Dr Satnam Singh Chhabra, Head Neuro and Spine department, Sir Gangaram Hospital
Quite many steps have been taken to reduce the number of people who smoke, but all in vain. Even the government is trying hard to curb this situation, which leads to thousands of deaths each year due to lung cancer and other respiratory issues because of smoking.
Many people begin to smoke despite published statistics that show its negative impact on health. According to the latest order by the government, cigarette packets will soon have bigger pictorial warnings, hoping to change the mindset of smokers.
The adverse effects of smoking include nicotine addiction, increased risk of lung and other types of cancer, higher rates of arteriosclerosis (hardening of the arteries) and heart disease, as well as decreased life expectancy.
Cigarettes contain dried tobacco leaves and flavourings, which includes more than 4,000 chemicals. Some of these substances are harmless until burned and breathed. Cigarette smoke can be divided into two categories – distinct particles and gases.
But, one of the issues that smokers ignore is that smoking can deteriorate the health of the spine, which can be a long term disease. As, we know that smokers have less physical endurance than non-smokers, which is mainly due to decreased lung function. Cigarette smoking reduces the amount of oxygen in the blood and increases the level of harmful substances, such as carbon monoxide. This combined with the effects of smoking on the heart and blood vessels can limit the benefits from physical activity.
Bone is a living tissue dependent on the functions and support provided by the other body systems. When these systems are not able to perform normally, bone is unable to rebuild itself. The formation of bone is particularly influenced by physical exercise and hormonal activity, both of which are adversely affected by cigarette smoking.
In men and women, cigarette smoking is known to influence hormone function. Smoking increases estrogen loss in women who are premenopausal or postmenopausal. This can result in loss of bone density and can lead to osteoporosis. Osteoporosis causes bones to lose strength, becoming more fragile. So, this silent disease is responsible for many spine and hip fractures.
The toxins in cigarettes wreak havoc on our bones and soft tissues. When we talk about the spine, which consists of vertebrae, cartilaginous intervertebral discs, connective tissue, small muscles and nerves, we begin to get a broader sense of how smoking can damage our spine’s ability to function normally.
All parts of the spine are affected by smoking. Below are a few dangers that one may not be aware of:
Intervertebral discs – the discs that separate adjacent vertebrae have a very low blood supply. Smoking inhibits circulation even further, making it impossible for these discs to absorb the nutrients they need to stay healthy.
Vertebrae – smoking reduces bone density, which puts the vertebrae at greater risk for developing osteoporosis, facet disease, spinal arthritis and other degenerative spine conditions.
Connective tissues – nicotine causes a reduction in collagen levels, which makes soft tissues and cartilage less elastic and resilient. Tendons and ligaments become vulnerable to injury.
Muscles – besides the general degenerative effects of smoking on the muscles, tobacco also harms the lungs, making physical activity difficult. The result can be lowered muscle mass due to inactivity.
Nerves – when cartilage, vertebrae and intervertebral discs get weakened, the chances of a herniated disc or bulging disc increases. These conditions can cause disc material to impinge spinal nerves.
One of the procedures to rectify the spine is spinal fusion, which is a surgical procedure used to join bony segments of the spine (eg, vertebrae). In order for fusion to heal, new bone growth must occur, bridging between the spinal segments. Sometimes fusion is combined with another surgical technique termed spinal instrumentation. Instrumentation consists of different types of medically designed hardware such as rods, hooks, wires, and screws that are attached to the spine. These devices provide immediate stability and hold the spine in proper position while the fusion heals.
Spinal fusion (also termed arthrodesis) can be performed at the cervical, thoracic, or lumbar levels of the spine. It takes months to heal. The long-term success of many types of spinal surgery dependents on successful spinal fusion. In fact, if the fusion does not heal, spinal surgery may have to be repeated. A failed fusion is termed as a nonunion or pseudoarthrosis.
Certain factors have been found to affect the success of spinal fusion. Some of these factors include the patient’s age, underlying medical conditions, like, diabetes, osteoporosis and cigarette smoking. Smoking disrupts the normal function of basic body systems that contribute to bone formation and growth. As mentioned previously, new bone growth is necessary for a fusion to heal.
Post-operative infection — Smoking compromises the immune system and the body’s other defence mechanisms, which can increase the patient’s susceptibility to post-operative infection.
However, quitting smoking is obviously easier said than done. However, there are a few tips that may help the transition go a bit more smoothly. You can try other smoking alternatives such as nicotine patches or nicotine free chew tobacco pouches. One can also drink plenty of water or opt for non-caffeinated beverages because caffeine can increase nicotine craving. Try to exercise on a regular basis and get about eight hours of sleep each night. Many people reach for their pack of cigarettes when they feel tired or energized. Finally, since so much of smoking has to do with habit, try changing the lifestyle or behaviour. Eat your lunch in a different spot, walk your dog on a different route or read a book instead of watching television.
