Smoking thrills but kills

Smoking causes a slow death which kills a person by damaging his internal organs one after another. Smokers not just harm themselves, as they also affect their co-workers, family members and others surrounding them by smoking. Passive smoking has now been directly linked with various kinds of cancer. Tobacco use continues to be the leading global cause of preventable death. It kills nearly 6 million people around the world and causes hundreds of billions of dollars of economic damage worldwide each year.The World Health Organisation (WHO) estimates that 84 million people will die of cancer between 2005 and 2015 without intervention. Low-income and medium-income countries are bit harder by cancer than the countries rich in resources. Tobacco in any form such as cigarettes, cigars and pipes are such a harmful thing that everyone should get rid of it. The immediate effects of over 4000 damaging chemicals including tar, carbon monoxide, hydrogen cyanide, metal, nitrogen oxides, ammonia and several radioactive elements can cause oral (mouth), throat and lung cancers besides heart diseases and mucous cough.
Right now, a large number of people are addicted to smoking and this ratio is increasing day by day. According to a WHO report, “By the year 2030, mortality from smoking related disease is expected to rise 10 millions and over 70 percent of these deaths will be in the developing countries like Pakistan where smoking is rising day by day.”
People, businesses, governments and non-profit organisations will work together on ‘World Cancer Day’ to be observed on February 4 to aware and help the general public learn more about the different types of cancer, how to watch for it, treatments and preventative measures.
Shifa International Hospitals has already launched a campaign to fight against cancer under which a string of activities including hiking, walk, soccer matches, and free resting and screening from January 22 to February 6, with an aim to create awareness among public about the disease. The Charter of Paris designated February 4 each year as World Cancer Day. The Union for International Cancer Control (UICC) is responsible for coordinating World Cancer Day globally. It receives support from various partners and organizations, including the WHO, the International Atomic Energy Agency (IAEA), and other international bodies. The UICC organised the first World Cancer Day in 2006.
According to the WHO report on “The Global Tobacco Epidemic”, Warning about the Dangers of Tobacco 2011”, most of these deaths occur in low-and middle-income countries, and this disparity is expected to widen further over the next several decades. If current trend continues, tobacco will kill more than 8 million people worldwide each year by 2030, with 80 percent of these premature deaths among people living in low and middle-income countries. Over the course of the 21st century, tobacco use could kill a billion people or more, unless urgent action is not taken. The WHO reports that tobacco use is the second highest cause of deaths globally after hypertension and is currently responsible for killing one in ten adults worldwide.
The death rate for oral cancer is higher than that of cancers which we hear about routinely such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer. It is not because of the fact that it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. According to National Institute of Health (NIH) report, more than 100,000 people in Pakistan die due to use of tobacco while lungs, neck, heart and lungs related diseases are also affecting the lives of youth because of excessive tobacco usage.
The report says 22 to 25 million people use tobacco in any kind and thus annually 82 billion cigarettes are consumed in the country on average. According to the report, Pakistan is one of the countries where the use of smokeless tobacco is a culturally accepted habit. Studies from Karachi have shown that 21 per cent of men and 12 per cent of women use betel, for both men and women 7.3 percent use pan, 6.7 percent chalia, 7.5 percent gutka, 14.6 per cent naswar and use of chewed tobacco is 20 percent and 17 per cent respectively.
In Pakistan, tobacco use is not limited to cigarette smoking. Other common forms of tobacco include water-pipe tobacco (sheesha in modern form), chewing tobacco and snuff. Over one-third of smokers are reported to use tobacco in other forms. Estimates show that nearly 25 per cent of adults smoke in Pakistan whereas the number of male smokers is about four times the number of female smokers.
The oncologists are of their views that tobacco is not only resulting in lungs cancer but also causing prostate, bladder and cancers in other reproductive organs among males and females in the country. They said quitting tobacco use, which include both smoking and tobacco-chewing, could result in increase in the average lifespan. The oncologists claimed that oral cancer is the most common disease among tobacco users. Other causes including occupational hazards, pollution, obesity, inadequate intake of fruit and vegetables and too much exposure could also result in causing other cancers.
Oral cancer is particularly dangerous because in its early stages it may not be noticed by the patient, as it can frequently prosper without producing pain or symptoms they might readily recognise, and because it has a high risk of producing second, primary tumours. Oral cancer is any abnormal growth and spread of cells in the mouth or oral cavity, including lips, tongue, inside of the lips and cheeks, hard palate (roof of the mouth), floor of the mouth (under the tongue), back of the throat, gums and teeth.
Oral cancers are diagnosed very late (Stage III and IV) in Pakistan leading to dismal prognosis. It needs not whether the patient is educated or not but awareness about the symptom is the key to prevent this deadly diseases. My brother, Moazzam Bashir, who was serving as an additional commissioner of Income tax in FBR, was diagnosed with oral cancer in 2007 at 3rd stage and he disappeared to meet his maker in January, 2008 after battling valiantly for months against the noxious tentacles of squamous cell carcinoma. Cancer can be treated in three ways: surgery, chemotherapy and radiotherapy. Moazzam went through all these three treatments yet neither the skills of surgeons nor the prayers of saints help him to delay his transition from this world to another, mainly because of lack of awareness and late diagnose.
Surgery is the art, practice or work of treating tumor by operative procedures. Chemotherapy is the treatment with drugs that kill cancer cells or make them less active. Radiotherapy is the use of high energy radiation to treat cancer. Out of these three techniques radiotherapy is the cheapest and most curative and palliative ways for various types of cancer. Usually combined therapy is mostly implemented in certain types and stages of cancer.
Talking to Pakistan Today, Dr Kamran Rasheed, a consultant oncologist, said there was an immediate need for creating public and professional awareness regarding the early signs and symptoms of oral cancer so that patient present early and medical professionals diagnose oral cancers early. Rasheed said excessive smoking and usage of gutka in particular was the main cause of oral cancer and stressed that the thousands of units preparing the substance used in it must be exposed and banned.
The oncologist also warned against the chewing of chalia imported from India, saying this too was a very dangerous habit. He pointed out that by the time patients come to a hospital, it is too late as they have already contracted oral cancer. He also stressed on the imposition of this ban all across the country, adding that the spitting out of Gutka was also causing environmental pollution.
Talking about the signs and symptoms of oral cancer, he said sores in the mouth that do not heal within 2 weeks, dark red or white patches in the mouth, lumps located on the lips, tongue or neck, bleeding in the mouth, and sore throat and difficulty with swallowing are the symptoms of mouth cancer. “There are many factors that can increase risk of developing oral cancer. If patient is over 40, he has Human Papillomavirus (HPV), uses tobacco products, especially if combined with high alcohol consumption, regularly drink a lot of alcohol, are the few of main causes of oral cancer or risk factors,” Dr Rasheed concluded.