Smoking reduces the amount of oxygen being carried in the blood and those people with spinal cord injuries (SCI) who also smoke have been shown to have a greater incidence of pressure sores and have a slower recovery time from these sores. (5.) People with spinal cord injuries need to shift their body weight constantly to prevent developing pressure sores caused by lying on the same area of skin. This is so oxygenated blood can carry nutrients to the skin and remove waste products so that the skin remains healthy. Smoking, and especially the nicotine in cigarettes, decreases the blood flow to the extremities by constricting the blood vessels. The carbon monoxide produced by smoking also hinders oxygen from being incorporated in the bloodstream. As a result, less oxygenated blood and nutrients are transported to the skin, and the volumes of waste product removed from the skin become reduced. This is the reason why smokers with SCIs are more likely to develop skin conditions such as pressure sores.(5.) Lamid S, El Ghatit AZ. 'Smoking, spasticity and pressure sores in spinal cord injured patients.' American Journal of Physical Medicine, 1983. 62:6; pp. 300-306.