Smoking, Obesity/Nutrition, Sun, and the Skin
It is well-known that costs for medical problems associated with smoking, obesity, malnutrition, and sun damage are very high, making it extremely important to push the notion of prevention in all of these cases. Between 1995 and 1999, it has been estimat
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Smoking, Obesity/Nutrition, Sun, and the Skin Robert A. Norman and Max Rappaport
It is well-known that costs for medical problems associated with smoking, obesity, malnutrition, and sun damage are very high, making it extremely important to push the notion of prevention in all of these cases. Between 1995 and 1999, it has been estimated that the United States spent $157 billion in healthcare costs.1 The costs associated with medical costs in the United States attributed to inactivity alone are around $75 billion.2 Many medical issues are preventable, which an uninformed person may not realize. But information on the risks of smoking, obesity, or tanning is welldocumented and readily available. Still today there are around 1.25 billion smokers who will die an average of 7 years earlier than their nonsmoking counterparts.3 About 30% of people worldwide are considered to be obese and the numbers have been increasing dramatically ever since the 1980s.4, 5 Every year according to the World Health Organization (WHO),6 sun damage causes 60,000 premature deaths and the loss of 1.5 million disability-adjusted life years (DALYs); in addition almost 30 million Americans tan indoors every year.7 Health risks associated with these three highrisk factors have become common knowledge in many countries. Yet doctors see patients seeking healthcare related to damage done by one or more of these risks time and time again. The most difficult and expensive approach will always be to treat the complications related to a risky behavior after an accumulation of damage, thus – as with anything else in life – preventing a problem before it occurs is always the best option.
R. A. Norman (*) Nova Southeastern University, Ft. Lauderdale, Florida and Private Practice, Tampa, FL, USA e-mail: [email protected]
All three of these risky behaviors are preventable. Positive behavioral changes, even after damage, can be extremely beneficial to a person’s future health.
2.1 Smoking The dangers of smoking cigarettes have become wellknown; though the damage to the skin has been less studied. The smoke released from burning cigarettes at temperatures of 830–900°C contains some 5,000 chemicals. Many of these are hydrophobic agents that can diffuse through many cell membranes, reaching to the far ends of the body’s precious organs, including the skin.3, 8 Many of the dangerous chemicals are in the form of free radicals and oxidants, which can cause the malfunction of many biological functions and create cell damage. Smoking has been shown to increase many symptoms associated with aging: altered hormone production, reduced fertility, cancer, cardiovascular and respiratory disease, and diseases of the lung, esophagus, pharynx, larynx, stomach, pancreas, bladder, uterine, cervix, and skin.3, 8–10 Smoking causes premature aging of the skin by affecting the color, tone, and wrinkling. Smoking can also increase the risk for developing psoriasis, melanoma, squamous cell carcinomas on lips and oral mucosa, acne, and hair loss. Smoking also causes poor wound he
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