title: Adverse effects of cigarette and noncigarette smoke exposure on the autonomic nervous system: mechanisms and implications for cardiovascular risk.
abstract: This review summarizes the detrimental effects of cigarette and noncigarette emission exposure on autonomic function, with particular emphasis on the mechanisms of acute and chronic modulation of the sympathetic nervous system. We propose that the nicotine and fine particulate matter in tobacco smoke lead to increased sympathetic nerve activity, which becomes persistent via a positive feedback loop between sympathetic nerve activity and reactive oxidative species. Furthermore, we propose that baroreflex suppression of sympathetic activation is attenuated in habitual smokers; that is, the baroreflex plays a permissive role, allowing sympathoexcitation to occur without restraint in the setting of increased pressor response. This model is also applicable to other nontobacco cigarette emission exposures (e.g., marijuana, waterpipes [hookahs], electronic cigarettes, and even air pollution). Fortunately, emerging data suggest that baroreflex sensitivity and autonomic function may be restored after smoking cessation, providing further evidence in support of the health benefits of smoking cessation.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California. Electronic address: hmiddlekauff@mednet.ucla.edu.
authors.forename: Holly R
authors.initials: HR
authors.lastname: Middlekauff
authors.affiliation: Renal Division, Department of Medicine, Emory University School of Medicine, and the Veterans Affairs Medical Center, Atlanta, Georgia.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Park
authors.affiliation: David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California.
authors.forename: Roya S
authors.initials: RS
authors.lastname: Moheimani
mesh_terms: D000818:Animals; D001341:Autonomic Nervous System / Q000187:drug effects / Q000502:physiology*; D017704:Baroreflex / Q000187:drug effects / Q000502:physiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology; D052638:Particulate Matter / Q000009:adverse effects; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology
chemical_list: D052638:Particulate Matter; D012906:Smoke
keywords: afferent neurons; autonomic nervous system; blood pressure; heart rate; inflammation; oxidative stress; reactive oxygen species