Killers in packs

Smoking was once considered macho, high-class and sophisticated. James Bond, Fidel Castro and socialites smoked publicly and elegantly. Now smoking has sunk way down in the etiquette scale and is socially unacceptable. Smoking in public places such as offices, trains and movie theatres is banned in many countries including India. Cigarette packets carry the warning: “Cigarette smoking is injurious to health”. Yet, there is no serious effort to implement a 2004 law banning the sale of cigarettes to minors. As a result, 7-8 per cent of teenagers in India use tobacco, as cigarettes, beedis or as chewing tobacco.


Cigarettes are made up of finely shredded tobacco leaves and stem rolled in a special kind of paper. When smoked or chewed, tobacco provides the body with a rush of nicotine and around 600 other addictive, harmful and cancerous chemicals. These produce elation and euphoria. Eventually, the intervals between “fixes” become shorter and the number of cigarettes smoked increases.

Addiction to tobacco is both genetic and environmental. A preconditioned individual reared in a conducive environment will eventually become addicted.

As the tobacco smoke enters the lungs, it paralyses the cilia. (These are small hair-like projections from cells lining the airways and are responsible for removing foreign particles.) The smoke can then settle in the interior of the lungs, causing destruction and difficulty in breathing. Attempts to clear the material are futile and result in hacking and unproductive cough. There are repeated bacterial and viral infections. Oxygenation becomes insufficient. The person may go into heart failure and become permanently breathless.

The build up of toxins can eventually lead to cancers — in the lung, urinary tract, oral cavity, pharynx, larynx, oesophagus, pancreas, stomach and blood (acute myeloid leukaemia).

In those who do not develop cancer, tobacco damages several organs. The teeth become yellow, plaque ridden, loosened from the sockets and may eventually fall. Conversation becomes difficult because of halitosis (bad breath). The bones weaken leading to early osteoporosis.

New evidence shows that the chemicals in tobacco alter the body metabolism, precipitating glucose intolerance and the changes associated with the metabolic syndrome X. Diabetes sets in, and the lipid levels are altered. Atherosclerotic plaques build up in the blood vessels, leading to heart disease, paralysis, stroke and vascular disease. The blocks in the peripheral vessels cause pain while walking and numbness, burning and tingling in the limbs.

The IQ (intelligence quotient) falls and the smoker’s cognitive skills decline faster than in non-smokers. This makes early dementia a very real possibility.

Women who smoke during pregnancy place themselves and their foetuses at great risk. They tend to have small babies. Also, there is a much higher incidence of abnormalities of the digits in the child. Fingers and toes may be more or less than normal or stuck together.

Non-smoking men and women who live in close contact with smokers suffer all the ill effects of smoking without the pleasures of addiction. Passive smokers are the single largest international group of victims of substance abuse.

More deaths are caused each year by tobacco use than from human immunodeficiency virus (HIV), illegal drug use, alcohol consumption, motor vehicle injuries, suicides and murders combined. Smoking causes diverse and silent deaths — an unpublicised form of slow suicide. The others diseases and causes of death receive far more media publicity.

Giving up smoking is not easy. As with all other addictions, it involves reconditioning of the body and the mind. Quitting has to be abrupt and overnight. There is no slow, weaning process.

Face-to-face interactive counselling on a one-is-to-one basis is very successful in motivating people to quit.

Medication to counter the urge to smoke is available in India. The sustained-release bupropion SR is a non-nicotine drug that supposedly reduces the craving by affecting the same chemical messengers in the brain that are activated by nicotine. It is expensive, the dosage has to be individualised, and it has to be taken for a prolonged period. Motivation and persistence are usually lacking in smokers, and thus the medication has not been a success in India.

Nicotine gum is available in some of the larger cities.

Most young smokers are convinced that they have the willpower to quit whenever they want to, but in reality 90 per cent are still smoking five years later. Many sincerely believe that complications will side step them and affect others!

It is never too late. Smokers who do manage to quit get a second lease of life. On average, they live longer and are healthier than those who continue the habit.

If you want to stop, grit your teeth and “just do it”.

Source:The Telegraph (Kolkata, India)

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