mini review

Cigarette Producers and Smokers are Responsible for Smoking-Related Deaths in the World and Commit a Crime Against Humanity: Smoking and Chronic Kidney Disease

Omer Toprak 1*, Burcu Y. Ozkan 2

1Department of Medicine, Division of Nephrology, Balikesir University School of Medicine, Balikesir, Turkey

2Department of Medicine, Division of Internal Medicine, Balikesir University School of Medicine, Balikesir, Turkey

*Corresponding author: Omer Toprak, Department of Medicine, Division of Nephrology, Balikesir University School of Medicine, Çagış Yerleşkesi, 10145, Balikesir, Turkey

Received Date: 04 May, 2020; Accepted Date: 10 May, 2020; Published Date: 14 May, 2020

Citation: Toprak O, Ozkan BY (2021) Cigarette Producers and Smokers are Responsible for Smoking-Related Deaths in the World and Commit a Crime Against Humanity: Smoking and Chronic Kidney Disease. J Urol Ren Dis 06: 1225. DOI: 10.29011/2575-7903.001225


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 [4]. 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 [4]. 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 [8]. 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 [11], leads to kidney transplant failure [12], 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 [11]. 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 [24]. Cigarettes are smoked nearly 20% of the world’s population. Nearly %90 of adult smokers began smoking at or before age 18 [25]. 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 [26]. 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 [29]. 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.

Figure 1: The effects of smoking on kidneys and other body systems. LDL: Low-density lipoprotein.


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Journal of Urology and Renal Diseases