Stay alert for the possibility that medical conditions were being masked and hidden by your dependency.
Smokeless tobacco introduces more than 2,550 chemicals into the body.[1] A burning cigarette gives off more than 4,000. A mini-pharmacy, these chemicals are capable of hiding a host of medical conditions, including some caused by tobacco use. One that some quickly notice is difficulty breathing.
"Why am I having trouble breathing?
It's like I need to keep breathing in deeply,
breath after breath after breath."
Rarely a day passes in overseeing our Internet sites (WhyQuit, Joel's Library, Turkeyville, or our YouTube videos) without the arrival of an email or message inviting us to play Internet doctor.
Although well-intended, I am a cessation educator who teaches recovery, including symptom possibilities.
I am not a trained and skilled physician, qualified to evaluate, diagnose, and treat actual conditions. Even though the symptom being described may sound like normal recovery, how could I possibly know the actual cause? I'd be guessing.
Difficulty breathing or shortness of breath is not normal.
Still, such concerns are not uncommon. When I hear them, my first thoughts are outrage and sadness. This could be a smoking-induced breathing disorder that until now tobacco industry cigarette engineering had kept hidden.
But again, I'd just be guessing. Instead, I tell them it isn't normal, that they need to get seen by a doctor as soon as possible.
How wrong and damaging could guessing be? Shortness of breath can be caused by "lung disease, asthma, emphysema, coronary artery disease, heart attack (myocardial infarction), interstitial lung disease, pneumonia, pulmonary hypertension, rapid ascent to high altitudes with less oxygen in the air, airway obstruction, inhalation of a foreign object, dust-laden environments, allergies (such as to mold, dander, or pollen), congestive heart failure (CHF), heart arrhythmias, de-conditioning (lack of exercise), obesity, compression of the chest wall, panic attacks, hiatal hernia, or gastroesophageal reflux disease (GERD).[2]
Possible hidden conditions aside, what are the odds of someone in the first few days of recovery developing pneumonia or noticing a hiatal hernia? Never-users develop hernias too. They also catch colds, the flu and get sick.
Remain mindful that a coincidental illness or other condition could occur during recovery.
Can cigarette engineering contribute toward hiding symptoms of early asthma or emphysema? Although disputed by the tobacco industry, it's reported that cocoa may cause cigarette smoke to act as a breathing nebulizer.[3]
A chemical within cocoa, theobromine, is known to relax airway muscles and expand bronchial tubes. It's suggested that this might allow more nicotine-laden smoke to penetrate deeper and faster, resulting in a bigger hit or bolus of nicotine assaulting brain dopamine pathways sooner. In theory, this could keep the user loyal to their brand and coming back for more.
According to Philip Morris, maximum concentrations of cocoa can be up to 5%. Theobromine within cocoa accounts for 2.6% of its weight. If a cigarette contains 5% cocoa it also contains up to 1 milligram of theobromine.[4]
The tobacco industry knows that cigarette smoking constricts lung bronchial tubes,[5] that theobromine relaxes bronchial muscles, and that in competition against theophylline, a chemical used in breathing nebulizers, theobromine compared favorably in improving breathing in young asthma patients.[6]
Philip Morris argues that it is "unlikely" theobromine in cocoa added to cigarettes can produce "a clinically effective dose."[7] Once secret industry documents evidence ongoing industry monitoring of both cigarette cocoa and licorice extract levels for at least three decades. Licorice extract contains glycyrrhizin which some contend is another means by which cigarettes act as bronchodilators.
But Philip Morris says its research shows that licorice extract is "pyrolyzed extensively" (decomposed due to heat), by the up to 900-degree temperatures found in cigarettes.[8]
Although additives have likely changed significantly since 1979, a Brown & Williamson report then documented that cigarette brands containing more than 0.5% cocoa included: Belair, Benson & Hedges, Camel Lights, Doral, Kool Super Lights, Marlboro Lights, Merit, Now, Salem Lights, Tareyton Lights, Vantage, Viceroy Lights and Winston Lights.
Brands then containing more than 0.5% licorice included: Belair, Benson & Hedges, Camel Lights, Marlboro Lights, Merit, Parliament, Pall Mall Lights, Salem Lights, Tareyton Lights, Vantage, Viceroy Lights and Winston Lights.[9]
Other possible once hidden health conditions include thyroid problems masked by iodine in tobacco,[10] chronic depression masked by nicotine,[11] and ulcerative colitis, also somehow suppressed, hidden or controlled by nicotine.[12]
Remember, nicotine is not medicine. It is a natural poison.
References:
2. National Institutes of Health and U.S. National Library of Medicine, Breathing difficulty, Medline Plus, Medical Encyclopedia, web page updated April 12, 2007, http://nlm.nih.gov/medlineplus/ency/article/003075.htm
3. ASH, Tobacco Additives, cigarette engineering and nicotine addiction, July 14, 1999, http://old.ash.org.uk/html/regulation/html/additives.html; as brought to my attention by Schwartz, L, "I'm an ADDICT! Hooray!" March 2, 2002, https://whyquit.com/freedom/i-am-an-addict-hooray.html
4. Philip Morris USA, TMA Presentation on Cocoa to the Department of Health, Carmines, October 18, 1999, Bates #2505520057
5. Hartiala J, et al, Cigarette smoke-induced bronchoconstriction in dogs: vagal and extravagal mechanisms, Journal of Applied Physiology, October 1984, Pages 1261-1270.
6. Simons FE, The bronchodilator effect and pharmacokinetics of theobromine in young patients with asthma, The Journal of Allergy and Clinical Immunology, November 1985, Volume 76(5), Pages 703-077.
7. Philip Morris USA, TMA Presentation on Cocoa to the Department of Health, Carmines, October 18, 1999, Bates #2505520057
8. Carmines EL, Toxicologic evaluation of licorice extract as a cigarette ingredient, Food and Chemical Toxicology, September 2005, Volume 43(9), Pages 1303-1322.
9. Brown & Williamson Tobacco Corporation, Cocoa & Licorice Contents of Competitive Hi-Fi Cigarettes, June 12, 1979, Bates #680224319
10. Vejbjerg P, The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency, European Journal of Epidemiology, 2008, Volume 23(6), Pages 423-429.
11. Covey LS, et al, Major depression following smoking cessation, American Journal of Psychiatry, February 1997, Volume 154(2), Pages 263-265.
12. Lakatos PL, et al, Smoking in inflammatory bowel diseases: good, bad or ugly? World Journal of Gastroenterology, December 14, 2007, Volume 13(46), Pages 6134-6139.
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