The focus of this year’s World No Tobacco Day, which is observed every year on May 31, is ‘tobacco and lung health’. It is essential to realise that all tobacco products consist nicotine, the chemical responsible for addiction. A generally floating misconception is that only smoking is harmful for health; but it should be noted that any form of tobacco consumption is dangerous.
As many as 28 different cancer-causing chemicals have been detected that are either present in tobacco or are formed during the production processes.
Chewing tobacco or consuming other smokeless products is sometimes perceived safer as compared to cigarettes or other tobacco products, largely due to the poor documentation of the health hazards associated with it. Smokeless tobacco is usually referred to the blend of tobacco that is chewed, sucked on or sniffed instead of being smoked. It consists of cut, ground, powdered, or leaf tobacco and is generally to be placed in the oral or nasal cavity.
In some cases, nicotine is even swallowed and in others, absorbed through the soft tissues of the mouth. Regardless of the common belief, health experts point out that smokeless tobacco causes similar health risks as cigarettes as there is no such thing as harmless tobacco product.
While those who smoke have a high risk of lung cancer, those who consume the smokeless one have a very high risk of oral cancer. All other cancers can also happen and the risk of heart diseases as well as other problems will also continue to remain the same.
Some common types of tobacco that is consumed through mouth include chewing, oral or spit tobacco which is available as loose leaves, plugs, or twists of dried tobacco, sometimes flavoured like gutka; snuff or dipping tobacco which is the finely ground tobacco packaged in cans or pouches and sold as dry or moist, sometimes with added flavours; Snus is a type of moist snuff often flavoured with spices or fruit, and packaged like small tea bags and dissolvable tobacco available as tobacco lozenges, orbs, or pellets; strips (like melt-away breath strips); and toothpick-sized sticks, some of which contain sweeteners or flavouring and look a lot like candy.
Smokeless but not stroke-less
World Health Organization (WHO) highlights that two fifths of all stroke deaths under the age of 65 years are linked to smoking. However, the use of smokeless tobacco also increases the risk of stroke and blood pressure. Long-term usage of smokeless tobacco has also been connected with the increasing the risk of death due to stroke and heart disease.
Some harmful health hazards of smokeless tobacco are addiction, heart disease, high blood pressure, increased risk of heart attack and stroke, blood circulatory conditions, increased risk of early delivery and stillbirth if consumed during pregnancy and cancer and other health problems.
Smokeless tobacco consists of over 2,000 chemical compounds including nicotine and is likely to cause stroke by elevating blood pressure acutely, and adding to chronic hypertension. Along with high blood pressure, tobacco has been a significant risk factor for stroke, even though it is modifiable.
Stroke or a cerebrovascular event takes place when there is a blockage in brain blood vessels, or when a blood vessel ruptures in the brain. Stroke is often referred to as the brain equivalent of a heart attack.
Severity of stroke usually depends on the area of the brain that is affected or the extent of the blockage. It is generally accompanied with a high risk of death and even greater risk of disability. Survivors can lose vision, speech or suffer paralysis and sometimes get significant physical, psychological and/or behavioural problems that disrupt their everyday activities.
Tobacco can also cause constriction of the blood vessels, have carcinogens and cancer-causing elements which get absorbed. When you smoke, it goes straight into the lungs and gets absorbed, whereas when it is chewed, it gets absorbed by the mouth and then goes into the blood. Either way, it gets absorbed into the body. Smoke has higher impact on the lungs which indirectly has affect on the heart, while smokeless tobacco does not have so much affect on the lungs but if taken over a longer period, eventually it will too.
Some ways to get over tobacco addiction are
*Increase use of e-cigarettes
*Use nicotine gums and nicotine patches
*Attend de-addiction counselling sessions
*Meet the peer groups who have overcome the addiction
Dr Neelesh Reddy is consultant medical oncologist, Columbia Asia Referral Hospital, Yeshwanthpur.