The WHO calls tobacco “the single most preventable cause of death in the world”—but cigarettes can also provide a handful of paradoxical, if pyrrhic, health benefits: smoking is likely to take years off your life, but some things in tobacco smoke can actually do good for your body. Here’s what science has to say about the paradox of the smoker.
- The relationship between obesity and smoking
Cigarette ads have long extolled the appetite-suppressive qualities of tobacco. Even today, a lot of the public believes that cigarettes can be used to lose weight. People actually eat less when they smoke, and quitting smoking can cause a temporary increase in weight. Four years ago , scientists finally identified how nicotine reduces appetite through the brain’s hunger circuit and provided an explanation for decades of studies that broadly correlated smoking with lower body weight.
- Ulcerative colitis
Ulcerative colitis is a serious intestinal disease in which the inner lining of the colon and rectum is inflamed and permanently damaged. Current smokers are at lower risk of developing ulcerative colitis compared to non-smokers and ex-smokers and, according to the U.S. Surgeon General, evidence suggests that this protective relationship may be causal. A dose-response relationship has also been found to be associated with a decreased risk of ulcerative colitis due to higher pack-years or the number of cigarettes smoked per day. Nicotine in tobacco smoke is thought to be the most likely component to affect the course of the disease. However, smokers are at higher risk of developing Crohn’s disease, another inflammatory bowel disease. Due to the devastating effects of tobacco use, smoking is not recommended as a treatment for ulcerative colitis, although one study found this to be an extreme possibility for ex-smokers with steroid-dependent and ulcerative ulcerative colitis.8 Various forms of nicotine therapy are undergoing research to assess possible benefits for individuals with this intestinal disease.
- Smoking lowers risk of knee-replacement surgery
While smokers may have gone broke buying a pack of cigarettes, they can at least save money by avoiding knee replacement surgery. Surprising results from a new study have shown that men who smoke are less likely to undergo total joint replacement surgery than those who have never smoked. The study, published by the University of Adelaide in Australia, is published in the July issue of Arthritis & Rheumatism. What kind of connection could be? Knee-replacement surgery was more common among joggers and obese; smokers rarely jog and are less likely to be morbidly obese. After controlling for age, weight and exercise, the researchers were at a loss to explain the apparent, albeit slight protective effects of smoking for osteoporosis. It could be that the nicotine in tobacco helps prevent cartilage and joint deterioration.
- Parkinson’s disease
The association between smoking and a lower incidence of Parkinson’s disease was observed in a number of studies. Analysis of longitudinal studies found a protective effect against Parkinson’s disease for current and former smokers compared to those who had never smoked; the risk of Parkinson’s disease was reduced by about half among smokers (RR 0.51; 95 % CI, 0.43–0.61). Similar findings of protection for Parkinson’s disease have also been reported in a case-control study conducted in Japan. Nicotine is thought to be the chemical in tobacco smoke most likely to be involved in this finding, but other chemicals or compounds may be involved.11-13 Based on 2004 data, theoretical estimates suggest that about 97 deaths from Parkinson’s disease are prevented annually by smoking in Australia. Recent research also suggests that nicotine can improve compromised semantic treatment for Parkinson’s disease and also influence semantic treatment in healthy older adults; however, the 2014 US Surgeon General report found that cont.
- Smoking lowers risk of death after some heart attacks
Compared to non-smokers, smokers who have had heart attacks appear to have lower mortality rates and more favorable responses to two types of treatment to remove plaque from their arteries: fibrinolytic therapy, which is basically a medicine; and angioplasty, which removes plaque by inserting balloons or stents into the arteries.
There’s a catch here, though. The reason smokers have heart attacks is that they smoke the arteries, allowing fat and plaque to build up in the first place. So, one theory as to why smokers do better than non-smokers after such treatments is that they are younger, experiencing their first heart attack about 10 years before non-smokers. However, a study published in the August 2005 issue of the American Heart Journal states that age alone is not enough to fully explain the differences in survival and that “the smoker’s paradox is alive and well.” No alternative theories have been put forward since then.
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