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Tobacco Smoking is a global health threat not only affecting the
developed, so-called world powers but also the poverty stricken, third
world countries. Although continuing awareness on this topic is
producing dramatic results, still it is estimated that a quarter of
world population is using tobacco in some form while globally the death
toll due to diseases caused by smoking is on the rise with an estimated
five million deaths every year, seventy percent of these in under
developed countries! Health care professionals especially physicians
with the support of media can make a difference by educating the smokers
to quit and motivating the nonsmokers, especially youngsters, to remain
nonsmokers. Remember, this is a preventable or an avoidable health risk.
Tobacco—a silent killer!
Tobacco no matter which form it is like cigarettes (even light or
filtered), cigars, chewable tobacco, huqqa or the ever popular sheesha,
is a silent killer. It does not kill anyone directly but the
approximately 4000 toxic chemicals including nicotine as well as the
direct irritant effect of the inhaled smoke cause various illnesses.
Cancers, cardiopulmonary and pregnancy related complications being the
few notable ones. Smokers are said to have a death rate twice of
non-smokers. More a person smokes; greater is the risk for
smoking-related diseases. While it is proven by research that smoking
cessation reduces risk of such diseases as well as pre-mature death
especially if one quits early.
Lung cancer is one of the leading cancers in males and females. 90% of
lung cancer in males and almost 80% in females is associated with
smoking. In addition to lungs, tobacco also causes cancer of the mouth,
throat, esophagus, stomach, pancreas, bladder and kidneys. Almost 20% of
heart related diseases are linked with smoking. It is an independent
risk factor for coronary heart disease. Risk of ‘heart attack’ increases
six fold in females and three fold in males who smoke as compared to
non-smokers. Diseases like chronic lung problems, stroke and
reproductive ability of both the genders are also adversely affected
(leading to impotence). Skin wrinkling and peptic ulcers are also
common, while the Carbon Monoxide inhaled in cigarette smoke impairs the
ability of hemoglobin to carry oxygen.
Non smokers (especially children and women) who are exposed to
environmental tobacco (second hand or passive smoking) are also at risk
for many of the same health problems. It increases childhood morbidity
and mortality from infections of sinuses, ears and respiratory illnesses
like asthma and bronchitis. Smokers and those who live with them are
also at risk for fire-related injury, additional financial burden and
even death. In the United States exposure to second-hand smoke is
estimated to cause 40,000 deaths each year from heart disease.
Women who smoke or are exposed to second hand smoke have premature
babies with greater risk of birth defects and sudden infant death
syndrome after birth.
Quit and live long!
It is all about making up your mind and having the will. Smokers who
quit go through different phases starting from ‘not wanting to quit’ to
‘considering quitting’ to ‘actively quitting’ and eventually
‘successfully quitting’. Smoking cessation has both immediate and long
term health benefits for men and women of all ages. Those who never
smoke or quit early (the sooner the better, especially before age fifty)
live a healthier and longer life than non-smokers (provided they are
otherwise healthy). Cessation decreases risk of cancer up to one- half
while there is substantial decrease in risk of other illnesses as well.
The risk of lung cancer reduces within five years of stopping, although
ex-smokers still carry greater risk of lung cancer than those who never
smoked in their life. Risk of dying from heart disease is also reduced
by almost fifty percent after stopping for one year and continues to
decline over time, even to the rate of nonsmokers within two years of
quitting. It also adds to better oral hygiene, gums, teeth and breath,
not to mention the smell a smoker emits.
It is the addictive effect of nicotine which makes it difficult for a
smoker to quit smoking. It has psychological dependence with
mood-elevation. Withdrawal symptoms are worst in the first week and
decrease over the next two months. Common symptoms include headaches,
nausea, shakes, cough, hunger, fatigue and restlessness, lack of sleep
as well as mild depression and anxiety. Many quitters complain of bad
constipation, intestinal upsets and mild weight gain. However, these
problems are minor and usually short lived with less of a health risk,
if any. In this regard medical advice to continue with a smoke twice a
day is nothing but a popular myth. Worst is the craving and especially
the ‘high’ feeling of lighting, then holding something between fingers
and taking a deep puff in.
How to Quit?
Smoking cessation starts with the recognition of the fact that this is
not just a habit but an addiction which eventually has fatal outcome.
Once motivated setting up a date to quit is the next step. Quitting
‘cold turkey’ is the most successful. Throw away the stock of cigarettes
(tobacco), including that at home and in office (drawers, closets, car
compartments, roof top etc.) as well as the ashtrays. Tell your close
friends, co-workers and family members of your plan and request for
their help in achieving this goal. Limit time spent with smokers. Ask
them to stop smoking in office, at home or in the car. They need to go
out to a designated area if they want to expose themselves to the
harmful effects of tobacco smoking. Cravings lead to relapse, so avoid
situations which produce the temptation, like alcohol consumption and
undue stress. Thoughts like ‘I can have one cigarette only as that will
not hurt’ should be discouraged as it is the one cigarette which leads
to more usage. Avoid alcohol consumption as this triggers the urge to
smoke. For Muslims the month of Ramadan is the best time to set this
target.
Nicotine craving is minimized by applying nicotine patch (es) in
consultation with a physician and using nicotine gum. Other forms like
nicotine lozenges, inhalers and sprays are also available in the west
but are costly. None of these is superior to the other. These modalities
supply a small, steady amount of nicotine to the body which the doctor
will slowly taper down as the craving is reduced. While using these,
patient will not be exposed to the thousands of additional toxic agents
and the hazardous effects of the smoke. Patients using nicotine
replacement therapy, however, must not smoke.
Behavioral counseling and therapy as well as some medications when
combined with above techniques enhance quit rates. Some patients also
benefit from regular exercise, drinking adequate fluids and eating fresh
fruits while quitting. This prevents weight gain and also keeps a person
fresh. Acupuncture and hypnosis have also shown limited benefits.
As individuals we can approach the administration and insist them on
re-enforcing NO-smoking laws at work places, schools and colleges as
well as other public places (parks, restaurants). Raise prices of
cigarettes. Physicians must discuss this issue during each clinic
encounter. Parents should frequently talk about this threat with
children and their teachers. Government should enforce strict penalty
for those who smoke in public places.
Say NO to smoking and do not feel ashamed of quitting. It is the best
gift you can give to yourself and your family. The message is clear---
No matter whatever your age is or when you started or the amount and
duration for which you smoke… quitting will definitely improve your
health!. |
