While the addictive aspect of smoking is well known,
less known are the other physiologic changes that can
affect chronic smokers' diving. Subscriber Edmund
Doering (Jupiter, FL), a pediatrician and member of the
Undersea and Hyperbaric Medical Society, explains.
"Heavy smokers have 5 to 7 percent less hemoglobin
available to bind to oxygen, nitrogen or other gases
used. This altered oxygen saturation in the blood significantly
changes the formulae used to program dive
computers and decompression tables, because carbon
monoxide binds more tightly to hemoglobin than the
other gases."
"Secondly, smokers have altered pulmonary function.
Parts of the lung get lots of blood supply but little
aeration by alveoli, while other parts get lots of air but
little blood. This produces markedly inefficient nitrogen
off loading. The second part of smokers' lung is chronic
bronchitis, producing the "smokers cough," as well as
diffuse inflammation of the airways. The inflammation
reduces overall lung function, again in a direction favoring
reduced nitrogen offloading."
Ern Campbell, who writes the ScubaDoc blog, also
warns about the effects of carbon monoxide. "Your
carbon monoxide (CO) level varies with the number of
cigarettes you have smoked that day, the length of time
since your last cigarette, and your level of activity on the
day of the reading. Acceptable CO level for diving is 10
parts per million (ppm) by volume; 10 to 20 ppm yields
a mild frontal headache, 20 to 30 ppm gives a throbbing
headache associated with nausea, 30 to 50 ppm causes
severe headache, fainting and weakness, and 50 to 80
ppm results in coma, convulsions and death.
"Typical end-of-dive-day readings are as follows:
0 to 10 ppm of CO for a non-smoker, 11 to 20 ppm of
CO for a light smoker, and 21 to 100 ppm of CO in a
heavy smoker. To work out the approximate percentage
of oxygen being replaced by CO in your blood, divide
your reading by six; 18 ppm of CO means three percent
of oxygen in your blood is being replaced by carbon
monoxide. If you are a heavy smoker, up to 15 percent
of your oxygen is possibly being replaced by carbon
monoxide."
Campbell adds that smokers also have nasal and
sinus drainage problems. "This markedly increases their
chances of middle ear and sinus blocks and squeezes."