Unit 10 Smoking and Related Diseases
Key Unit Competence
To be able to describe the effects of tobacco smoking on the gas exchange system.
LEARNING OBJECTIVES
At the end of this unit, the learner will be able to:
• state the features of a genetic code.
• describe the effects of tar and carcinogens in tobacco smoke on the gas exchange system.
• describe the signs and symptoms of lung cancer and chronic obstructive pulmonary diseases
(COPD).
• describe the effects of nicotine and carbon monoxide on the cardiovascular system.
• explain how tobacco smoking contributes to atherosclerosis and coronary heart disease.
• interpret photographs to differentiate healthy lungs from infected lungs.
• interpret data linking cigarette smoking to disease and early death.
• observe and interpret research statistics linking to tobacco smoking.
• evaluate the epidemiological and experimental evidence linking cigarette smoking to disease
and early death.• influence the campaign against cigarette smoking.
INTRODUCTORY ACTIVITY
Observe the following image and answer the following
Suggest the possible consequences undergone by that man who smokes
10.1 CIGARETTE SMOKING
ACTIVITY 1
To observe the effect of tobacco on animals.
Collect some tobacco leaves or cigarette butts and boil them with water.
Allow the solution to cool. Now filter it with a stainer. Pour the solution into
a large squirt bottle. Spray the solution on a plant infested with aphids. Wait
for a while. Do you find the aphids stay on the plant? What makes them
leave the plant? This is the tobacco that forces the pests to leave the plant.
Tobacco leaves contain toxins which are harmful to human.
ACTIVITY 2
To observe the effect of cigarette smoking.
Put some cotton bolls inside a flexible plastic bottle. Wrap
some modelling clay around the cigarette as shown. Fit
the cigarette on the mouth of the bottle with the filter end
inside. Light the cigarette end outside the bottle. Squeeze
and release the bottle to simulate smoking. When the
cigarette is almost finished, remove it from the bottle.
Take out the cotton bolls on a petri dish. Touch the bolls
with your finger. Do you find some black coloured tar onthe bolls? Where does this tar come from?
This is how cigarette smoke harms the lungs. Cigarette smoking is very harmful for health,
and it nearly affects every organ of the body, causes many diseases, and reduces the health of
smokers in general.
Cigarette smoking is the leading preventable cause of death in the United States.
• Smoking causes more deaths each year than the following causes combined:
♦ Human immunodeficiency virus (HIV)
♦ Illegal drug use
♦ Alcohol use
♦ Motor vehicle injuries
♦ Firearm-related incidents
• Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths in men and women.
More women die from lung cancer each year than from breast cancer.
• About 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease
(COPD) are caused by smoking.• Cigarette smoking increases risk for death from all causes in men and women.
Tobacco Control
ACTIVITY 3
Discuss the steps to control the use of tobacco. Everyone knows the detrimental effects oftobacco but still it is used. Write a journal stating why the youth need to control tobacco.
Tobacco control is a field of international public health science, policy and practice to reduce
the tobacco use which causes high morbidity and mortality due to tobacco smoke. Tobacco
control is a priority area for the World Health Organization (WHO), through the Framework
Convention on Tobacco Control. It has started to protect present and future generations from the
devastating health, social, environmental and economic consequences of tobacco consumption
and exposure to tobacco smoke. Progress was initially notable at a state or national level,
particularly the pioneering smoke-free public places legislation introduced in New York City
in 2002 and the Republic of Ireland in 2004, and the UK effort for tobacco control in 2004.
WHO produced an internationally-applicable and now widely recognised summary of the
essential elements of tobacco control strategy, publicised as the mnemonic MPOWER tobacco
control strategy. The 6 components are:
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion and sponsorshipRaise taxes on tobacco
10.2 DANGEROUS CHEMICALS IN TOBACCO SMOKE
Smokers inhale about 7,000 chemicals in cigarette smoke. Many of these chemicals come from
burning tobacco leaf. Some of these compounds are chemically active and trigger profound
and damaging changes in the body. Tobacco smoke contains over 60 known cancer-causing
chemicals. Smoking harms nearly every organ in the body, causing many diseases and reducing
health in general.
The most damaging components of tobacco smoke are:
1. Tar: Tar is the collective term describing toxins produced by smoking cigarettes and the
coating they place on the lungs. Tar is sticky and brown, and stains teeth, fingernails andlung tissue. Tar contains the carcinogen benzo(a)pyrene. When inhaled, these toxins form
a particulate matter that coats lungs much the same way that soot from log fires coats
chimneys. But unlike chimneys, which are made of stone or brick, human lungs are made
of thin, delicate tissue not intended for toxic smoke intake.
2. Nicotine is the addictive drug in tobacco smoke that causes smokers to continue
to smoke and affects the brain activity. Addicted smokers need enough nicotine over
a day to ‘feel normal’—to satisfy cravings or control their mood.
How Nicotine Affects the Brain
• Brain is made up of billions of nerve cells. They communicate by releasing chemical
messengers called neurotransmitters. Each neurotransmitter is like a key that fits
into a special “lock,” called a receptor, located on the surface of nerve cells. When aneurotransmitter finds its receptor, it activates the receptor’s nerve cell.
• The nicotine molecule is shaped like a neurotransmitter called acetylcholine. Acetylcholine
and its receptors are involved in many functions, including muscle movement, breathing,
heart rate, learning, and memory. They also cause the release of other neurotransmitters
and hormones that affect your mood, appetite, memory, and more. When nicotine
gets into the brain, it attaches to acetylcholine receptors and mimics the actions of
acetylcholine. Nicotine also activates areas of the brain that are involved in producing
feelings of pleasure and reward. Recently, scientists discovered that nicotine raises the
levels of a neurotransmitter called dopamine in the parts of the brain that produce feelings
of pleasure and reward. Dopamine, which is sometimes called the pleasure molecule, is
the same neurotransmitter that is involved in addictions to other drugs such as cocaine
and heroin. Researchers now believe that this change in dopamine may play a key role in alladdictions.
3. Carbon monoxide (CO): This odourless gas is fatal in large doses because it takes the place
of oxygen in the blood. It is also called ‘Silent killer’. Each red blood cell contains a protein
called haemoglobin that transports oxygen molecules around the body. However, carbonmonoxide binds to haemoglobin better than oxygen. In response, the body makes more
Figure 10.2: Carbon monoxide poisoning
red blood cells to carry the oxygen it needs, but it makes the blood thicker. This means
that when the body demands more oxygen during exercise, less oxygen reaches the brain,heart, muscles and other organs.
How it Affects to the Body
• Carbon monoxide poisoning occurs when carbon monoxide builds up in your bloodstream.
When too much carbon monoxide is in the air, your body replaces the oxygen in the red
blood cells with carbon monoxide. This prevents oxygen from reaching your tissues and
organs. This leads to serious tissue damage, or even death.
Carbon monoxide poisoning can be especially dangerous for people who are sleeping orintoxicated. People may have irreversible brain damage or even be killed before anyone realizes
Figure 10.3: Typical symptoms of carbon monoxide poisoning
(increasing percentage of CO in blood).
• Hydrogen cyanide – The lungs contain tiny hairs (cilia) that help to clean the lungs by
moving foreign substances out. Hydrogen cyanide stops this lung clearance system from
working properly, which means the poisonous chemicals in tobacco smoke can build up
inside the lungs. Other chemicals in smoke that damage the lungs include hydrocarbons,
nitrous oxides, organic acids, phenols and oxidising agents.
• Oxidizing chemicals – These highly reactive chemicals (which include free radicals) can
damage the heart muscles and blood vessels. They react with cholesterol, leading to the
build-up of fatty material on artery walls. Their actions lead to heart disease, stroke and
blood vessel disease.
• Metals – Tobacco smoke contains dangerous metals including arsenic, cadmium and lead.
Several of these metals are carcinogenic.
• Radioactive compounds – Tobacco smoke contains radioactive compounds that are knownto be carcinogenic.
APPLICATION 10.1
1. Complete with appropriate terms:
(i)................... is also called Silent killer.
(ii) ................... is the addictive drug found in cigarette.
(iii) Tar contains carcinogen ...........................
(iv) Radiation compounds present in tobacco smoke are ............................
(v) Carbon monoxide poisoning .................... percentage of CO in flood.
2. Name the three main substances in tobacco smoke that can be harmful
3. Explain how the deposition of tar can lead to smoker’s cough4. Explain why smokers are more than non-smokers to suffer from infections in the lungs
10.3 LUNG CANCER AND SMOKING
Lung cancer is strongly correlated with cigarette smoking, with about 90% of lung cancers
arising as a result of tobacco use. The risk of lung cancer increases with the number of cigarettes
smoked over time. If someone smokes one pack of cigarettes per day, he/she has a risk for the
development of lung cancer that is 25 times higher than a non-smoker. Among those who smoke
two or more packs of cigarettes per day, one in seven will die of lung cancer. But even though
the risk is higher; the more you smoke, there is no safe level of exposure to tobacco smoke.
Passive smoking, or the inhalation of tobacco smoke from other smokers sharing living or
working quarters, is also an established risk factor for the development of lung cancer. Research
has shown that non-smokers who reside with a smoker have a 24% increase in risk for developinglung cancer when compared with other non-smokers.
Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs;
usually in the cells that line the air passages. The abnormal cells do not develop into healthylung tissue, they divide rapidly and form tumours.
As tumours become larger and more numerous, they undermine the lung’s ability to provide
the bloodstream with oxygen. Tumours that remain in one place and do not appear to spreadare known as “benign tumours”.
Malignant tumours, the more dangerous ones, spread to other parts of the body either through
the bloodstream or the lymphatic system. Metastasis refers to cancer spreading beyond its siteof origin to other parts of the body. When cancer spreads, it is much harder to treat successfully.
Primary lung cancer originates in the lungs, while secondary lung cancer starts somewhere
else in the body, metastasizes, and reaches the lungs. They are considered different types ofcancers and are not treated in the same way.
According to the World Health Organization (WHO), 7.6 million deaths globally each year
are caused by cancer; cancer represents 13% of all global deaths and lung cancer is by far thenumber one cancer killer.
10.3.1 Signs and Symptoms of Lung Cancer
The most common symptoms of lung cancer are:
• A cough that does not go away or gets worse
• Chest pain that is often worse with deep breathing, coughing, or laughing
• Hoarseness
• Weight loss and loss of appetite
• Coughing up blood or rust-coloured sputum (spit or phlegm)
• Shortness of breath
• Feeling tired or weak
• Infections such as bronchitis and pneumonia that don’t go away or keep coming back
• New onset of wheezing
If lung cancer spreads to distant organs, it may cause:
• Bone pain (like pain in the back or hips)
• Nervous system changes (such as headache, weakness or numbness of an arm or leg,
dizziness, balance problems, or seizures), from cancer spread to the brain or spinal cord
• Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
• Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes(collections of immune system cells), such as those in the neck or above the collarbone.
Figure 10.4: Tumour formation in lung (right) and healthy lung (left)
10.3.2 Effect of Lung Cancer on the Lung
Tobacco smoke contains over 4,000 chemical compounds, many of which have been shown
to be cancer-causing, or carcinogenic. The two primary carcinogens in tobacco smoke arechemicals known as nitrosamines and polycyclic aromatic hydrocarbons.
10.4 CHRONIC OBSTRUCTIVE PULMONARY DISEASES
(COPD) AND SMOKING
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. COPD is always caused by smoking. Over time,
breathing tobacco smoke irritates the airways and destroys the stretchy fibres in the lungs. It
usually takes many years for the lung damage to start causing symptoms, so COPD is most
common in people who are older than 60. Other things that may put you at risk include breathing
chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke also may
damage the lungs.
The main symptoms are:
• A long-lasting (chronic) cough.
• Breathing difficulty, especially during physical activities.
• Cough
• Sputum production.
• Wheezing.
• Blueness of the lips or fingernail beds (cyanosis).
• Frequent respiratory infections.• Lack of energy.
As COPD gets worse, you may be short of breath even when you do simple things like get
dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy.
People often lose weight and get weaker. People with COPD are at increased risk of developingheart disease, lung cancer and a variety of other conditions.
Emphysema and Chronic bronchitis are the two most common conditions that contribute toCOPD. It causes airway obstruction in the lungs.
People with COPD are also likely to experience episodes called exacerbations, during which their
symptoms become worse than usual day-to-day variation and persist for at least several days.
The main cause of COPD in developed countries is tobacco smoking. In the developing world,
COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in
poorly ventilated homes.
Only about 25 per cent of chronic smokers develop clinically apparent COPD, although
up to half have subtle evidence of COPD. Some smokers develop less common lung
conditions. They may be misdiagnosed as having COPD until a more thorough evaluationis performed.
Risk factors for COPD include:
• Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette
smoking. The Pipe smokers, cigar smokers and marijuana smokers are at risk, as are people
exposed to large amounts of secondhand smoke.
• People with asthma who smoke. The combination of asthma, a chronic airway disease,
and smoking increases the risk of COPD even more.
• Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes,
vapours and dusts in the workplace can irritate and inflame your lungs.
• Age. COPD develops slowly over years, so most people are at least 35 to 40 years old when
symptoms begin.
• Genetics. As noted above, the uncommon genetic disorder alpha-1-antitrypsin deficiency is
the cause of some cases of COPD. Other genetic factors are likely to make certain smokersmore susceptible to the disease.
Complications of COPD include:
• Respiratory infections: People with COPD are more susceptible to cold, the flu and
pneumonia. Any respiratory infection can make it much more difficult to breathe and
could cause further damage to lung tissue.
• Heart problems: COPD increases the risk of heart disease, including heart attack.
• Lung cancer: Smokers with chronic bronchitis have a greater risk of developing lung cancer
than those smokers who don’t have chronic bronchitis.
• High blood pressure: COPD may cause high blood pressure in the arteries that bring blood
to your lungs (pulmonary hypertension).
• Depression: Difficulty in breathing and dealing with serious illness can contribute todevelopment of depression.
10.5 SMOKING CONTRIBUTES TO CARDIOVASCULAR DISEASE
Athrosclerosis (Artherosclerosis) and Coronary Heart Disease (CHD):
1. Atherosclerosis (or arteriosclerotic vascular disease) is a condition where the arteries
become narrowed and hardened due to an excessive build up of plaque around the artery
wall (Figure 10.5). The disease disrupts the flow of blood around the body, posing serious
cardiovascular complications. The plaque clogs up the artery, disrupting the flow of blood
around the body. This potentially causes blood clots that can result in life-threatening
conditions such as heart attack, stroke and other cardiovascular diseases which are the
usual causes of heart attacks, strokes, and peripheral vascular disease — what together
are called “cardiovascular disease.” Carbon monoxide exposure has been implicated inthe process of atherosderosis.
Figure 10.5: Showing plaque formation around the artery wall in Atherosclerosis
2. Coronary Heart disease, where platelets: components in the blood—stick together along
with proteins to form clots which can then get stuck in the plaque in the walls of arteries
and cause heart attacks (Figure 10.6). The most common symptoms of coronary artery
disease are angina (say “ANN-juh-nuh” or “ann-JY-nuh”) and shortness of breath when
exercising or doing other vigorous activity. Women are somewhat more likely than mento have other symptoms like nausea and back or jaw pain.
10.5.1 Effect of Carbon Monoxide and Nicotine in Cardiovascular Diseases
You have already studied that both carbon monoxide and Nicotine along with other carcinogens
affect the brain and heart. They too increase the risk of developing cardio vascular diseases,which includes coronary heart disease and stroke.
• The carbon monoxide in tobacco smoke reduces the amount of oxygen in blood. This meansthe heart has to pump harder to supply the body with the oxygen it needs.
• The nicotine in cigarettes stimulates body to produce adrenaline, which makes the heartbeatfaster and raises the blood pressure, making the heart work harder.
Figure 10.6: The process of blocking arteries by plaque in
coronary heart disease
10.6 SMOKING AND HEALTH RISKS
ACTIVITY 4
Research on the effects of smoking on gas exchanges system and its health risks. You may takehelp of magazines, books and the internet. Present your findings in class.
Smokers are more likely than non-smokers to develop heart disease, stroke, and lung cancer.
• Smoking is estimated to increase the risk—
♦ For coronary heart disease by 2 to 4 times
♦ For stroke by 2 to 4 times
♦ Of men developing lung cancer by 25 times
♦ Of women developing lung cancer by 25.7 times
• Smoking causes diminished overall health, increased absenteeism from work, and increasedhealth care utilization and cost.
10.6.1 Smoking and Cardiovascular Disease
Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular
disease).
• Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular
disease.
• Smoking damages blood vessels and can make them thicken and grow narrower. This makes
your heart beat faster and your blood pressure go up. Clots can also form.
• A stroke occurs when a clot blocks the blood flow to part of your brain or when a blood
vessel in or around your brain bursts.
• Blockages caused by smoking can also reduce blood flow to your legs and skin.10.6.2 Smoking and Respiratory Disease
Immediate Effects of Smoking on the Breathing System
Smoking is bad for health from the very first cigarette, because some of the chemicals in the
smoke have an immediate effect on the body.
• Carbon monoxide from the smoke is taken into the blood instead of oxygen. The cells get
less oxygen for respiration, especially during exercise. This is particularly damaging during
pregnancy because a developing baby can be starved of oxygen.
• The cilia in your trachea and bronchi are anaesthetised so they no longer move mucus
and pathogens away from the lung and lungs become more likely to get infections of the
breathing system. Long-term smokers may also develop a ‘smoker’s cough’ as your bodytries to get rid of the mucus which builds up in the lungs.
• Irritation of the trachea (windpipe) and larynx (voice box)
The effects of tobacco smoke on the respiratory system include:
• Reduced lung function and breathlessness due to swelling and narrowing of the lung airways
and excess mucus in the lung passages
• Impairment of the lungs’ clearance system, leading to the build-up of poisonous substances,
which results in lung irritation and damage
• Increased risk of lung infection and symptoms such as coughing and wheezing
• Permanent damage to the air sacs of the lungs.
Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli)
found in your lungs.
• Lung diseases caused by smoking include COPD, which includes emphysema and chronic
bronchitis.
• Cigarette smoking causes most cases of lung cancer.
• In condition of asthma, tobacco smoke can trigger an attack or make an attack worse.• Smokers are 12 to 13 times more likely to die from COPD than non-smokers.
10.6.3 Smoking and Other Health Risks
Smoking harms nearly every organ of the body and affects a person’s overall health.
• Smoking can make it harder for a woman to become pregnant and can affect her baby’s
health before and after birth. Smoking increases risks for:
♦ Preterm (early) delivery.
♦ Stillbirth (death of the baby before birth).
♦ Low birth weight.
♦ Sudden infant death syndrome (known as SIDS or crib death).
♦ Ectopic pregnancy.
• Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for
birth defects and miscarriage.
• Smoking can affect bone health.
♦ Women past childbearing years who smoke have weaker bones than women who never
smoked, and are at greater risk for broken bones.
♦ Smoking affects the health of your teeths and gums and can cause tooth loss.
♦ Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it
hard for you to see) and age-related macular degeneration (damage to a small spot nearthe centre of the retina, the part of the eye needed for central vision).
Evidence Linking Cigarette Smoking to Disease and Early Death
Cigarette smoking began en masse in the beginning of the twentieth century, and doctors
started noticing a huge increase in cases of lung cancer from 1930 onwards, and by 1950s it
was declared an epidemic. For comparison, in 1912 there were 374 lung cancer cases, and nowthere are over 35,000 deaths a year, an increase of nearly 100 times.
The correlation between lung cancer and cigarette smoking is plain in the chart—it shows the
20 year ‘lag’ between the rise of cigarettes and the rise of lung cancer. Epidemiological data
links smoking and cancer, and up to 50% of smokers may die of smoking-related diseases(Figure 10.7).
One third of cancer deaths are as a result of cigarette smoking, and a quarter of smokers die
of lung cancer. Chronic obstructive pulmonary disease is very rare in non-smokers, less than
10% of victims are non-smokers, and less than 2% of people with emphysema are non-smokers.
One fifth of smokers suffer from emphysema, and as a result, deaths from pneumonia andinfluenza are twice as high amongst smokers.
Figure 10.7: Lag time between smoking and lung cancer
Cigarette smoke contains over 4,000 chemicals, including 43 known cancer-causing (carcinogenic)
compounds and 400 other toxins. These cigarette ingredients include nicotine, tar, and carbon
monoxide, as well as formaldehyde, ammonia, hydrogen cyanide, arsenic,and DDT. Nicotine is highly addictive
Figure 10.8: Cigarette ingredients
Anti-smoking Campaigns
We will continue to run ‘smoke-free’ campaigns to encourage people to change their behaviour.
The campaigns are aimed at:
• Making people aware of the health dangers of smoking.
• Stopping young people from taking up smoking.
• Encouraging smokers to try and quit, and to do so in the most effective way.
• Encouraging people to stop smoking in their homes and family cars—emphasising how itaffects children
10.7 SUMMARY
• Smoking harms nearly every bodily organ and organ system in the body and diminishes
person’s health and smokers are more likely than non-smokers to develop heart disease,
stroke, and lung cancer.
• Smoking is a leading cause of lung cancer and death from cancer.
• It causes stroke and coronary heart disease, which are among the leading causes of death
in the United States.
• Atherosclerosis and coronary heart disease results in damaging of blood vessels and
make them thick and grow narrow, when a clot blocks the blood flow to part of brain or
when a blood vessel in or around your brain bursts, it causes stroke.
• Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease
caused by smoking which damage the airways and the small air sacs (alveoli) found in the
lungs. Emphysema and Chronic bronchitis condition also contributed to COPD which
obstruct the airways of the lung.
• People with COPD are at higher risk of developing heart disease, lung cancer and a variety of
other conditions. They suffer from breathing difficulty, suddenly lose weight and feel low energy.
• Cigarette smoking and tobacco smoking contain number of harmful and carcinogenic
chemicals like:
• Nicotine — not carcinogenic but highly addictive. Smokers find it very hard to quit
because they are hooked on nicotine. Nicotine is an extremely fast-acting drug. It reaches
the brain within 15 seconds of being inhaled. Nicotine is used as a highly controlled
insecticide. Exposure to sufficient amounts can lead to vomiting, seizures, depression of
the CNS (central nervous system), and growth retardation.
• Carbon Monoxide — a poisonous gas with no smell or taste. The body finds it hard to
differentiate carbon monoxide from oxygen and absorbs it into the bloodstream. Carbon
monoxide decreases muscle and heart function, it causes fatigue, weakness, and dizziness.
It is especially toxic for babies still in the womb, infants and individuals with heart or
lung disease
• Tar — Tar’ describes the particulate matter which, generated by burning tobacco, forms a
component of cigarette smoke. Each particle is composed of a large variety of organic and
inorganic chemicals consisting primarily of nitrogen, oxygen, hydrogen, carbon dioxide,
carbon monoxide, and a wide range of volatile and semi-volatile organic chemicals. In its
condensate form, tar is a sticky brown substance that is the main cause of lung and throatcancer in smokers. Tar can also cause unsightly yellow-brown stains on fingers and teeth..
10.8 GLOSSARY
• Atherosclerosis: A condition where the arteries become narrowed and hardened due to
an excessive build up of plaque around the artery wall.
• Benign tumour: Tumour that remains in one place and does not appear to spread.
• COPD: Chronic Obstructive Pulmonary Disease is a chronic inflammatory lung disease
caused by smoking which damage the airways and the small air sacs (alveoli) found in
the lungs.
• Cardiovascular disease: It includes all types of heart and blood vessel diseases.
• Malignant tumour: Tumour that spreads to other parts of the body either through the
bloodstream or the lymphatic system.
• Tar: A sticky, dark brown substance that can accumulate and coat the airways andlungs.
END UNIT ASSESSMENT 10
I. Choose whether the following statements are True (T) or False (F)
1. Smoke from cigarettes can make non-smokers sick.
2. Smoking can affect a person’s ability to smell and taste food.
3. Secondhand smoke kills about 3,000 non-smokers each year from lung disease.
4. It takes about ten seconds for nicotine absorbed into the bloodstream to reach the
brain.
5. Smoking is a difficult habit to quit.
6. Nicotine, the chemical found in cigarettes, is an addictive drug.
7. A smoker is twice as likely to have a heart attack as a non-smoker is.
8. Cigarette brands that are heavily advertised on TV, in magazines, on billboards, and
on T-shirts are the brands more teens buy.
9. One out of every ten smokers will die of a smoking-related sickness.10. More germs get into your lungs when you smoke.
II. Multiple Choice Questions
1. Smoking causes
(a) Lung cancer (b) Heart disease
(c) Respiratory disease (d) All of above
2. Atherosclerosis is a condition where,
(a) Body needs more energy
(b) Lungs get filled with mucus
(c) Plaque clogs up the artery, disrupting the flow of blood around the body
(d) Brain becomes dead
3. Chronic Obstructive lung disease occurs due to
(a) Chronic bronchitis (b) Emphysema
(c) None of these (d) Both of these
4. COPD stands for
(a) Cuticular Obstetric Pelvic Disease
(b) Critical Obstructive Pituarity Disorder
(c) Chronic Obstructive Pulmonary Disease
(d) Chronic Obesity Personal Decision
5. Emphysema is caused due to
(a) Bursting of alveoli (b) A decrease in the surface area of gas exchange
(c) Both A and B (d) None of above
6. Gas exchanging system cannot be damaged by
(a) Carcinogens (b) CO
(c) Nicotine (d) Any of these
7. The blood is not oxygenated well enough due to
(a) Asthma (b) Emphysema
(c) Chronic Bronchitis (d) All of above
8. Common causes of Chronic Obstructive Pulmonary Disease (COPD) does not include
(a) Smoke from the factory furnace (b) Vehicle pollution
(c) Industrial pollution (d) Water pollution
9. Chronic Obstructive Pulmonary Disease (COPD) does not include
(a) Asthma (b) Chronic Bronchitis
(c) Emphysema (d) Retinoblastoma
10. The smoker’s cough is
(a) A sign of recovery
(b) An attempt to move the mucus up the airways
(c) An attempt to move the air down the airways(d) A mixture of bacteria and BCs
III. Long Answer Type Questions
1. What are the dangerous components of tobacco smoke?
2. In your words, describe the effects of tar and carcinogens in tobacco smoke on the
gas exchange system.
3. How can you control the use of tobacco in your society? Explain briefly.
4. Describe the signs and symptoms of lung cancer and chronic obstructive pulmonary
diseases (COPD).
5. Describe the effects of nicotine and carbon monoxide on the cardiovascular system.
6. Explain how tobacco smoking contributes to atherosclerosis and coronary heart
disease.
7. Interpret data linking cigarette smoking to disease and early death.
8. Comment on smoking gender disparities prevalent in the community. Also state the
effect of smoking on a pregnant woman. How does it affect the infant?
9. Correlate smoking to behavioural economics and health behavioural changes. Support
your answer with examples.
10. Differentiate between:
(a) Emphysema and chronic bronchitis
(b) Atherosclerosis and coronary heart disease11. Look at the pictures and answer the questions that follow:
