Health 07-Jan-2016 Dr Benley George
Globally, tobacco use remains the leading preventable risk factor for premature morbidtiy and mortaltiy. Tobacco has led to a huge burden on families for thet reatment of tobacco induced problems in the users. In 2011, tobacco use killed almost 6 million people, with nearly 80% of these deaths occurring in low- and middle-income coutnries. If currentt rends continue, by 2030 tobacco will kill more than 8 million people worldwide each year, with 80% of these premature deaths among people living in low- and middle-income coutnries. Tobacco use in any form is dangerous and is the single most preventable cause of death. Tobacco use is a major risk factor for death from heart attacks and strokes. By the year 2030, it is estimated that around eight million people will die annually from tobacco use. Tobacco caused 100 million deaths during the twentieth century, and if currentt rends continue, approximately 1 billion people will die during the twetny-first century because of tobacco use.
Tobacco use is harmful to all human biologicals ystems, including the oral cavtiy. Smoking during pregnancy is dangerous to the mother and can cause growth retardation, low birth weight, and possibly death of the fetus. The harm caused by today's tobacco use will extend for decades into the future, which is made moret ragic by the fact that the negative effects of tobacco are entirely preventable. Quitting tobacco use greatly reduces illness by immediately providing short-term benefits and lowering the risk of all diseases caused by smoking.
Secondhand smoke, or 'forced smoking,' kills even those people who have consciously chosen not to smoke. Secondhand smoke, also known as environmental tobacco smoke, is a mixture of side stream smoke from the burning tip of a cigarette, cigar, or pipe, and mainstream smoke, which smokers exhale. Side stream smoke is the major component of secondhand smoke, and it contains higher concetnrations of carcinogens than mainstream smoke. An estimated 600,000 individuals die annually from exposure to secondhand smoke, and the majortiy of secondhand smoke deaths are among women and children. Breathing secondhand smoke causes immediate harm to the cardiovascular and respiratorys ystems. Long-term exposure to secondhand smoke can even cause lung cancer. Expectant mothers, fetuses, and infants exposed to secondhand smoke are at particularly high risk of adverse health consequences. Sudden Infant Death Syndrome, respiratory issues, and behavioral and learning problems can result when infants and children are exposed to secondhand smoke.
Types of Tobacco
There are basically twot ypes of Tobacco;
Smoked Tobacco and
The various forms of smoked tobacco are Bidi, Cigarettes, Chillum, Chutta, Dhumti, Gudakhu, Hookah, Hookli. Manufactured cigarettes consist of shredded or reconstituted tobacco processed with hundreds of chemicals. Often with a filter, they are manufactured by a machine, and are the predominant form of tobacco used worldwide.
Bidis consist of a small amount of tobacco, hand-wrapped in dried temburni leaf and tied with string. Despite their small size, their tar and carbon monoxide deliveries can be higher than manufactured cigarettes because of the need to puff harder to keep bidis lit. In reverse chutta and dhumti smoking, the ignited end of the cigar is placed inside the mouth. There was a revival of cigar smoking at the end of the20th century, among both men and women. Kreteks are clove-flavoured cigarettes. They contain a wide range of exotic flavourings and eugenol, which has anaesthetising effect, allowing for deeper smoke inhalation. Pipes are made of briar, slate, clay or other substance – tobacco is placed in the bowl and inhaled through the stem, sometimes through water. Sticks are made from sun-cured tobacco known as brus and wrapped in cigarette paper.
The various forms of smokeless tobacco are Chewing tobacco, Snuff, Snus and Dissolvable.
Chewing tobacco is also known as plug, loose-leaf, and twist. Pan masala, or betel quid consists of tobacco, areca nuts and staked lime wrapped in a betel leaf. They can also contain other sweetening's and flavouring agents.
Moist snuff is taken orally. A small amount of ground tobacco is held in the mouth between the cheek and gum. Increasingly manufacturers are pre-packaging moist snuff into small paper or cloth packets, to make the product easier to use.
Dry snuff is powdered tobacco that is inhaled through the nose or taken by mouth. Once
widespread, its use is now in decline.
Deadly Tobacco Chemicals
Tobacco smoke contains over 4,000 chemicals, some of which have marked irritant properties
and some 60 are known or suspected carcinogens.Smokeless tobacco contains 28 cancer-causing agents.
Tobacco smoke includes as found in;
Acetone paint stripper
Ammonia floor cleaner
Arsenic ant poison
Butane lighter fuel
Cadmium car batteries
Carbon monoxide car exhaust fumes
Hydrogen cyanide gas chambers
Methanol rocket fuel
Napthalene moth balls
Toluene industrial solvent
Vinyl chloride plastics
Effects of Tobacco on General Health
Cancer of Lung
Cancer of Larynx and Pharynx
Cancer of Oesophagus
Cancer of Stomach
Cancer of uterine cervix
Cancer of Kidney and Pancreas
Acute myeloid leukemia
Chronic obstructive lung disease- Emphysema and Chronic bronchitis
Low birth babies
Spine and Hip fractures
Sudden Infant Death Syndrome (SIDS)
Reduced sense of smell
Wrinkles over the skin
Delayed wound healing
Non- insulin dependent diabetes mellitus
Infertiltiy and Impotence
Weakening of the immunes ystem
Increased risk for abortion
Effects of Tobacco on Oral Health
Oral Cancer- Smoking is a risk factor for developing oral cancer. Smoking has a direct carcinogenic effect on the epithelial cells of the oral mucous membrane. The most common form of oral cancer associated with smoking is squamous cell carcinoma.
Periodontal disease- Tobacco use has a direct relationship with the development of periodontal disease. The use of tobacco results in loss of attachment, gingival recession and associated bone loss. It also decreases the blood supply to the gingiva as it is a vasoconstrictor.
Tooth loss- Tobacco has resulted in periodontal disease due to which there is destruction of periodontium and bone loss which ultimately leads to loss of tooth.
Staining of teeth- A brownish black discoloration of teeth is usually seen with the use of tobacco. The extent of staining depends on the severtiy of tobacco use. Usually the stains are temporary and can be removed by scaling of teeth. Sometimes the stains can be removed by undergoing bleaching of the teeth.
Halitosis- Decreased wound healing- smoking results in vasoconstriction of the gingiva as a result there is decreases blood supply to the site of the wound and thereby the wound healing is delayed. Usually etxraction sites heal slowly in smokers when compared to non smokers.
Cleft lip/Cleft palate- Pregnant mothers who smoke during pregnancy are at high risk for delivering babies with cleft lip/palate.
Acute Necrotizing Ulcerative Gingivitis
Reduced sense of taste
What are the Benefits of quitting smoking?
Quitting smoking cuts cardiovascular risks. Just 1 year after quitting smoking, the risk for a heart attack drops sharply.
Within 2 to 5 years after quitting smoking, the risk for stroke could fall to about the same as a non-smoker's.
If you quit smoking, the risks for cancers of the mouth, throat, oesophagus, and bladder drop by half within 5 years.
Ten years after you quit smoking, the risk for lung cancer drops by half.
There are immediate and long-term health benefits of quitting for all smokers.
Beneficial health changes that take place:
Within 20 minutes, the heart rate and blood pressure drop.
12 hours, the carbon monoxide level in the blood drops to normal.
2-12 weeks, circulation improves and lung function increases.
1-9 months, coughing and shortness of breath decrease.
1 year, risk of coronary heart disease is about half that of a smoker's.
5 years, stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting.
10 years, risk of lung cancer falls to about half that of a smoker and risk of cancer of the mouth, throat, oesophagus, bladder, cervix, and pancreas decreases.
15 years, the risk of coronary heart disease is that of a non-smoker's.
2. People of all ages who have already developed smoking-related health problems can still benefit from quitting.
Benefits in comparison with those who continued:
At about 30: gain almost 10 years of life expectancy.
At about 40: gain 9 years of life expectancy.
At about 50: gain 6 years of life expectancy.
At about 60: gain 3 years of life expectancy.
After the onset of life-threatening disease: rapid benefit, people who quit smoking after having a heart attack reduce their chances of having another heart attack by 50%.
3. Quitting smoking decreases the excess risk of many diseases related to second-hand smoke in children. Quitting smoking decreases the excess risk of many diseases related to second-hand smoke in children, such as respiratory diseases and ear infections.
4. Others benefits.
Quitting smoking reduces the chances of impotence, having difficutly getting pregnant, having premature births, babies with low birth weights and miscarriage.
Tobacco has become the global killer of mankind across the world. Coutnries have spent huge amount of money for thet reatment of tobacco users. Families have spent large amount of money for thet reatment of their near and dear ones and many have lost their loved ones due to tobacco. It is very important that we realise that tobacco is a deadly poison and an evil which aims to kill its users.
Quit Tobacco and Live Happy
(Dr Benley George is Vice Principal of Pushpagiri College of Dental Sciences, Tiruvalla)