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Department
of Podiatry - Vascular Assessment
Smoking
As
is well documented, and encouraged in informed Western society of the
past 30 years, smoking of tobacco is bad for a person’s health. As
health practitioners, the podiatrist should whole-heartedly encourage
patients to not smoke, regardless of their age, gender, vascular, and
medical history. Regardless of whether or not smoking increases risk for
peripheral vascular disease, smoking has dramatic affects on the lungs,
and build-up of tar and other particles in the blood stream (Bowker et
al, 2001).
Having said that, the public is largely unaware of the effects smoking
may have on their lower extremities. It has been suggested that smoking
is the most significant predisposing factor to atherosclerotic peripheral
arterial disease (Levy, 1992).
McGill (1998) proposed that smoking accelerates the natural development
of atherosclerosis by an increase in white blood cell count and a decrease
in high density lipoproteins in the blood plasma. Trap-Jenson (1988) concluded
cigarette smoking increases plasma catecholamine levels, inducing vasoconstriction.
Levy (1992) also stated there is a decrease or partial resolution of both
Buerger’s disease and occlusive arterial disease in heavy smokers
that reduce or stop smoking. He also found a relationship between the
severity of pathology and the daily amount of cigarettes smoked.
As mentioned, the podiatrist's role here is one of education, and should
especially be so for patients with diabetes,
as they are already at an increased risk for developing arterial disease
regardless of their smoking status (Levy, 1992).
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