8.9.4 Smoking
The wide range of negative impacts on individual health and vitality should be encouragement enough
to avoid smoking, yet nicotine addiction remains. With approximately 500 chemicals and a host of
negative symptoms present, giving up smoking could be the best choice any individual could make. This
should be obvious from the fact that approximately 420,000 people die each year in smoking-related
deaths, and 300,000 cases of second-hand smoke-related illnesses are reported.
With respect to a number of factors, smokers increase their risk of ascent-related pulmonary barotrauma
such as AGE. First, nicotine increases blood pressure, ones heart rate and coronary vasoconstriction.
Second, smoking introduces tar and nicotine, which cause increased bronchospasm, depressed cilial
activity, and increased mucus production. These factors may lead to intrapulmonary air trapping and
increased pulmonary infection.
Carboxyhaemoglonin levels in smokers range from 5% to 9%, with significant psychomotor effects
being reported from exposure to this level of carbon monoxide (Diving and Subaquatic Medicine,
1992). Furthermore, with smoking, ones general fitness capacity declines. Increased heart rate, and
decreased stroke volume (the opposite effect of aerobic training), is commonplace. Reduced blood
volume also results from prolonged smoking, which undermines the hydration attempts of responsible
divers. Lastly, increased congestion from smoking is also likely to predispose individuals to sinus and
middle ear barotrauma.
Approximately 15% of a smokers hemoglobin is bound to carbon monoxide, thereby reducing
circulatory efficiency. When called upon to transport required oxygen to tissues and to remove carbon
dioxide, bound hemoglobin are helpless to assist, reducing oxygenation and increasing CO2 levels. In
addition to its potential for increasing DCI risk, smoking place the diver in serious peril by limiting
oxygen intake precisely when it is needed most. Furthermore, there are many indications that CO2 plays
a prominent role in a host of physiological problems, and is likely a key component in episodes of
oxygen toxicity. In general, there are likely few things that rank as highly for general physical
degradation as does smoking.