Integritus Prime

We observed World No Tobacco Day on the 31^st of May. The theme this year was how the industry manipulates young people. I have been observing this process for over 40 years. The industry is always ahead with new ways of finding young clients. The young ones are vulnerable and easily sucked into the fanciful and covert advertising. Interestingly, the article Marilyn and others wrote about how to stop youth from smoking didn’t even make it into mainstream media.

So I wondered, do youth know what they are subscribing to? Apparently not! But why not?  Maybe, because:

• Smoking is glamorized and the bad effects are never mentioned;
• Cigarette packets have health warnings but the rolls are bought individually and shared amongst young people without any warnings being visible;
• Peers who smoke do not talk about the negative effects of smoking – either they don’t know or the habit was modeled as acceptable from their own peers, parents or loved ones.

Is this how the problem starts? People are saying that government should ban tobacco products. But cigarettes have been around for donkey’s years and we know that the choice is ours. Otherwise, where is our independence or freedom of choice? Why would our choice be dependent on the government or anyone else?

We all have brains that we use for making a decision. We do that when we want to travel – our main choices are public transport, walking or get our own car. We make the decision. The same happens when we buy a car or stove – we look at the quality, price, our own budget then make a decision. Sometimes, we ask a learned person for a second opinion. However, at the end of the day, the decision is ours.

So, what is the point of my diatribe? Why do we start smoking or using tobacco products? Do we conduct our own investigation or background check before starting? These days the information is very easily available at the touch of a button for young people. Internet is available even in many rural areas. However, other modes of information on harmful products are available in schools, health clinics, and government departments. So, really the excuse of not knowing is pretty lame. It’s clear that knowledge alone does not necessarily change behavior.

On the other hand, the highly addictive properties of tobacco, combined with clever advertising, stress, and peer pressure create influences such that youth pick up the smoking habit quite easily. By the time young people realize the bad effects of smoking, they are addicted to it and the damage to their blood vessels has already started.

So what are the bad effects of tobacco use?

1. CANCERS: Smoking is related to cancer in more than 12 areas of the body, including the mouth, throat, larynx, liver, cervix, and gut. Many times there may not be any symptoms or complaints but the cancer has already spread to other parts of the body. Cancer, if not diagnosed early, may not be treatable and can lead to death.
2. BREATHING PROBLEMS: The respiratory (breathing) system also gets affected. The air passages in the lungs start to get clogged; dirt and impurities are unable to be coughed out. The lining of the breathing pipes (bronchioles) is damaged so mucus starts to pool back into the lungs and increases the risk for bronchitis (chronic lung infection). If this persists then breathing problems, shortness of breath, and chronic cough develops. When this happens on a long-term basis, it is called chronic obstructive airway or respiratory disease (COAD or CORD). This condition is not reversible or curable, although it may improve a little after smoking is given up.
3. SECOND HAND SMOKING: Smoking increases the risk of asthma attacks and second hand smoking (breathing someone else’s cigarette smoke), which also increases the risk of cancer and breathing problems in family and friends.
4. BLOOD VESSEL PROBLEMS: The carcinogens (cancer causing agents) in tobacco cause damage to the blood vessels of the body as well. These blood-carrying pipes get thickened and clog up causing increase in blood pressure, heart disease and strokes. In a person with diabetes, this process happens faster and affects the blood vessels in the legs, thus increasing the risk of poor oxygen and nutrient supply, infection and amputations.
5. DIABETES: Some studies are showing that diabetes is harder to control in people who smoke. Uncontrolled diabetes has many other complications apart from thickened and clogged blood vessels, which are made worse by smoking. In people who have had uncontrolled diabetes for some years and also smoke, there maybe nerve damage as well and there may not be any chest pain when the heart attack occurs – this is called a silent attack. The person may feel weak, have cold sweating, pain in the left arm or neck, or heaviness in the chest. They need to be seen by the doctor soon so that they can be treated for possible heart disease.
6. FERTILITY and PREGNANCY: Smoking is related to lowered fertility in both parents, as well as problems in pregnancy and young children. Chemicals found in cigarette smoke affect the unborn child inside a mother, and may cause birth defects, preterm delivery (premature baby), low birth weight, miscarriage, or even death of the baby before the baby is born (stillbirth). In a male, smoking affects the sperm, causing low fertility and birth defects in a baby fathered by him.
7. HEART ATTACKS: Heart diseases, especially heart attacks are also related to smoking. The blood vessels supplying oxygen and nutrients to the heart become thickened and clogged. This in turn affects the function of the heart in pumping the blood around the body. Most of the times this is a slow process, taking years, and we experience chest pain. Some times the heart just gives up; this is called a massive heart attack and it kills a person. After smaller attacks, we can develop heart failure if we do not quit and take other preventive measures.
8. HIGH BLOOD PRESSURE: People with high blood pressure who smoke also damage their blood vessels. This can lead to heart disease, stroke, kidney damage or failure. A good way to control blood pressure is to quit smoking, cut down on salt, reduce the intake of saturated fat (mainly from animal products), and deal with stress through exercise, yoga, meditation, listening to soothing music and spending time in nature.

Realizing that smoking is not a good substitute for stress relief is a very important step towards not starting the habit, or quitting if we already smoke. There are many healthier choices for dealing with stress. Also, there are other ‘cool’ things to do like volunteering to help under privileged people, gardening, sports, artwork, yoga, and many others. The trick is to start off with the right habits and stick to them.  

This blog is written by the inimitable Dr. Margaret Cornelius.