Pak­istan has high­est to­bacco con­sump­tion in S Asia

Pakistan Observer - - NATIONAL -

DR FAHEEM MAH­MOOD BUTT

Smok­ing is a world­wide haz­ard. It is a sin­gle most im­por­tant cause of pre­ventable pre­ma­ture death. Ac­cord­ing to WHO fig­ures there are about 1.3 bil­lion smok­ers in the world. 20 bil­lion ci­garettes are sold ev­ery day. Smok­ing is de­clin­ing in US and many other west­ern coun­tries In USA smok­ing rate have de­creased to al­most half over the last three decades but it is on the rise in de­vel­op­ing coun­tries like Pak­istan, In­dia, Philip­pine, Thai­land and Cam­bo­dia . In some de­vel­oped coun­tries in far East like Ja­pan and China more than 60 % of male pop­u­la­tion smokes. One third of the world pop­u­la­tion smokes, 12 % of them are women and ev­ery day 100,000 kids are added to this num­ber. Ev­ery year 5.6 mil­lion peo­ple die of to­bacco/smok­ing re­lated dis­eases. Ev­ery 6-se­cond a cur­rent or former smoker dies. 70 % of smok­ers die younger than nor­mal pop­u­la­tion. Smok­ers die 15 year younger than non smok­ers.

In 21st cen­tury, 1.3 bil­lion peo­ple will die of smok­ing. Smok­ing ci­garette, pipe, cigar, Huqua, Shisha and other use of to­bacco like chew­ing to­bacco and to­bacco sniff­ing all are dan­ger­ous and ad­dic­tive. Nico­tine present in to­bacco smoke causes ad­dic­tion by in­creas­ing the brain lev­els of chem­i­cals like Dopamine and En­drophine. These chem­i­cals give a sense of hap­pi­ness hence there is crav­ing for to­bacco prod­ucts. If a per­son tries to quit, with­drawal ef­fects in­clude ir­ri­tabil­ity, anx­i­ety, de­pres­sion and lack of con­cen­tra­tion. To­bacco and to­bacco smoke have about 4,000 chem­i­cals , 200 of these are poi­sonous and 60 of these chem­i­cals are known to cause can­cer (car­cino­gens). Some of these chem­i­cals are, ben­zene (a petroleum prod­uct), am­mo­nia (used in dry clean­ing and toi­let clean­ing), formalde­hyde (a chem­i­cal used to pre­serve dead bod­ies and ) and Tar. To­bacco smoke causes ath­er­o­scle­ro­sis (hard­en­ing of the blood ves­sels) lead­ing to hart at­tack and stroke. It also con­tains car­bon mono ox­ide which de­creases oxy­gen in the blood. How smok­ing kills?

Lung Can­cer: 90% of peo­ple who de­velop lung can­cer are cur­rent or former smok­ers. Risk for lung can­cer in­creases with num­ber of ci­garette smoked (1 pack per day smoker is at higher risk than half packs per day smoker) longer one has smoked more is the risk for lung can­cer ( a per­son who has smoked for 20 years is at a higher risk than one who smoked for 10years). In USA, lung can­cer causes more deaths than breast can­cer, pros­trate can­cer and colon can­cer to­gether. Smok­ing is known-cause of many other can­cers like throat can­cer, esophageal can­cer, stom­ach can­cer, can­cer of pan­creas, breast can­cer, kid­ney can­cer and pros­trate can­cer.

Other Lung Dis­eases: Smok­ing causes med­i­cal con­di­tions called em­phy­sema and bron­chi­tis (COPD). In these con­di­tions the lung tis­sue is per­ma­nently dam­aged, as a re­sult pa­tient de­vel­ops cough, dif­fi­culty in breath­ing and may de­velop symp­toms which mimic asthma. Pa­tient gets lung in­fec­tions (pneu­mo­nia) eas­ily. In this case, lung can not make enough oxy­gen which, ul­ti­mately, leads to breath­ing fail­ure and death.

Heart At­tack: To­bacco smok­ing is a lead­ing cause of heart at­tack. Smok­ers have twice risk of fa­tal heart dis­ease. To­bacco smoke has chem­i­cals which cause hard­en­ing of the blood ves­sel with plaque for­ma­tion (ath­er­o­scle­ro­sis) which blocks the blood sup­ply to the heart mus­cle re­sult­ing heart at­tack and death.

Stroke: Smok­ing in­creases the risk of stroke. Smok­ers have three fold risk of stroke. 15% deaths due to stroke are smok­ing re­lated.

Other Ad­verse Ef­fects Of Smok­ing: Risk for Hip, due to tin­ning of bones (os­teo­poro­sis), stom­ach ul­cer, early wrin­kling of skin and sleep dis­tur­bance.

Se­cond Hand Smok­ing is a serous busi­ness. A per­son who smokes not only harms him­self but peo­ple around him like co­work­ers and fam­ily mem­bers who are at a high risk to de­velop can­cers, heart dis­ease, stroke and lung in­fec­tions. Chil­dren of smok­ers are at risk of de­vel­op­ing asthma, bron­chi­tis, si­nus in­fec­tions and men­tal re­tar­da­tion. Smoke­less to­bacco like chew­ing and sniff­ing to­bacco also has poi­sonous and can­cer­ous chem­i­cals which cause mouth, gum and throat can­cers. “I Cant Quit,” is the most com­mon re­sponse when a smoker is asked to quit. “Yes You Can Quit,” should be the an­swer. “How?” By un­der­stand­ing the ill ef­fects of smok­ing and also that you are not only poi­son­ing your self, but also your fam­ily and friends by giv­ing them se­cond hand smoke. There is help avail­able in form of coun­sel­ing by physi­cians, by nico­tine prod­ucts like nico­tine patches, nico­tine gum, and nico­tine spray, and two drugs namely Bupro­pion and Vareni­cline. They help by pre­vent­ing with­drawal symp­toms by nico­tine de­pen­dence. If a pa­tient is mo­ti­vated with the help of a physi­cian, and one of these med­i­ca­tions, he may able to quit. ROLE of so­ci­ety and government: Pak Government gets 0.7 % of its GNP from to­bacco tax­a­tion.

This amount is close to the amount spent on health care. Be­ing a big source of rev­enue, there is a lack of de­sire to dis­cour­age to­bacco use. So­ci­ety in gen­eral is not fully aware of smok­ing/to­bacco re­lated haz­ards. There is a dire need of ag­gres­sive anti-smok­ing aware­ness cam­paign, in­volv­ing civil so­ci­ety, me­dia, busi­ness com­mu­nity, school,col­lege and univer­sity stu­dents. Government needs to strictly im­ple­ment al­ready ex­cit­ing anti-smok­ing laws which pro­hibit smok­ing in pub­lic places.

Pak­istan has high­est con­sump­tion of to­bacco in South Asia while smok­ing preva­lence has in­creased by 30 per­cent dur­ing last decade in the coun­try. In a state­ment is­sued on Mon­day in con­nec­tion with World No To­bacco Day be­ing ob­served on May 31, Pres­i­dent Can­cer So­ci­ety Mul­tan, Dr Ibrar Javed said, dur­ing 2014, Pak­ista­nis smoked 64 bil­lion ci­garettes cost­ing Rs 264 bil­lion.

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