TOBACCO BREAKS HEARTS

by Manjari Peiris

Every year the campaign for World No Tobacco Day (WNTD)  aims to increase awareness on feasible actions and measures that key audiences, including governments and the public, can take to reduce the risks to heart health posed by tobacco.

In 2018, World No Tobacco Day (WNTD) will focus on "tobacco and heart disease". Cardiovascular diseases (CVD), including stroke, which are the world’s leading causes of death, and tobacco use being the second leading cause of CVDs, after high blood pressure.

They say for ‘’every one cigarette smoked you will lose around 11 minutes of your life’’…and ‘’if you have some 1000 20 year old current smokers around 250 will die in middle age (not old age) from smoking-related condition’’, said Dr Sandy Gupta MBBS MD FRCP, Consultant Cardiologist, Whipps Cross/Barts NHS Hospitals, London, UK.

As a Cardiologist I see on a daily basis premature and ‘avoidable’ cardiac events (and sadly deaths at times) and tobacco is often a strong factor. Even a single cigarette may be harmful.

How does  tobacco smoking damage your heart?

CVDs kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12 percent  of all heart disease deaths. In the WHO European Region, CVDs cause around half of all deaths. Of the 6 WHO regions, the highest overall prevalence for smoking in 2017 was estimated to be in the European Region, at 28 percent.

Smoking increases the risk of developing cardiovascular diseases, which includes coronary heart disease and stroke. Smoking damages the lining of your arteries, leading to a buildup of fatty material (atheroma) which narrows the artery. This can cause angina, a heart attack or a stroke

Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.

Chemical effects

Thirty percent of all heart disease deaths are caused by cigarette smoking. Smoking is the single largest preventable cause of heart disease in the United States. Tobacco smoke contains high levels of carbon monoxide. Carbon monoxide affects the heart by reducing the amount of oxygen the blood is able to carry.

The chemicals in tobacco smoke harm your blood cells. They also can damage the function of your heart and the structure and function of your blood vessels. This damage increases your risk of atherosclerosis. Atherosclerosis is a disease in which a waxy substance called plaque builds up in the arteries.

A third mechanism is through hemodynamic effects of nicotine. These include an increase in heart rate and blood pressure, which in turn increase myocardial work and oxygen demand, as well as constriction of coronary arteries, which would impair blood flow and oxygen supply to the heart.

Some forms of smokeless tobacco too increase your heart rate and blood pressure. Evidence suggests that long-term use of smokeless tobacco increases your risk of dying of heart disease and stroke.

Does secondhand smoking bring in detrimental effects to your heart?

Exposure to secondhand smoke damages the heart and blood vessels in many ways.  Quitting smoking and avoiding secondhand smoke can help reverse heart and blood vessel damage and reduce heart disease risk. Therefore non-smokers should ask smokers not to smoke in your home or car or public transport. If you are near someone who is smoking, politely ask him not to smoke around you.

Secondhand smoke is a mixture of two forms of smoke that come from burning tobacco  which is mainstream smoke, the smoke exhaled by a smoker and side-stream smoke which is smoke from the lighted end of a cigarette, pipe, or cigar, or tobacco burning in a hookah.

Influence of parents to children

Children who grow up watching their parents smoke are also more likely to become smokers as teens.

The best and wise decision for a human being is not to initiate smoking and be away from smokers  as much as possible. Moreover, engage yourself as a responsible and kind citizen to educate, encourage and empower  people not to become a prey of the tobacco industry strategies of whatsoever and refrain from  taking up smoking and contribute your precious time and energy for saving others well from this  global disaster.

As regards prevention, Dr. Gupata emphasized the fact that it is never too late to help people stop smoking; and it is indeed  a priority to deter people from starting.

Two things we need to change now with the  approach  of  WNTD 2018 -

1) for current smokers…ask, assess, assist, advise and arrange for them to enroll into stop smoking services. And

2) provide  education to prevent people, especially the young from taking up smoking (in all its forms…shisha, cigarettes, vaping..)

Today 31st May, is World No Tobacco Day - Protect your heart from tobacco smoking

By Manjari Peiris

In Sri Lanka tobacco industry is owned by trans-national corporations which takes almost all of its profits to their countries in the West. Therefore the wealth is drained from a poor country to a rich country.

While the tobacco products sold is said to have decreased, the profits of the industry have increased almost tenfold within 10 years.

Even the senior citizens are taxed on their miserable  interest income plus on their medical needs, and even the poorest of the poor are heavily burdened by more and more taxes while the taxation of tobacco has not changed over 18 months. There must be a significant reason for this!

There are certain laws and regulations to control tobacco promotions and consumption, but action for monitoring  of  law enforcement is very weak.

One strategy the tobacco industry seems to adopt is to influence decision makers to  be inactive or very slow in the implementation of TC measures approved for implementation. Thus we observe several important TC related regulations  have not been  implemented/amended for years in Sri Lanka.

Governments and government institutions that exist with the cost of people's taxed money are meant to protect people. But we observe people's  money is sucked in two ways, i.e. to maintain these institutions and the tobacco industry's engagement in sucking people's blood through cigarette smoking which is detrimental to health.

It is high time to stop allowing this intentional, targeted and heartless carnage that is freely going on  right now. We understand that WNTD is not meant for one particular day, i.e. to celebrate it by authorities concerned by again wasting people's money at 5 star hotels to scratch each others' back for no creditable work whatsoever, but for show-off!

Why should I quit smoking?

Quitting smoking is the single best thing you can do for your heart health.

If you're a smoker, stopping smoking is the single most important step you can take to protect the health of your heart, states the British Heart Federation.

Smokers are almost twice as likely to have a heart attack compared with people who have never smoked. A heart attack happens when there is a sudden loss of blood flow to a part of your heart muscle. Most heart attacks are caused by coronary heart disease. A heart attack is life-threatening and while stopping smoking is the single best thing you can do for your heart health, and the good news is that the risk to your heart health decreases significantly soon after your stop. By quitting you will be improving your own health by dramatically reducing your risk of coronary heart disease, stroke and a variety of cancers, as well. You will feel better, and have more money to spend on other things that you enjoy. Thus quitting has huge benefits and it is never too late to give up.

How does smoking damage your heart?

Smoking increases the risk of developing cardiovascular diseases,  which includes  coronary heart disease and stroke.

• Smoking damages the lining of your arteries, leading to a build up of fatty material (atheroma) which narrows the artery. This can cause  angina, a heart attack or a stroke.
• The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. This means your heart has to pump harder to supply the body with the oxygen it needs.
• The nicotine in cigarettes stimulates your body to produce adrenaline, which makes your heart beat faster and raises your blood pressure, making your heart work harder.
• Your blood is more likely to clot, which increases your risk of having a heart attack  or stroke. 
• Raise triglycerides which is (a type of fat in your blood.
• Damage cells that line the blood vessels.
• Increase the buildup of plaque -fat, cholesterol, calcium, and other substances in blood vessels.
• Cause thickening and narrowing of blood vessels.

Secondhand smoke

When non-smokers breathe in secondhand smoke - also known as passive smoking - it can be harmful. Research shows that exposure to secondhand tobacco smoke is a cause of heart disease in non-smokers, which means you could be harming the health of your children, partner and friends.

Breathing secondhand smoke can cause coronary heart disease, including heart attack and stroke.

·         Secondhand smoke causes nearly 34,000 early deaths from coronary heart disease each year in the United States among nonsmokers.

·         Nonsmokers who breathe secondhand smoke at home or at work increase their risk of developing heart disease by 25–30 percent. Secondhand smoke increases the risk for stroke by 20−30 percent.

·         Each year, secondhand smoke exposure causes more than 8,000 deaths from stroke.

·         Breathing secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase your risk of having a heart attack.

·         Even briefly breathing secondhand smoke can damage the lining of blood vessels and cause your blood to become stickier. These changes can cause a deadly heart attack.

"The cigarette is the deadliest artifact in the history of human civilization. It is also one of the most beguiling. Thanks to more than a century of manipulation at the hands of tobacco industry chemists - the author of Golden Holocaust, Robert N. Proctor draws on reams of formerly secret industry documents to explore how the cigarette came to be the most widely used drug on the planet, selling six trillion sticks per day. He paints a harrowing picture  of tobacco manufacturers conspiring to block the recognition of health hazards of while ensnaring legions of scientists and politicians in a web of  denial."

"Smokers may think they are smoking cured tobacco leaf, but there is actually quite a bit of other stuff in  cigarettes - some of which enters just by chance. The tobacco industry doesn't like to admit it, but we know from their internal archives that unwanted filth  sometimes makes its way into cigarettes. This includes shards of metal or glass but also substances that enter through rough handling in the growing stage - dirt, sand, and pesticides, for example, but also grease from the machines and even chemicals that gas off from the cellophane." Golden Holocaust