The rise in cigarette smoking resulting in serious health outcomes both on the smoker and the non smoker if he /she happens to be in close vicinity to the smoker has raised health concerns among health officials in Sri Lanka as well as across the world, who have reiterated their call for an end to smoking or drastically reduce smoking so that in the not too distant future Sri Lankia could be a country with zero smoking.
The Sunday Observer spoke to Senior Prof. of Forensic Medicine at the Sir John Kotelawala Defence University), Professor Ravindra Fernando, who has spearheaded the campaigns to end smoking in Sri Lanka for several years in the various posts he has held as a experienced Toxicologist, for his opinion as to what drives this persistent toxic health trend in Lankans, and to find out more insights into its harmful impacts, as well as most importantly guidelines and suggestions with regard to how both chain smokers and those leading risky lifestyles or those about to take their first cigarette can stop becoming addicted to it.
Excerpts
Q: As a Toxicologist tell us what do cigarettes contain that make them so unhealthy for us? What are the long term and short term health consequences of inhaling the chemicals hat cigarettes contain?
Prof. Ravindra Fernando
A. The short term and long term health consequences of inhaling these chemicals which are mostly harmful can be severe if not fatal . The gases inhaled from a cigarette causes constriction of the bronchi, numb the cilia, thickens the mucus-secreting membranes, dilates the distal airways, and destroys the alveolar walls. A particular component of a cigarette is carbon monoxide; this gas increases the risk for coronary artery disease. Smoking also impacts your cardiovascular health and also affects the health of those around who don’t smoke as well. Risks that smokers face can include, stroke, heart disaese including heart attacks.
Q: So how many of these harmful chemicals are there in a tobacco smoke?
A. There are more than 7,000 chemicals in tobacco smoke, at least 250 of which are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia. Commercial tobacco smoke contains hundreds of harmful chemicals. As I just mentioned, there are more than 7,000 chemicals in commercial tobacco smoke, including hundreds of chemicals that are toxic and about 70 that can cause cancer. Here are just a few of the chemicals and toxins in commercial tobacco smoke: Benzene (Found in gasoline), Toluene (Used in paint thinners), Butane (Used in lighter fluid), Cadmium (Used in making batteries), Ammonia (Used in household cleaners), and Hydrogen Cyanide( Used in chemical weapons.)
Q: Are men and women affected equally?
A. Yes.
Q: Chronic Obstructive Pulmonary disease (COPD) is said to be one of the commonest outcomes of smoking with fatal results as well. What is COPD?
A. Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems.
COPD includes emphysema and chronic bronchitis. With COPD, less air flows through the airways—the tubes that carry air in and out of your lungs—because of one or more of the following:
The airways and tiny air sacs in the lungs lose their ability to stretch and shrink back.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (irritated and swollen).
The airways make more mucus than usual, which can clog them and block airflow.
Q: Symptoms?
A. In the early stages of COPD, there may be no symptoms, or you may only have mild symptoms. As COPD worsens, the symptoms may become more severe. Symptoms of COPD include:
A cough that lingers for a long time and doesn’t go away completely, or a cough that produces a lot of mucus
Shortness of breath, especially with physical activity
Wheezing (a whistling sound when you breathe)
Tightness in the chest
Q: “Second hand smoking”? For our readers’ benefit can you explain what it is and how it affects the health of even those who do not smoke? By inhaling these fumes will he/she also suffer from the same complications that the smoker is likely to suffer from?
A. Secondhand smoke (SHS) is smoke from burning tobacco products, like cigarettes, cigars, or pipes. Secondhand smoke exposure occurs when people breathe in smoke breathed out by people who smoke or from burning tobacco products.
There is no safe level of exposure to secondhand smoke; even brief exposure can cause serious health problems and be deadly.
Completely eliminating smoking is the only way to fully protect people who do not smoke from secondhand smoke exposure.
Q: Yet, Smokeless tobacco products such as Babul, Beedi, Mawa, Pampara, and Gurkha are still available in the market. Are they better or worse than smoking cigarettes or cigars?
A. They also contain nicotine and other harmful substances.
Q: Who are those most vulnerable to secondhand smoking? Children? Elderly with lowered immunity?
A. People who do not smoke who are exposed to secondhand smoke, even for a short time, can suffer harmful health effects. In adults who do not smoke, secondhand smoke exposure can cause coronary heart disease, stroke, lung cancer, and other diseases. It can also result in premature death. Children as well as elderly with lowered immunity are most vulnerable.
Q: What about pregnant women? Will toxic fumes from cigarettes affect their foetus?
A. Smoking doubles your risk of abnormal bleeding during pregnancy and delivery. This can put both you and your baby in danger. Smoking raises your baby’s risk for birth defects, including cleft lip, cleft palate, or both. A cleft is an opening in your baby’s lip or in the roof of her mouth (palate).
Q: Are persons with asthma also vulnerable?
A. If you have asthma, an asthma attack can occur when something irritates your airways and “triggers” an attack. Your triggers might be different from other people’s triggers. Tobacco smoke is a common trigger for asthma. Tobacco smoke—including secondhand smoke—is unhealthy for everyone, especially people with asthma.
Q: Babies? Children?
A. They are more vulnerable.
Q: What is the safest distance to be to avoid inhaling the fumes of second hand smoking?
A. Do not smoke or allow others to smoke in your home or car. Opening a window does not protect you from smoke. Look for restaurants and other places that do not allow smoking. “No-smoking sections” in the same restaurant with “smoking sections” do not protect adequately from secondhand smoke—even if there is a filter or ventilation system. Make sure your children’s day care centers and schools are tobacco-free. For schools, a tobacco-free campus policy means no tobacco use or advertising on school property is allowed by anyone at any time. This includes off-campus school events. Teach children to stay away from secondhand smoke.
Q: Can cigarette smoke remain in the environment even after the smoker has stopped smoking? If so, for how long and in what way?
A. Yes, it can remain for several minutes.
Q: A Global School based survey conducted nearly a decade ago revealed that more than 6,000 children (10-14 years old) and 17,2500 adults (15+ years old) reportedly continue to use tobacco each day and that the smoking prevalence among aged 13-15 years in Sri Lanka was believed to be around 2 percent Is the number the same today? Or has it increased?
A. Yes, there is no significant increase of smokers in Sri Lanka.
Q: Chronic Obstructive Pulmonary disease (COPD) is said to be one of the commonest outcomes of smoking with fatal results as well. Do you agree?
A. COPD refers to a group of diseases that cause airflow blockage and breathing-related problems. COPD includes emphysema and chronic bronchitis. With COPD, less air flows through the airways—the tubes that carry air in and out of your lungs—because of one or more of the following:
The airways and tiny air sacs in the lungs lose their ability to stretch and shrink back.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (irritated and swollen).
The airways make more mucus than usual, which can clog them and block airflow.
In the early stages of COPD, there may be no symptoms, or you may only have mild symptoms. As COPD worsens, the symptoms may become more severe. Symptoms of COPD include:
A cough that lingers for a long time and doesn’t go away completely, or a cough that produces a lot of mucus
Shortness of breath, especially with physical activity
Wheezing (a whistling sound when you breathe)
Tightness in the chest
Q: Yet smokeless tobacco products such as Babul, Beedi, Mawa, Pampara, and Gurkha are still available in the market. What are the health impacts of these smokeless products? Are they better or worse than smoking cigarettes or cigars?
A. They are also harmful as they have toxic products.
Q: Can cigarette smoke remain in the environment even after the smoker has stopped smoking? If so, for how long and in what way?
A. Yes, it can remain for several minutes.
Q: A Global School based survey conducted nearly a decade ago revealed that more than 6,000 children (10-14 years old) and 17,2500 adults (15+ years old) reportedly continue to use tobacco each day and that the smoking prevalence among aged 13-15 years in Sri Lanka was believed to be around 2 percent Is the number the same today? Or has it increased?
A. No new data available. I think it is the same.
Q: So what is the best solution to halt a further spread of dangerous drugs and smoking among schoolchildren and teenagers?
A. Reduction of smokers in the community.
Q: This year’s theme is “We need food, not tobacco”. What is the significance of this global theme in our Lankan context given that commercial tobacco cultivation is one of the highest revenue earners for our badly hit economy?
A. The 2023 global campaign aims to raise awareness about alternative crop production and marketing opportunities for tobacco farmers and encourage them to grow sustainable, nutritious crops. It will also aim to expose the tobacco industry’s efforts to interfere with attempts to substitute tobacco growing with sustainable crops, thereby contributing to the global food crisis. In my personal opinion I strongly feel that tobacco growing should be substituted with food and other economical crops, in order to ensure that we have a healthy future generation . This is what our health policymakers MUST priortise.
Q: What are the gaps you see in our health system with regard to reducing the prevalent soaring rates of smoking in the country?
A. I reiterate, harmful effects of smoking should be highlighted in every forum. Efforts at conveying this message of reducing smoking and its harmful impacts ,to the community is extremely important.
Q: Currently, there are several myths swirling around smoking, which drive smoking among young people. Which of these do you wish to dispel?
A. The myth that smoking is important to protect your personality should be dispelled. Also that it is not additive and can be easily stopped if one wanted to. My message to them is that smoking is addictive. Once you take that first smoke, the majority crave for more and find it difficult to give it up until they become chain smokers. There is a widespread assumption that smoking behaviour is largely established by the age of 18 years. As a result, smoking prevention has focused almost exclusively upon youth. However, recent trends suggest that young adulthood may be an important—and largely overlooked—period in the development of regular smoking behaviour. The myth of enjoying smoking should be dispelled.
Q: Your message to all smokers out there who want to kick the habit and those about to take their first puff?
A. Stop smoking NOW. It is harmful.
