EVERY May 31 is observed as World No Tobacco Day. This year, the World Health Organisation (WHO) has declared the slogan “Grow food not tobacco”. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than eight million people a year, including around 1.2 million deaths from exposure to second-hand smoke.
All forms of tobacco are harmful, and there is no safe level of exposure to tobacco. Cigarette smoking is the most common form of tobacco used worldwide. Other tobacco products include waterpipe tobacco, various smokeless tobacco products, cigars, cigarillos, roll-your-own tobacco and pipe tobacco. Over 80 per cent of the 1.3 billion tobacco users worldwide live in low and middle-income countries, where the burden of tobacco-related illnesses and death is heaviest. For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases the risk of tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. Second-hand smoke causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to second-hand smoke are at increased risk of sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth. Smoking can cause cancer and then block the body from fighting it. Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill cancer cells.
Doctors have known for years that smoking causes most lung cancers. It is still true today, when nearly nine out of 10 lung cancers are caused by smoking cigarettes. Quitting smoking lowers the risks of cancers of the lung, mouth, throat, oesophagus, and larynx. Within five years of quitting, the chance of getting cancer of the mouth, throat, oesophagus, and bladder is cut in half. Smoking is a major cause of cardiovascular diseases (CVD) and causes one of every four deaths from CVD. Smoking can raise triglycerides (a type of fat in the blood), make blood sticky and more likely to clot, which can block blood flow to the heart and brain. Smoking during childhood and teenage years can slow the growth and development of lungs. This can increase the risk of developing chronic obstructive pulmonary diseases (COPD) in adulthood. The best way to prevent COPD is to never start smoking, and if you smoke, quit. Talk to your doctor about programmes and products that can help you quit. Also, stay away from second-hand smoke, which is smoke from burning tobacco products such as cigarettes, cigars, or pipes. Second-hand smoke is also smoke that has been exhaled or breathed out by a person smoking. Women who smoke have more difficulty becoming pregnant and have a higher risk of never becoming pregnant. Smoking during pregnancy can cause tissue damage in the unborn baby, particularly in the lung and brain, and some studies suggest a link between maternal smoking and cleft lip.
Studies also suggest a relationship between tobacco and miscarriage. Carbon monoxide in tobacco smoke can keep the developing baby from getting enough oxygen. Tobacco smoke also contains other chemicals that can harm unborn babies. Others who smoke are more likely to deliver their babies early. Preterm delivery is a leading cause of death, disability, and disease among new-borns. One in every five babies born to mothers who smoke during pregnancy has low birth weight.
Mothers who are exposed to second-hand smoke while pregnant are more likely to have lower birth weight babies. Babies born too small or too early are not as healthy. Both babies whose mothers smoke while pregnant and babies who are exposed to second-hand smoke after birth are more likely to die from sudden infant death syndrome (SIDS) than babies who are not exposed to cigarette smoke. Babies whose mothers smoke are about three times more likely to die from SIDS. Babies whose mothers smoke while pregnant or who are exposed to second-hand smoke after birth have weaker lungs than other babies, which increases the risk of many health problems. In addition, women have unique and higher risks of cancer and artery disease. Tobacco causes similar health problems and threats to men and women. But women have unique and higher risks of cervical cancer, breast cancer, and coronary artery disease. Lesotho had the highest prevalence of tobacco users in Africa as of 2019. That year, 26.7 percent of Lesotho’s population consumed tobacco. Morocco followed close with 23.4, then South Africa with a prevalence of 20.3 percent. West African countries like Nigeria and Ghana had the lowest prevalence rankings in Africa that year. In 2019, the Ministry of Health in Zambia stated that the smoking prevalence was 24 percent in men and 7.8 percent in women. WHO predicts that the number of smokers in Zambia will increase by an additional 300,000 people by 2025.
The number of tobacco-related deaths in Zambia increased from an estimated 3,000 per year (43 per 100,000) in 1990 to 7,142 per year (45 per 100,000) in 2020. The latest Global Youth Tobacco Survey and the most recent wave of the International Tobacco Control (ITC 2015) Project survey results indicate that a higher proportion of girls than boys in Zambia now use tobacco products, suggesting a major and potentially catastrophic shift. Consumption of tobacco in any form should be discouraged and teenagers as well as adults need to be educated about the adverse effects of tobacco through health education programmes.
Author is dean of the School of Medicine at Texila American University.