The article emphasises the damaging effects of smoking on public health, highlighting nicotine's addictiveness and the different ailments it causes, as well as the significance of preventive and stopping methods to address the problem.

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Since smoking causes six million deaths worldwide each year, it is one of the biggest public health issues. The leading causes of death due to smoking are cancer.

Stroke, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer—of which lung cancer is the most prevalent. Most tobacco usage starts while people are young and increases as they get older. 

More than 3,200 children aged less than 18 smoke their first cigarette every day. Nearly 90% of smokers begin before the age of 18, and virtually 100% begin smoking by the age of 26.1 out of every 13 children born today will pass away too soon from a smoking-related ailment if smoking rates stay the same.

Because nicotine narrows blood arteries, raises blood pressure, and increases cardiac workload. Indeed, Kerala leads the Indian statistics among the highest number of tobacco smokers in India.

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Composition of tobacco

1. There are approximately 600 ingredients in cigarettes.
2. When burned, they create more than 7000 chemicals.
3. At least 69 of these chemicals are known to cause cancer such as Acetone, Acetic acid, Arsenic, Butane, and ammonia which are found in hair dye, nail polish, Rat poison etc.
4. The list goes on with cadmium, methanol, and tar, all of which are fatal to all earthly species.

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What makes cigarettes so addictive?

1. Tobacco products such as cigarettes are very addictive because of a toxic colourless oily liquid called NICOTINE.
2. Nicotine enters the bloodstream and then moves to the brain. Within seconds of inhaling cigarette smoke, nicotine causes the release of a happy chemical called dopamine in the brain, which gives people a good feeling.
3. People need to consume more and more cigarettes to achieve the same positive feeling over time as their brain starts to crave the effects of nicotine.
4. Because nicotine interacts with the adrenal glands to produce adrenaline in the body, some users may experience an increase in energy or focus as a result.

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Smoking and cardiovascular health

The chemicals in cigarette smoke cause the blood vessel lining cells to swell and inflame. As a result, several cardiovascular diseases may develop and blood vessels may get narrowed.

1. Atherosclerosis is a condition in which the arteries narrow and loses flexibility as a result of the buildup of plaque in the artery walls caused by blood components such as cholesterol, fat, and other chemicals. As plaque accumulates inside the arteries, the aperture gets smaller, making it difficult for blood to effectively circulate throughout the body. Plaque formation in blood arteries is increased by smoking.
2. Coronary Artery Disease occurs when arteries that carry blood to the heart muscle are narrowed by plaque or blocked by clots. Chemicals in cigarette smoke cause blood in veins and arteries to thicken and clot. A clot's blockage can cause a heart attack and instantaneous death.
3. A stroke is a loss of brain function brought on by an interruption of the blood supply to the brain. Strokes can cause permanent brain damage and death. Smoking increases the risk of strokes. Smokers are more likely to die from a stroke than ex-smokers or persons who have never smoked.
4. Peripheral Arterial Disease (PAD) and peripheral vascular disease occur when blood vessels become narrower and the flow of blood to arms, legs, hands and feet is reduced. Reduced blood flow deprives cells and tissue of essential oxygen. An infected limb may need to be amputated in severe circumstances. The most frequent avoidable cause of PAD is smoking.

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Benefits of quitting

Earlier a person quits, more the benefit he/she gets. For eg, when one quits at 30yrs of age, he gains 10 years of life whereas if he quits at 60 yrs of age, he gains just years of life.

The point of interest is, if one quits smoking after a heart attack, he can reduce the chance of a second attack by 50%.

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Second-hand smoke: A silent gun!

Second-hand smoke is smoke you don’t mean to breathe in. Exposure to second-hand smoke comes from side streams or mainstream smoke. hen burning tobacco products like cigarettes, cigars, or pipes, sidestream smoke is produced.

Unfiltered side stream smoke comes out of the end of a cigar, cigarette, or pipe. When someone breathes it in, it contains more toxic substances that are hazardous.

Studies have shown that damage from second-hand smoke occurs in as little as five minutes:

• After five minutes: Arteries become less elastic, similar to how they do in a cigarette smoker.
• After 20-30 minutes: Blood starts clotting, and fat deposits in blood vessels increase the risk of heart attack and stroke
• After two hours: An irregular heartbeat (arrhythmia) can develop and trigger a heart attack or other serious cardiac problems.

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The hidden dangers of e-cigarettes

1. These are smoking pipes without tobacco. An electronic cigarette is a gadget that resembles a cigarette, cigar, pipe, pen, or USB drive.
2. Although the liquid within might have a delicious scent, it might also contain a lot of nicotine.
3. Manufacturers assert that e-cigarettes offer a healthy alternative to tobacco use by avoiding many of its health dangers.
4. While these devices may help quit smoking, there is growing evidence that e-cigarettes can pose serious health risks, especially to people who do not smoke traditional cigarettes because they contain Nicotine and other toxins.

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Smoking in adolescents and its prevention

Adolescents smoke mainly because of the social influences drawn by the media as well as the curiosity or stress busters (myth). Media has a great impact on a teen’s decision to smoke. Smoking is often portrayed as a sign of glamour in mass media. Smoking scenes in films leave a mark on teen’s minds and they try to copy them.

Quit smoking: The 5A’s model

• Ask: Ask if he/she smokes
• Advice: Advise them repeatedly about smoking and its hazards
• Assess: Assess the person to know the barriers to quitting
• Assist Pharmacological assistance: Some medicines help in quitting
• Arrange: Arrange frequent visits for follow-up to keep him in the loop

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What can be done?

• Prohibit smoking
• Educate children
• Parental guidance
• Decode advertisements- WILLS Kills; CHARMS harms
• Stop the trend
• Anti Advertising

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Manju Bhargav B R is an MD(Gold Medal), DM Cardiology Resident, Govt Medical College, Thiruvananthapuram.