Tobacco and Smoking

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Dr Noureen Ahmad

General Practitioner, Belgium

Smoking is one the greatest causes of many diseases accompanied with many health problems. In the United Kingdom 15.1% of people aged 18 years and above smoke. Unfortunately, a group of regular smokers are school children aged between 11-15 years old. 

There are two forms of smoking: active and passive. Active smokers are the ones who smoke the cigarette while passive smokers are those who are exposed to the smoke created by others.

Smoking can create many health problems and can lead to many long-term diseases. Smokers face double the risk of cardiovascular diseases such as chronic heart disease and stroke. Smoking also creates many lung problems such as chronic obstructive diseases like emphysema of the lungs and thus being prone to regular chest infections. 

In children, exposure to smoking can lead to asthma. Roughly 80-90% of patients with lung cancer developed the cancer due to smoking. If smokers stop smoking, further damage to the lungs can be stopped. This will lead to prevention of lung complications such as shortness of breath and chest infections. However, the damage already done to the lungs due to smoking cannot be reversed. 

Other cancers have also been reported in smokers such as cancers of the oesophagus, stomach, mouth, bladder and intestines. 

Studies suggest that there are approximately more then 70 cancer-causing agents in tobacco smoke. In pregnant women, smoking can lead to poor growth of the unborn child or a preterm delivery. 

Some studies suggest that smoking can lead to osteoporosis, indigestion and gastro-oesophageal reflux disease, diabetes mellitus and thrombosis. Smokers also have an increased chance of early skin ageing and problems of the reproductive systems such as infertility and impotence. 

As mentioned above, smoking can lead to many diseases, so it is necessary to stay as far away from smoking as possible. Smoke cessation will lead to immediate health improvements. However, it is categorised as a chronic addictive disease and quitting can be challenging. 

Relapse is common when quitting smoking and if this occurs, one should not feel like they have failed. It is important to understand what factors led such a person to smoking again and prevent those the next time. It is also advisable to seek advice from a healthcare professional to gain proper guidance and support through the smoking cessation process.

Smoking cessation depends on practical tips, nicotine replacement products and medication. First, there are practical tips, which can ease one into quitting. 

A smoker should be determined of stopping and should choose a fixed date to start. Informing family and friends about the smoking cessation plan, the smoker can count on support and encouragement. 

Sometimes a change in behaviour is needed, like avoiding situations or activities that can lead to cravings of smoking. It is advised to minimise time spent with smokers or at places where smoking is allowed. These tips can be helpful but should be combined with nicotine replacement products or special medication to improve efficiency of smoking cessation.

Cigarettes contain nicotine, a substance that is highly addictive. Nicotine alters the level of two chemicals (noradrenaline and dopamine) in the brain, which result in feelings of pleasure and reduces stress. The brain gets used to the nicotine and if smokers want to have the same effect, they must keep smoking. However, when smokers suddenly stop smoking, the nicotine-effect on the brain disappears. 

This leads to withdrawal symptoms such as cravings for cigarettes, increased appetite, anxiety, frustration, anger, sleep problems, irritability and concentration problems. To reduce these symptoms, uses of nicotine replacement products are necessary. These are available in many stores and in many forms such as skin patches, tablets, inhalers and nasal sprays. It is advised to use one of these products in the first weeks of smoking cessation due to the high chance of withdrawal symptoms and relapse of smoking. 

Lastly there are special medications produced to help, like varenicline
and bupropion, and these medications are usually on prescription.

Tobacco is commonly associated with cigarettes, but there are also other forms of tobacco available. Smokeless tobacco such as kimam, mishri, naswar, gul, ghutka and zarda are particularly used in the South Asian communities. This smokeless form of tobacco gives a high risk of dental diseases, but also a high risk for mouth and throat cancers. Heating of tobacco happens in hookahs also known as waterpipes. Hookah-users have an increased risk of lung cancer and lung problems, but also a high risk of carbon monoxide poisoning. 

Recently, e-cigarettes have been introduced to aid in smoking cessation.
These devices create a vapour by heating the nicotine. The vapour does contain fewer toxins than cigarettes, but it is not free from toxins. 

Studies suggest that these e-cigarettes contain cancer-causing agents and should be prevented in smoking cessation. 

(Always discuss with your doctor what supplements you want to take or are taking so that your health and wellbeing can be properly looked after.)

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