The hand has primarily vasoconstrictor innervation, while the forearm is primarily vasodilator.

But in their endless quest for pseudo-scientific propaganda, the anti-smokers routinely misuse hand skin studies as "supporting evidence" that smoking causes vasoconstriction, ischemia, and various other harmful circulatory effects in virtually every organ of the body.

The simplistic line that "smoking causes vasoconstriction" has been one of the most versatile myth-making tools. Nicotine is actually a direct-acting vasodilator when there is no innervation (Fewings JD et al. Brit J Pharmacol 1966;26:567-579; Mitolo-Chiepa D. Boll Soc Ital Biol Sper 1968;44:892-893).

Mental stress, exercise, cold pressor test, serotonin, acetylcholine and smoking all constrict a stenosed artery segment, but dilate a normal one. (AC Yeung et al. NEJM 1991;325:1551-1556; and P Golino et al. NEJM 1991;324:641-648.)

But the anti-smokers misrepresent this nonspecific paradoxical constriction of stenotic artery as evidence that smoking causes cardiac ischemia. And they attempt to blame smoking, but not mental arithmetic serotonin, etc., for causing heart disease out of purely ideological motives.

Although muscle perfusion is opposite to that of skin (Redish W et al. Angiol 1968;19:232-237), anti-smokers lie that smoking reduces blood flow to the muscles, supposedly causing cramps. Because vasoconstrictor action in inhibited at high temperature, the anti-smoker claim that smoking increases the risk of heat stroke is fraudulent.

Roddie: "If the circulation to the hand is arrested with a pneumatic cuff... release of the occlusion is followed by flushing of the skin of the hand and an increase in hand skin temperature. The degree of flushing is related to the duration of the ischemia. When the hand is warm, the reactive hyperaemia is greater than when it is cold."

If the smokers hands were cold, which they are usually contended to be, that should have been considered in accounting for the slightly decreased reactive hyperaemia that Tur et al. (Angiology 1992;43:328-335) attributed to impaired microvasculature in smokers. And their claim that "reactive hyperaemia plays an important role in protecting, or at least limiting, tissue damage following the ischemia," should be weighed against the evidence that it causes damage via free radicals. And how about the hyperaemia following injury, for which we are advised to apply ice? (Because these people are fundamentally hate propagandists, they probably would have claimed the opposite if they had seen more reactive hyperaemia in smokers!)

Roddie: "Blood flow in the hands and feet is very labile," and the vessels "undergo waves of constriction and dilation when the subject is comfortably warm..." Hand blood flow tends to fall in response to minor sensor stimuli, and "many stimuli that have an alerting effect cause strong transient vasoconstriction in the hands and feet that last about 60 s."

And in an experiment involving mental arithmetic, JK Wilkin et al. (Arch Dermatol 1987;123:1503-1506) found, "During the period of mental activity, cutaneous blood flow in the finger fell to 59%, digital cutaneous pulse fell to 62%, and heart rate increased by 24% of the subjects' initial baseline values." These changes are of a magnitude larger than those which have been attributed to smoking, which has also been found to have an arousing effect in EEG.

However, "Cutaneous blood flow in the malar region [cheek] did not change. Because vasomotor control of the finger skin is principally vasoconstrictor and that of the malar area vasodilator, these results suggest that mental activity unrelated to obvious stress may provoke changes in cutaneous blood flow in areas controlled by sympathetic vasoconstrictor fibres." He also notes that "the face has a poor vasoconstrictor supply and stimuli that provoke intense vasoconstriction on the finger are ineffective on the face."

But the anti-smokers have put out reams of hate propaganda claiming to be able to instantly detect a "smokers' face" by its pallor, supposed due to "intense vasoconstriction," and embellished with malicious speculation about "microvascular damage," collagen abnormalities, and wrinkles.

The anti-smoker delusion of massive vasoconstriction is integral to their lie that smoking causes high blood pressure. Most studies in the 1960s found that smokers actually has somewhat lower blood pressure (Lasrson PS, Silvette H. In: Tobacco: Experimental and Clinical Studies. A Comprehensive Account of the World Literature. Baltimore: The Williams & Wilkins Co., 1971 pp. 81-83), but it was speculated that smokers' lower weight was the reason. In the following years, a torrent of propaganda obliterated the truth. But a recent ambulatory blood pressure monitoring study by MS Green (Am Heart J 1991;121:1569-1570), plus confirmation from others, has resulted in a sudden rediscovery of the truth.

Courtesy of Carol Thompson 08/23/93
Smokers' Rights Action Group
P.O. Box 259575
Madison, WI 53725-9575
Phone: 608-249-4568