[1] In
2018, in Indonesia, there will be an increase
in the number of smokers from the age of
10-18 years, from 7.2% in 2013 to 9.1%.[2]
It is feared that the increasing number
of smokers at a young age will lead to more
human resources who are at risk of
developing non-communicable diseases
(NCDs). Smoking is closely related to the
occurrence of various lung diseases. More
than 80% of the incidence of Chronic
INTRODUCTION
44
Obstructive Pulmonary Disease (COPD) in
the United States is caused by smoking.[3]
Also, smoking habits cause other NCDs
such as hypertension, stroke, heart disease
to cancer.
NCDs incident is closely related to the
chemical content contained in cigarettes.
Various studies have shown that smoking
can be a risk factor for NCDs. It is
estimated that smoking increases the risk of
coronary heart disease about 2-4 times,
stroke 2-4 times, lung cancer 25 times in
men, and 25.7 times in women. Besides,
smoking can lead to an increased risk of
type 2 diabetes mellitus by 30% -40%.[4]
Side effects from smoking are not only
about the smoker (active smoker); people
around smokers also get the impact. To
prevent this smoking habit, cooperation
from various parties, including
government, medical staff, the
communities, and religious leaders, are
needed. This article was written to describe
the health effects caused by smoking.
The method for writing this article is
through literature searching. Information is
sought from various sources, namely from
e-books, websites, and search engines. The
book used is a book that has a discussion
chapter on cigarettes. The site used is the
Ministry of Health and WHO (for finding
prevalence data and other information).
Search engines used are Pubmed and
Google Scholar.
Epidemiology of Smoking
Globally, there has been a decline in
the number of smokers over the age of 15
from 23.5% in 2007 to 20.7% in 2015.[5]
There are several factors related to the
decrease in the prevalence of smokers,
namely increases in tobacco taxes and
prices, anti-tobacco campaigns, access to
services to stop using tobacco, and
government regulations regulating tobacco
products.[6] The prevalence of smokers in
Indonesia has increased from 7.2% in 2013
to 9.1% in 2018 in smokers aged 10-18
years.[2]
Every year, more than 7 million deaths
are caused by cigarette use, and 1.2 million
are non-smokers exposed to cigarette
smoke.[1] A smoker's life expectancy is ten
years shorter than someone who has never
smoked.[7] In reducing the number of
smokers in Indonesia, the government
seeks to make various health counseling,
anti-smoking campaigns, regulate cigarette
advertisements, and increase cigarette
excise tax by 23% and retail price by
35%.[8] This effort can help reduce the
number of smokers in Indonesia.
Chemical Substances in Cigarettes
Since 1950, there has been an
identification of the chemical components
in tobacco.[9] Until now, almost 7,000
chemical compounds have been identified
in cigarette smoke. Of the 7,000 chemical
compounds, 69 of them are known to be
carcinogenic.[10] Carcinogenic compounds
are present in cigarette smoke such as
acetaldehyde, arsenic, benzene, cadmium,
ethylene oxide, formaldehyde, polonium
nickel (Figure 1).[11] Smoking is enjoying
burned nicotine.
Nicotine is a specific organic
compound contained in tobacco leaves. If
we smoke nicotine, it will cause
psychological stimulation of addiction. In
addition to nicotine, the additives,
flavoring, and aroma of cigarettes are also
formed to fulfill the tastes of consumers
(smokers). Currently, several types of
cigarettes have been equipped with filters to
reduce tar and nicotine levels.[12] Even
though you have used a filter, this does not
mean that cigarettes will be safe for
consumption, as some chemicals can still
pass through the filter. Table 1 and Table 2
describe some cigarette compounds that
can penetrate and be caught by the filter.
METHODS
DISCUSSION
45
Figure 1. Illustration of the chemical substance in cigarettes[13]
Table 1. The main chemical component of smoke caught in Cambridge filters[12]
Compound
µg/cigarette
Nicotine
Solanesol
Total nonvolatile HC*
Catechol
Dihydroxybenzenes
Neophytadienes
Benzofuranes
Linoleic acid
Acetic acid
Phenol
Nornikotine
Oleic acid
n-Hentriacontane
Lactic acid
Stearic acid
Cyclones
Limonene
Bipytidils
Scopoletin
Skatole
100-3000
600-1000
300-400
200-400
200-400
200-350
200-300
150-250
100-150
80-160
5-150
40-110
100
60-80
50-75
40-70
30-60
10-30
15-30
12-16
*HC: Hydrocarbon
46
Table 2. The main chemical component of smoke that passes through the Cambridge filter[12]
Compound
Concentration/cigarette
Nitrogen
Oxygen
Carbon dioxide
Carbon monoxide
Water
Argon
Methane
Hydrogen
Acetaldehyde
Nitrogen Oxide
Acetone
Formic acid
Hydrogen cyanide
Propionic acid
Acetonitrile
Pyridine
Acrolein
Ammonia
Formaldehyde
Methanol
120-280 mg
50-70 mg
45-65 mg
14-23 mg
7-12 mg
5 mg
1,0-2,0 mg
0,5-1,0 mg
400-1400 µg
100-680 µg
100-650 µg
200-600 µg
400-500 µg
100-300 µg
100-150 µg
20-200 µg
60-140 µg
10-130 µg
20-100 µg
80-100 µg
General Disease Manifestations Due to
Smoking
Smoking can increase the risk of
various diseases. The ratio of smoking-
related conditions compared to non-
smokers (relative risk) is higher at a young
age, especially in types of stroke and
coronary artery disease.[14] Common
diseases often caused by smoking are
described in Table 3. From 1965-2014,
more than 20 million Americans died due
to chronic conditions caused by smoking or
as passive smokers, and complications due
to smoking during pregnancy (Table 4).
The mechanism of chemical
compounds in cigarettes in causing various
side effects is a series of multiple stages.
Toxic compounds and free radicals in
cigarettes can trigger oxidative stress,
inflammation to DNA damage that can
trigger cancer. These chemical compounds
can be taken by the body from the lungs and
circulated in the bloodstream to reach
almost the entire body.[6]
Smoking and cancer
Smoking is the most significant
risk factor for cancer triggers due to
30% of deaths in cancer patients.[3]
Various carcinogenic substances found
in cigarettes. This carcinogenic
substance can bind to DNA, causing
mutations. If the body cannot repair
this mutation, it will become cells that
grow out of control and become
cancerous.[6]
These substances in cigarettes also
induce mutations in p53 protein.[3] This
p53 protein plays an essential role in
regulating cell division and death.
Mutations in this protein will cause
uncontrolled cell growth that triggers
cancer. The nicotine content can
influence the occurrence of disease by
activating angiogenesis, cell growth,
and invasion of cancer cells.[15]
Smoking and lung
Cigarette smoke can invite
cytotoxic cells and inflammatory cells
to trigger a pro-inflammatory effect on
47
Cigarettes and Its Effects on Health
Table 3. The relative risk of illness due to smoking[14]
Diseases
Smokers
Males
Females
Coronary heart disease
Age 35-64
Age ≥65
2.8
1.5
3.1
1.6
Cerebrovascular disease
Age 35-64
Age ≥65
3.3
1.6
4
1.5
Aortic aneurysm
6.2
7.1
Cancer
Lung
Larynx
Lip, oral cavity, pharynx
Esophagus
Bladder
Kidney
Pancreas
Stomach
Liver
Colorectal
Cervix
Acute myeloid leukemia
23.3
14.6
10.9
6.8
3.3
2.7
2.3
2
1.7
1.2
1.4
12.7
13
5.1
7.8
2.2
1.3
2.3
1.4
1.7
1.2
1.6
1.4
Sudden infant death syndrome
2.3
Infant respiratory distress syndrome
1.3
Low birth weight at delivery
1.8
Table 4. Total death caused by smoking and exposure to secondhand smoke (1965-2014)[6]
Cause of death
Total
Cancer
6.587.000
Metabolic and cardiovascular diseases
7.787.000
Pulmonary diseases
3.804.000
Perinatal conditions
108.000
Lung cancer in secondhand smoke
263.000
Coronary heart disease in secondhand smoke
2.194.000
nasal epithelial cells, which will
increase the production of Reactive
Oxygen Species (ROS), Toll-like
Receptor-4 (TLR-4),
lipopolysaccharides and IL-17A
synthesis. Moreover, cigarette smoke
causes mucous hypersecretion so that
the mucus cleaning process will be
disrupted.[17] Smoking decreases
immunoglobulin levels in the
circulation, decreases CD4+
lymphocytes, and decreases phagocyte
activity. This process makes smokers
become more easily infected. This
immunological disorder will recover
within six weeks when smokers stop
smoking.[3]
Smoking and cardiovascular
Cigarettes have the property to
cause inflammation. Smoking is
associated with an increased risk of
atherosclerotic plaque. This plaque
formation is characterized by an
inflammatory reaction and an increase
48
in the expression of matrix
metalloproteinases. The pro-
inflammatory effect occurs in not only
an active smoker but also a passive
smoker.[16]
Smoking and pregnancy
The content of cigarettes can harm
the fetus. Smoking habits during
pregnancy are associated with the
incidence of Low Birth Weight
(LBW). This relates to the carbon
monoxide (CO) due to the cigarette
burning process, which can bind
strongly to hemoglobin. A strong bond
of CO with hemoglobin will reduce
oxygen transport to the fetus, causing
hypoxia in the fetus and LBW.[6,18]
Also, smoking during pregnancy is a
risk factor for ectopic pregnancy. The
content of cotinine (active nicotine
metabolite) increases the expression of
prokinetic (PROKR1) in the fallopian
tubes. This process disrupts fallopian
contractility and triggers ectopic
pregnancy.[19]
Tips for Quitting Smoking
Quitting smoking is not easy to do for
smokers because nicotine addiction is one
of the obstacles to quitting smoking.
Quitting smoking is not impossible. Here
are the ways you can stop smoking.[20]
a. Strong inner determination. Consider
first to make a list of reasons to stop
smoking to sustain the determination
b. Think positive, and be sure to quit
smoking successfully. Give a reward
to yourself when the money is usually
used for cigarettes and can now be
used to buy favorite things
c. Set a target time. Never immediately
stop smoking. Try to reduce smoking
habits slowly
d. Give support to stop smoking,
especially from the smoker's family
and friends
e. Look for activities to keep yourself
busy. Activities such as worship,
exercise, work can reduce the desire
to smoke
f. Visit smoke-free places such as
houses of worship, libraries or other
places
g. Look for a substitute for smoking like
gum, with the consumption of gum is
expected to forget the smoking habit
h. Busy after eating. Most smokers after
eating will start smoking again, so
when you finish eating, try to busy
yourself to forget about smoking
i. Consult a doctor. The doctor will
prescribe drugs that can replace the
effects of opium from nicotine to
reduce tobacco frequently. Currently,
the medications used to help stop
smoking are nicotine, bupropion, and
varenicline.[3]
When smoking is stopped, the body
will start a toxic disposal response and
improve bodily functions. The effects of
smoking cessation can be seen in Table 5.
49
Table 5. Benefits of quitting smoking[21]
Start to stop smoking
Benefits
20 minute
Blood pressure, heart rate and peripheral blood flow improve
12 hours
Almost all nicotine in the body has been metabolized
The level of carbon monoxide in the blood returns to normal
24-48 hours
Nicotine begins to be eliminated from the body. The taste and
smell function starts to improve
5 days
Most of the nicotine metabolites in the body are gone.
Taste/taste and odor function is much better
2-6 weeks
The risk of infection in a post-surgical wound is reduced
Ciliary airway function and pulmonary function improve
Shortness of breath and coughing are reduced
1 year
The risk of coronary heart disease is reduced by half
compared with people who continue to smoke
5 years
The risk of stroke decreases at the same level as people who
have never smoked
10 years
All causes of mortality and the risk of coronary heart disease
decrease at the same level as people who have never smoked
Until now, smoking is one of the
toughest challenges in the world of health.
Smoking is a risk factor from various
diseases to cancer. This is due to the
different chemicals contained in cigarettes
that endanger health. Stopping smoking is
not only saving yourself but also protecting
people around smokers.
[1] World Health Organization. Tobacco
[Internet]. Geneva: World Health
Organization; 2019 May [cited 2020
Jan 04]; Available from:
https://www.who.int/news-
room/fact-sheets/detail/tobacco
[2] Kementerian Kesehatan Republik
Indonesia. Hasil Utama RISKESDAS
2018. Jakarta: Kementerian
Kesehatan Republik Indonesia; 2018.
[3] Benowitz NL, Brunetta PG. Smoking
hazards and cessation. In: Broaddus
VC, Mason RJ, Ernst JD, King TE Jr,
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respiratory medicine. 6th ed.
Philadelphia: Elsevier Saunders;
2016. p. 807-13
[4] Centers for Disease Control and
Prevention. Health effects of cigarette
smoking [Internet]. Atlanta, GA:
Centers for Disease Control and
Prevention; 2020 Apr [cited 2020 Jan
06]. Available from:
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[6] Onor IO, Stirling DL, Williams SR,
Bediako D, Borghol A, Harris MB, et
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[7] Jha P, Ramasundarahettige C,
Landsman V, Rostron B, Thun M,
Anderson RN, et al. 21st-Century
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[8] Kementerian Koordinator Bidang
Pembangunan Manusia dan
Kebudayaan. Pemerintah Indonesia
CONCLUSION
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52
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Now presented in two volumes New text design greatly enhances readability New chapters on cutting-edge issues in clinical medicine Expanded fovus on global considerations of health and disease More evidence-based than ever How-to videos cover topics such as central venous line placement, endotracheal intubation, pericardiocentesis, and thoracentis NEW print chapters include: World Demographics of Aging The Biology of Aging Clinical Problems of Aging The Human Microbiome Acinetobacter Infections Antiphospholipid Antibody Syndrom NEW DVD-only chapters include: Primary Care in Low and Middle Income Countries Neoplasia During Pregnancy Fluid and Electrolyte Imbalances and Acid-Base Disturbances: Case Examples Less Common Malignancies of Lymphoid Cells Interstitial Cystitis/Painful Bladder Syndrome The Schilling Test War-Related Neuro-Psychiatric Illness High-Altitude Illness The Clinical Laboratory in Modern Healthcare Authoritative Content Essential to Medical Practice and Education: Condensed Table of Contents: Part 1: General Considerations in Clinical Medicine; Part 2: Cardinal Manifestations and Presentation of Disease; Section 1: Pain; Section 2: Alterations in Body Temperature; Section 3: Nervous System Dysfunction; Section 4: Disorders of the Eyes, Ears, Nose, and Throat; Section 5: Alterations in Circulatory and Respiratory Functions; Section 6: Alterations in Gastrointestinal Function; Section 7: Alterations in Renal and Urinary Tract Function; Section 8: Alterations in Sexaul Function and Reproduction; Section 9: Alterations in the Skin; Section 10: Hematologic Alterations; Part 3: Genes, the Environment, and Disease; Part 4: Regenerative Medicine; Part 5: Aging; Part 6: Nutrition; Part 7: Oncology and Hematology; Section 1: Neoplastic Disorders; Section 2: Hematopoietic Disorders; Section 3: Disorders of Hemostasis; Part 8: Infectious Diseases; Section 1: Basic Considerations in Infectious Diseases; Section 2: Clinical Syndromes: Community-Acquired Infections; Section 3: Clinical Syndromes: Health Care Associated Infections; Section 4: Approach to Therapy for Bacterial Diseases; Section 5: Diseases Caused by Gram-Positive Bacteria; Section 6: Diseases Caused by Gram-Negative Bacteria; Section 7: Miscellaneous Bacterial Infections; Section 8: Mycobacterial Diseases; Section 9: Spirochetal Diseases; Section 10: Diseases Caused by Rickettsia, Mycoplasmas, and Chlamydiae; Section 11: Viral Diseases: General Considerations; Section 12: Infections Due to DNA Viruses; Section 13: Infections Due to DNA and RNA Respiratory Viruses; Section 14: Infections Due to Human Immunodeficiency Virus and Other Retroviruses; Section 15: Infections Due to RNA Viruses; Section 16: Fungal and Algal Infections; Section 17: Protozoal and Helminthic Infections: General Considerations; Section 18: Protozoal Infections; Part 9: Terrorism and Clinical Medicine; Part 10: Disorders of the Cardiovascular System; Section 1: Introduction to Cardiovascular Disorders; Section 2: Diagnosis of Cardiovascular Disorders; Section 3: Disorders of Rhythm; Section 4: Disorders of the Heart; Section 5: Vascular Disease; Part 11: Disorders of the Respiratory System; Section 1: Diagnosis of Respiratory Disorders; Section 2: Diseases of the Respiratory System; Section 3: Neurologic Critical Care; Section 4: Oncologic Emergencies; Part 13: Disorders of the Kidney and Urinary Tract; Part 14: Disorders of the Gastrointestinal System; Section 1: Disorders of the Alimentary Tract; Section 2: Liver and Billiary Tract Disease; Section 3: Disorders of the Pancreas; Part 15: Disorders of the Immune System, Connective Tissue and Joints; Section 1: The Immune System in Health and Diseases; Section 2: Disorders of Immune-Mediated Injury; Section 3: Disorders of the Joints and Adjacent Tissues; Part 16: Endocrinology; Section 2: Disorders of Bone and Mineral Metabolism; Section 3: Disorders of Intermediary Metabolism; Part 17: Neurologic Disorders; Section 1: Diagnosis of Neurologic Disorders; Section 2: Diseases of the Central Nervous System; Section 3: Nerve and Muscle Disorders; Section 4: Chronic Fatigue Syndrome; Section 5: Psychiatric Disorders; Section 6: Allcoholism and Drug Dependency; Part 18: Poisoning, Drug Overdose, and Evenomation; Part 19: High Altitude and Decompression Sickness
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Epidemiological studies have shown that cigarette smoking is a major risk factor for tubal ectopic pregnancy but the reason for this remains unclear. Here, we set out to determine the effect of smoking on Fallopian tube gene expression. An oviductal epithelial cell line (OE-E6/E7) and explants of human Fallopian tubes from non-pregnant women (n = 6) were exposed to physiologically relevant concentrations of cotinine, the principle metabolite of nicotine, and changes in gene expression analyzed using the Illumina Human HT-12 array. Cotinine sensitive genes identified through this process were then localized and quantified in Fallopian tube biopsies from non-pregnant smokers (n = 10) and non-smokers (n = 11) using immunohistochemistry and TaqMan RT-PCR. The principle cotinine induced change in gene expression detected by the array analysis in both explants and the cell line was significant down regulation (P<0.05) of the pro-apoptotic gene BAD. We therefore assessed the effect of smoking on cell turnover in retrospectively collected human samples. Consistent with the array data, smoking was associated with decreased levels of BAD transcript (P<0.01) and increased levels of BCL2 transcript (P<0.05) in Fallopian tube biopsies. BAD and BCL2 specific immunolabelling was localized to Fallopian tube epithelium. Although no other significant differences in levels of apoptosis or cell cycle associated proteins were observed, smoking was associated with significant changes in the morphology of the Fallopian tube epithelium (P<0.05). These results suggest that smoking may alter tubal epithelial cell turnover and is associated with structural, as well as functional, changes that may contribute to the development of ectopic pregnancy.
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Smoking represents one of the most important preventable risk factors for the development of atherosclerosis. The present review aims at providing a comprehensive summary of published data from clinical and animal studies, as well as results of basic research on the proatherogenic effect of smoking. Extensive search and review of literature revealed a vast amount of data on the influence of cigarette smoke and its constituents on early atherogenesis, particularly on endothelial cells. Vascular dysfunction induced by smoking is initiated by reduced nitric oxide (NO) bioavailability and further by the increased expression of adhesion molecules and subsequent endothelial dysfunction. Smoking-induced increased adherence of platelets and macrophages provokes the development of a procoagulant and inflammatory environment. After transendothelial migration and activation, macrophages take up oxidized lipoproteins arising from oxidative modifications and transdifferentiate into foam cells. In addition to direct physical damage to endothelial cells, smoking induces tissue remodeling, and prothrombotic processes together with activation of systemic inflammatory signals, all of which contribute to atherogenic vessel wall changes. There are still great gaps in our knowledge about the effects of smoking on cardiovascular disease. However, we know that smoking cessation is the most effective measure for reversing damage that has already occurred and preventing fatal cardiovascular outcomes.
  • Republik Kementerian Kesehatan
  • Indonesia
Kementerian Kesehatan Republik Indonesia. Hasil Utama RISKESDAS 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018.