A shocking video shows doctors removing the black lungs of a deceased chain smoker.
The unnamed 52-year-old, from China, smoked continuously for 30 years.
After being declared brain dead, medics set about removing his organs, which he opted to donate.
However, they quickly realised his lungs were too diseased to be used.
The viral clip, which has been viewed more than 25 million times, has been called the “best anti-smoking ad ever”.
“Many smokers have lungs which look like this,” Dr Chen Jingyu, from Wuxi People’s Hospital in Jiangsu said.
“Our team decided to reject these lungs for transplant.
“Look at these lungs, do you still have the courage to smoke?”
After the patient was declared brain dead, tests initially suggested his lungs would be suitable for donation.
“Oxygenation index tests were okay, but when we harvested the organs, we realised we wouldn’t be able to use them,” Dr Jingyu said.
“We Chinese love smoking. It would be impractical to say we wouldn’t accept the lungs of all smokers, but there are strict standards.”
More than 300 million people in China use cigarettes, accounting for nearly one third of the world’s smokers, according to the World Health Organization.
Smoking is responsible for one in six deaths in the Asian country, with someone dying from complications around every 30 seconds.
Upon inspection, the doctors discovered calcium deposits had accumulated in the man’s lungs.
This can be a sign of infection or amyloidosis, a dangerous condition that occurs when the protein amyloid builds up in the organs.
The lungs were also less able to expand and contract due to the formation of air-filled sacs called bullae, triggering breathlessness.
Pulmonary emphysema, damage to the air sacs in the lungs, was also evident.
This was all put down to decades of smoking.
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In England alone, cigarettes were responsible for 77,800 deaths (16%) in 2017, NHS data shows.
Smokers are permitted to donate their lungs after they die providing the quality is at least “marginal”.
Lighting up is responsible for seven in 10 cases of lung cancer.
It is also linked to tumours in many other parts of the body, including the mouth, throat, bladder, stomach and pancreas.
Looking at lung health specifically, smoking raises the risk of pneumonia and chronic obstructive pulmonary disease.
It can also worsen asthma and respiratory infections, like colds.