The Negative Effects of Tobacco and How to Quit Smoking

by Dr. Vikram Kekatpure, Senior Consultant – Head & Neck Surgical Oncology

‘SMOKING CAUSES CANCER’ surely ranks as one of the phrases that are most commonly heard, probably understood but hardly adhered to by people across the world and especially in India.

As we get closer to ‘World No Tobacco Day’ observed globally on 31st May, it would be relevant to understand the importance of quitting tobacco not for a day but for a lifetime.

Globally, India is one of the highest consumers of tobacco as well as one of the largest users of smokeless tobacco (SLT).

Various form of tobacco consumption

Some of the common ways people consumed tobacco in India include:

  • Smoking cigarettes,
  • Smoking cigars / chutta / cheroot, dhunti (Goa)
  • Smoking Beedi`s (most commonly used form of smoked tobacco in India)
  • Smoked in loose form in hookahs/water pipes (mainly in north India)
  • Reverse chutta smoking (in coastal Andhra Pradesh and Orissa)
  • Hookli (Gujarat)
  • Chillum (Northeast part of India)
  • Khaini, a tobacco, lime mixture (most commonly used form of SLT in India)
  • Gutkha, a tobacco, lime, areca nut mixture
  • Betel quid with tobacco

Cigarettes are available in various types, filtered/unfiltered, length-based, and flavoured. In India, we have the indigenous Beedi, made with 0.2 to 0.3 g of tobacco wrapped in temburni leaf and tied with a small string. Typically, Beedis contain 3 times more nicotine and 5 times more amount of tar than the regular cigarette.

The risks and negative effects of tobacco usage can never be overemphasized. Thanks to the numerous public campaigns undertaken over the years, there is some awareness of Tobacco usage being the single largest risk factor for head and neck cancer. The most common locations in the human body where Head & Neck cancer arises are the oral cavity, oropharynx, larynx, and hypopharynx.

Head & Neck Cancers

More than 80% of head and neck cancers are linked to tobacco use in some form or the other, and the amount of tobacco use may affect the prognosis, i.e the chance of recovery as well.

While Head & Neck cancer is a common form of cancer everywhere, it is the most prevalent cancer in India constituting almost one-third of all incidences of cancer in the country which illustrates the importance & benefits of reducing and in due course of time, eliminating tobacco usage completely.

Associated Risks

The risk for Head & Neck Cancer in smokers is approximately 10 times higher than that of never-smokers and 70–80% of new Head & Neck Cancer Diagnosis are associated with tobacco and alcohol use.

Moreover, most of the Head & Neck cancer cases are diagnosed in the advanced stages and the disfigurement caused by the treatment further affects the quality of life apart from imposing the financial burden on self and family. In addition to other health risks as men, women also experience increased risk of infertility, pregnancy complications, premature births, low birth weight infants, and stillbirths.

Further, it is not themselves alone who a tobacco user is likely to harm. Today, it is an established fact that second-hand smoke (SHS) also increases a person’s risk of developing head and neck cancer. This is particularly important in the Indian scenario, where a significant number of Non-smokers are exposed to SHS. Among pregnant women, tobacco use and SHS exposure are detrimental to health.

If anyone has been diagnosed with cancer, quitting tobacco use is one of the best goals a person can have to improve the chances of successful cancer treatment. Unfortunately, a large number of people believe that smoking caused their cancer and feel like they have brought this upon themselves. There are also a lot of others who believe that it is too late to quit and that the damage has already been done.

These preconceived notions have to go. People who use tobacco must be given the confidence that they do not blame themselves for a cancer diagnosis or feel that nothing can be done to help them.

Benefits of quitting tobacco

Quitting tobacco after a cancer diagnosis can have immediate benefits of which a few are mentioned below:

  • Longer survival, better prognosis
  • Better result of treatment in managing the cancer
  • Relatively fewer and less serious side effects from all types of cancer treatment
  • Faster recovery from treatment
  • Lower risk of recurrence or second cancers
  • Lower risk of infection
  • Easier breathing
  • More energy
  • Better quality of life

Risks of continuing to smoke

Continuing to use tobacco after a cancer diagnosis increases the risk of the following:

  • Worse side effects from surgery. There are plenty of them and may include side effects involving the heart and lungs, along with a slower recovery.
  • Worse side effects of chemotherapy. These may include infection, fatigue, heart and lung problems, and weight loss.
  • Worse side effects of radiation therapy. These may include but are not limited to mouth sores, loss of taste, worse voice quality, and bone and soft tissue problems.
  • A higher probability of the cancer recurrence.
  • Higher risk of other grave illnesses caused by tobacco use, such as heart and lung diseases or a second cancer.

Myths about quitting smoking

There are a lot of preconceived notions and misunderstandings that people have about smoking.

Here are 4 myths about quitting smoking

Myth 1: There is no benefit in quitting smoking now since I already have cancer.
Fact: It is never too late to quit smoking. People who quit smoking after a cancer diagnosis have a better chance at the management of cancer, thereby resulting in better prognosis, faster and easier recovery and also low chances of recurrence.

Myth 2: Quitting smoking is too stressful for people receiving cancer treatment.
Fact: Nicotine addiction is hard to break. And you may find the withdrawal process uncomfortable. But the benefits of quitting smoking outweigh the challenges. Also, there are tobacco cessation clinics and counseling that can significantly reduce the stress associated with quitting tobacco.

Myth 3: People can quit by themselves. They do not need help from a healthcare professional.
Fact: Many people can and do quit by themselves, but you may increase your chances of quitting successfully with the help of your health care team. They can offer support, information, and medication to help you quit for good.

Myth 4: Most medications used to quit smoking are not successful.
Fact: Many studies show that several medications can lower nicotine withdrawal symptoms and increase your chances of overcoming nicotine addiction. Your health care team can recommend the right medicine for you.

Other health risks associated with tobacco use

While the association of tobacco usage with Head & Neck Cancer is well-publicized, there are several other serious and life-threatening effects of tobacco usage which are relatively lesser-known.

Cardiovascular disease (CVD) which typically includes the below-mentioned conditions are the single biggest causes of death in India today as well as in many of the countries across the world.

  • Coronary heart disease
  • Hypertension (high blood pressure)
  • Heart attack
  • Stroke
  • Aneurysms
  • Peripheral artery disease

Smoking is also the chief cause of CVDs and can practically harm any part of the human body.

Effects of smoking on the body

During breathing in air from the atmosphere, the lungs take in oxygen and deliver it to the heart, which pumps this oxygen-rich blood to the rest of the body through the blood vessels. But when one breathes in cigarette smoke, the blood that is distributed to the rest of the body becomes contaminated with the smoke’s chemicals. These chemicals can damage your heart and blood vessels, which can lead to cardiovascular disease.

In addition to permanently damaging your heart and blood vessels, cigarette smoke can also cause CVD by changing your blood chemistry and causing plaque—a waxy substance comprised of cholesterol, scar tissue, calcium, fat, and other material—to build up in the arteries, the major blood vessels that carry blood from your heart to your body. This plaque buildup can lead to a disease called atherosclerosis.

When the chemicals in cigarette smoke cause atherosclerosis and thickened blood in the arteries, it becomes more difficult for blood cells to move through arteries and other blood vessels to get to vital organs like the heart and brain. This can create blood clots and ultimately lead to a heart attack or stroke, even death.

Quit Smoking

Having outlined some of the myriad problems associated with smoking, we finally come to the question that has puzzled many since ages. If tobacco usage is so harmful, why is it so difficult to do away with it? Well, there is no simple solution to it, else the government would not be spending such huge resources in creating & executing such mammoth programmatic initiatives to discourage tobacco usage.

Tobacco has found its way across the very fabric of our nation, cutting across different socio-economic groups & demographics. For many of us, it has become a natural way of life, like breathing, sleeping & eating.

While it is not easy to stop a habit which is so deep-rooted, it is certainly possible if one wants to get rid of this killing habit and is willing to make the efforts, if not for oneself then for your loved ones, as second-hand smoking or SHS is on its way to emerge as a great killer on its own.

Tips to help quit using tobacco

 

Here are 8 helpful tips to reduce the urge to use tobacco

1. Avoid triggers

Urges for tobacco are likely to be strongest in the situations where you smoked or chewed tobacco most often, such as at parties or bars, or while feeling stressed or sipping coffee. Identify your trigger situations and have a plan in place to avoid them entirely or get through them without using tobacco.

Don’t set yourself up for a smoking relapse. If you usually smoked while you talked on the phone, for instance, keep a pen and paper nearby to occupy yourself with doodling rather than smoking.

2. Delay

If you feel like you’re going to give in to your tobacco craving, tell yourself that you must first wait 10 more minutes — and then do something to distract yourself for that period of time. Try going to a public, smoke-free zone. These simple tricks may be enough to derail your tobacco craving.

3. Chew on it

Give your mouth something to do to fight a tobacco craving. Chew on sugarless gum or hard candy, or munch on raw carrots, celery, nuts or sunflower seeds — something crunchy and satisfying.

4. Don’t have ‘just one’

You might be tempted to have just one cigarette to satisfy a tobacco craving. But don’t fool yourself into believing that you can stop there. More often than not, having just one leads to another— and you may end up using tobacco again.

5. Get physical

Physical activity can help distract you from tobacco cravings and reduce their intensity. Even a short burst of physical activity — such as running up and down the stairs a few times — can make a tobacco craving go away. Get out for a walk or jog.

If you’re stuck at home or the office, try squats, deep knee bends, pushups, running in place, or walking up and down a set of stairs. If physical activity doesn’t interest you, try prayer, needlework, woodwork or journaling. Or do chores for distraction, such as vacuuming or filing paperwork.

6. Practice relaxation techniques

Smoking may have been your way to deal with stress. Resisting a tobacco craving can itself be stressful. Take the edge off stress by practicing relaxation techniques, such as deep-breathing exercises, muscle relaxation, yoga, visualization, massage or listening to calming music.

7. Call for reinforcements

Touch base with a family member, friend or support group member for help in your effort to resist a tobacco craving. Chat on the phone, go for a walk together, share a few laughs, or get together to commiserate about your cravings.

8. Remind yourself of the benefits

Write down or say out loud the reasons you want to stop smoking and resist tobacco cravings.

These might include:

    • Getting healthier
    • Sparing your loved ones from SHS
    • Saving money

Remember, trying something to beat the urge is always better than doing nothing. And each time you resist a tobacco craving, you’re one step closer to being totally tobacco-free.

Finally, let us not wait for any occasion like World No Tobacco Day to give up on tobacco. The moment you succeed, it becomes Your No Tobacco Day and that can happen NOW.

References:

Think201