Nicotine has an effect on the sympathetic nervous system (part of the nervous system involved in the classic "fight or flight" response); part of this effect is to cause the blood vessels within the body to constrict. Since, hopefully, the same amount of blood is still going through the body, this results in a net increase in the pressure within the system (think of what happens when you squeeze a garden hose). Why is it bad? The increase in pressure has to come from somewhere, and that's the heart that is trying to pump against this. Also, higher pressure can lead the "blowing up" of blood vessels, called aneurysms (think again of that garden hose and what happens if you hold it bent for too long).

As we all age, there are plaques building up on the inside walls of our arteries. Some people have this peripheral vascular disease (PVD). It is commonly recognized in the hands and feet because these are the points farthest away from the heart where the blood vessels are the smallest.

This PVD in combination with the effects of nicotine can lead to a painful lack of blood flow to our feet. Our skin is a living organ, which means it needs to have nourishment to remain healthy. The arteries are the conduits to bring that nourishment to all aspects of our body.

People relate to sharp, deep stabbing pains. Some people even relate to having very painful ulcerations, or openings in their skin. When ulcerations occur, it can sometimes be very difficult and time consuming for the skin to heal. When there is an opening in the skin, an infection can begin and spread throughout the human body, which can ultimately lead to amputation or even death in the worst cases. Appropriate wound care should be initiated after a thorough examination has taken place.

Smoking can play a vital role in your everyday health as well as in the health of your feet. As you know, your feet are important. They get you to the many places you have to go. Be wise, take care of your feet, and see your podiatrist.