Tobacco: The Killer

Prof. (Dr.) Karuna Hazarika

(Principal-cum-chief superintendent, Tezpur Medical College. He can be reached at drkaruna97@gmail.com)

With nearly 8 million deaths worldwide each year from the tobacco pandemic, it is one of the largest risks to public health that the world has ever faced. Of those deaths, almost 7 million are directly related to tobacco use, and over 1.3 million are caused by secondhand smoke exposure for nonsmokers. “Protecting children from tobacco industry interference” is the theme for World No Tobacco Day in 2024. This is contemplated to safeguard the next generation and guarantee that tobacco usage keeps declining. The tobacco industry’s concerning practice of marketing specifically to young people is the focus of attention this year. Young people are becoming more and more exposed to the appeal of tobacco products through massive social media and streaming platform marketing, which poses a serious risk to their health and wellbeing. It is revealed in most countries studies that children between the ages of 13 and 15 use tobacco and nicotine products regularly.

Young people all throughout the world are calling on governments to protect them from deceptive tobacco marketing strategies, and World No Tobacco Day 2024 will provide a forum for them. For a lifetime of financial gain, the industry targets a young person, by virtue of advertisements through celebrities, which fuels a fresh wave of addiction. In every region, children are using e-cigarettes at rates higher than adults, and 37 million youngsters between the ages of 13 and 15 use tobacco worldwide.

Tobacco use poses a significant risk for over 20 distinct types or subtypes of cancer, as well as numerous other crippling medical issues. Nicotine, which is found in tobacco products, is also highly addictive. Things are easily available near schools and colleges, despite the laws. Moreover, there is no strict restriction for younger people in allowing entry to easily available pubs, clubs, bars, etc. Over 8 million individuals die from tobacco use each year. The majority of tobacco-related deaths take place in low- and middle-income nations, which are frequently the focus of intense marketing and industry influence. There is no safe amount of tobacco exposure, and using tobacco in any form is dangerous. In the world, smoking cigarettes is the most prevalent way to use tobacco. Cigars, cigarillos, hot tobacco, roll-your-own tobacco, pipe tobacco, bidis and kreteks, and smokeless tobacco products like ghutka and other snuf are examples of further tobacco products. Some people have switched to vaping (inhaling e-cigarette smoke) as an alternative to cigarette smoking to avoid health hazards. But recent studies show there is no reduction in health issues; rather, they are more dangerous. Other products that contain tobacco that, when heated or when a device that contains tobacco is activated, release aerosols that contain nicotine and harmful compounds are known as heated tobacco products (HTPs). They are frequently flavoured, contain non-tobacco ingredients, and include the extremely addictive chemical nicotine. There is no proof to support the notion that HTPs are less dangerous than traditional tobacco products, despite promises of “risk reduction.”

For those who do not smoke, secondary tobacco use can be fatal as well. Exposure to secondhand smoking has also been linked to detrimental health effects, including 1.2 million fatalities every year. Every year, 65,000 children pass away from diseases linked to secondhand smoke, and nearly half of all youngsters breathe air contaminated by tobacco smoke. Pregnancy-related smoking has been linked to a number of chronic health issues in the offspring.

The burden of tobacco-related sickness and death is greatest in low- and middle-income countries, home to almost 80% of the 1.3 billion tobacco users globally. Because tobacco smoking takes money away from fundamental necessities like food and shelter, it contributes to poverty. Tobacco is so addictive that it is impossible to break this spending habit. Additionally, it results in the early demise and disability of working-age adults within homes, which lowers household income and drives up healthcare expenses.

The most economical method of reducing tobacco use, especially among young people and low-income groups, is to impose tobacco taxes, which are used in part to counteract this effect. Tax rises that result in a 10% increase in tobacco prices also reduce tobacco use by approximately 4% in high-income nations and roughly 5% in low- and middle-income countries.

WHO actions: Although the scope of this economic and personal calamity is startling, it is also avoidable. Big Tobacco and all other tobacco product producers are fighting to keep the risks associated with their products hidden, but we are retaliating: The WHO Framework Convention on Tobacco Control (WHO FCTC), the only public health agreement endorsed by the WHO, was overwhelmingly ratified by WHO Member States in 2003. It is presently in effect and has 181 parties as of 2005. WHO established MPOWER, a set of technical tools and measures that each align with a minimum of one WHO FCTC clause, to assist nations in putting the convention into practice. MPOWER strengthens the capacity of countries to implement six measures to reduce the demand for tobacco products: monitor tobacco use and prevention policies, protect people from tobacco use, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising, promotion, and sponsorship, and raise taxes on tobacco.

There are some crucial details about tobacco facts worldwide.

n Up to half of tobacco smokers who do not give up die from the drug.

Approximately 1.3 million non-smokers who are exposed to secondhand smoke are among the over 8 million people who die from tobacco use annually.

n In 2020, 22.3% of the world’s population used tobacco—36.7% of males and 7.8% of women—with 1.3 billion smokers living in low- and middle-income nations.

n The WHO Framework Convention on Tobacco Control (WHO FCTC) was ratified by WHO Member States in 2003 as a response to the tobacco epidemic. Presently, 182 nations are signatories to this agreement.

n The WHO MPOWER initiatives have been demonstrated to save lives and lower healthcare costs by avoiding unnecessary medical procedures. They also comply with the WHO FCTC.

Quitting is one of the key factors to be initiated.

Addiction to tobacco is a complex combination of behavioural, cognitive, and physiological issues that makes it difficult to stop smoking. Few tobacco users are able to kick the habit completely on their first try. However, there is ample proof that it is possible. There are many helpful ways to stop using tobacco products, including prescription medications, counselling, and quit lines.

n Decide when to stop. Giving yourself a brief window of time to stop can help you stay motivated and focused on your objective. You can begin your quit right now!

n Inform your loved ones, coworkers, and friends. They can help you resist temptation and motivate you to resist cravings.

n Be prepared for obstacles. Anticipating triggers and obstacles in the future endeavour is crucial, especially in the crucial initial few weeks.

n Get rid of all tobacco items from your surroundings. Reducing one’s exposure to stimuli is crucial.

In certain high-burden nations, social norms do not encourage tobacco smokers to give up. The Global Adult Tobacco Survey (GATS), for instance, reveals that:

n Only 23.2% of Chinese adults think smoking is a major cause of illness in China. Merely 24.6% of people think that adult lung cancer, heart disease, and paediatric lung diseases are caused by tobacco smoke exposure. Merely 16.1% of adult smokers who are currently smoking intend to or are considering quitting within the next 12 months.

n Approximately 26% of adult smokers in India intend to stop smoking over the next 12 months, or are considering it.

Approximately 4,000 compounds are identified in tobacco smoke, of which at least 250 are deemed hazardous and over 50 are known to cause cancer in people. Everyone breathes in tobacco smoke in enclosed places, which exposes both smokers and nonsmokers to the dangerous consequences of the smoke. It is not possible to bring indoor tobacco smoke levels to a level that is deemed acceptable by using ventilation or filtration alone. Environments free of smoke are the only ones that offer adequate protection. Despite popular opinion, most smokers and nonsmokers support smoke-free areas.  Several nations have already passed legislation to shield citizens from tobacco smoke in public areas. On May 31, World No Tobacco Day, let us celebrate along with other people around the world, inspiring more individuals and nations to ban tobacco and prohibit tobacco products.