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Jadilah, hemoglobin bergandengan dengan gas CO. Kadar gas CO dalam darah bukan perokok kurang dari 1 persen, sementara dalam darah perokok mencapai 4 – 15 persen. Berlipat lipat!Tar adalah kumpulan dari beribu ribu bahan kimia dalam komponen padat asap rokok, dan bersifat karsinogen. Pada saat rokok dihisap, tar masuk ke dalam rongga mulut sebagai uap padat. Setelah dingin, akan menjadi padat dan membentuk endapan berwarna cokelat pada permukaan gigi, saluran pernapasan, dan paru paru. Pengendapan ini bervariasi antara 3 40 mg per batang rokok, sementara kadar tar dalam rokok berkisar 24 – 45 mg. Merokok dapat menyebabkan perubahan struktur dan fungsi saluran napas dan jaringan paru paru. Pada saluran napas besar, sel mukosa membesar hipertrofi dan kelenjar mucus bertambah banyak hiperplasia. Pada saluran napas kecil, terjadi radang ringan hingga penyempitan akibat bertambahnya sel dan penumpukan lendir. Pada jaringan paru paru, terjadi peningkatan jumlah sel radang dan kerusakan alveoli. Akibat perubahan anatomi saluran napas, pada perokok akan timbul perubahan pada fungsi paru paru dengan segala macam gejala klinisnya. Hal ini menjadi dasar utama terjadinya penyakit obstruksi paru menahun PPOM. Dikatakan merokok merupakan penyebab utama timbulnya PPOM, termasuk emfisema paru paru, bronkitis kronis, dan asma. Hubungan antara merokok dan kanker paru paru telah diteliti dalam 4 5 dekade terakhir ini. Didapatkan hubungan erat antara kebiasaan merokok, terutama sigaret, dengan timbulnya kanker paru paru. Bahkan ada yang secara tegas menyatakan bahwa rokok sebagai penyebab utama terjadinya kanker paru paru. Partikel asap rokok, seperti benzopiren, dibenzopiren, dan uretan, dikenal sebagai bahan karsinogen. Juga tar berhubungan dengan risiko terjadinya kanker. Dibandingkan dengan bukan perokok, kemungkinan timbul kanker paru paru pada perokok mencapai 10 30 kali lebih sering. Banyak penelitian telah membuktikan adanya hubungan merokok dengan penyakit jantung koroner PJK. Dari 11 juta kematian per tahun di negara industri maju, WHO melaporkan lebih dari setengah 6 juta disebabkan gangguan sirkulasi darah, di mana 2,5 juta adalah penyakit jantung koroner dan 1,5 juta adalah stroke. Survei Depkes RI tahun 1986 dan 1992, mendapatkan peningkatan kematian akibat penyakit jantung dari 9,7 persen peringkat ketiga menjadi 16 persen peringkat pertama. Merokok menjadi faktor utama penyebab penyakit pembuluh darah jantung tersebut. Bukan hanya menyebabkan penyakit jantung koroner, merokok juga berakibat buruk bagi pembuluh darah otak dan perifer. Asap yang diembuskan para perokok dapat dibagi atas asap utama main stream smoke dan asap samping side stream smoke. Asap utama merupakan asap tembakau yang dihirup langsung oleh perokok, sedangkan asap samping merupakan asap tembakau yang disebarkan ke udara bebas, yang akan dihirup oleh orang lain atau perokok pasif. Telah ditemukan 4. 000 jenis bahan kimia dalam rokok, dengan 40 jenis di antaranya bersifat karsinogenik dapat menyebabkan kanker, di mana bahan racun ini lebih banyak didapatkan pada asap samping, misalnya karbon monoksida CO 5 kali lipat lebih banyak ditemukan pada asap samping daripada asap utama, benzopiren 3 kali, dan amoniak 50 kali. Bahan bahan ini dapat bertahan sampai beberapa jam lamanya dalam ruang setelah rokok berhenti. Umumnya fokus penelitian ditujukan pada peranan nikotin dan CO. Kedua bahan ini, selain meningkatkan kebutuhan oksigen, juga mengganggu suplai oksigen ke otot jantung miokard sehingga merugikan kerja miokard.
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