ISSN: 1391 - 0531
Sunday, February 18, 2007
Vol. 41 - No 38
MediScene

The Killer Stalks

Inspite of increased awareness of the dangers of smoking, every year, at least 15,000 Sri Lankans lose their lives to the silent killer of tobacco.

By Melanie Amarasooriya reports

The World Bank estimates that the single biggest cause of death worldwide by 2030 will be smoking with the expected death toll predicted to be 10,000,000 (ten million) each year. To simplify the facts a little more, one in every ten adults is dying because of this deadly substance at the moment, and by 2030, one in every six will die due to it.

What is more important for our part of the world is that seven people out of ten who die because of smoking will be from low and middle income nations.

Glamour associated with smoking: One of the subtle ways of indirect promotion

More harmful than any other substance, tobacco kills half its users through the many severe disease conditions linked to it. Tobacco smoke contains 4000 chemicals and 40 of them are carcinogenic, that is they are known to cause cancer. Not only cancers but also about 60 severe disease conditions are associated with smoking.

Yet, despite our rising awareness of the harm caused by tobacco we still spend a huge amount of money on smoking. "In 2005, Sri Lankans spent Rs. 37,000,000,000 (thirty seven thousand million rupees) on tobacco," says Dr. Manoj Fernando, Executive Director of Mel Medura , quoting the Ceylon Tobacco Company's annual report.

"Thousands of people quit smoking every day, but thousands of others acquire the habit," explains Dr. Fernando, pointing out the difficulty in making a dramatic change in the smoking pattern. The reason behind the tragedy is very subtle, he says. It is indirect promotion.

Direct promotions and advertising have been banned by the new Tobacco and Alcohol Act. "But it's very hard to pin down the indirect promotions," Dr. Fernando says. On TV for instance, we often see cartoons, films and teledramas where smoking comes across as a desirable pastime, Dr. Fernando says, citing the famous cowboy cartoon where the hero does only two things, shooting and smoking.

Nobody can guarantee that the children who watch the cartoon and imitate shooting, will not have a positive attitude towards smoking which could affect their future behaviour.

When a father smokes, the child sees him as giving life to an advertisement and it makes the child feel that it is an ‘adult thing' to smoke. For an adolescent boy this creates the ideal environment and just a cigarette offered with peer pressure could be the trigger.

The same principle is exploited by the industry, to promote smoking. "When they say that smoking is only for those above 18 or 21 it invariable becomes an 'adults only' activity, and all teenagers want to try it out," Dr. Fernando said, explaining the psychology behind it. The other aspect that should sound the alarm is that that there is an untapped market in Asian countries -- women. If an image can be formed that smoking makes women stylish or attractive, the gains would never be small. That would create a huge market and surely double the death rates, he warns.

In Sri Lanka, the World Health Organization, the World Bank and many Non Governmental Organizations are teaming up to prevent this hazard. Mel Medura, a part of Sri Lanka Sumithrayo and other NGOs are also actively working towards this goal. As a result, keeping with the global trends our smoking rates are reducing slightly. "But it is still not at a satisfactory level," said Dr. Fernando.

At the end of the story there is a note of hope. Quitting smoking is not a big issue. Although some may need psychological help from a doctor, the majority who quit the habit do so on their own and testify that it is not that hard. Figures from the West suggest one in ten people will quit smoking just on a doctor's suggestion. The figure for our country, where people are more likely to follow to advice from a medical professional should be higher. That is a plus point for our part of the world. Even alone, with no medical help you can quit smoking. Moreover, you can prevent your children smoking too.

So the next time you see Shah Rukh Khan or some Bollywood star smoking in a movie, point out to your child the risks and consequences to your health by smoking. Enjoy life and realize that life is not a cigarette.

How smoking affects your health
  • Cardiovascular disease
    Cigarette smoke contains substances that accelerate the deposition of cholesterol plaques in blood vessels.
    This leads to heart attacks when the blood vessels supplying the heart get occluded (obstructed or closed). Once this happens in vessels in the leg, it leads to 'peripheral vascular disease' and the patient can end up with an amputation of the leg.
    The majority who undergo amputation for peripheral vascular disease are long-term smokers.
    This arterial occlusion can happen anywhere in your body, including the brain, which results in a stroke.
  • Sexual impotence
    The blood vessel that supplies the penis is one-third the diameter of the vessel supplying the heart. It can also get occluded by the same process. Because it is small, occlusion happens long before the vessels of the heart get occluded. The implication is that if you smoke, you will suffer from sexual impotence long before you suffer your first heart attack.
  • Cancers
    If you smoke you are more at a risk of getting cancers. 90% of lung cancers occur due to smoking. But that is not the only risk.Cancers in the esophagus, kidney, and bladder are all linked with smoking and if you are a woman, the list includes carcinoma of the cervix (part of the female uterus). The tragedy is it can occur even when you don't smoke but if your husband does as a result of passive smoking.
  • Respiratory diseases
    Long term smokers get Chronic Obstructive Pulmonary Disease (COPD) and ultimately can go into respiratory failure. In addition the clearing function of the respiratory passage gets impaired and you are more likely to suffer frequent respiratory infections. The risk of dying from tuberculosis also rises with smoking.
  • Appearance
    Cigarette smoke contains formaldehyde, the active substance in formalin, which is used to preserve dead bodies. Continued smoking thus makes your skin wrinkled. It will also darken your lips, give you mouth odour and stain your fingers with nicotine. Most chain smokers' eyes develop a red-muddy tinge as well.

 
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Copyright 2007 Wijeya Newspapers Ltd.Colombo. Sri Lanka.