Life expectancy for a female in Minnesota is now approaching 80 years of age (with males being close behind). The longer one lives the longer ones body endures the accumulation of bodily insult and injury. In cultures where average life expectancy is only 35-50 years many potential liabilities never become evident before death. While many of these insults may be beyond our personal control some of the most adverse are directly within an individual’s influence. In this regard the continual smoking of cigarettes stands out as a distinctive personal and public health care problem, not only for one’s body in general, but specifically for the human spine.
There are only two structures in the adult human body which, under normal circumstances, lack a blood supply in adult life. These are the cornea of the eye (which gets its nutrition from tears) and the intervertebral disc (which obtains its nutrition from the convection and diffusion of nutrients from the end plates of adjacent vertebral bodies).
By smoking cigarettes nicotine and carbon monoxide infuse into the blood stream and then into body tissues. Researchers have found that smokers carry a 3-4x higher risk of disc degeneration non-smokers. These are poisons which have a particular focal destructive effect on the intervertebral discs and this is particularly true when the vertebral endplates or discs are abnormal (i.e. genomic spine disorders) at birth.
In addition to this chronic smokers have vertebrae which less strong and healthy, have reduced bone blood supply, as well as fewer, and less functional, bone forming cells and are also minerally deficient. This condition is referred to as osteoporosis.
When one considers that the highest single cost for health care in the United States today (after that of chemical dependency and psychiatric disease) is that of treating back problems the contribution of cigarette smoking in potentiating this expenditure is not trivial.
It does indeed seem cruel that we are continually being advised that many of the things we enjoy are associated with significant medical problems. The only thing left which seems to have escaped censure seems to be a glass or two of wine each day. The cigarette industry has maintained, for over 35 years (sometimes under oath), that cigarettes are not addicting and have not been a direct cause of cancer, heart disease, emphysema or other health problems. 1999 was a banner year for society because, after a well-financed campaign, extending over decades, specifically designed to obfuscate accumulated scientific data on the many liabilities of smoking cigarettes, the tobacco industry finally admitted that they had lied.
In addition to the frightening association between cigarette smoking and disc degeneration it needs to be pointed out that the great majority on non-smokers with degenerated discs self-heal with associated conservative (non-surgical) care. It is well established that patients who smoke do not spontaneously heal and have a higher failure rate of surgery in general and fusions in particular. Because of the adverse effect of nicotine and carbon monoxide on bone metabolism and bone growth many spine surgeons including this Editor, who understand that there is a higher surgical failure rate in smokers, require patients undergoing elective fusion to be non-smokers for at least 3 months to clear their bodies of stored nicotine. Blood levels of carboxyhemoglobin and urine level of nicotine can be used to document compliance.
How can a for-profit cigarette industry pay billions of dollars in fines and still be able to continue in business?
Shown below is a typical example of one brand’s “saturation” advertising in Greece, which has one of the highest smoking rates in Europe:
The World Health Organization on the United Nations has released figures indicating that the global death rate from tobacco-related illness and disease is rising. It is estimated that about 4 million individuals die annually from disease directly related to smoking tobacco.
The American tobacco industry has engaged in a half-century long disinformation campaign regarding the true risks of smoking cigarettes. Their modus operandi has been: creating doubt…without actually denying it. Should these observations on the past and present state of business ethics come as a surprise to anyone?
A Centers for Disease Control and Prevention study researchers found that the level of tobacco nitrosamines in American cigarettes, particularly the Marlboro brand, were at least twice as high as in the local brands of 10 of 13 nations tested by the CDC. In some countries the nitrosamine level of Marlboro cigarettes was as much as 22 times higher than the local brand of cigarette (KaufmanM: MarlborosHigh in One Carcinogen, Study Says, WSJ, May 30, 2003).
On January 1, 2004 Ireland became the first country in the world to ban smoking in pubs. The State of Minnesota is presently ranked as America’s healthiest state (United Health Foundation, America’s Health Rankings) and has been for many years. Smoking has progressively decreased, over the years, but 20% of the population continues to puff away.