Chronic kidney disease; Cigarette; Toprak’s kidney care; Smoking cessation
CKD: Chronic Kidney Disease; LDL: Low-Density Lipoprotein
Smoking is not only a simple, innocent habit. Also is a crime to humanity. If we smoke, we are also responsible all the dies secondary to smoking in this world. Because if we do not smoke, cigarette producing companies will not be able to produce cigarettes. Since we smoke, cigarettes can be produced and millions of people die because of this. In a sense, those who produce or smoke are committing crimes against themselves and humanity. Tobacco products and especially cigarettes are a weapon of mass destruction. Its production should definitely be stopped. Almost 20 times the total number of people who die as a result of the atomic bombs dropped on Nagasaki and Hiroshima die every year from smoking [1-3]. For a thinking person, this is sufficient reason to ban the production of this poison all over the world. Smoking is responsible not only for the deaths of humans, but also of sea creatures, especially due to cigarette butts . Cigarette producers should be judged for killing people and animals and for polluting our world. Cigarette butts are the most common harmful waste in the world. A cigarette butt pollutes 7.5 liters of water within 1 hour and kills life in the water [4,5]. Cigarette butts pollute our environment, seas and oceans even more than plastic. Six trillion cigarette butts produced every year mix into the seas and oceans in the form of toxic garbage, posing a serious threat to marine life . A single cigarette butt contains enough toxic substances to kill 1 liter of aquatic fish, namely cellulose acetate, plastic, arsenic and lead [4-7]. Cigarette butts adversely affect the growth of plants. Germination and growth of plants are significantly reduced. By the way, we shouldn’t throw cigarette butts in toilets. By smoking, you are poisoning ourselves, and as if this is not enough, you poison the creatures in the sea and ocean with their butts. Every cigarette butt flushed on it kills marine life. Flushing the butts into the toilet causes them to enter the sea and oceans through sewers and pollute the oceans [4,5]. Smoking is an important cause of forest fires in the world. As a result of the fires caused by smoking, 17 thousand people and countless living creatures die around the world every year . Also, smoking disrupts the balance of the ecosystem. Approximately 5.2 billion kilograms of methane gas are released into the atmosphere annually as a result of cigarette consumption [9,10].
Smoking is associated with progression of renal disease , leads to kidney transplant failure , increases the risk for cardiovascular events and death in patients with Chronic Kidney Disease (CKD) [13,14]. Smoking causes vascular occlusion in the kidneys, causes cell damage in kidney tubules, causes insulin resistance, increases low-density lipoprotein cholesterol, increases blood pressure and makes it difficult to control hypertension, increases oxidative stress, increases endothelin-1 and vasopressin, decreases nitric oxide, causes both physical and psychological addiction, increases the risk of cancer in the kidneys, increases the risk of lung disease, chronic obstructive pulmonary disease, infertility, weakens the immune system, and increases proteinuria [15-21]. In addition, smoking causes premature aging and predisposes to infections (Figure 1). Smoking is the cause of 35% of all cancer deaths in men and 15% in women [18,19]. It shortens the life expectancy of 14.5 years in women and 13.2 years in men [2,6]. Smoking also impairs oral and dental health. Studies have shown a close relationship between smoking and dental caries [6,18]. Dental caries can lead to the progression of the patient’s kidney failure. In addition, nephrotoxic antibiotics and analgesics to be used after infection and dental caries may cause additional damage to the kidneys. Cigarette smoke contains thousands of chemical compounds, 250 of which are toxic. More than fifty of them cause cancer [9,19,20]. Carbon monoxide, formaldehyde, hydrogen cyanide, nicotine, naphthylamine, cadmium, tar and arsenic are just some of these chemicals. All these poisons also damage the kidney. Around 8 million people die every year in the world from smoking and smoking related causes [22,23]. Smoking cessation decreases the risk of kidney failure . In the light of all this information, smoking of a CKD patient is officially nothing more than suicide. Not only CKD patients but also no people should smoke. Smoking for a CKD patient is the same as shooting a bullet in the head.
Smoking is the main cause of preventable deaths . Cigarettes are smoked nearly 20% of the world’s population. Nearly %90 of adult smokers began smoking at or before age 18 . It is unacceptable for millions of children and adults around the world to smoke. If only smoking is quit, deaths from cancer all over the world will be greatly reduced and the deaths of millions of people around the world will be prevented. When a smoking CKD patient stops smoking almost all systems and organs begin to regenerate and kidney impairment begins to slow or even reverse. The immune system is strengthened, the progression to end stage kidney disease and proteinuria slows down, cardiovascular mortality decreases, stroke risk decreases, cancer risk decreases, lung functions are improved and as a result, quality of life increases [11,23]. The annual cost of smoking to the world economy is 1 trillion 400 billion dollars . An average of $ 1.5 trillion annually is spent on dialysis and other CKD treatments. With this money, no patient in underdeveloped or developing countries will die because they cannot undergo dialysis. If the money spent on cigarettes was spent for hungry people, not a single person in the world would go hungry and nearly 30 thousand people who die of hunger every day would not die.
In our CKD patients, as a part of our kidney care program which name is Toprak’s Kidney Care, we prohibit the use of not only cigarettes but also all forms of tobacco products such as waterpipe tobacco, chewing tobacco, cigars, cigarillos, pipe, electronic cigarettes, bidis and kreteks [27,28]. We quit smoking around 98% of our CKD patients only through Toprak’s Kidney Care, by raising awareness of patients and their relatives, by supporting them, and by providing moral and motivational support. The COVID-19 pandemic is the best time to quit smoking. Because the risk of death due to COVID-19 infection is 14 times higher in smokers . Already, CKD patients are more prone to COVID-19 infection, and if they smoke a cigarette, they officially invite death.
It is very important for the health of patients with CKD to stay away from smoking. Our message to smokers is “Stop smoking if you respect yourself, your family, your environment, animals, seas, forests and the whole world”. If you quit smoking, those who produce cigarettes will not be able to produce.
- Shimizu Y, Kodama K, Nishi N, Kasagi F, Suyama A, et al. (2010) Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003. BMJ 340: b5349.
- Thun MJ, Carter BD, Feskanich D, Freedman ND, Prentice R, et al. (2013) 50-year trends in smoking-related mortality in the United States. N Engl J Med 368: 351-64.
- Grant EJ, Furukawa K, Sakata R, Sugiyama H, Sadakane A, et al. (2015) Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study. Lancet Oncol 16: 1316-1323.
- Dobaradaran S, Soleimani F, Akhbarizadeh R, Schmidt TC, Marzban M, et al. (2021) Environmental fate of cigarette butts and their toxicity in aquatic organisms: A comprehensive systematic review. Environ Res 195: 110881.
- Pirozzi C, Scholand MB (2012) Smoking cessation and environmental hygiene. Med Clin North Am 96: 849-867.
- Baraona LK, Lovelace D, Daniels JL, McDaniel L (2017) Tobacco Harms, Nicotine Pharmacology, and Pharmacologic Tobacco Cessation Interventions for Women. J Midwifery Womens Health 62: 253-269.
- Guan WJ, Zheng XY, Chung KF, Zhong NS (2016) Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action. Lancet 388: 1939-1951.
- Smith J, Bullen C, Laugesen M, Glover M (2009) Cigarette fires and burns in a population of New Zealand smokers. Tob Control 18: 29-33.
- Morgan JC, Byron MJ, Baig SA, Stepanov I, Brewer NT (2017) How people think about the chemicals in cigarette smoke: a systematic review. J Behav Med 40: 553-564.
- Moeller DW, Sun LS (2010) Chemical and radioactive carcinogens in cigarettes: associated health impacts and responses of the tobacco industry, U.S. Congress, and federal regulatory agencies. Health Phys 99: 674-679.
- Lee S, Kang S, Joo YS, Lee C, Nam KH,et al. (2021) Smoking, Smoking Cessation, and Progression of Chronic Kidney Disease: Results From KNOW-CKD Study. Nicotine Tob Res 23: 92-98.
- Anis KH, Weinrauch LA, D'Elia JA (2019) Effects of Smoking on Solid Organ Transplantation Outcomes. Am J Med 132: 413-419.
- Staplin N, Haynes R, Herrington WG, Reith C, Cass A; SHARP Collaborative Group (2016) Smoking and Adverse Outcomes in Patients With CKD: The Study of Heart and Renal Protection (SHARP). Am J Kidney Dis 68: 371-380.
- Nakamura K, Nakagawa H, Murakami Y, Kitamura A, Kiyama M,; EPOCH–JAPAN research group (2015) Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease. Kidney Int 88: 1144-1152.
- Cedillo-Couvert E, Ricardo AC (2016) Smoking, Vascular Events, and ESRD in Patients With CKD. Am J Kidney Dis 68: 338-340.
- Pourmand G, Alidaee MR, Rasuli S, Maleki A, Mehrsai A (2004) Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study. BJU Int 94: 1310-1313.
- Onor IO, Stirling DL, Williams SR, et al. (2017) Clinical Effects of Cigarette Smoking: Epidemiologic Impact and Review of Pharmacotherapy Options. Int J Environ Res Public Health 14: 1147.
- Huang C, Shi G (2019) Smoking and microbiome in oral, airway, gut and some systemic diseases. J Transl Med 17: 225.
- Gottlieb J, Higley C, Sosnowski R, Bjurlin MA (2016) Smoking-related genitourinary cancers: A global call to action in smoking cessation. Rev Urol 18: 194-204.
- Parkin DM, Pisani P, Lopez AD, Masuyer E (1994) At least one in seven cases of cancer is caused by smoking. Global estimates for 1985. Int J Cancer 59: 494-504.
- Jo W, Lee S, Joo YS, Nam KH, Yun HR, et al. (2020) Association of smoking with incident CKD risk in the general population: A community-based cohort study. PLoS One 15: e0238111.
- GBD 2015 Tobacco Collaborators (2017) Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet 389: 1885-1906.
- Jha P (2020) The hazards of smoking and the benefits of cessation: a critical summation of the epidemiological evidence in high-income countries. Elife 9: e49979.
- Samet JM (2013) Tobacco smoking: the leading cause of preventable disease worldwide. Thorac Surg Clin 23: 103-112.
- St Claire S, Fayokun R, Commar A, Schotte K, Prasad VM (2020) The World Health Organization's World No Tobacco Day 2020 Campaign Exposes Tobacco and Related Industry Tactics to Manipulate Children and Young People and Hook a New Generation of Users. J Adolesc Health 67: 334-337.
- Makate M, Whetton S, Tait RJ, Dey T, Scollo M, et al. (2020) Tobacco Cost of Illness Studies: A Systematic Review. Nicotine Tob Res 22: 458-465.
- Toprak O, Bozyel EA, Alp B, Kirik A (2021) Discontinuation of Hemodialysis After 8 Years in Favor of Toprak’s Kidney Care in a Patient with End-Stage Kidney Disease. Am J Case Rep 22: e930857.
- Toprak O, Bozyel EA, Alp B. (2021) Discontinuing Hemodialysis with Patient Care and a Successful 9-Year Follow-up in a Patient Presumed to have End-Stage Kidney Disease Scheduled to Lifelong Hemodialysis: A Case Report. Clin Pract 11: 131-142.
- Patanavanich R, Glantz SA (2020) Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine Tob Res 22: 1653-1656.