A big push for a smoke-free environment on World Tobacco Day
THE international theme for World No Tobacco Day on Thursday is: Tobacco breaks hearts, a theme which calls on the global community to focus on the ill-effects of tobacco use, including tobacco smoking, on heart health.
Professor Pamela Naidoo, chief executive officer of the Heart and Stroke Foundation notes: “Smoking triples the risk of having a heart attack and doubles the risk of having a stroke. Cardiovascular disease (CVD) is the single most important cause of death in many countries.
“Even people who smoke fewer than five cigarettes a day may show signs of early CVD, with the risk of heart disease increasing with the number of cigarettes smoked per day and duration of smoking.
“Exposure to second-hand smoke also causes CVD in non-smokers,” adds professor Ntusi, chair of the Department of Medicine, UCT.
One in 8 deaths globally are tobacco-related
Twice as many women die of exposure to second-hand smoke as men do (an estimated 600 000 women died from second-hand smoke-related deaths in 2016). More men smoke worldwide, but many women get exposed to smoke from their partners within the household.
In South Africa, the prevalence of smoking is 16.5% with 44 000 smoking-related deaths each year.
That is equivalent to 121 avoidable deaths each day.
Savera Kalideen, executive director of the National Council Against Smoking (NCAS) said that, “The nicotine in cigarette smoke results in an increase in blood clotting, blood pressure and heart rate. It also results in a decrease in oxygen reaching the heart.”
A recent study in the Western Cape found that over a third of women in a local township were exposed to passive smoking, putting them at a high risk of CVD and other complications. In the Drakenstein Child Health Study, one in five babies surveyed in two townships had the same level of nicotine in their system as active smokers. Many infants face the consequences of high smoking rates among pregnant women, including being underweight and developing lung problems.
SA proposed changes anti-tobacco legislation
Kalideen said the Department of Health had proposed significant and welcome changes to the existing tobacco legislation which aims to reduce consumption of tobacco products and protect non-smokers.
These changes include the proposal to make all public places, including stadiums, beaches and parks smoke-free. E-cigarettes will be legislated in exactly the same way as combustible cigarettes and all cigarette packaging will have to uniform colour and font used on the packets (plain packaging). Tobacco and heart health Both active and passive cigarette smoke exposure increases the risk of heart attacks, stroke, heart failure, peripheral arterial disease and atrial fibrillation. Evidence suggests there is a distinct direct dose-dependent relationship between cigarette smoke exposure and risk of CVD.
UCT’s Professor Ntobeko Ntusi remarks: “On a positive note, the risk of CVD is rapidly reversible and stopping smoking following a heart attack reduces an individual’s risk of heart disease by 36% in two years. Despite the decline in smoking rates since the introduction of anti-smoking legislation and taxation in SA, CVD remains the second biggest killer in the country.”
Prof Naidoo adds that the optimal target for heart health harm reduction through tobacco smoking should be a no-smoking policy at an individual and at population levels. She further “urges South Africans to help facilitate the government’s commitment to harm reduction through tobacco control policies and make an effort to keep themselves and their environment smoke-free”.
In addition, Prof Ntusi suggests: “Doctors and other health professionals should contribute as role models and advocates. As advocates, they should call for their hospitals to adopt smoke-free policies and make tobacco treatments available and affordable.
“Doctors in academic settings should advocate with medical schools to teach tobacco treatment methods to the next generation of physicians.”
The National Council Against Smoking, the Heart and Stroke Foundation SA and the Department of Medicine, University of Cape Town