World No Tobacco Day!

Dr. Arun R Warrier 
Consultant Medical Oncologist,
Aster Medcity, Kochi

The theme for World No Tobacco Day 2017 is "Tobacco - a threat to development."

Maybe it is through damaging health of public that tobacco poses a major threat to the economic development. Advances in the healthcare sector and society are to a large extent off set by the tobacco addiction.The common man who inhales/chews tobacco is unaware of the fact that he is giving entry to more than 7000 chemicals , of which at least 250 have been proven to be carcinogenic.

Because of unawareness about the long term implications, the habit takes root in the teenage years. Nicotine, whose addictive potential has been compared to cocaine/heroine spares no time to get them hooked to tobacco .The chemicals stream through the mouth, lungs ,food pipe and various organs and damages the DNA content. Cells start to grow without control , form a mass and get the ability to spread to other parts OR they are converted to CANCER CELLS.

Tobacco is the major cause for premature deaths in adults, not just through cancer but also by increasing the number of heart attacks, stroke and lung problems.The severity of these conditions is directly proportional to the years spent with the habit. There is a 10- 15 years reduction in life span for heavy smokers because of the above mentioned diseases.

Tobacco addiction has a physical and chemical form in that some are attracted by the very concept of holding the tube, draw a puff or chewing the gum to show that they are “cool”. This is sometimes substituted by e cigarettes which contain just Nicotine minus the harmful chemicals. Still most of the authorities don’t recommend them as there is no surety about the content of these e cigarettes. Nicotine gums also serve a similar purpose.

Fact remains that less than 5 % of smokers completely give up the habit. It requires a multidisciplinary team of doctors including counsellors and strong family support to escape the claws of tobacco. The best bet is never to start and for this , campaigns have to start from schools.

Stopping at any stage is beneficial as the risks of diseases start to decrease almost immediately from the time of quiting, but take 5- 10 years to completely reach zero levels.

Cancers of the mouth are the most common ones among smokers, closely followed by lung cancer. Mouth cancers begin like a sore which does not heal, can ulcerate and cause bleeding and pain. Recently there is an increase in oral cancers among young adults who chew tobacco as there are deadly excipients added to many such products which leads to cancer in a short time. They may sometimes be resistant to usual treatment modalities also.

Change or hoarseness of voice may be a sign of larynx or voice box cancer.

Lung cancer is among the leading causes of cancer deaths now. This is because 75% are diagnosed at an advanced stage. Symptoms like cough, chest pain, spitting of blood occurs late and they grow very rapidly making it difficult to diagnose at an early stage. Low dose CT scans in chronic smokers is being tried to pick up early cancers with serial evaluations. If suspicious symptoms are seen in smokers, they must consult a doctor, take scans and do a biopsy.

Some of these cancers may be caused by mutations in the gene like EGFR, ALK and they respond very well to oral tablets. Chemotherapy also helps to reduce the symptoms and improve quality of life in advanced lung cancer.

Second hand smoking is another major concern. Presently,15- 20 % of lung cancers are seen in non smoking females. Side stream smoke containing harmful chemicals leads to similar damage in their body also. Adenocarcinomas which were rare few decades back have become the most common lung cancer due to increase in cancer among non smokers. Even children of smokers have been found to have increased rate of lung infection as well as reduced growth. The risks are compounded by smoking in closed spaces like rest rooms as the particles linger around for a long time.

Tobacco is clearly the most evident form of “slow suicide” practised by humans! If one is lucky not to have any of the health hazards, then also it remains a fact that large amounts of money and precious time are wasted by tobacco addicts. Indirectly by harming their dear ones, they are increasing the intentional self harm.

The only sure way to escape from this huge epidemic is not to start using tobacco in any form. Its time for the world to say NO TOBACCO not just for a day but on all days for a better tomorrow.