1.  Cigarette smoke can be divided into 2 phases Gaseous phase and a particulate phase. ◦ The gaseous phase contains CO and other dangerous gases. ◦ The particulate phase includes nicotine and tar, polycyclic aromatic hydrocarbons, benzopyrene, and nitrosamine, all of which induce malignant transformation. Environmental diseases

2. Gaseous Phase (CO) Particulate Phase - shortness of breath - neonatal problems - nicotine (increases CHD risks) - tar (increases cancer risks)

3.  Cigarettes are like little chemical factories. When lit, they put out over 4,000 chemicals, 43 of which are known to cause cancer, as well as over 400 other poisons.  CO combines with hemoglobin more strongly than oxygen and therefore limits the oxygen carrying capacity of the blood. (This explains why smokers are always out of breath.)  Neonatal problems from smoking during pregnancy are also related to poor oxygen delivery to the fetus

4.  Nicotine is the addictive component in cigarettes and it also increases the risk of CHD due to decrease HDL, & increased platelet aggregation  Tar contains the carcinogenic compounds that lead to cancer. The compounds get stuck in the mouth, throat, esophagus and lungs and increase risk for cancers.  50% of smokers will die from smoking related illness, including heart disease, emphysema, chronic bronchitis, and lung cancer.  Smoke increases neutrophils in the lungs and release elastase that damage alveoli.

5.  FETAL TOBACCO SYNDROME: ◦ Low birth weight: 200 grams lighter (low birth weight for gestational age)  Premature Rupture of Membranes (PROM) ◦ Increased perinatal mortality, due to:  Increased risk of placental rupture  uterine bleeding  FETAL ALCOHOL SYNDROME: ◦ Growth retardation ◦ Characteristic facial features (epicanthal folds) ◦ CNS dysfunction

6. Risks of Smoking to Fetus  The risks of smoking to the fetus include: low birth weight, prematurity, spontaneous abortion, and still birth. Risks of Passive Smoking  Passive exposure to cigarette smoke increases the risk of lung carcinoma by a factor of 1.5.  It also increases the risk of cardiovascular disease and respiratory disease.