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..)