Smoking & Other Diseases

More news on smoking and diseases came last week in a new book, The Biologic Effects of Tobacco (Little, Brown; $4.50). Far from supplying the single, simple answer that so many seek, it makes clear that the relation between smoking, disease and premature death is highly complex. On the subject of cancer, the book's editor, Dr. Ernest L. Wynder, supplements some of his reports made at Atlantic City (see above). Smoking, and especially long-continued and heavy smoking of cigarettes, "plays a role in the causation of lung cancer," says Wynder. He is quick to add: "This statement does not deny the role of other factors." What to do? Dr. Wynder does not prescribe total abstinence, but that old standby, moderation. He also hopes that fiiters can be improved or that the cancer-causing factor in tobacco can be identified and taken out in manufacture.

In addition to cancer, the book reports on the effects of smoking in other disease areas.

Heart & Arteries. Smoking makes the heart beat faster, as many as 20 extra beats per minute for ten to 20 minutes after each cigarette. It also sends the blood pressure up, by as much as ten to 20 points (systolic) in normal subjects, and more in those who are especially sensitive or who already have high blood pressure. There is some (not yet conclusive) evidence that smoking cuts down the flow of blood through the coronary arteries to the heart muscle, and that certain individuals may be especially susceptible.

Smoking certainly cuts down the blood flow in the capillaries of the extremities--the familiar effect of cooling the fingers. This same phenomenon can be deadly in victims of thromboangiitis obliterans (or Buerger's disease, from which the late King George VI suffered). Their limb-tip blood flow is already reduced so that they are subject to gangrene, and it is in this connection that the strength of the smoking habit is most clearly seen. Writes Cornell University's Professor Irving S. Wright: "We have seen patients . . . continue to smoke even though they suffered agonizing pain from gangrene and multiple amputations until in the most extreme cases they were left without either leg. At least one patient lost all four extremities because he would not stop smoking." Giving up smoking, Dr. Wright points out, nearly always brings recovery, and these patients had been amply warned. For them, filters do no good.

Digestive System. Internal evidence from a patient who has an opening in his stomach shows that smoking makes little difference when the smoker is happy and at ease, but if he smokes under stress (as most smokers do), the results may be bad: nausea, stopping of stomach contractions, decrease in blood flow and stomach secretions. When the stomach or duodenum is already diseased (as with ulcers), smoking must be cut down or cut out.

Allergy. A few cases of skin inflammation, asthma or stuffy nose may be traced to tobacco. But for most people, allergy is the last thing they need to worry about when they light up.

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