Why Quit
Smoking?
Every
year the world celebrates May 31st as a No Tobacco Day. The campaign
against tobacco largely owes its origin to the first
official report of the US Surgeon General in 1964 who identified smoking as a
health hazard of sufficient importance and identified many causal relationships
and smoking-disease associations.
Several US Surgeon General’s reports have been published since then and
over one-third of a century later, smoking todate remains the leading cause of
preventable premature death.
It has
now been estimated that from the 1990 level of 2.6 percent of all
disease-burden worldwide, tobacco is exported to increase its share to just
under 9 percent of the total burden in 2020 killing more people than any single
disease.
The
scenario for the developing countries is much worse. The World Bank assessment of the tobacco
issue in 1993 clearly states that “unless smoking behaviour changes, three
decades from now, premature deaths caused by tobacco in the developing world
will exceed the expected deaths from AIDS, tuberculosis and complications of
child birth combined”.
The
awareness on tobacco hazards spread rather fast in the United States and
Europe. It is the third World which is
going to sustain the trauma for long. An
analyst had very correctly stated that the tobacco industry has got a good
buffer – no matter how badly things go in the United States, international
sales will carry them along.
Although
one has talked about it repeatedly, it is always useful to recall the enormous
health problems with which tobacco is either related causally or associated
promotionally. It is an important cause
of cancers of not only the respiratory tract such as mouth, pharynx, larynx,
trachea and lungs, but also of oesophagus, stomach and even of distant organs
such as the urinary bladder. It can even
promote cancers of blood and of almost any other organ of the body. It causes chronic bronchitis and emphysema
subsequently resulting in chronic respiratory debility, failure and death. It contributes to about a quarter of cases of
coronary heart disease, cerebral stroke and peripheral vascular diseases. It increases the incidence of respiratory
infections especially amongst the children.
It can cause abortion and low birth weight of a newborn baby in case a
pregnant woman smokes. A prolonged
exposure of a nonsmoker to smoking from others can also cause problems such as
cough and precipitation of an acute attack in an asthmatic individual, worsening
of angina in a patient with heart disease or pneumonia in even a young healthy
child.
It is
because of these associations that tobacco has been identified as almost a
disease in itself. According to Dr
Brundtland, the WHO Director General, tobacco is a communicated disease –
communicated through advertising.
It is
rather unfortunate that advertising has caught the fancy of many young
minds. There is no better exposition of
this strategy than that by Allan Landers, who for years was the macho man for
“Winston” – the tobacco company: “They
make you believe that if you smoke, you are going to be sexy, attractive,
successful, accepted by your peers, rocking and macho, cool and sassy. They project this image in every media – from
day-time movies to night-time movies, magazines and even cartoon
characters”. Landers had realised his follies in advertising after he had
suffered from consequences of smoking.
He is now a dedicated tobacco control activist.
The
stories of tobacco enthusiasts turning into no-tobacco activists after becoming
victims of this poison are endless. The
list includes the celebrated Dr Jeffrey Wigand, a farmer executive of Brown
& Williamson, whose true story, “The Insider” depicted in a CBS television
“60 Minutes” had shook entire America.
What is most depressing about the
tobacco story is not necessarily its disease potential, but an enormous amount
of misery it brings to the families of its victims in particular and the
societies of these poor developing countries in general. It poses a huge economic burden, not only by
way of expenditure on tobacco products, but more because of the costs of
management and huge losses due to disability and early deaths from the smoking
related diseases.
In modern
times when information is easily disseminated, there is no reason to accept
what has proven to be dangerous the world over.
We must also benefit from the results of this global research.
Dr S.K. Jindal,
Professor & Head,
Department of Pulmonary Medicine,
Postgraduate Institute of Medical
Education & Research, Chandigarh.
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