How Smoking and Vaping Affect Your Sinus Health

Audio Transcript:

Dr. Reddy
Hey guys, welcome to another episode of NJENT’s podcast called We Nose Noses. I’m Dr. Reddy, I’m joined by my partner, Dr. Undavia today. And we will be discussing a topic today that a lot of patients have questions about, and that is regarding smoking and vaping, and how does that affect your nose and sinus health? So maybe Dr. Undavia, maybe you can give a little bit of background on this.

Dr. Undavia
Well, what is the problem with smoking? In general, first, just from a physiological perspective, smoking is bad for many reasons. But the reason that we’re talking about is that smoking produces something called carbon monoxide. And carbon monoxide binds to red blood cells in the same place where oxygen should bind to blood cells. But it does so in a way that’s irreversible.

If you are normally taking a breath of air in, oxygen goes and attaches to the red blood cell and then the red blood cell delivers that oxygen to wherever it is needed. However, if you smoke cigarettes or vape, the carbon monoxide is attaching to those same red blood cells. They go to the area where the oxygen is needed, but it cannot deliver oxygen. It can’t even release the carbon monoxide. So now that red blood cell permanently has carbon monoxide on.

So you’ve effectively taken the amount of oxygen that’s still required for your cells and decreased the delivery of oxygen to your cells. And so every red blood cell turns over on itself every 90 days. So new red blood cells are always being produced and they last about 90 days. So in order to get rid of that red blood cell, takes 90 days. Smoking also does a lot of stuff to our sinuses.

I’ll talk about some of them. So it, it acts as an irritant to some of the lining. So your nose normally makes a lot of mucus and you have lots of little hair cells inside your nose called cilia. And the mucus is cleared out by this, by the cilia. So your nose makes a mucus and then it sweeps it out. And that’s really a cleaning function, right? The mucus attaches to any debris, any irritants in the, in the air, it takes them and it removes them from the nose. But the smoking irritates the ocelia and then they can’t sweep the mucus out. So the mucus ends up staying there in your nose and patients sometimes get a little bit stuffy because of it. They actually get more sick because of it. Allergens might hang out in their nose more often. It’s generally a very uncomfortable feeling. Patients often come to the office saying they’re always getting sick in their nose. Well, part of the reason might be that it’s just because they’re smoking. It’s not because they’re exposed to any more sickness than any of us are, but it’s just because what they are exposed to hangs out in their nose for longer.

Dr. Reddy
And vaping is also potentially equally or maybe in some cases, maybe more irritating to the nose and sinuses than traditional smoking is. know, with traditional smoking, you’re burning the tobacco and you get a lot of irritants from a lot of the extra chemicals and extra part of the cigarette that’s being burned. With vaping, you get a higher concentration of the nicotine and maybe less of those other irritants, but the nicotine itself can be harmful. You know, some practical question I get sometimes asked from patients is, you know, if I’m smoking through my mouth, why is my nose and sinus affected? Right? You’re not, you’re not necessarily inhaling the smoke directly through your nose and sinuses. And the reason for that is one, I mean, you’re eventually going to be breathing through your nose and you’re in an environment where there’s smoke there. So it’s going to get in that way, but a lot of times people don’t realize that when you’re breathing through your mouth, some of those chemicals kind of hang out in the back of your throat and you get retro kind of breathing of the smoke. So it goes into the back of your throat and it actually goes from the back up into your nose and sinuses above your soft palate. And so that’s kind of one of the ways. But also nicotine affects some of the microvasculature in the entire head and neck.

So the entire head and necks, the little blood vessels in your head and neck called the capillary systems, which are the smaller branches of your arteries and arterioles, those can get partially blocked. And when those get partially blocked, the nose and sinuses may not be able to withstand like allergens and viruses as easily because the nose and sinuses aren’t able to fight those insults easier because of the disruption of those blood vessels.

Dr. Undavia
Yep, they’re not delivering all the cells that help you fight those infections and sweep away those allergens.

Dr. Reddy
Can you comment on patients that are going to get nose and sinus surgery or even had a neck surgery, how smoking or vaping can affect their healing process?

Dr. Undavia
Yeah, so for the very basic reason that Dr. Reddy just said, blood flow is altered when you smoke and when you vape, your healing process will definitely be slower. And there may be little nuances that we can’t necessarily predict, but we could chalk up to smoking. But I definitely noticed that our patients who smoke before and after sinus surgery, have a lot more crusting, there’s a lot more stuffy afterwards, there’s more swelling for the rhinoplasty patients. You get like the stippling inside, so it looks like the cells aren’t as healthy, like it just looks different. The nose on the outside for our rhinoplasty patients looks a little bit more red. I actually won’t even do a facelift on a patient that smokes because there’s such a high likelihood of the complication with it that we can’t. We can’t safely do that if somebody’s smoking. The question becomes like, do you try and counsel them to stop before and when do you? Because the red blood cells are already attached to that. Yeah, carbon monoxide.

Dr. Reddy
Yeah. There’s no right or wrong answer. I think the longer that you can quit smoking prior to the procedure, the better. I would say minimum two months.

Dr. Undavia
Yep.

Dr. Reddy
And even if you can’t stop smoking and you’re able to cut back significantly, I think that’s still makes a huge improvement.

Dr. Undavia
That does. And I think if, if they can switch to, like, not necessarily smoking cigarettes, but chewing gum with tobacco, with nicotine, that can be very helpful as well and bridge the gap. and then have them see a doctor about Chantix or something. Yep. From quitting perspective. Great.

Dr. Undavia
Anything else to add? No, think, don’t smoke.

Dr. Reddy
Yeah. That’s all we have for today’s episode. We’ll catch you on the next one. Thank you. Bye.

Dr. Undavia
Bye.

In extreme cases, prolonged smoking-related damage can lead to chronic sinus disease where sinus surgery might be considered as part of the treatment plan.