The process of smoking directly involves your respiratory tract: nose, mouth, throat, and lungs you inhale the smoke and exhale it out; so it makes sense when you hear that smoking causes breathing and lung-related problems such as cough, wheezing, emphysema, and lung cancer. However, smoking also affects circulatory ability and hence the body's process to heal!

In a non-smoker, healing of a bone fracture by growing 1 cm of new bone takes 69.6 days. Yet, that same physiological process takes 89.4 days in smokers. Why is there a difference in healing rates? Healing rates are directly affected by blood flow and in smokers blood flow is impaired.

Smoking-induced circulatory disease (which is essentially damage to the blood flow systems of the body) actually causes more deaths than lung-associated diseases. Another alarming fact is that circulatory system damage starts early on in the course of smoking!

What is the circulatory system? The circulatory system is composed of our heart and all the associated pipelines that transport blood to tissues of the body and then bring them back to the heart (arteries, veins and capillaries). Blood is an important component because it carries oxygen and vital nutrients to tissues and organs. The blood vessels (pipelines) need to be clean and unobstructed on the inside to transport blood through them.

The smoke from cigarettes has a molecule called carbon monoxide that damages the smooth inside walls of these vessels and as a result substances such as plaques and fat can start to stick onto them. These adherent substances start to build up in the vessels and slow the transport of blood. However, carbon monoxide is not the only culprit in smoking causing circulatory disease. Nicotine is another compound that worsens circulatory disease.

Nicotine plays two roles that can greatly exacerbate circulatory disease. 1) It activates the sympathetic nervous system which is the fight or flight" mode in our bodies this increases blood flow and now this blood has to be forced through the clogged vessels and 2) the fight or flight" mode triggers a release of stored fats as a mechanism for instant energy. This increase in fats has a greater probability of attaching themselves into our blood vessels damaged by carbon monoxide and further impeding blood flow!

If only the damage to the circulatory system caused by smoking stopped here! Not only does nicotine increase blood flow and mobilization of fats into the bloodstream, nicotine has been found to promote angiogenesis (the growth of new blood vessels) to supply nutrients and oxygen to the blobs of fat that have attached themselves to our blood vessels! In other words, nicotine basically causes growth of vessels within vessels!

What is the outcome of this vessel growth phenomenon? The arteries and veins of a smoker become more clogged, narrowed and now become less elastic. The damage becomes more profound when these events occur within the coronary arteries (the arteries that supply the muscles of the heart). Remember, the heart is a muscle that also requires oxygen and nutrients so that it can pump blood to oxygen and nutrients to organs and tissues to other areas of the body. If the muscles of the heart do not receive enough oxygen, they will start to die and this causes heart attacks (also known as a myocardial infarction). If a certain area of the brain is deprived of oxygen due to impaired blood flow, a stroke can occur!

Smokers are always considered risky surgical candidates because of their poor healing ability. In terms of healing, an injury such as a cut or fracture at the foot is less likely to heal completely with there is circulatory disease present. So many signs and symptoms of smoking can be attributed to the impaired blood vessel flow: tooth loss, hair loss, wrinkles in the skin and early aging.

The foot is affected by poor circulation because medical conditions such as ulcerations, sores or infections and has reduced ability to heal. In some cases, circulatory disease is so bad special intervention is required for proper healing. Your podiatrist can assess your circulation status by evaluating your health and habits. In addition, your doctor will advise you on proper footwear to prevent trauma and accidents. If footwear produces excess pressure in an area, your skin can breakdown causing more problems. Your podiatrist will also provide foot care such as trimming calluses and toenails! Prevention of injury is of the utmost importance in a smoker since healing is a challenge due to circulatory disease.

Remember, the best way to stop circulatory disease is to stop smoking!