Dr. Shyam P Lohani

Tobacco use dates back to 5000 BCE and has been found in many different cultures around the globe. An early smoking practice has been associated with religious ceremonies. In India and Sub-Saharan Africa, its use was merged with then-existing practices of cannabis use. There is no single benefit of smoking whatsoever. Cigarette smoking is one of the most significant preventable causes of disease and premature deaths worldwide. It is one of the prominent causes of cancer and cancer-related deaths. Tobacco use harms every organ in our body. Smoking tobacco introduces not only nicotine but also more than 5,000 chemicals, including numerous carcinogens into our lungs, blood, and organs. The effect of smoking leaves no body part behind. Every organ of our body is affected by tobacco.

High death rate
Worldwide around 1.3 billion people use tobacco and over 80 per cent of them live in low- and middle-income countries. Each year more than 8 million people die due to tobacco use, of which more than 7 million deaths are the result of direct tobacco use and about 1.2 million deaths are the result of second-hand smoke to non-smokers (WHO, 2021). If we look into statistics closely, it has been estimated that tobacco kills half of its users.
Tobacco use is linked to many other cancers and health problems. Among them, cancers, including lung and oral cancers, lung diseases, such as chronic obstructive pulmonary disease (COPD), damage and thickening of blood vessels causing high blood pressure, blood clots and stroke, vision problems, such as cataracts and macular degeneration (AMD), erectile dysfunction and birth defects are significantly associated with tobacco use.
Smoking during pregnancy has a greater chance of many pregnancy problems including babies with a higher rate of sudden infant death syndrome (SIDS). Not only smokers but also non-smokers develop many of the problems related to direct smoking such as heart disease and lung cancer. A higher risk of ear infections, colds, pneumonia, bronchitis, and more severe asthma are seen among children exposed to secondhand smoke. Preterm labour and babies with low birth weight are associated commonly among women who are exposed to secondhand smoke during pregnancy.

No forms of tobacco use are safe. Other forms of tobacco use are also associated with health problems. Cigars and hookahs, smokeless tobacco such as chewing tobacco and snuff have also been associated with many of the problems seen with smoking. All forms of tobacco use viz. smoke or smokeless are harmful. It must also be noted that there is no safe level of tobacco use. One cigarette per day over a lifetime can potentially cause smoking-related cancer and premature death. Quitting smoking reduces the risk of harm and overall diseases associated with it. To get the greater the benefit, it is suggested to quit early. The instant benefit of quitting includes fall of heart rate and blood pressure, lesser amount of carbon monoxide in the blood, bettering circulation, and less coughing and wheezing.

Quitting smoking has its health benefit at any age despite the duration and amount of smoking exposure. Smoking cessation improves overall health status and enhances the quality of life. It reduces the risk of premature death and can increase much as 10 years to life expectancy and reduces the risk for many adverse health effects which includes poor reproductive health sequels, heart diseases such as stroke, respiratory diseases such as COPD, and cancer.

It also benefits people who are already diagnosed with coronary heart disease or COPD and benefits the health of pregnant women, their fetuses and babies. Quitting smoking reduces the direct financial burden on smokers and their families, healthcare systems, society, and the country at large. Quitting smoking helps family members, coworkers, friends, and others from the health risks linked to second-hand smoke. It improves the overall working environment and helps improve productivity indirectly.

Health benefits
The health benefits after quitting smoking begin immediately and a series of affirmative changes continue for years. Heart rates drop within minutes of stopping smoking to dropping of nicotine level to zero within 24 hours. After several days, carbon monoxide level in the blood drops to the level of non-smokers, and within 1 to 12 months, coughing and shortness of breath decreases (CDC, 2020).

The risk of heart attack declines sharply in 1 to 2 years and the risk of coronary heart disease decline by half within 3 to 6 years. After 10 to 15 years, the risk of lung cancer decreases by half. Twenty years after quitting, the smoking risk of cancer of the mouth, throat, larynx, and pancreatic cancer drops to close to that of non-smokers (CDC, 2020). The resolution to quit smoking is one of the best decisions in a lifetime for smokers for the sake of their own health as well as the health of their significant others. It is often seen that the first few days of not smoking will be the hardest. It is suggested to develop a quit plan which may help one remain focused and motivated.

Many of the smoking cessation programmes suggest writing down when you smoke, why you smoke, what activities you do while smoking, and activities you can do instead of smoking. Initially, before quitting stop smoking during lunch break or after dinner. It is also suggested to tell family and friends about quitting smoking and ask for their help. Last but not the least, you can and will quit smoking.

(Prof. Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)