Heart. Johannes Hinrich von Borstel

rather a lot of unwanted material collects in the lungs, making our breathing apparatus more susceptible to infection and other causes of illness.

      Nicotine and tobacco smoke also reduce the concentration of ‘good’ HDL cholesterol in the blood, and increase that of ‘bad’ LDL cholesterol.^* Furthermore, they thicken the blood and damage the inner wall of the blood vessels. This is one of the main causes of arteriosclerosis,^† a real roundhouse punch with negative consequences for our cardiovascular system. It’s no wonder, then, that in Germany alone, 110–140,000 people die every year from the effects of smoking. In the US, the figure is 480,000; in Britain, it’s 100,000; while in Australia, it’s 15,000.

      If, to make matters even worse, these effects are combined with other risk factors for heart attacks, such as high blood pressure, increased blood-cholesterol levels, and life as a couch potato who’s on first-name terms with every McDonald’s employee in town, the risk of cardiovascular disease can reach enormous proportions. In addition, smoking is one of the main causes of peripheral arterial occlusive disease (PAOD), known to most non-medics as smoker’s leg.

      In this condition, the blood vessels of the legs become so damaged by deposits of fat and plaque that the patient has difficulty walking any distance. Sufferers have to take a break every few metres. Since this behaviour resembles that of a window-shopper, stopping regularly and often to admire window displays in town, it is sometimes known as ‘window-shopping disease’. A walk round the shops is supposed to be a pleasant experience, but in serious cases of PAOD, the undersupplied tissue can die off, and must be surgically removed.

      Furthermore, tobacco smoke also affects our immune system, weakening it enormously. Men may smoke more and be more likely to suffer from vascular disease, statistically speaking, but that doesn’t mean that smoking isn’t also extremely dangerous for women. Especially women who take the birth-control pill. The contraceptive pill can increase the risk of the blood vessels becoming blocked by blood clots — a condition known as thrombosis. If a woman smokes while she’s on the pill, she is combining two risk factors and thus hugely increasing the likelihood of negative medical consequences.

      All this means that, when it comes to smoking, there can be only one sensible decision: to kick the habit as quickly as possible. Even long-time smokers will really be doing their bodies a favour by quitting, since many studies show that an ex-smoker’s body will begin to regenerate soon after that last cigarette — slowly, admittedly, but continuously. Ah, that last cigarette; it really is the best one!

      The first positive changes kick in just 20 minutes after the final puff. In that time, the ex-smoker’s blood pressure will have returned to the level it was at before that last cigarette. The body’s blood circulation and temperature begin to return to normal. After about half a day, the amount of carbon monoxide in the ex-smoker’s blood will have sunk to a safe level. This allows the blood corpuscles to deliver pure oxygen to our cells once again. After just one day, therefore, giving up smoking will already have helped the heart. And that considerably reduces the risk of a heart attack.

      Two days after quitting, we begin to smell better, and I don’t just mean our body odour, but also, more importantly, our sense of smell. At the same time, our sense of taste begins to regenerate, which increases our quality of life immensely. The taste of ripe Italian tomatoes can now really blow your socks off!

      After two weeks, our lungs begin to perform better, and even after just a month, the cilia will have regained their pre-smoking functionality. This means much less coughing to expel mucous and dust from our breathing apparatus. The result is that we suck more fresh air into our lungs with each breath we draw.

      Once six months have passed since that final cigarette, the risk of suffering a heart attack will have sunk by half. And if an ex-smoker holds out for another six months — so, a whole year in total — then his or her risk of dying due to the effects of smoking will be about half as high as it was immediately after that last cigarette. Then the worst is over, although the danger of slipping back into old ways remains present for years.

      I know this from personal experience. In my final years at high school and during my paramedic’s training, I no longer smoked. But when I went to Vienna to study, one single drag on a cigarette was all it took to put me back where I was at the time I stopped smoking. Unfortunately, we humans have an excellent memory when it comes to addictions. Even years after we quit, our body remembers how great the feeling was when we indulged our addiction. By contrast, the negative effects are soon forgotten. The simple fact is that our brains are greedy for dopamine.

      Luckily, human beings also have the capacity to conquer their urges. For those who manage to quit permanently, their risk of suffering a heart attack will fall to the same level as a non-smoker within 15 years. It really is worth doing more than just thinking about quitting.

      There’s also no reason to be afraid of withdrawal symptoms after quitting smoking. It is true: lack of concentration, increased irritability, and often bouts of sweating and nausea make life difficult at first; but, when you think about it, these are positive signs! They show that the body is adjusting to the new, altered circumstances it now finds itself in. So the best thing to do is simply grin and bear it, and to make sure you never have to go through it again!

Bomb Shots for the Heart