Puffing their lives away

Sure, smoking is bad for you — but what happens when you combine it with something really good — like running eight miles a day?

Do you get a healthier smoker? Or an unhealthy athlete? It's one of those is-the-cigarette-half-smoked-or-half-unsmoked conundrums.

And there's no definitive answer. “If people can quit, that's the best thing,'' said Dr Robert Sallis, director of sports medicine at Kaiser Permanente Medical Centre in Fontana, California.

That seems obvious but Sallis says many of the risks associated with smoking are immediately reduced upon quitting.

He adds: “If you can't stop smoking, exercise will mitigate some of the effects.'' Lung cancer is a prime example.

Although smoking increases the risk of the disease, exercise seems to provide a protective effect.

In a 2006 study published in the journal Cancer Epidemiology Biomarkers & Prevention, women who were former smokers or smokers at present and had high levels of physical activity were much less likely to develop lung cancer than those who were sedentary.

Exercise helps

“When you exercise, it improves your cardiovascular function and your HDL cholesterol and generally, it's just good for you,'' said Dr Stanton Glantz, professor of medicine in the division of cardiology at the University of California, San Francisco.

“So if you smoke and exercise, you're going to be better off than if you smoke and don't exercise at all.'' But, he adds, smoking may also hamper athletic abilities.

“The balance is going to depend on how much you smoke and how much you exercise. But I can tell you unequivocally that people would be better marathoners if they didn't smoke.''

Inhaling cigarette smoke has a number of effects on the body that can affect performance.

Breathless

In the lungs, it increases tissue inflammation, narrowing airways and allowing less oxygen to the body.

Since working muscles need more oxygen, this could result in less strength and energy during exercise.

A recent study examining the effects of smoking cessation showed some fitness improvements after a week.

Eleven young men who smoked about a pack a day for 3-1/2 years were subjected to several tests while on a stationary bike before quitting and a week later.

The study, which was published in Medicine & Science in Sports & Exercise, showed that pulmonary functions showed no improvement but oxygen concentration increased considerably and exercise time was greatly extended.

“Part of what's happening is the irritation'' to the lungs, Glantz said. “The industrial solvents present in cigarette smoke — benzene, acrolein — and then there are the particulate matter and the tars.

"You're bathing cells in industrial-grade solvents and it's going to reduce oxygen transport.''

The effects of carbon monoxide in cigarettes while smoking and afterwards take a tremendous toll on the body, said Dr Zab Mosenifar, medical director of the Women's Guild Lung Institute at Cedars-Sinai Medical Centre in Los Angeles.

It compromises the ability of the blood's haemoglobin to transport oxygen from the lungs to the body, especially the muscles, during exercise.

Carbon monoxide molecules get attached to haemoglobin molecules, hampering the ability of haemoglobin to pick up oxygen from the lungs and deliver it to the body. “This robs the muscles of extra oxygen,'' Mosenifar said.

Nicotine, he adds, is a vasoconstrictor, narrowing the muscular wall of blood vessels and slowing blood flow.

Over time, this can even cause permanent damage to the arteries.

In denial

After years of smoking, some people may contract chronic obstructive pulmonary disease, which is a combination of emphysema and chronic bronchitis. It causes irreversible lung damage and airway obstruction.

So why do some smokers who exercise say they feel little or no effect from cigarettes? Health experts say part of it might be a degree of denial.

Age, how long they've been smoking and how much they smoke are factors. Genetics and physiology might also play a part in how the body handles the damage from cigarette smoke.

Lung and cardiovascular function have to be fairly compromised, Glantz said, for people to notice a change: “A lot of these effects accumulate over time,'' he said and smokers may not feel them until they have tremendous trouble breathing or serious heart problems.

Quitters win

People who exercise might get tired or winded sooner or feel their legs cramp up but if they have been smoking for a long time and with no significant breaks in the habit, Glantz said, they may have nothing to which they can compare it.

The good news, he adds, is that most cardiovascular effects begin to reverse with a few days of quitting.

“So if you were to take a group of athletes and have them quit for a week or two and have them do the same run again, on the average they would do better.''

Some acute effects from smoking, such as lung tissue inflammation, can go away permanently, while others, such as cancer risks, linger.

“Two cigarettes a day are enough to have adverse cardiovascular effects,'' Glantz said.

“In terms of the underlying biology, there's no question that it's affecting their cardiovascular systems in ways that are affecting their ability to exercise.''

Mosenifar, a marathoner, is not in favour of the argument that regular exercisers can use their healthy habits to justify their smoking.

“It's like someone saying, ‘I steal, but I also go to church or synagogue, so I'm doing something positive.'

"They're two separate issues. and people who smoke need to do some serious soul-searching.''

The effects of smoking

The question

Does smoking affect a person's reasoning, memory and other cognitive abilities?

A study that appeared in a recent issue of the American Journal of Public Health involved 1,964 generally healthy people (average age 56); about 21 per cent smoked, 44 per cent were former smokers and 35 per cent had never smoked.

At the start of the study, smokers scored lower on average than people who had never smoked on all tested aspects of cognition except memory; the scores were about the same.

During a five-year span, smokers' scores in all areas, including memory, declined about twice as fast as that of non-smokers. The more cigarettes smoked, the greater the decline.

Who may be affected?

People who smoke. Smoking causes lung cancer and several other types of cancer and is associated with heart disease, stroke, chronic obstructive lung disease, cataracts and an array of reproductive and early-childhood problems.

Caveats

Smoking status was determined by participants' responses to a questionnaire.