Dr Sunil Kumar S, Consultant Interventional and Structural Cardiologist & Endovascular Interventionalist & Dr.Hirennappa B Udnur, Consultant – Pulmonology, Columbia Asia Hospital, Hebbal

Dear Smokers, Smoking Kills. Smoking causescancer. But of course you aren’t oblivious to that! But do you know whichof your organs is the greatest victim of smoking? Lungs? Well, you couldn’thave got it more wrong. It is your heart that tobacco smoking affects theworst! In the early stages it is the lungs that gets affected and every smokerliterally feels the repercussions of smoking on their lungs as they pant forbreath and are divested of certain degree ofvigour andstamina. Then takes over the regular bouts of morning wheezes. However, it isthe cardiovascular disorders triggered by smoking that eventually acts as asneaking assassin!

May 31 has been denominated as the annual World NoTobacco Day (WNTD)by the World Health Organization (WHO). The theme for thisyear’s WNTD is “Tobacco and heart disease”. The cynosure of the WNTD 2018will be how tobacco impacts the cardiovascular health. Tobacco use is known tobe lethal factor inducing cardiovascular diseases (CVD), that ranges fromcoronary heart disease and peripheral vascular disease to stroke. According tothe reports by WHO, CVD is one of the major causes of the deaths in India andover 12% of all the deaths related to CVD are credited to smoking, eitheractive or passive. Yet the awareness of the public about the impact of tobaccoon the heart and the circulatory system is almost negligible.

Carbonmonoxide, emitted during smoking tobacco, binds to haemoglobin- with anaffinity that is 200-250 times greater than that of oxygen- and formscarboxyhaemoglobin and stays in the blood stream even two to four hours aftersmoking. This not only deprives the body of the necessary oxygen but itsnocuous properties damage the smooth endothelium lining of blood vessels. Nicotinepresent in tobacco also damages the endothelium and trigger inflammatoryreactions. This leads to deposition of cholesterol and narrowing of thearteries. Eventually absolute blockage occurs due to which alldownstream tissues which are to be supplied with oxygen by the blood vesselstarts to suffocate and die. The most common site of circulatory tissue deathfor a smoker is the heart muscle that leads to a heart attack, followed by thebrain leading to a stroke. 

Tobaccoconsumption disrupts the normal blood flow and harms the circulatory systemmore markedly than it does to the pulmonary system. Studies show that, whilelung cancer is accountable for 28% of the deaths related to tobacco smoking,CVDs are culpable of around 43% of the fatalities related to tobaccoconsumption. 

Bydesignating “Tobacco and heart disease” as the theme of WNTD 2018, WHO aims topromote awareness on the stark connection between tobacco and heart diseases,and on the viable measures that can be undertaken by the government and thepublic health organizations to reduce tobacco induced heart healthhazards. Tobacco is consumed in multifarious ways such as cigarettes,bidis, cigars, pipes, creamy snuff (tooth paste), kreteks and gutkha. Theday is celebrated across the world with the objective toencourage tobacco consumers to quit consumption of tobacco in all forms. Itis of utmost necessity to ban the use of tobacco globally since it fosters manyailments that are fatal like Chronic Obstructive Pulmonary Disease, Heartattacks, emphysema, and stroke, apart from the well chronicled lung cancer,throat cancer and oral cancer.

In India,approximately 10 lakh people die every year due to tobacco consumption. Tobaccosmoke contains about 4000 chemicals in every puff, of this at least 250 areknown to be hazardous and more than 50 are recognized as lethal carcinogens. Inevery form, tobacco is toxic, noxious and malignant. Even non-smokers today,are not immune from this bane. In grown-ups, passive smoking leads to chroniccardiovascular and respiratory ailments like coronary heart disease and lungcancer. In infants, it can be fatal. Pregnant women are at high risk too, sincepassive smoking can lead the neonate to suffer from low birth weight. Childrendaily breathe in air tobacco smoke in public places. WHO data has corroboratedthat, children constitute almost 28% of the deaths due to passive smoking. 

Tobaccoconsumption ranks as the second leading cause of CVD, after hypertension. Thisis indeed a matter of consequence, that demands our attention and firm action.Government should come forward with initiatives to ban smoking. It is high timewe realise that we are sitting on a ticking bomb, which if not diffused timelywould be fatal for the entire society. Let us create a tobacco free world!

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