Why smoking is much more harmful to divers
by Jorge Mezcua on Feb 23, 2023
Anyone who has smoked and tried to quit several times knows how easy it is to fail. Many have tried four, five, and even ten times, with increasingly painful relapses. And even some have quit for more than a year without relapsing.
Smokers are expert procrastinators, very skilled in the art of making excuses. "As soon as I (insert a specific time here, but not too specific), I will quit smoking." People have quit drugs considered more addictive, such as cocaine or heroin, but are unable to quit smoking. Even smokers with cardiovascular disease and very advanced lung cancer have been unable to quit smoking and this has led to their death.
Trying to convince you that if you keep smoking you will die of cancer in a few years is, in my opinion, a poor strategy to fight an addictive substance as powerful as nicotine. If it doesn't kill me today, I'll probably quit tomorrow.
If you're reading this, you're probably a diver, and you know the blessed martyrdom involved in diving (expensive and time-consuming trips, early mornings, money invested in scuba gear, hauling heavy equipment while taking time away from family and friends) to merge with the blue. Many of us would be different people if we could not dive and stay in touch with the ocean. If you smoke and dive regularly, I will explain why smoking seriously endangers your life and even your dive buddy every time you go into the ocean. If you continue to smoke and dive, cigarettes will surely win the battle and you may have to stop diving.
Why divers should quit smoking
You've probably seen dozens of divers who smoke and never had a problem. I used to smoke three minutes before putting my regulator in my mouth and I have dived with divers who smoked more than a pack a day and nothing ever happened to them. And they actually use less air than a non-smoker! What you've probably never done is dive with a smoker who gets decompression sickness, probably because they can't dive again.
DAN, an organization dedicated to the study of diver safety and health, has spent years analyzing the effects of smoking on divers. One of the most striking aspects has been to discover how smoking affects divers who have experienced decompression sickness. In a study initiated in 2007 with the participation of more than 4,000 smoking divers who had suffered this syndrome, they found that the neurological damage was more severe among smokers, especially among heavy smokers of more than 20 cigarettes a day. Smoking does not directly cause decompression sickness, but if you suffer from it and smoke, chances are you will have more serious damage.
Why is it worse in smokers? Smoking damages the endothelium, a thin layer of cells in the inner zone of all blood vessels, including the heart, and we weaken it by smoking, leading to diseases such as atherosclerosis, hypertension, sepsis or thrombosis. Damage to the endothelium blocks our arteries, and when we suffer from decompression sickness, the bubbles that travel through our circulatory system can cause strokes in various areas, including the brain. There is no need to wait for a cancer to cause irreversible damage.
One of the most important aspects of diver safety, and one that is repeated ad nauseam in diving courses, is the prevention of lung overdistension. As you ascend during a dive, the pressure gradually decreases and the air in your lungs increases in volume. If you do not expel the air, it will expand to a volume greater than the lungs, rupturing them and causing serious damage. I'm sure all divers who smoke and use little air know this. What they probably do not know is that their bronchial tubes have cilia, little projections that are responsible for preventing fluid and foreign particles from entering the lungs. The absence of these cilia causes mucus to form, and this mucus is what causes the typical smoker's morning cough. I know for a fact, smoking diver, that you're killing those tiny hair-like organelles, allowing the mucous membrane to enter your lungs and trap residual air, blocking the way out of your lungs. Do you follow me? More tobacco = less cilia = more mucosa = more residual air = more likely to develop lung overdistension, one of the most serious diving accidents anyone can suffer.
Let's talk about CO2 production for a moment. When we do aerobic physical activity, we increase the production of CO2, both smokers and non-smokers. However, the smoker can develop, unknowingly of course, hypercapnia or increased partial pressure of carbon dioxide (PaCO2) and in short, have a greater amount of carbon dioxide in the blood. What is the problem with hypercapnia for divers? In addition to having to work harder to breathe (using more air with more effort), CO2 production increases as you go deeper. Symptoms of hypercapnia include headache, confusion, lethargy, panic, dizziness and slowed reaction time, similar to the effects of narcosis, one of the most dangerous aspects of diving. You can get intoxicated by your own production of CO2, and you are more likely to suffer from it while diving.
No, smoking will not kill you with cancer overnight. But if you dive, yes, it can seriously complicate a dive and make it difficult to offer help to your buddy. Diving involves gas exchange under stress and pressure, and severely damaging the organs responsible for that exchange is a bad idea.
These are a few reasons to quit smoking, perhaps the most important for divers, but there are many more. So Mr. Diver, if you want to quit smoking, think about the damage it can cause in the short term, excuses may serve those who live only on the surface, not for you.