Why 'World No Tobacco Day' is observed

On May 31 every year, the world observes World No Tobacco Day (WNTD). The objective of observing World No Tobacco Day is to reduce tobacco consumption which can lead to deadly diseases like cancer and early death.

World No Tobacco Day primarily focuses on encouraging users to refrain from tobacco consumption and its related products for a period of at least 24 hours. On No-Tobacco Day the attempt is to draw public and government attention on the need to take effective measures to prevent tobacco consumption which contaminates the air we live in.

The health effects of tobacco

Tobacco is the single greatest cause of preventable death globally. Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD) (includingemphysema and chronic bronchitis), and cancer (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer). It also causes peripheral vascular disease and hypertension. The effects depend on the number of years that a person smokes and on how much the person smokes. Starting smoking earlier in life and smoking cigarettes higher in tar increases the risk of these diseases. Also, environmental tobacco smoke, or secondhand smoke, has been shown to cause adverse health effects in people of all ages. Cigarettes sold in underdeveloped countries tend to have higher tar content, and are less likely to be filtered, potentially increasing vulnerability to tobacco-related disease in these regions. The World Health Organization (WHO) estimates that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. The global epidemic of tobacco use has killed 100 million people during the 20th century and could kill an estimated 1 billion people during the 21st century. This year, globally more than 5 million people will die from heart attack, stroke, cancer, lung disease, or other illnesses related to tobacco use. An additional 600,000 people-more than a quarter of them children-will die from exposure to secondhand smoke. The World Health Organization (WHO) estimates that by 2030, tobacco use will kill about 8 million people each year

Smoke contains several carcinogenic pyrolytic products that bind to DNA and cause many genetic mutations. There are 45 known or suspected chemical carcinogens in cigarette smoke. Tobacco also contains nicotine, which is a highly addictive psychoactive drug. When tobacco is smoked, nicotine causes physical and psychological dependency. Tobacco use is a significant factor in miscarriages among pregnant smokers, it contributes to a number of other threats to the health of the fetus such as premature births and low birth weight and increases by 1.4 to 3 times the chance for Sudden Infant Death Syndrome (SIDS). Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers, and is a key factor causing erectile dysfunction (ED)!

10 ways to quit smoking Go public - Talking to others about quitting Is beneficial. Being public about the quit attempt, particularly with those closest to you like family and friends, can help address this issue. Stress less -Stress is a major factor in keeping some people smoking. Exercise enough -Experts say ten minutes of cycling or jogging can significantly help people quit smoking. Scientists have shown that changes in brain activity, triggered by physical exercise, may help reduce cigarette cravings. Another possibility is that exercise causes a shift in blood flow to areas of the brain less involved in anticipation of reward and pleasure generated by smoking images. Go for e-Cigarettes -Yes, it's true there are electronic cigarettes available easily! They feel and look like regular cigarettes but they aren't bad for your health. It's a battery powered, cigarette shaped device that releases a small dose of nicotine with each puff. As the nicotine goes into the bloodstream, the smoker feels the same high but the (bad) effect is substantially less.

Tablets and patches -Smokers wishing to kick the butt can double their success rates by using nicotine patch. Available at select pharmacy shops but do check the label. The current labelling comes as a result of concerns that using a patch while smoking could lead to nicotine overdose, but a literature review found concurrent use of a nicotine patch and cigarette smoking appears to be safe. People who use the patch before quitting are likely to spontaneously reduce the number of cigarettes they smoke because the

patch satisfies their need for nicotine and makes the act of smoking less enjoyable. Nicotine patch also decreases withdrawal symptoms. Help on your phone -There's help from your phone as well! The new iPhone has a free application which provides a live quitline coach and uses live text to advice on how to kick the butt. It connects the user to the National Cancer Institute's quitline service where they speak to a live quitline coach or use live text to get advice on quitting. Chew the urge -There's a new cure on the block and that's a chewing gum. These are not ordinary ones, but nicotine-based chewing gums by which smokers can be wooed to desist from picking up a cigarette. Also, the National Botanical Research Institute (NBRI), Lucknow, has developed herbal chewable tablets. These herbal tablets will not only help those who want to quit smoking, but are also useful for all those who want to give up other tobacco products like pan-masala and ghutka. Opt for counselling -Nimhans has a Tobacco Association Clinic that comes to the rescue of those who want to quit smoking or any other form of tobacco. A combination of group or individual counselling, Nicotine Replacement Therapy (NRT) and medication is necessary in most cases. Hypnosis will work -This technique helps by giving suggestions of reminders to relax during times of craving, or unconscious commands, which create a negative impression in the brain. Think, feel, quit -You only live once. So take out time to think and feel for your loved ones, the environment and the passive smokers around you. Tobacco dirties the teeth and forms pigments in palms, fingers and nails; it leads to hair loss and skin wrinkles; tobacco users are two to three times more likely to develop heart disease and paralysis, apart from diabetes; men may become impotent and women may have fertility problems. Don't give up - Even if you have tried several times to give up the habit but failed, do continue trying. The number of times you've gone back to it is not important, but maybe the fifth or sixth time, you will actually be successful in kicking the habit.

1. There are immediate and long-term health benefits of quitting for all smokers. Here are some things that take place in your body as soon as you quit smoking: Within 20 minutes – Your heart rate and blood pressure drop. 12 hours - The carbon monoxide level in your blood drops to normal. 2-12 weeks – Your circulation improves and your lung function increases. 1-9 months - Coughing and shortness of breath decrease. 1 year - Your risk of coronary heart disease is about half that of a smoker. 5 years - Your stroke risk is reduced to that of a non-smoker’s, 5 to 15 years after quitting. 10 years - Your risk of lung cancer falls to about half that of a smoker and your risk of cancer of the mouth, throat, oesophagus, bladder, cervix, and pancreas decreases. 15 years - The risk of coronary heart disease is that of a non-smoker’s.

2. People of all ages who have already developed smoking-related health problems can still benefit from quitting Here are some things that happen in a smoker’s body compared to those who continue: At about 30: Gain almost 10 years of life expectancy At about 40: Gain 9 years of life expectancy At about 50: Gain 6 years of life expectancy At about 60: Gain 3 years of life expectancy Also people who quit smoking after having a heart attack reduce their chances of having another one by 50%.

3. Quitting smoking decreases the excess risk of many diseases related to second-hand smoke in children, such as respiratory diseases (e.g., asthma) and ear infections.

4. Quitting smoking reduces the chances of impotence, having difficulty getting pregnant, having premature births, babies with low birth weights and miscarriage.

Dr. Ravi Malik

M.B.B.S., M.D. (Paed)

Convener Medical Education, IMA-National Asstt Secretery General, IMA-National