It has been said that the only excuse for smoking…is being on fire.

I want to discuss and emphasize the carcinogenic (cancer causing) effects of cigarette smoke. Then we can review the role of thoracic surgery and thoracic surgeons in the care of patients with lung cancer, the subject of the next few blogs.

Let me remind you that lung cancer kills more Americans than any other cancer. Despite our best efforts most patients can’t be cured. So efficacious prevention tactics would save many lives. Since exposure to cigarette smoke causes at least 80% of lung cancers, elimination of cigarette smoking would nearly end this public health scourge. You don’t even have to be the smoker to be affected. If you are downwind from a smoker you are what is called a passive smoker and you are breathing both exhaled smoke and the smoke that curls up from the cigarette tip. Your risk of developing lung cancer just increased by an estimated 25%.

How does this heinous smoke do what it does? Cigarette smoke contains more than 5,000 different chemicals. Is it surprising to learn that more that 70 of these are carcinogenic? They exert their effect primarily by damaging the DNA inside the cells of the airways. Of particular note are the chemicals benzene and the nitrosamines. For good measure some other chemicals such as arsenic and nickel interfere with the cells’ ability to repair injured DNA.

I am aware that people have the right to choose to how to live their lives; but, cigarettes constitute a public health issue that should be addressed. On a more personal note, it was painful as a thoracic surgeon watching patients and their families deal with a death sentence when they might otherwise have enjoyed more happy years together.

There are many websites with useful information such as www.cancerresearchuk.org.

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