Johnathan Waugh, Chairman of the AARC Tobacco Free Lifestyle Round Table, answers questions about smoking.

1. What chemical/chemicals in the cigarette affects the lungs the most?

That depends on what danger you are talking about. The some of the dangerous compounds in tobacco smoke are carbon monoxide, tar, benzene, toluene, formaldehyde, acetone, phenol, ammonia, formic acid, nitrogen oxides, polycyclic aromatic hydrocarbons (or PAH), and nicotine. Chemicals such as nitrogen oxides, tar, ammonia, and acrolein cause lung inflammation whereas phenol, benzene, and PAH compounds can cause cancer. Nicotine does not cause lung damage (that we know of) but it is the primary cause of addiction to smoking which makes it dangerous. Carbon monoxide probably does not cause lung damage but it interferes with how the blood delivers oxygen to the heart muscle and is thought to be a significant cause of heart disease. Tobacco smoke can also include small amounts of radioactive substances depending on where the tobacco comes from. You can see there are “many” dangers from smoking.

2. How do damaged lungs,(from cigarettes) affect the rest of the body?

Smoking is by far the most common cause of a lung disease called Chronic Obstructive Pulmonary Disease (COPD or COLD). This lung disease affects the body in many ways including interfering with getting oxygen to the rest of the body. Tobacco smoke is known to increase the risk of heart attacks and cause problems with blood vessels. Smoking can cause cancer not only in the lungs but in many other parts of the body. Chemicals in tobacco smoke can be absorbed through the skin as well as through the lungs. After sunlight, tobacco smoke is the most potentially damaging environmental factor for your skin.

3. How much worse is second hand smoke, than smoking yourself?

This is a complex answer. A non-smoker can inhale two forms of tobacco smoke in the presence of a smoker: 1) “mainstream smoke” which is tobacco smoke emitted from a person's mouth after inhaling it and 2) “sidestream smoke” which comes from a smoldering cigarette. Comparing the two types of second-hand smoke, mainstream smoke andsidestream smoke share many compounds but sidestream smoke has higher concentrations and is more toxic gram for gram compared to mainstream. Smoking a cigarette directly is probably the worst but it depends on how much you get of each type of smoke and how old it is (lingering tobacco smoke undergoes chemical changes and becomes more 2-4 times more toxic after 30 minutes than “fresh” smoke). This “aged smoke” is related to a third type of tobacco exposure called “Third-hand smoke” which is really the chemical residue leftover on surfaces from smoke. Gram for gram, it has been reported that environmental tobacco smoke (Fresh + Aged) is 6-12 times more toxic than what smokers inhale.

4. How does second hand smoke affect the lungs, and the rest of the body?

Smoking aggravates the lung condition asthma, and new information indicates it increases the risk of developing it as well. For infants, smoking can increase the incidence of low birthweight, stillborn, neurologic problems, SIDS, bronchiolitis, and meningitis. For children, smoking can increase the frequency of ear infections, leukemia, and fire injuries.

5. What do you do to treat patients who's lungs are severely damaged?

People whose lungs have been damaged by tobacco smoke often benefit from breathing concentrated oxygen. Respiratory therapists give other drugs and therapies that help people by removing the extra mucous from the lungs that often results from smoking-related lung disease and open inflammed/constricted airways. Therapists also help physicians monitor lung function and educate people on how to take care of their lungs and do their treatment in the most effective way.