When man first started using tobacco, he probably did not know that it would grow to be an epidemic that could cause multiple health issues. Be it smoking or chewing, tobacco has severe negative effects on health. Take any of the current lifestyle diseases from diabetes to obesity, the common risk factor is tobacco abuse. In addition, depending on the form of tobacco used, specific organs are affected. For instance, chewing tobacco leads to oral cancer while smoking causes lung cancer.

The statistics around tobacco abuse are extremely startling and can be read below:

A total of about 90 trillion rupees are spent on various tobacco products.
About 1.4 trillion is spent on healthcare-related to conditions caused by tobacco abuse.
India has about 120 million tobacco users.
More than 7 million people die every year due to tobacco usage.
The Government has levied a GST of 28% on cigarettes, making them unaffordable, which is one of the ways to promote quitting.
For those who want to quit but are not able to, there is a quit-line setup, which is toll-free, 1800-11-2356 and is accessible from 8 a.m. to 8 p.m.
Tobacco is a menace in all the strata of society. The lower economic classes are adversely affected both due to lack of knowledge and healthcare facilities. Therefore, the government uses the World No Tobacco Day (WNTD) that is observed by all members of the World Health Organization as an opportunity to drive this awareness.

This is celebrated on May 31st every year. Some measures that are taken to promote 'say no to tobacco' campaign are listed below.

In 1975, the Cigarettes (Regulation of Production, Supply, and Distribution) Act was introduced, which made it mandatory for cigarette packs to have a warning stating  Smoking Kills  or  Smoking is injurious to health. 
Marketing campaigns are shown in the movie theatres at the beginning of movies which depict the hazards of tobacco
Smoking is banned in most public areas, and warnings are on display.
Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
Schools and colleges do not have tobacco selling within 100 meters of the campus.
The price increase ensures that not everybody has easy access to cigarettes.
Celebrities promote quitting tobacco and smoking by talking about their personal stories.
How can a healthcare professional help you?

A healthcare professional plays a vital role in a smokers life, as it the healthcare professional that can increase the odds of quitting with guidance, medication, and support. 

What should a healthcare professional do?

Identify people who smoke 
Motivate them to quit or think about quitting
Refer a person who smokes for treatment and support
Support ongoing abstinence
What is the right smoking cessation strategy?

Ask: Every smoker to visit a healthcare professional
Advice: Urge the smoker to leave smoking
Assess: Assess whether the person is willing to quit in 30 days
Assist: Plan and help Rx Quit
Arrange: Arrange a follow-up through phone or SMS or in-person
What is that people who smoke need help with?

First and  the foremost challenge are the withdrawal symptoms 
Urge to smoke and borderline depression with a possibility of relapse
People who have high pre-abstinence nicotine intake
How to get over the initial withdrawal discomfort?

Behavioural support is of proven efficacy
Can be delivered in different formats
Face-to-face
Telephone
Internet
Nicotine replacement therapy and nortriptyline are of proven efficacy
Facts On Nicotine Replacement Therapy (NRT)

There are no real contradictions related to NRT
No drug interactions 
Side effects, if there are any are localized e.g.
Taste of oral products
Hiccups with the mouth spray 
Skin irritation with patch 
Treatment for quitting Nicotine  - Medications: Medicines which are useful adjuncts in the determined but unsuccessful quitters are Varenicline and Bupropion. 

Though smoking out in the open has reduced, there are miles to cover when it comes to eradication of tobacco. 

World No Tobacco Day - Making An Effort To Control Tobacco Usage!

Smoking   Some Naked Facts!

Smoking kills > 420,000 people per year worldwide.
In India one million people die of smoking related diseases each year.
Tobacco use is the second leading cause of death world-over.
Smoking is more lethal than AIDS, Accidents, Homicides, Suicides, Fire, etc.
2700 substances have been identified in Cigarette smoke, most of them harmful including cyanide, benzene, formaldehyde, methanol, acetylene, ammonia, nitrogen oxide, carbon monoxide, etc.
Every cigarette takes 5.5 minutes of your life.
Smoking one packet a day for 10 years increases risk for Ischemic Heart Diseases by 300 % & risk for lung cancer by 500 %.
Passive smoking (breathing second hand smoke) is also harmful. Spending 2 hours in a smoky bar is equivalent to smoking 4 cigarettes. Living with a pack-a-day smoker is like smoking 3 cigarettes by yourself.

What are the Risks? 

Cancer: 85% of Lung Cancers and 28% of all cancer deaths are attributed to smoking. Smokers have higher rates of leukemia, kidney, stomach, bladder, and pancreas cancers. About 30% of cervical cancers have been attributed to both active and passive smoking.

Lungs: Smokers are generally at higher risk for nearly all major lung diseases like pneumonia, flu, COPD, bronchitis, emphysema, asthma, etc.

Brain: Smokers run almost two and a half times the risk of stroke as non-smokers and the risk for dementia is also higher in smokers.

Male Sexuality and Reproduction: Smoking decreases the amount of blood flowing into the penis, reduces sperm density, reduces sperm motility, and may lead to impotence & infertility

Female infertility, Pregnancy: Smoking increases the risk of female infertility, ectopic pregnancy, miscarriages, stillbirth, prematurity and low-birth weight, so also there is a risk of passing genetic mutations that increase cancer risks to unborn babies.

Children: Mothers exposed to smoke (active or passive) are more likely to have children with motor control problems, perception impairments, and attention disabilities. Exposure to smoke early on affect the lungs of infant as early as the first 2 to 10 weeks of life, it increases the risk for lower respiratory infections (asthma, bronchitis, and pneumonia) by 50% and worsens the condition of children who have existing asthma.
 
Spine & Bones: Smokers whose jobs involve lifting heavy objects are more likely to develop low back pain than non-smokers. They are at increased risk for developing osteoporosis and rheumatoid arthritis. Smokers are more prone to develop degenerative disorders and injuries in the spine, they have more trouble recovering from spinal surgery as smoking also impairs formation of new bone.

Why Quit?


Physical Benefits: They start as early as in few minutes.

Blood pressure and Pulse rate return to Normal in 20 minutes.
Levels of carbon monoxide and oxygen in the blood return to normal in 8 hours and chance of heart attack decreases in 24 hours.
Nerve endings start to regrow; ability to taste and smell increases within 48 hours.
Bronchial tubes relax; lung capacity increases by 72 hours.
In 2 to 12 weeks  time circulation improves and lung functions improve up to 30%.
In 1 to 9 months  time there is a decreased incidence of coughing, sinus infection, fatigue, and shortness of breath; cilia in lungs start re-growing, increasing the ability to handle mucus, clean the lungs, and reduce chance of infection.
Overall energy level increases.

Smoking - Facts, Risks & Why To Quit!

Ready to Quit? Then Expect this!

Withdrawal Symptoms: Be aware that the withdrawal symptoms may begin as soon as four hours after the last cigarette, generally peak in intensity at three to five days, and disappear after two weeks. Withdrawal

Symptoms can be

Physical like Headache, tingling in the hands and feet, sweating, gastro-intestinal (cramps, nausea) and/or Mental like tension, craving, anxiety to withdrawal, feelings of dependency, temper tantrums, irritability, intense needs, , insomnia, mental confusion, strong emotional and mental responses like feelings of being an infant.

Plan to Quit:

Before you plan to quit, ask a few questions to yourself like,

Do I really want to stop smoking?
What is holding me back?
What are the Real problems/excuses?
Do I accept that there is no miracle cure?
  Be clear about your reason &amp; readiness to stop.
  Draw up an action plan.
  Set a date and stick to it.
  Plan what you will do instead of smoking.
  Give up completely.
  Don t allow even a quick puff.
  Make quitting number one priority.
  Particularly in the first crucial week.
  Plan it with your friends, agree to support each other and make a pact not to let each other down.
  Make sure all cigs are destroyed.
  Get rid of all smoking reminders.
  Stay away from people who smoke.
  Keep busy.
  Pamper yourself.
  Decide what you are going to do with the saved money and put it aside.
  Try to avoid danger areas.
  Find activities that focus the hands and mind but are not taxing or fattening: computer games, solitaire, sewing, crossword puzzles, etc.
  Set quitting goals on a day to day basis and reward yourself when they are met.
  Think repeatedly about the advantages of quitting.
  Do deep breathing exercises.

Intense Cravings:

When the cravings become uncontrollable, try these 5 D s
  Delay
  Deep breathing
  Decide
  Drink water
  Do something else

Pharmacological Agents:

Your physician can prescribe you one of the following treatment options to help you quit.

Nicotine replacement in the form of Nicotine patches, gums.
Medication like Bupropione hydrochloride (Zyban) and Verenicline,(Champix)
Always Remember: MOTIVATION IS THE ONLY KEY TO SUCCESS !

Quitting Smoking - Know Everything About It!

E-cigarettes : Good Or Bad?

E-cigarettes or electronic cigarettes are vaporizers powered by battery which instigates the feeling of smoking. Though it has emerged as a measure to quit smoking, it is not so successful in achieving the same. 

Check out its Benefits Vs Risks

BENEFITS.
1. Alternative to smoking - For those who find hard to quit smoking can replace this smoke and tobacco free device with the traditional cigarettes and can reduce the intake of smoke or tobacco to minimal.

2. Easy on the pocket book - The cost of e-cigarettes is relatively low than traditional cigarettes. Hence, it fits well under the budget of chain smokers.

3. Reduces the risk to diseases - Cigarette smoking is injurious to health. It can cause innumerable diseases from cancer, stroke, heart attack, pneumonia to osteoporosis, Alzheimer’s etc. E-cigarettes have reduced the risk of many of these diseases for the smokers.

4. Odor free Cigarette - The odor from a smoker after smoking is unbearable. E-cigarettes help get rid of the maleficent odor and so others won’t notice the smell.

RISKS.

1. E-liquids - E-cigarettes have e-liquids which are very harmfull for the body. A small amount of e-liquid is enough to kill a child or an adult. Hence, there is an increased risk to life of a smoker.

2. Lacks labeling - E-cigarettes do not have proper labeling, health warnings, directions to use and its safe disposal technique. Hence, it has an added risk to environment if the e-liquids get exposed/leaked.

3. High levels of Nicotine - Though it is a tobacco and smoke-free cigarette, over usage of the same can make you addicted to nicotine which has further negative impacts on your health.
Hence, e-cigarettes may help in quit smoking, it is equally hazardous to your health. 


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How Good Are E-cigarettes, Really?

Smoking can cause irreparable damage to your mind and body. Chemicals in the tobacco travel to all parts of the body, leaving no area unaffected. According to available data, smoking causes 30% of all cancer deaths and about 80% deaths from emphysema and bronchitis. In addition to adversely affecting yourself, smoking also has a severe impact on your near and dear ones. According to WHO, about 600,000 people die every year from passive smoking. Out of the deaths that occur due to this, 1/3rd is that of children.

The Indian situation
While 85% of tobacco users worldwide consume it in the form of cigarettes, in India only 13% use it in that form. Additionally, 54% use it in the form of beedis. A study conducted on Indian smokers has revealed that an average of 8.2 cigarettes is smoked by an individual daily.

The study also revealed that the number of cigarettes smoked every year had grown to over 6 trillion. While 1 out of 10 adults dies from tobacco use worldwide, 5% of deaths in women and 20% of deaths in men in India are caused by cigarette and beedi smoking.

What happens when you smoke?
Cigarette smoke is made up of 4000 chemicals that are present either as tiny particles or gases and about 50 are known to lead to cancer, the toxin nicotine being one of them. In addition to nicotine, the chemicals that make up cigarette smoke also include tar and carbon monoxide. Prolonged exposure to these toxins can hamper your body's ability to filter air and clean the lungs. The smoke not only irritates the lungs but also causes excess production of mucus.

It also causes a paralysis of the tiny hair-like structures like cilia that line the airways and are responsible for removing dust and dirt from the organ. Paralysis of these hair-like structures also causes a buildup of mucus and toxic substances, leading to lung congestion. The extra mucus that is produced causes smokers to suffer from the very ubiquitous smoker's cough and chronic bronchitis.

It's also one of the many triggers of asthma, which brings about the narrowing and inflammation of the airways. Long-term exposure to tobacco smoke causes the destruction of the structure of the lung, walls of the airways as well as lung tissue. The result is a condition known as emphysema. Additionally, smoking also leads to cancer of the lung and over 80% lung cancer cases occur due to this habit.

Health Consequences of Smoking 3 Cigarettes A Day

The consumption of tobacco by humans began many years ago and has taken many forms ranging from rolled tobacco leaves and pipes to cigarettes. Smoking is a habit that is easy to start, but is difficult to quit. Smoking has both short term effects such as bad breath, tooth and gum loss, premature ageing and weakened immune system and long term effects that impair the respiratory system and cardiovascular system. 

Smoking can cause and worsen diseases like cancer of lungs, throat, mouth, kidneys and blood and other chronic obstructive pulmonary diseases. Smokers also have a higher risk of conditions such as dementia, cataract, pulmonary fibrosis, psoriasis, osteoporosis and optic neuropathy. Smoking can also affect fertility, cause erectile disorders and speed up the onset of menopause.

It is said that a smoker s life expectancy is 10 years less than that of a non-smoker. There are three main components of cigarette smoke that can harm the body.

Nicotine: Nicotine is what makes cigarettes addictive and make smoking a habit. In the beginning, it may stimulate the brain but in the long run, your body can begin to crave for nicotine. If this craving is not fulfilled, it can cause irritability, restlessness, headaches and shortened attention span.
Tar: Tar in cigarettes contains many harmful chemicals and is deposited in the lungs. From here it enters the blood vessels and is carried to other parts of the body. In many ways, tar is akin to a poison.
Carbon monoxide: Carbon monoxide affects the blood s capacity to transport oxygen from the heart to the rest of the body. In the case of pregnant women, carbon monoxide can also reduce the amount of oxygen available to the growing foetus and hence cause complications in pregnancy. Children born to smokers are also said to have an increased risk of suffering from congenital defects and conditions like asthma.
The good news is that quitting it is possible and its benefits can be experienced right away. Within the first 72 hours of quitting, the bronchial tubes begin to open up and breathing becomes easier. If you stop smoking before the age of 50, you can reduce your risk of dying from smoking related complications by 50%. The most important part of quitting nicotine is your own determination and willpower. Nicotine replacement therapy in the form of gums, patches, lozenges and inhalers can also help deal with nicotine withdrawal symptoms and make the process easier.

Smoking - A Slow Poison?

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