title: Are healthy smokers really healthy?
abstract: Cigarette smoke contains more than 4500 chemicals which have toxic, mutagenic and carcinogenic effects. Strong evidences have shown that current smokers take a significantly higher risk of cardiovascular diseases, chronic obstructive pulmonary disease (COPD) and lung cancer than nonsmokers. However, less attention has been paid to the smoking induced abnormalities in the individuals defined as healthy smokers who are normal with spirometry, radiographic images, routine physical exam and categorized as healthy control group in many researches. Actually, 'healthy smokers' are not healthy. This narrative review focuses on the smoking related pathophysiologic changes mainly in the respiratory system of healthy smokers, including inflammation and immune changes, genetic alterations, structural changes and pulmonary dysfunction.
authors.affiliation: Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China.
authors.forename: Zijing
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011 People's Republic of China.
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
keywords: Genetic alterations; Healthy smokers; Immune changes; Inflammation; Respiratory system