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Chapter 10 - Legal Drugs ________________________________________

If you haven’t figured it out yet, you’ve just developed a disease called bronchitis…the inflammation of the bronchial cells. And what is the major symptom of bronchitis? If you said a deep cough, you are perfectly right. Now you know why that is the case. Interestingly, people who work in extremely polluted environments (coal mine, foundry and etc.) can develop bronchitis. Nevertheless, the incidence of this disease in smokers is 20 times greater than in non-smokers. That’s just the beginning of what smoking can do to you.

If you are a regular smoker (about a pack of cancer sticks a day), in roughly 20 years, the tar that coats the epithelial tissue of the bronchial cells will begin to eat through the lining of the cell. Once inside, the tar somehow (the etymology of this process is not known) rearranges the genetic structure of the cell causing it to become an X or mutant cell.

These mutant cells are a modification of the original cell except that they don’t have a productive function. In brief, they compete for oxygen, nutrients and replicate, but do not perform absolute no useful function.

They are basically parasitic in nature. They take from you, but give you nothing in return. Do you ever date someone like that?

They take everything you have, your money, your car, your house and they give you nothing in return. They are called jingaloes or gold diggers. What do you do with those people? We will tell you what you do. You cut them out of your life. The same thing you do with those X-cells. As soon as your doctor detects that you have those X-cells, he will take you down to the operating room. Then, he will put you on a marble slab, take out a Black’N’Decker chain saw and slice your chest cavity wide open. He will then pin your chest back so that he can get a better look. If there are just a few X-cells there, what he’ll do is take out a set of those $19.95 Ginsu knifes…you know, the ones that come with a purple table cloth…and cut them out. If, on the other hand, he gets in there and your chest is deluged with X-cells or if some of the X-cells broke off and/or became metastatic and colonized in different areas of your body, there is a good chance your doctor will stitch you back up. He will then tell you to go home to make out your will because you will be checking out in the near future because what those little X-cells are cancer cells and what you have is terminal cancer, the second leading cause of death in middle aged American men.

Oh, but wait! There’s more. If you’re unfortunate enough to survive the cancer, there’s a good chance that you’ll develop a disease that’s even worse…emphysema. This bad boy won’t only shorten your life, but it will make you wish you were dead when you are alive. The disease has a significant deleterious effect on the cardiorespiratory system. Consequently, even the simplest tasks like walking across the room can be extremely taxing. Some emphysema patients can’t even blow out a match only two inches from their lips. When you develop emphysema, your entire life is compromised. You can’t run, you can’t swim, you can’t have sex, you can’t play

Chapter 10 - Legal Drugs ________________________________________

ball…you really can’t do anything that requires any type of cardiovascular endurance. Did we mention you couldn’t have sex? Actually, you probably can do all those things, but you just couldn’t do them for more than 30 seconds. Trust us on this one. Your life is totally screwed when you develop this disease.

The alveoli are the tiny air sacs we talked about when we were discussing the vascular system. Remember, it’s where the capillaries give off carbon dioxide and pick up oxygen. The gases are exchanged by creating a pressure differential. The basic principle underlying the movement of air or gas is that it will travel from a high-pressure area to an area of lower pressure. It will also travel from an area of greater concentration to an area of lower concentration. The process is called diffusion and takes place as a result of the pressure gradient or difference. The muscles and the elasticity of the alveoli create the pressure differential that first allows air to flow into the air sacs and then allows air to be expelled from the sacs.

Let’s begin with inspiration, or the act of taking air into the alveoli. First, the muscles around the air sacs contract thereby expanding the alveoli cavity from side to side and from front to back. The enlargement of the alveoli cavity causes a decrease in pressure. Air pressure outside the alveoli is then greater than the air pressure inside, causing air to flow into the alveoli until alveoli pressure is equal to the out pressure.

Remember, the balloon analogy we used in Chapter 4 when were talking about how air gets into the lungs. Well, it applies here to. What happens to a balloon when you put it under water? It shrinks because of the pressure that the water on the balloon. Does the amount of air in the balloon change? No. It’s still the same. So, we have the same amount of air in a smaller space. As a result, the pressure in the balloon goes up. Accordingly, when you take the balloon out of the water, the size of the balloon expands and the pressure decreases according to the change in the size of the balloon. The alveoli are like balloons such that as the space that holds the air expands, the pressure in them goes down. After the muscles increase the space in the alveoli, you will have air in your lungs…right? Right!

Now, let’s see how it gets back out. Let’s look at expiration or the expelling of air from the alveoli. Expiration is nearly the opposite of inspiration. In this case, the muscles relax, thereby returning to their original position. When this occurs, the volume of the alveoli cavity decreases by all parameters, causing the pressure inside the alveoli to increase. The pressure in the alveoli is greater than the outside pressure, which causes air to flow out of the cavity until the external and internal pressures are once again the same. If you don’t understand what we are talking about, Simon says, “Read it again.” If you want the easy way out, just put a gun to your head.

Okay, now that you understand how air enters and exits the alveoli, let’s see how emphysema gums up the whole works. As mentioned, the capillaries intermingle with the millions of tiny air sacs throughout the lungs. It is there in the tiny air sacs that the real work of the vascular system takes place.

The carbon dioxide in the capillaries is exchanged for the oxygen in the alveoli.

The oxygen is necessary for breaking down ATP. Without oxygen your cells can’t do any work.

Anywho, what happens with emphysema is that the tar collects on the alveoli walls decreasing their elasticity and their ability to create a pressure differential. Air is allowed into the alveoli through their normal expansion, but is then trapped due to the blockage caused

Chapter 10 - Legal Drugs ________________________________________

by the tar. As pressure builds, it causes the air sacs to rupture. This reduces the surface area in which oxygen and carbon dioxide can be exchanged. Without the air sacs, the blood cannot exchange its carbon dioxide for oxygen. Without oxygen being supplied by the blood, the cells can’t do work and you know what that means… NO SEX! In short, emphysema compromises your aerobic capacity. As the condition worsens, you get less and less oxygen into the body. Eventually, you can’t even get enough oxygen to survive. The long range consequence is a slow and painful suffocation. Isn’t that great news! That’s just some of the things that tar in the cigarette smoke will do to you. Actually, all that is just kid stuff. The real “ass kicker” is nicotine. The majority of deaths among smokers are mainly due to the effects that nicotine has upon the cardiorespiratory and circulatory systems. Coronary artery disease alone accounts for about 45 percent of the deaths related to smoking. If you add up all the other cardiorespiratory diseases that are linked to nicotine, they would account for over 50 percent of all smoking related deaths. If you want to know physiologically how all of that works raise your hand…to bad, we are going to tell you anyway.

- Nicotine Nicotine is a central nervous system (CNS) stimulant. It affects the body in much the same manner as a mild amphetamine.

Its action on the body causes the heart rate to increase, the peripheral blood vessels to vaso-constrict and adipose (fat) stores to release fatty acids into the vascular system. It also gives you a feeling of mild euphoria or well being. That is one reason cigarettes are so popular…they make you feel good when you use them. Generally, when a response is followed by an unpleasurable consequence, the response will decrease. Conversely, when the response is followed by a pleasurable consequence, the response is increased. As mentioned, the response of smoking is generally followed by a pleasurable consequence (mood elevation). Thus, the frequency of the behavior (smoking) is likely to increase, which eventually leads to psychological addiction. This form of habituation or mental dependence is nothing to sneeze at. Research has consistently shown that habituation is much more difficult to overcome than physical addiction to drugs.

The physical withdrawal from even the harshest of drugs would only take six to ten days. Once accomplished, the body’s craving for the drug is gone forever. Once you develop habituation for a drug, you have to contend with that persistent craving throughout your life. Remember how much trouble Lori had with her psychological craving for heroin.

Naturally, physical addiction is no bowl of cherries either. The physical addiction to a drug has forced even the strongest of wills to crack. Unfortunately, cigarettes are extremely addicting. According to contemporary research, nicotine is more physically addictive than heroin. Indeed, it has been shown that the success rate of physically withdrawing from heroin is significantly higher than that for nicotine.

When nicotine is inhaled into the lungs, it is readily absorbed by the blood and carried throughout the body. The immediate consequence of nicotine stimulation causes the heart to be overworked. Heart rate can be elevated as much as 20 to 25 beats per minute as a result of the excitatory effects of nicotine. If the heart is placed under this type of stress 20 or 30 times each day, as it is with most smokers, adverse effects are almost certain. This constant stress of the heart, which is not in proportion to the workload, predisposes the individual to cardiac infarction…you know, what Olivia Newton John is always singing about…HEART ATTACK! Nicotine can also predispose you to arteriosclerosis, which is the occlusion of the artery. Here is how that works. Now, don’t freak out on us here. It’s easy to understand. By the time we are done, you will probably want to drop out of here and go to medical school. If you were smart, you would have done that in the first place.

Anywho, your body produces two types of fat: lowdensity lipoproteins (LDL’s) and high-density lipoproteins (HDL’s). The LDL’s are the bad guys and the HDL’s are the good

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guys. The LDL’s are little round balls of fat while the HDL’s are much larger and irregular in shape. Both of these fats circulate through the blood. Now, envision the walls of your arteries as being made of Velcro and the LDL’s as little Velcro balls. You know what happens when you throw a Velcro ball against a Velcro wall? They stick to the wall you moron! That is exactly what happens. The little LDL’s start collecting on the artery walls and start forming plaque. If this continues, the walls of the arteries are going to narrow and eventually an occlusion of the vessel will occur. When that happens, you are basically screwed because the vessel will eventually burst, you will have a major bleed, and then there is a good chance you will be taking residence in either heaven or hell. This is one reason why God invented HDL’s.

What the HDL’s do is go through the vascular system and knock the LDL’s off the artery walls. Actually, this system works out really well in healthy human beings…which goes to show you that God is pretty smart. One thing He didn’t consider is that human beings are…well, human. Like fools, some of them smoke. The problem is that the nicotine in the cigarettes significantly increases the production of LDL’s and decreases the production of HDL’s. And you know what that means…heaven or hell!

Another action of nicotine is that it inhibits pancreatic bicarbonate secretions. We went through some of this before when we talked about the weight control so we will just give you our celebrated Reader’s Digest version here. You go over to McDonald’s restaurant and order one of those 99-cent Big Macs that sells for $5 nowadays. Remember now? You take a big bite and chew it up into bolus. After you chew your food up, you swallow it and it goes down your esophagus and into your stomach where it is churned up into chime. Your pancreas then squirts out hydrochloric acid that breaks the chime down to glycogen. Remember that? Okay, what we didn’t tell you is that when the glycogen leaves the stomach, the acid is left behind. This high level of acidity is a major problem. That acid in your stomach can break down just about anything short of tempered steel. Since the lining of your stomach and upper small intestine (duodenum) are not composed of tempered steel, the acid can eat through the lining. The reason it doesn’t eat right through the walls of your stomach is because the pancreas, after the stomach is empty, secretes a type of bicarbonate soda, which buffers the acid. Well, it does if you don’t smoke. If you do smoke, the nicotine in the cigarette inhibits the pancreas from secreting the bicarbonate soda.

Consequently, the acid begins to eat through the stomach wall and the duodenum lining, thereby predisposing you to acute peptic ulcers and duodenal ulcer formation. Neat, huh!

- Carboxyhemoglobin After all that negative stuff, you probably want to hear something positive. Well, what if I told you that we had a solution to all your problems…would you be interested?

Of course, you would! Okay, then, here goes.

Go home tonight, pull your car into the garage and close all the windows and doors. Then take a garden hose, put one end in your exhaust pipe and the other end in the driver's window. Once you have everything tight and secure, start the car up. Then put your Michael Jackson I’m Bad CD into your CD player and then sit back and relax. In about twenty minutes you won’t have a care in the world because you are going to be elevated to a celestial level. Still interested? Probably not! The interesting thing is that the gas you would be taking in from the car exhaust is the same poisonous gas that you inhale when you smoke cigarettes, only in a smaller quantity. The gas, of course, is carbon monoxideer along with tar and nicotine, it is one of the major contaminants of cigarette smoke.

Although cigarette doesn’t emit enough carbon monoxide to kill you, it has more than enough to play havoc with your cardiorespiratory system. First of all, carbon monoxide has a very high affinity for adhering to hemoglobin, the oxygen-carrying content of the blood. When carbon monoxide combines with hemoglobin, it actually forms an entirely new substance

Chapter 10 - Legal Drugs ________________________________________

called carboxyhemoglobin. It is estimated that the average smoker has about 8 to 10 percent carboxyhemoglobin in his blood. This has the effect of adding approximately 5000 feet of altitude to the individual’s physiology. Needless to say, the individual’s ability for aerobic work is significantly decreased. The reason for this is that the hemoglobin that is tied up with carbon monoxide cannot carry oxygen. Thus, less oxygen will be delivered to the heart and the tissues of the body. Do we need to say that without oxygen you can’t do work because you need oxygen to break down ATP? Okay, without oxygen, you can’t do work because you need oxygen to break down ATP. How is that?

Now, believe it or not, that is just a few of the health problems you are going to experience if you smoke. Actually, there are a lot more physiological problems associated with smoking, but our intention here is not to write an entire book on smoking. We could do that, but you are not paying us enough, so you will have to settle for the abbreviated version.