The Telegraph
Monday , December 10 , 2012
Since 1st March, 1999
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Don’t go up in smoke

In the Sixties and Seventies, puffing on what we now call the cancer stick was considered sophisticated by adults and “cool” by the younger generation. Movie stars, politicians, doctors, academics — they all smoked. My professors in medical college disappeared into the canteen at 10 am every day for a smoke and a coffee.

Forty years have gone by. One professor has developed lung cancer and another has succumbed to it. The world has belatedly woken up to tobacco addiction in its myriad forms (puffs, chews or snuff). The Indian government has passed a few laws but not only is it too little too late, the enforcement too is rather lax.

We know the effects of addictive drugs such as cannabis and heroin. They have been banned. If the tobacco industry had not managed to conceal the dangerous and addictive nature of tobacco for so many years, it too would have joined the list of banned drugs.

Tobacco grows in India, has always been freely available and its use is widespread, often starting in the teenage years. Males tend to smoke cigarettes or beedis while women seem to prefer chewing tobacco, gutka or snuff. Some female addicts begin their day by brushing their teeth with tobacco and then placing a wad of it in a corner of the mouth. Social acceptance has resulted in more young urban women openly smoking.

Tobacco use varies from state to state. In India 30-50 per cent of males and 20-30 per cent of females above the age of 15 use tobacco regularly. Many more, particularly children, are affected by exhaled second hand smoke.

There are more than 4,000 chemicals in tobacco, most of which are harmful. The main constituent is nicotine, which immediately makes the heart beat faster and pushes up the blood pressure. It crosses over into the brain where it affects certain chemicals. There is a pleasurable feeling of relaxation and reduction of tension and stress. As the nicotine is cleared from the blood stream, the tension and stress return, producing a craving for “another fix”. As the body enzymes become more efficient at removing this poison, the cravings return at shorter intervals. The consumption of tobacco perceptibly increases. Other harmful chemicals in tobacco are ammonia, acetone, cadmium, vinyl chloride, naphthalene and carbon monoxide. In short, imagine eating or inhaling smoke from a burning concoction of paper, moth balls, old batteries, toilet cleaner and nail polish remover!

Smoking causes long term changes in the lung tissue. Their function and air exchange is compromised with perpetual breathlessness, chronic obstructive airways disease and emphysema. Smoking or inhaling second hand smoke causes 90 per cent of lung cancers. It is responsible for 1.4 million deaths annually worldwide.

The chemicals in tobacco affect every organ in the body. Cancers can occur in the oral cavity, pharynx, larynx, oesophagus, pancreas, stomach, urinary tract, and blood (acute myeloid leukaemia).

Even if cancer does not develop, the teeth become yellow, plaque ridden, loosened from the sockets and may eventually fall out. Conversation becomes difficult because of halitosis (bad breath). The bones weaken, leading to early osteoporosis. The body metabolism changes, precipitating glucose intolerance and eventually diabetes. Atherosclerotic plaques build up in the blood vessels, leading to heart disease, paralysis, stroke and vascular disease. Blocks develop in the peripheral blood vessels. Walking becomes painful. Numbness, burning and tingling in the limbs interferes with sleep.

The IQ (intelligence quotient) falls with tobacco use and cognitive skills decline. This places users at risk for early dementia and Alzheimer’s.

Women who use tobacco tend to be less fertile, have smaller babies, weaker bones and reach menopause two to three years earlier. They also tend to have small babies who may develop Attention deficit -hyperactivity disorder (ADHD). They may have supernumery or less than five digits. Fingers and toes may be stuck together.

Tobacco use shortens the life span considerably. The death rate from related causes is 60 per cent higher in both sexes between the ages of 30 and 70.

The bad news is that addiction gets established within a year. By that time, the brain receptors change. The craving for nicotine may be present lifelong.

The good news is that you can stop and reverse many harmful body changes. No matter what your age, it’s high time you said bye to that stick.

Time to stop

• You can do it on your own—the mind is a very powerful tool.
• Set a date and stick to it.
• Avoid areas and friends who use tobacco.
• The government as well as private organisations run programmes to help de-addiction.
• Cravings can be reduced with nicotine patches and aversion produced by some medication.
• Regular aerobic exercise (running, walking, swimming or cycling), and yoga, improve fitness and lung capacity and reverse the negative effects.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at