Some surprising side effects of smoking
For some, smoking does indeed prevent or mitigate a range of medical disorders
The rapid spread of smoking in the 16th century was fostered, at least in part, by the enthusiastic endorsement by Spanish physicians of the health benefits of tobacco. “To seek to tell the virtues and greatness of this Holy herb,” wrote Juan de Cárdenas, “the ailments that can be cured by it, the evils from which it has saved thousands, would go unto infinity.”
Now we know better, but there is no denying that for some, smoking does indeed prevent or mitigate a range of medical disorders.
They include a woman in her thirties who developed the inflammatory bowel disorder ulcerative colitis soon after quitting, having smoked a packet a day for many years. She took it up again to cope with the stress of her symptoms of abdominal pain and diarrhoea and, reports her gut specialist, “noted a marked improvement within a week. Since then she has stopped and started on two further occasions with the same effect.”
German physician Dr Andreas Altenburg noted a similar phenomenon in those plagued by the immensely painful aphthous ulcers of the mouth. Accordingly, he now commends chewing nicotine gum that has resulted for some in a complete remission.
Smoking, too, increases the number of nicotine-sensitive receptors in the brain that in turn influences the amount of the neurotransmitter acetylcholine – providing a plausible explanation for why it reduces the risk of developing Alzheimer’s and Parkinson’s disease.
To be sure, the overall hazards of tobacco are very serious, but those with either condition might consider applying a nicotine patch daily to see if this improves matters.
All in good time
The recent item in this column considering why blood pressurelowering pills might be more effective taken in the evening has prompted much interest. The timing of medicines, it is pointed out, is important, too, for those taking certain types of statins (pravastatin and simvastatin) – and for similar reasons, as the enzymes involved in producing cholesterol in the liver have a circadian rhythm, being more active at night.
The necessary qualifications for switching pill-taking from morning to evening include those taking diuretics, where any potential benefit in improving blood pressure control is likely to be offset by the inconvenience and interrupted sleep from frequent nocturnal visits to the loo. The further possible drawback is that both beta blockers and statins may cause distressing nightmares, resulting in frequent awakenings and subsequent daytime exhaustion.
And, finally, a former pilot in his early seventies warns that blood pressure pills taken at night-time may be too effective. “I got up for my usual visit to the bathroom in the early hours,” he writes, “and that is the last I remember till my wife found me on the floor having luckily missed the Royal Doulton on the way down.”
Wind direction
This week’s medical query comes courtesy of Mrs AL from London, who reports how, over the last two years, she has periodically been overwhelmed by profound nausea and loss of appetite associated with persistent burping. This goes on for several weeks and then, quite suddenly, her symptoms disappear and all is well until a further relapse. “I have been investigated from head to toe and told there is nothing wrong,” she writes. Any suggestions would be gratefully received.
Visionary’s legacy
Last Friday, November 29, marked the 70th anniversary of the most successful operation ever conceived, the intraocular lens implant for those with cataract impaired vision. First carried out at St Thomas’ Hospital by Sir Harold Ridley, it now restores the gift of sight to more than 10million people every year. Sir Harold subsequently set up the Ridley Foundation, which currently funds surgeons in the developing world, including Nepalese ophthalmologist Sanduk Ruit in remote parts of the Himalayas. Further information and details of how to support the foundation can be found on their website, ridleyeyefoundation.org