Speaking recently on “World No Tobacco Day”, Minister of Health Leslie Ramsammy bemoaned the lack of regional cooperation on reaching a standard on labelling and packaging of cigarettes. This lassitude ignores the incredible devastation wrought by this scourge.
The figures alone are very stark: Extensive prospective epidemiologic data clearly establish that cigarettes cause over three million deaths annually across the globe – with over one million of those deaths due to lung cancer. Cigarette smoking is the major cause of lung cancer.
Clearly, lung cancer is an important and widespread disease that constitutes a major public health problem. This was not always so. Some 150 years ago it was an extremely rare disease, but its seemingly inexorable rise correlates with the explosive rise in the use of cigarettes since that time. Smoking harms nearly every organ of the body and diminishes a person’s overall health. Smoking is a leading cause of cancer and of death from cancer. It causes cancers of the lung, oesophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukaemia.
Smoking also causes heart disease, stroke, lung disease (chronic bronchitis and emphysema), hip fractures, and cataracts. Smokers are at higher risk of developing pneumonia and other airway infections. A pregnant smoker is at higher risk of having her baby born too early and with an abnormally low weight. A woman who smokes during or after pregnancy increases her infant’s risk of death from Sudden Infant Death Syndrome (SIDS).
Tobacco smoke contains chemicals that are harmful to both smokers and nonsmokers. Breathing even a little tobacco smoke can be harmful. Of the 4,000 chemicals in tobacco smoke, at least 250 are known to be harmful. The toxic chemicals found in smoke include hydrogen cyanide (used in chemical weapons), carbon monoxide (found in car exhausts), formaldehyde (used as an embalming fluid), ammonia (used in household cleaners), and toluene (found in paint thinners).
The dangers posed by cigarette smoking are not confined to those that smoke. Multiple studies have shown that the risk of lung cancer in patients who have never smoked, but have been exposed to environmental tobacco smoke in the home or at the job, has a statistically significant increase in the frequency of lung cancer, compared to people who have not had such environmental exposure. This is the so-called “passive smoking”. It is for this reason that in the US and several developed countries, there is a fast-growing movement to ban cigarette smoking from all public buildings.
But if cigarette smoking is so harmful, why do so many people – some 1.22 billion worldwide – persist with the practice? Well, simply put, cigarette acts like a drug: the active substances after absorption in the lungs, trigger chemical reactions in nerve endings which heighten heart rate, memory, alertness, and reaction time. Dopamine and later endorphins are released, which are often associated with reward and pleasure. To make matters worse, the nicotine from cigarettes is highly addictive.
A strong link between advertising and smoking in young people has been proven. The more aware and appreciative young people are of tobacco advertising, the more likely they are to smoke or say they intend to. The tobacco industry spends billions of dollars worldwide each year spreading its marketing net to target young customers.
Tobacco companies market their products wherever youths can be easily accessed – in the movies, on the Internet, in fashion magazines, and at music concerts and sports events. One of the most effective ways to protect young people from the harms of tobacco use is to ban advertising or promotion of tobacco products, and the sponsorship by the tobacco industry of any events or activities.
According to several reputable studies, if a person quits smoking, it was largely shaped by social pressure. If a spouse quits smoking, the other spouse is 67% less likely to smoke, but if one of his/her friends quits smoking he/she is 36% less likely to keep smoking. Our governments must agree on standards on advertising, which are crucial in influencing social mores.