World No Tobacco Day - Tobacco and its hazards

Dr MA Razaque *

Campaign espouses tobacco free Manipur on August 19 2014 :: Pix - TSE

Every year, 31st May is observed as the World 'No Tobacco Day'. Tobacco consumption, particularly smoking is the leading preventable causes of Diseases, Disability and premature Death. In spite of all the facts and the data available and increased taxes imposed on cigarette, people continue smoking and the habit is increasing.

Tobacco is the dried leaves of the plant Nicotiana Tabacum which belongs to the family of Solanacae. When Christopher Columbus discovered America, he found the native Indians using tobacco in much the same manner as it is used today. The American Indians believed it to possess medical properties. Portuguese and Spanish sailors took tobacco from Europe to all parts of the world.

Tobacco was brought to India by Portuguese sailors in the 16th century and it was offered to Emperor Akbar. The royal hakim (physician) advised the Emperor to smoke the tobacco only after it passes through water. Subsequently, the use of tobacco spread far and wide.

The leaves of tobacco are either smoke as cigarette, bidis, pipes, cigars or snuffed or chewed in raw state or mixed with lime (khaini) or with pan and other various forms like pan masala, gutkha etc.

According to the World Health Organisation, there are 1100 million smokers worldwide. Of these 800 millions are in the developing countries. Globally three million deaths occur every year due to tobacco use. Death rate is three times higher in smokers. Tobacco-related death worldwide is more than death due to AIDS, TB, RTA, suicide and maternal mortality combined together.

In India, according to ICMR, there are 18.4 crore tobacco users. Of these 4 crore use cigarette, 8 crore use bidis, 6 crore use chewable form of tobacco. Nearly 45% of Indian men and 12% of women use some form of tobacco. Tobacco kills 8 lacs persons every year or 90 persons every minute.

Tobacco use is motivated primarily by the desire for nicotine. Most tobacco use begins in childhood or adolescence. Smokers give a variety of reasons for smoking including pleasure, arousal, enhanced vigilance, improved performance, relief of anxiety or depression, and reduced hunger etc. However with long term use of tobacco physical dependence and addiction develops. Tobacco use is responsible for a vast majority of diseases of heart, lung and other organs of the body.

Tobacco and Health

India is among the top consumers of cigarette and it is the fourth largest producer of tobacco and second in cigarette and bidi production.

Tobacco smoke contains more than 4000 chemicals including nicotine, tar, carbon monoxide, benzopyrene, butane, cadmium, acetone, ammonia, lead, benzene, formaldehyde etc, out of which 40 are known to cause cancer (Carcinogens). Tobacco consumption has far reaching health consequences.

Acute health risks of tobacco use include breathlessness, increased heart rate, exacerbation of asthma, frequent respiratory infections, increased incidence of TB, hypertension, increase in blood level of carbon monoxide etc.

Long-term health risks of tobacco use include:

1. Coronary artery disease
2. Stroke
3. Cancer of lung, larynx, oral cavity and lips, pharynx, oesophagus, pancreas, bladder, cervix, etc.
4. Leukaemia
5. Chronic obstructive pulmonary disease
6. Premature facial wrinkling
7. Osteoporosis in women and early menopause.
8. Increased incidence of gastric and duodenal ulcers
9. Impotence and infertility
10. Increased risk of non insulin dependent diabetes mellitus.
11. Increased risk of cataract and amblyopia (blindness )

Those who smoke not only harm themselves but also those around them by second hand smoke. This is also known as passive smoking. It means indirect inhalation of tobacco smoke by non-smokers living in environmental tobacco smoke. The second hand smoke contains basically all of the same harmful and toxic chemicals as that of the active smoke. Thus the second hand/passive smoker is at equal risks as that of active smoker more so among the children.

Smoking is one of the leading causes of indoor air pollution. The levels of sulphur dioxide, nitrogen-dioxide and suspended particulate matters are significantly higher in the homes of smokers. Parental smoking in the homes exposes the children to harmful effects of the smoke, such as:

1. More episodes of cold and cough
2. Greater risks of developing asthma
3. Frequent respiratory tract infections
4. Middle ear infections
5. Teeth and gum disease
6. Sudden infant death syndrome etc.

Smoking during pregnancy can adversely affect the chance of survival and proper development of the foetus. Effects of maternal smoking during pregnancy include:
1. Spontaneous abortion.
2. Pre-term birth
3. Low birth weight
4. Prenatal death
5. In nursing mother who smoke heavily, nicotine may be found in the breast milk, thus causing harm to the breast-fed infants.

In view of the alarming health problems due to tobacco consumption, it has become imperative to take urgent steps to curb the growing menance of tobacco. Preventive measures are needed by way of effective implementation of laws related to tobacco consumption. Counselling, massive awareness campaigns and behavioural changes at individual and community levels are needed. Health education as well as organising seminars and conference highlighting the benefits of quitting tobacco use would be helpful.

Anti-tobacco campaign in India is gaining momentum. The Supreme Court of India has made a ban on smoking at public places. For those who want to quit smoking, tobacco cessation clinics are being set up in India since 2002. Also effective drug therapies for smoking cessation are also available.

Now, it is our responsibility to keep the air clean and it is also our right to live healthy.