"Cigarette is good for you" Wait what??
cigarettes·@thethinkingdr·
0.000 HBD"Cigarette is good for you" Wait what??
 Cigarette-smoking is the single-most important risk factor to almost all form of cancer and non-communicable diseases so much so that if you’re a medical student and your specialist asks you “What’s the cause/risk factor of getting this cancer/disease?” You’ll have an 80% chance of getting it right by just answering cigarettes – that and of course the notorious alcohol, a match made in hell.  But as the old adage goes, nothing is completely bad or completely good (At least that’s what I think it means) and the same could be said to cigarette although it’s a really really tough case to make especially when it contain thousands of different dangerous chemicals that is not just bad for the people smoking it, but also the people around them (passive smokers) and the environment. With that said, how in the name of everything that’s holy is cigarette good for you?? Well here’s the top 2 studied conditions that shows cigarettes may be good for you.  A) Parkinson's disease Parkinson’s disease is a horrible disease to have and despite the dad jokes you often hear, Parkinson’s disease is not funny. In fact, it’s very near the top of the list of things that aren’t funny so stop making fun of someone’s grandpa for their relentless grooving. Anyway, PD is cause by the deficiency of Dopamine in the Substantia Nigra (Part of the brain where you are absolutely allowed to forget about) The reduction in Dopamine level led to the classical features of PD although I’m really oversimplifying things here, and that treatment goal is to increase the dopamine level in the Substantia Nigra. When it comes to cigarettes, a study by Tanaka et. Al in 2010 observed the markedly low incidence of PD amongst smokers and at least one longitudinal study found a protective effect against PD for both current and former smokers compared to those who had never lit a bud in their life. Another study in Japan really drove this point home after their case-control study reported the same finding such that the risk for current smokers to acquire PD is 1/3 of that to non-smokers. Nicotine, the most prominent chemical found in tobacco is dubbed to be the likely chemical to exert this PD-protective effect although they’re not dismissing the potential contribution of other chemicals found in cigarettes in which as you might have heard from anti-cigarettes campaign, are in the thousands. The land down under postulated that based on their data from 2004-2005, approximately 97 deaths from Parkinson's disease were prevented by smoking in Australia annually.  B) Ulcerative colitis Ulcerative Colitis is one out of two condition under the group ‘Inflammatory bowel disease’ or IBD, with the other one being Crohn’s disease. Needless to say, both are nasty because the underlying pathology is that it’s your immune system attacking your gastrointestinal lining and causing all the miserable symptoms associated with these conditions. Symptoms include ulceration from your oral mucosa to anywhere along the GastroIntestinal lining, abdominal pain, bowel obstruction, altered bowel habit, blood in the feces and non-specific joint and muscle pain. Not to mention that IBD has a risk of transforming into a full blown malignancy. Ulcerative colitis however, has a specific and limited site of pathology which is just around the lining of the large bowel and the rectum which is really no surprise since the name itself implies Ulceration (Ulcerative) and inflammation of the large bowel (Colitis). As a medical student, this odd yet intriguing fact often appear in our textbooks claiming that smoking cigarette is thought to protect oneself from developing Ulcerative Colitis. This is based on data and observation of cases illustrating that active smokers have a lower risk of developing ulcerative colitis, compared to non-smokers and ex-smokers. The US Surgeon General even went out to show evidence that this protective relationship may be of causation! It was also found that the protection it incurs follows a dose-response relationship such that greater pack-years or numbers of cigarettes smoked per day were associated with a decreased risk of ulcerative colitis. A pack years is our way of communicating with other health-care professionals in quantifying the burden of cigarettes of a patient which can be represented by this formula: No. Cigarette smoked __________________ X Years of smoking 20 Now, if you’re a fan of House and the immune sensitivity theory like me, you’d probably think that the possible explanation to this is because the harmful effect of cigarettes keep our immune system busy fighting off unworthy dwelling chemicals and has little time to spare to attack one’s own colon lining. This theory of ‘keeping your immune system busy’ has been coined before to explain why first world countries has high incidence of autoimmune diseases as compared to third world countries and developing countries, in which their main concern are infectious disease and diseases of crowded living. This theory suggest that as the condition and lifestyle becomes cleaner and healthier with the introduction of sanitisation, clean water supply, antiseptic, alcohol rub and exceptional level of food and hygiene care, the immune system is basically ‘unemployed’ and sort of went rogue looking for something to attack since the host rarely gets sick. Unfortunately, as likely as that may sound, the whole explanation to why cigarettes could exert protective effect against Ulcerative Colitis is, as you might have guessed from Parkinson’s disease, it’s because of Nicotine. In fact, one research in 2011 on steroid-dependent and resistant ulcerative colitis amongst ex-smokers advocated for the use of cigarettes as the modality of treatment. Now before the smokers make a case out of this, smoking won’t be a treatment anytime soon or at all since as much as it protects you from Ulcerative Colitis, it predisposes you to the other much nastier twin of IBD – Crohn’s disease. As a matter of fact, instead of the whole cocktail, nicotine is currently isolated and being studied in various forms as therapy with possible benefits for individuals with this bowel disease. These are just the example of 2 most studied conditions that has a protective effect following tobacco use. There are few more conditions currently being studied that shows promising cigarette-related protective effect such as Endometrial cancer and uterine fibroids and Pre-eclampsia (hypertension in pregnancy). Thank you for reading, leave a comment below. Don’t forget to upvote if you enjoyed this and follow me for more. I really appreciate it. -The thinking Dr. #wheniscigarettesgoodforyou #science