[gallery size="medium" td_select_gallery_slide="slide" td_gallery_title_input="Why do we smoke?" ids="149338,149337,149339"] By Dr. Jemshith Ahmed USAGE of tobacco has been with mankind for about 3,500 years now. The earliest evidences of usage of tobacco date back to 5000 BC. What started as rituals in religious ceremonies is now being religiously practiced across the world for other reasons. Anyone who buys a pack of cigarettes is greeted with a death warning. Statutory mandates require 60% of the area of the packet to be having a cautionary image or message. More than one billion people who smoke conveniently overlook this farce. Smoking kills 50% of its users. It is the major contributor as an aetiology (set of causes) to the leading causes of death in the world. Heart attack, stroke, lung infections and other pathologies and lung cancer are just some of the ailments contributed by this addiction. World Health Organization (WHO) in 2008 granted tobacco the status of the world's single greatest preventable cause of death. Tobacco killed more than 6 million people in 2016 and is continuing to do so at a rate of one death due to tobacco related illnesses in every 6 seconds. This number is expected to reach 10 million deaths by 2020. Of the 6,000 plus identified chemicals in tobacco smoke, around 70 are carcinogenic. Tobacco smoke contains dangerous ingredients like Carbon Monoxide, Formaldehyde, Arsenic, Nitrosamines, Cadmium, Polonium etc. The annual estimated economic burden of tobacco use is $200 billion. Premature deaths, morbidity expenses, loss of pay due to illnesses related to smoking etc. add up to this figure In spite of all the overwhelming data convincing us on the harmful effect of smoking and the huge financial burden it imposes on mankind, the habit thrives in all countries of the world. If this argument were put up to a court of law, the case would be won with full jury majority. The culprit to be blamed is the highly addictive nicotine. Its addictive powers are comparable to the notorious cocaine. The molecular similarity between nicotine and acetylcholine, which is a major neuro-transmitter in the brain leads to the release of certain chemicals like Dopamine that creates a pleasurable feeling for the person using it. F-17 is a fighter jet used by the US Navy. In medical terms, it carries significance. According to ICD-10 (International Statistical Classification of Disease and related health problems -10th revision), F-17 denotes nicotine addiction. Habituated smokers are in a never-ending battle with the addictive powers of nicotine to maintain a level in blood. The grasp that nicotine has on body's metabolism is formidable. Smokers try to get over this by quitting multiple times, only to be snared back into the trap. The battle can only be won by strong determination by the person involved. Medical therapy aims to replace nicotine in low dose through different delivery mechanisms and medications that alter the chemical milieu in the brain. The benefits of quitting are immediate. Within 30 minutes, the blood pressure starts dropping and within a week breathing starts to get back to normal. In 15 years time of abstinence, the risk of heart attack reverses back to that of a non-smoker. The fight against tobacco is much effective in prevention. About 80-90% of people start smoking in their adolescent age. It is at this age and probably in schooling years that anti-smoking initiatives should focus on. Awareness campaigns, restricting availability, banning commercials and building a social stigma around the habit are some of the proven measures. Saudi Vision 2030 has identified smoking, along with obesity as the two principal illnesses to address. Coordinated efforts from the public and private sector in this regard are needed to achieve the target of reducing the incidence of smoking by 2%. The Ministry of Health has undertaken several initiatives in the regard. Private players like our group are also encouraged to participate to take the edge off this menace. Our vision is to build a healthy nation. To achieve it, unhealthy habits like smoking have to be curtailed. Now, the holy month of Ramadan is the right time, not just to put a pause to smoking, but to take a solemn resolution to quit the habit forever. — Dr Jemshith Ahmed MD, DNB, MRCP (UK) is the vice president – strategic planning in Abeer Medical Group.
