Smoking Tobacco

Smoking and use of Tobacco

Use of tobacco is the leading preventable cause of death worldwide. Nearly 6 million deaths every year are related to tobacco use in some form or other.

Nicotine can be used in the form of cigarettes, bidis, cigars, cigarillos, chewing tobacco, electronic cigarettes and Hookahs.

Most adult smokers begin smoking before reaching adulthood. Cigarette smoking has become less prevalent in developed world during last 2 decades. The use is now less in graduates and economically well off people. However, the poor and uneducated have shown little change over the years. The less educated smokers do not try to quit smoking and if they try are less likely to continue abstaining as per the various data available.

The following diseases are linked to tobacco:

Cardiovascular disease- about ½ of all deaths in smokers are due to tobacco use. A large contribution to death is made by high incidence of ischemic (coronary artery disease) leading to heart attacks.

It is a leading factor in causing diabetes, hypertension, Chronic obstructive lung disease and infections in the lungs. Osteoporosis and bone fractures are more common in smokers.

A long list of cancers is associated with smoking. These include cancer of lungs, oral cavity (almost exclusively in tobacco chewers), esophageal cancer, urinary bladder cancer and various others.

Acid peptic disease (peptic ulcer) , various disorders of reproductive organs (decreased fertility and libido) are also related to smoking and tobacco use. In pregnant ladies exposure to tobacco leads to damage to the fetal organs and increased risk of pregnancy complications.

In patients who smoke, post operative period is less likely to be smooth. Infections especially of chest are common.

Quitting smoking and tobacco use:

Most of the harmful effects of smoking are reduced if the smoker quits. Quitting however is not easy due to high addiction of nicotine use.

Withdrawl syndrome similar to alcohol may occur in smokers.  This can lead to transient depression, sleeplessness, dysphoria, irritability and difficulty in performing tasks requiring concentration. Nevertheless the benefits of smoking cessation far outweigh the difficulty in quitting. Weight is common after smoking cessation.

To reduce the side effects of quitting and making it easier to quit, nicotine substitutes (patches or nicotine gums have been popular. Bupropion and varenicline are two drugs which increase the success rate in smokers who are trying to refrain from tobacco use.

Avoidance of tobacco use has to be lifelong. A long term vigil for first few years is necessary to prevent relapse.

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