Dr. Sushil Kumar Sharma
Each year, the World Health Organization (WHO) holds World No Tobacco Day on May 31st. The goal is to spread awareness about the risks of tobacco use and how we can make the world tobacco free. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year around the world. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. There are 1.3 billion tobacco users worldwide. That number would be even larger if tobacco didn’t kill half of its users. Every four seconds, tobacco takes another life. Decades of the tobacco industry’s deception and devious tactics have hooked generations of users to nicotine and tobacco, driving this global epidemic. The multi-billion-dollar industry recruits new tobacco and nicotine users to reward investors with as much profit as possible and keep its business alive. Tobacco and related industries have increasingly preyed on children and adolescents, employing advertising tactics and targeting them directly with a new portfolio of products that threaten their health. These industries are moving at a rapid speed to launch existing and new products and use every means to expand their market share before regulations can catch up with them. Tobacco and related industries continue to oppose evidence-based measures, such as increases in excise taxes and comprehensive bans on tobacco advertising, promotion and sponsorship, and have threatened legal actions against governments that try to protect the health of their citizens.
The 2023 global campaign aims to raise awareness about alternative crop production and marketing opportunities for tobacco farmers and encourage them to grow sustainable, nutritious crops. It will also aim to expose the tobacco industry’s efforts to interfere with attempts to substitute tobacco growing with sustainable crops, thereby contributing to the global food crisis.
Supporting the creation of alternative livelihoods – The tobacco industry often touts itself as an advocate for the livelihood of tobacco farmers. This is a far cry from the truth. The intensive handling of insecticides and toxic chemicals during the cultivation of tobacco contributes to many farmers and their families suffering from ill health. Further, unfair contractual arrangements with tobacco companies keep farmers impoverished, and the child labour that is often woven into tobacco cultivation interferes with the right to education and is a violation of human rights.
Smoking harms the Cardiovascular System
Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed. This can narrow the blood vessels and can lead to many cardiovascular conditions.
Atherosclerosis, in which arteries narrow and become less flexible, occurs when fat, cholesterol, and other substances in the blood form plaque that builds up in the walls of arteries. The opening inside the arteries narrows as plaque builds up, and blood can no longer flow properly to various parts of the body. Smoking increases the formation of plaque in blood vessels.
Coronary Heart Disease occurs when arteries that carry blood to the heart muscle are narrowed by plaque or blocked by clots. Chemicals in cigarette smoke cause the blood to thicken and form clots inside veins and arteries. Blockage from a clot can lead to a heart attack and sudden death.
Stroke is a loss of brain function caused when blood flow within the brain is interrupted. Strokes can cause permanent brain damage and death. Smoking increases the risk for strokes. Deaths from strokes are more likely among smokers than among former smokers or people who have never smoked.
Peripheral Arterial Disease (PAD) and peripheral vascular disease occur when blood vessels become narrower and the flow of blood to arms, legs, hands and feet is reduced. Cells and tissue are deprived of needed oxygen when blood flow is reduced. In extreme cases, an infected limb must be removed. Smoking is the most common preventable cause of PAD.
Abdominal Aortic Aneurysm is a bulge or weakened area that occurs in the portion of the aorta that is in the abdomen. The aorta is the main artery that carries oxygen-rich blood throughout the body. Smoking is a known cause of early damage to the abdominal aorta, which can lead to an aneurysm. A ruptured abdominal aortic aneurysm is life-threatening; almost all deaths from abdominal aortic aneurysms are caused by smoking. Women smokers have a higher risk of dying from an aortic aneurysm than men who smoke. Autopsies have shown early narrowing of the abdominal aorta in young adults who smoked as adolescents.
Are there immediate and long-term health benefits of quitting for all smokers?
Benefits of Smoking Cessation
The aim of a stop smoking intervention with patients from any group is to encourage and enable the patients to make health enhancing behaviour changes for themselves. This may involve work on motivation, skill building and confidence building it will certainly demand the best of communication skills.
The short-term benefits of quitting smoking include the following:
v 20 minutes after quitting, heart rate and blood pressure drop.
v 2 hours after quitting, the amount of nicotine in the bloodstream will drop by half.
v 8 hours after quitting, there will be more oxygen in the blood.
v 12 hours after quitting, the carbon monoxide level in the blood drops to normal.
v 72 hours after quitting, breathing becomes easier and bronchial tubes begin to relax.
v 2 to 12 weeks after quitting, circulation improves and lung function increases.
v 1 to 9 months after quitting, coughing and shortness of breath decrease. Cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
The long -term benefits of quitting smoking include the following:
At one year, you have halved your risk of coronary heart disease. By two to five years, your risk of stroke is now the same as a non-smoker, and at five years you have halved your risk of mouth, throat, oesophageal and bladder cancer.
By 10 years, your risk of dying from lung cancer is half that of a current smoker, and your risk of developing kidney and pancreatic cancers decreases.
Key Message:
Any profits to be gained from tobacco as a cash crop may not offset the damage done to sustainable food production in low- and middle-income countries. Against this background, there is an urgent need to take legal measures to reduce tobacco growing and help farmers to move into the production of alternative food crops.The 2023 WNTD campaign calls on governments and policy-makers to step up legislation, develop suitable policies and strategies, and enable market conditions for tobacco farmers to shift to growing food crops that would provide them and their families with a better life.
So, the only proven strategy to keep your heart safe from the effects of smoking is to Quit. As the world grapples with a new and terrifying virus, WNTD reminds us that smoking, too, is a pandemic. Relief from its devastation will come not from a vaccine but from innovative solutions that consider the needs of smokers themselves.
(The author is HoD Cardiology Department, GMC, Jammu)
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