CNS: Tobacco - a threat to human health

Tobacco, the age old slow poison, takes a human life every eight seconds, which means approximately 6 million deaths annually. It is consumed in many forms, all of which are equally harmful. It could be smoked as cigarettes and cigars, or used in smokeless forms such as chewing tobacco or inhaling tobacco such as hookah/sheesha. Globally approximately 10 million cigarettes are purchased a minute, 15 billion are sold each day, and an upward of 5 trillion are produced and used on an annual basis. It is estimated that worldwide, one in five teenagers in the age group 13-15 years smoke cigarettes. Youth and kids are still picking up smoking at the alarming rate of about 80,000 to 100,000 a day worldwide. Tobacco poses a serious danger to public health despite the fact that it is a preventable cause of death.

The primary risks of tobacco usage include many forms of cancer, heart attacks, strokes, hypertension, and chronic obstructive pulmonary disease. Smoking tobacco is a major cause for lung cancer and heart disease. Long term smoking affects lungs by drying and choking the lung pipes. It causes blood vessels to constrict leading to arteriosclerosis which may later form clot and cause stroke. Tobacco can affect almost every organ of the body-- mouth, tongue, throat, esophagus, lungs, heart, brain, kidney, liver, stomach and bladder. Smoking also affects calcium levels in the body and smokers are 2.5 times more prone to osteoporosis as said by the University of Pittsburgh Medical Center.

Consumption of tobacco in women may lead to breast cancer and cystic ovary- a major cause of infertility. Tobacco use during pregnancy can lead to stillbirths. It is also a major cause for miscarriages in pregnant smokers; increases risk of infertility in women and chances for impotency is approximately 85% higher in males who smoke. Maternal smoking can also cause lower infant birth weights, infants born with attention deficit disorder and certain other psychological problems in children. Thus there is an urgent need to expose and counter tobacco hazards.

Chewing tobacco, which is so popular in India, leads to oral cancer, a greater risk of tooth loss, loss of taste sensation and bad breath. Tobacco usage also leads to psychological alterations. Contrary to popular belief it does not relieve stress; instead it is known to cause hypertension. There is only a false feeling of relaxation as nicotine dependency exacerbates stress levels.

Tobacco smoke contains more than 4,000 chemicals, and 50 of them are known to cause cancer as estimated by the World Health Organization. Thus it becomes important for the tobacco users to know about its harmful contents and their devastating effects. Some of these lethal chemicals are-- nicotine which is addictive, cyanide and carbon monoxide which are poisonous gases, formaldehyde which is a poison used to preserve dead animals, phenol which we use as a toilet cleaner and various other lethal chemicals. A single cigarette might not be harmful but is capable enough to cause health deterioration if consumed on a regular basis.

Smoking is injurious not only to those who smoke but also to those who become the victims of second hand smoke. Guidelines to Article 8 of the WHO Framework Convention on Tobacco Control (FCTC) state that there is “no safe level of exposure to tobacco smoke”. Creating 100% smoke-free environments is the only way to protect people from the harmful effects of second-hand tobacco smoke which causes 600 000 premature deaths every year. It is harmful for all--adults, women, children and especially infants who become the helpless victims of the tobacco smoke around them. About 40% of all children are regularly exposed to second-hand smoke at home and it is known to cause about 31% of deaths among children. The youngsters exposed to second-hand smoke at home are 1.5-2 times more likely to start smoking than those not exposed. Through the tobacco control package called MPOWER, WHO helps countries to implement the provisions of FCTC to protect people from second-hand smoke.

The major victims of tobacco manufacturers are the children and youth as they are their future potential customers. The majority of the tobacco users begin using tobacco at their early age. Nicotine addiction can occur at any age but according to National Institute on Drug Abuse, minors who smoke will have the most difficult time quitting the habit. Around 50% of adolescent smokers are found to continue it as a habit. It is shocking to know that worldwide 30% of the children below 10 years of age have smoked at least 1 cigarette. An average smoker looses 5 minutes of his life on every cigarette that he smokes.

Tobacco use imposes both direct economic costs on society, (such as those associated with treating tobacco-related diseases) and indirect costs, such as those associated with reduced productivity or lost wages because of death or illness as stated by W.H.O. Thus there is a need for serious preventive measures. The W.H.O FCTC focuses on eliminating trade in tobacco products. India became a Party to the WHO FCTC on February 5, 2004 and formulated laws on prohibiting tobacco advertising, promotion and sponsorship, ban on smoking in public places, and mandating pictorial and texted health warning labels on tobacco packets. But still, more efforts are needed for proper their implementation and controlling the abuse of tobacco products. Dr Tara Singh Bam, Technical Advisor, Tobacco Control at the International Union Against Tuberculosis And Lung Disease (The Union) emphasizes that, “Strong tobacco control measures such as higher tobacco taxes and prices, more prominent graphic health warnings,100% smoke-free laws, complete ban of tobacco advertising, promotion and sponsorship, hard-hitting mass media campaign and a complete stop to tobacco industry interference in public health policy are simple, cost effective and doable measures which can curb tobacco usage in all settings.”