Expert Tells How Smoking Can Deteriorate Your Health In More Ways Than One

A huge population dies every year worldwide due to tobacco use alone. As per Global Adult Tobacco Survey (GATS), 48% of males and 20% of females in India consume tobacco products. More alarming is that the average age of initiation of tobacco use is just 17 years in India. 60,000 people succumb to tobacco-related illness worldwide due to exposure to second-hand smoke. More than 50% of Indian people are exposed to secondhand smoking daily, as per the household survey. Tobacco consumption reduces the expected lifespan by ten years due to many illnesses and disabilities linked to its use.

Smokers are twice likely to have a heart attack compared to nonsmokers. One in three people admitted with heart failure has strong tobacco consumption history. Smoking increases the two to the four-fold risk of stroke. Smoking increases the risk of asthma and bronchitis, leading to gradually progressive breathlessness impairing ambulation, and leading to premature death. Pregnant women exposed to smoke have a higher risk of premature, low birth weight babies and stillbirths. Young men often complain of erectile dysfunction and premature ejaculation. Tobacco use has also been linked to poor appetite, weight loss, loss of taste, cataracts, premature aging, and blindness.

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Smoking and tobacco use are two common risk factors for a variety of health issues
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Smoking is the most common preventable risk factor for lung cancer. More than 80% of lung cancers are identified in current or past smokers. Unfortunately, more than 85% are diagnosed in the advanced metastatic stage, where only one in ten patients manage to survive more than five years. Moreover, smoking-induced lung cancer responds dismally to standard chemotherapy and radiotherapy compared to cancer in non-smokers. Smoking also increases the risk by four-fold of the throat, food pipe, stomach, bladder, pancreas, and blood cancers. Consumption of tobacco has led to an epidemic of oral cancer in Indian Subcontinent. Majority of them present in advanced stages where curative therapy is impossible and average survival is measured in months.

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Though two-third of active smokers are desirous to quit, but less than 3% manage to do so by themselves without medical assistance, mainly due to a powerful addictive ingredient called nicotine in tobacco smoke. With integrated behavioral therapy and pharmacological measures under specialised physician care, tobacco quit rates can increase dramatically. India shares 20% of the oral cancer burden of the World, making it the capital of oral cancers. Similarly, 1% of India's total population has an underlying oral premalignant lesion, which can be easily detected by an oral cancer screening program and prompt complete tobacco products cessation. Though Low dose CT scan of the chest can help detect early pre-symptomatic lung cancers in high-risk smokers. Primordial and primary prevention by increasing awareness in the community at schools, colleges, and workplace levels will boost the goal of achieving 'no- tobacco' milestones early soon.

(Dr. Avinash Kumar Pandey is a Professor and H.O.D, Medical Oncology at AIIMS, Patna)

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