Posted by: wockhardthospitals | August 7, 2009

All Up In Smoke!!!!!!

Introduction:


Smoking is the leading cause of preventable death worldwide today. Surprisingly, however, most of us still consider smoking a matter of individual choice rather than an addiction or a social issue.


click image to know more

click image to know more

Incidence:


Close to 1 billion people smoke world over. These figures are expected to increase to 1.2 billion by 2025. Among the continents, Africa has the lowest number of smokers with very little public smoking in many African countries. In comparison, India and China alone account for 40% of the world’s smokers.


More than 120 million Indians smoke. This is almost 10% of our population. Tobacco use leads to almost 20% of India’s cardiovascular deaths. The proportion of all deaths attributed to tobacco use alone is expected to rise from 1.4% in 1990 to 13.5% by 2020. It is estimated, in 2010, smoking will cause about 930,000 adult deaths in India; about 70% of these in the age group of 30 to 69 years. 1 in every 5 death in men and 1 in every 20 death in a lady of this age group is causally related to smoking.


Thus, the strain on our economic resources can well be imagined. In fact, very soon, India would also have the dubious distinction of harboring almost 60% of the world’s cardiac patients. No wonder, we are actually staring at a health crisis waiting to implode.


Pathophysiology:


Smoking increases the risk of developing vascular disease, whether coronary or peripheral six fold. This risk increases exponentially with the number of cigarettes and the number of years smoked. However, it’s not just the heart. Smokers are also at a high risk of developing lung disease and cancers.


A matter of concern is also the number of women smoking. A pregnant lady who smokes is at a high risk of having a still birth or a growth retarded child.


Exposure to second hand smoke or passive smoking also increases the risk of developing lung disease.


Tobacco use in India:


India has a heterogeneous and diverse spread of population. Thus, the pattern of tobacco use varies among the various states, with a distinct socio economic divide. Many religions consider smoking a taboo. Tobacco use has also shown to be inversely related to the educational status. Moreover, this refers not just to smoking cigarettes but also beedis and chewing tobacco. The beedi industry in itself provides employment to a large number of rural men and women. Closing these down is tantamount to depriving them of their livelihood. Thus, this is a complex social issue with no easy solution.


With the exception of Punjab and Sikkim, tobacco smoking is reported in 25 to 50% of adult men above 15 years of age. Among women, smoking is more common in the NE states, J&K and Bihar. Elsewhere, the prevalence in them is less than 4%.


So what are we doing?


India has been in the forefront in this crusade against tobacco and has been one of the first to ratify the Framework Convention on Tobacco Control negotiations. The 14th World Conference on Tobacco or Health was also held in Mumbai recently. India has also joined a few nations including the UK and Ireland in banning smoking at public places. At a national level, Kerala was the first state to ban smoking in 1999 while Chandigarh was the first city to be declared smoke free in 2007.


The onus is also on health care professionals to stop being passive about smoking and its detrimental effects. Smoking is not a lifestyle choice. Rather, once this habit encroaches on public health, it no longer remains an individual choice.


Conclusion:


Implementation of effective tobacco control policies requires sustained and unwavering commitment. Smoking cessation is more cost effective than any other preventive cardiology measures. Along with legislative measures, it requires intensive and aggressive public education and participation. It is indeed a matter of shame that an entirely preventable cause – smoking is responsible for one in ten deaths of an Indian today.

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