Lagrue G, Branellec A, Lebargy F
INSERM U139, hôpital Henri-Mondor, Créteil.
Rev Prat. 1993 May 15;43(10):1203-7.
Tobacco is one of the major toxic agents in our civilization. The extent and severity of the current smoking epidemics are due to the use of industrial cigarettes: their smoke, less irritant than that of cigars and pipe, can be inhaled intensively with rapid absorption of all toxic compounds. Tobacco smoke is composed of a gas phase (CO2, CO, CNH, etc.) and a particle phase (a very fine aerosol) in which more than 4000 substances have been identified. The main toxic compounds in tobacco are Co, nicotine and tars. CO binds to haemoglobin to form COHb, a major factor of hypoxia and vascular accidents. Within a few seconds, nicotine reaches the brain where it binds to specific receptors, which explains its psycho-active effects (psychological dependence) and the induction of physical dependence. This dual dependence is responsible for the failures and relapses observed in attempted withdrawals. Furthermore, nicotine stimulates the sympathetic system with hypersecretion of catecholamines resulting in vascular complications. Tars contain carcinogenic substances, such as aromatic hydrocarbons, which exert local effects on the respiratory tract and systemic effects since they are absorbed by the lungs; this explains the remote neoplasias such as cancer of the bladder. Tars also contain irritant agents (acrolein, formaldehyde, etc.) and oxidative substances responsible for chronic bronchitis and emphysema. Thus, all organs and tissues can be damaged by the toxic compounds that are present in tobacco and, in particular, in tobacco smoke.
烟草是现代社会主要的有毒物质之一。当前吸烟流行的广度和严重程度归因于工业卷烟的使用:其烟雾比雪茄和烟斗的烟雾刺激性小,可被大量吸入,所有有毒化合物能迅速被吸收。烟草烟雾由气相(二氧化碳、一氧化碳、氢氰酸等)和颗粒相(一种极细的气溶胶)组成,已在其中鉴定出4000多种物质。烟草中的主要有毒化合物是一氧化碳、尼古丁和焦油。一氧化碳与血红蛋白结合形成碳氧血红蛋白,这是导致缺氧和血管意外的一个主要因素。几秒钟内,尼古丁就能到达大脑并与特定受体结合,这就解释了其精神活性作用(心理依赖)和身体依赖的产生。这种双重依赖导致了戒烟尝试中出现的失败和复吸现象。此外,尼古丁刺激交感神经系统,导致儿茶酚胺分泌过多,进而引发血管并发症。焦油含有致癌物质,如芳香烃,它们对呼吸道产生局部影响,并因被肺部吸收而产生全身影响;这就解释了诸如膀胱癌等远处肿瘤的发生。焦油还含有刺激性物质(丙烯醛、甲醛等)和导致慢性支气管炎和肺气肿的氧化物质。因此,烟草尤其是烟草烟雾中存在的有毒化合物会损害所有器官和组织。