Have you ever heard your doctor say to you “I would recommend that you quit smoking?” As the physician, I can see the look of irritation on the patients face. I would mention the risks and dangers of smoking. However, I know that all the patient is hearing is “ blah..blah..blah…”

Are you frustrated that you are told to quit smoking?

Frustrated and annoyed

I see this too often. It is only once I changed my conversation to something more relatable, that I could see my patient’s eyes open up. Their interest was piqued. I have now managed to compare smoking to Romeo and Juliet. Did you know that Shakespeare had a role in cardiovascular disease?

So how do Romeo and Juliet affect your life? Well, first I need to explain the pathophysiology of smoking and free radicals. What do free radicals do to your body? Your first lesson in organic chemistry: Free radicals are atoms that have an unpaired electron. This makes the atom highly unstable. Once the cigarette is lit and the first breath of smoke is drawn into the lungs, the unstable atoms are in the smoke. This atom missing an electron is called a free radical. I have called the free radical ‘Romeo’.

The free radical attacks the blood vessels

Our free radical, Romeo, is crazy in love. He is literally bouncing off the walls looking for his Juliet, Juliet is the missing electron. In fact, he will do absolutely anything to find Juliet. It is merely a matter of time before he bounces up against an endothelial cell. This is the cell that makes up the lining of the blood vessel. The endothelial cell may line a blood vessel that is perhaps passing through the lung or it may be the lining the blood vessel which takes oxygen to the heart. It may be in the blood vessel that feeds the nerves in your feet or it may be in the blood vessel that feeds your eyeball or your brain.

The free radical damages the blood vessels

Somewhere in your body once you have inhaled the smoke, Romeo will bounce up against an endothelial cell. Romeo will steal an electron and in doing so Romeo then finds his Juliet. When Romeo finds Juliet, he is complete. This means that he has found his missing electron and he is now stable. The problem now is that your blood vessel got damaged in the process.

Your body fixes the damage by building plaque

Your blood vessel has just suffered an ‘oxidative insult’ and will try to fix the problem by sending a blood clot to the area or developing a scab that then later becomes an atherosclerotic cholesterol plaque. The plaque that develops could be in any blood vessel. As mentioned above, damage from smoking can occur in the form of coronary artery disease where you can have a heart attack. It can cause peripheral vascular disease where you develop ulcers on your legs due to the poor blood supply and this can lead to amputations of a limb. It can cause a stroke where your brain is damaged and can result in permanent disability or death.

Long term damage from smoking can lead to coronary artery disease and result in a heart attack

Smoking causes cancer

The damage of smoking is insidious. You don’t see the consequences of the free radical damage until many years later. In addition to the vascular consequences, it can also cause cancer. The free radical damages the lung tissue and interferes with the DNA repair in the cells. This damage leads to cancer. Yes: many different types of cancer. It can cause lung cancer, bladder cancer and head and neck cancers. In addition, the smoking damages the lung tissue and can cause emphysema or COPD. This is where you are struggling to breath and may be oxygen dependent.

Change your lifestyle


Stop smoking:
Photo by Steven Pahel on Unsplash

How can you solve this free radical assault on your body? Well clearly you already know the answer to this one. Stop smoking, stop vaping, stop inhaling anything that is not just regular air that you were born to breathe.

Eat a healthy nutritious low glycemic index diet

The next thing you need to do is change your lifestyle. You should eat a healthy nutritious low glycemic index diet (low processed food) that is rich in antioxidants. Antioxidants are essentially atoms with an extra electron to share. Antioxidants neutralize the free radical and make Romeo happy and prevent your blood vessel from an attack. So how do you get antioxidants? You should eat fruits and vegetables that are bright in color. Brightly colored foods tend to have lots of antioxidants. Another important aspect that needs to be controlled in your life would be your blood sugar. High blood sugar and especially in poorly controlled Diabetes leads to similar damage in the blood vessel.

Brightly colored fruits and vegetables are antioxidants that fight free radicals

Fake it until you make it!

Plenty of patients say it is not that easy to quit. Though the smoker is aware of the social implications such as the taste and smell of smoke and that is off-putting to a non-smoker, the person still finds it is challenging to quit. I have found that explaining the pathophysiology is enlightening to them. I have suggested that they think of Romeo and Juliet when they are smoking. They should imagine that their body is the playground for this Shakespearean couple. I suggest holding carrots and celery sticks in the fingers when in moments of needing that oral-tactile stimulation. They can fake it with a carrot!

Medications to help you quit smoking

There are medications that can be used such as Nicotine patch, Wellbutrin and Chantix to help quell the desire to smoke. Ultimately, I think it is mind over matter!

Quit smoking before you have problems

When I was 7 years old, I watched a short video clip in my classroom called “I am Joe’s lung”. It was about an elderly man who was a smoker and was still a smoker with COPD and requiring oxygen, despite having had a
laryngectomy due to laryngeal cancer. He could not talk without covering up his airway and he used a special “ box” to communicate through. I was horrified! I immediately started working towards getting my father to quit smoking.

You can quit today!

My chore when I was 7 years old was to set the dining room table with the tablecloth, knives, and forks. If I found my dad’s cigarettes on the kitchen counter, I would hide the full boxes in the serving cabinet. My goal was to limit his access to cigarettes and stop him from smoking. One Sunday afternoon, my dad set the table when I was out. He found out that I was hiding his cigarette boxes in the serving cabinet. My father quit smoking ‘cold turkey’. He realized that I was willing to get into trouble in order to help prevent my dad from smoking. Smoking is a habit just like any other. It has catastrophic consequences in your body. Think about Romeo and Juliet the next time you light up.

Contact me at info@adoctorsview.com if you need more information on how to improve your health, how to quit smoking and start living life.