World No Tobacco Day - Commit to quit

Tobacco use is the leading preventable cause of death globally.  The World Health Organisation estimates that over 8 million premature deaths occur annually secondary to tobacco use.

The most common form of tobacco are cigarettes.  Some other conventional tobacco products include cigars, smokeless tobacco (such as chewing tobacco) and water-pipe tobacco (also known as shisha or hookah). 

What are the health risks associated with tobacco use?

Tobacco use is a leading risk factor for multiple adverse health outcomes: 

• Cardiovascular disease - toxic chemical substances in tobacco damage the lining of arteries. This narrows your blood vessels, increasing the risk of heart attacks, strokes and blood clots.
• Lung disease - Smoking is the leading cause of emphysema and chronic bronchitis, making it difficult to breathe and increases the risk of pneumonia. 
• Cancer – at least 80% of lung cancer deaths are related to smoking, and it is a major risk factor for at least 15 different types of cancers, such as mouth, stomach, kidney, bowel, bladder and ovary.
• Weakened immune system.
• Vision problems.
• Gum disease.
• Decreased fertility.
• Erectile dysfunction in men.
• Increased risk of miscarriages and birth defects in babies born to individuals who smoke during pregnancy.
• Premature aging

What is passive smoking and what are the risks associated with it?

Passive or second-hand smoking is the inhalation of harmful chemicals smoked by individuals around you.  Individuals exposed to passive smoking are at an increased risk of heart disease, stroke and cancer.  Statistics show 15% of tobacco related deaths are the result of non-smokers being exposed to second-hand smoke. 

What steps can I take to quit smoking?

1. Set a quit date and add it to your calendar; this date should be within 2 weeks of making your decision.
2. Although you can choose to gradually cut down on the number of cigarettes you smoke per day as you approach your quit day, research has shown quitting abruptly results in increased success.
3. Complete abstinence, remove all tobacco products from your environment.
4. Inform family and friends for support and understanding.
5. Anticipate challenges e.g nicotine withdrawal causing physical symptoms so plan coping strategies. Implement different modes of exercise, such as, brisk walking, cycling or yoga prior to your quit date. Stock up on oral substitutes, such as sugarless gum and carrot sticks.
6. Avoid triggers - triggers could be behavioural, environmental or emotional.
   1. Behavioural triggers - our brains are conditioned on previous experiences. If you usually smoke when you carry out specific activities it would be best to avoid these particular habits while trying to quit.
   2. Environmental triggers – avoid settings where you would normally smoke, at home, workplace or when socialising.  Living with other smokers can make it particularly challenging; encourage family members to quit with you or not to smoke around you.
   3. Emotional triggers – find effective strategies to deal with emotional stress or low mood.  This can include any form of physical activity, relaxation techniques or breathing exercises.  Ensure you are getting 7-9 hours of sleep a day as this will help with lowering stress hormones.
7. Avoid alcohol as even small amounts of alcohol can decrease inhibitions and increase the chance of a relapse.
8. Ensure you don’t fall into the trap of thinking “one cigarette won’t hurt” as this can often increase the likelihood of a relapse.
9. Consider extra support such as stop smoking groups or one-to-one counselling programmes.
10. Effective nicotine and non-nicotine replacement therapies are available, and should be guided by your healthcare professional.

Is vaping a safe alternative to tobacco?

E-cigarettes, commonly referred to as vaping have gained popularity in recent years.  With a range of different flavours, they have become particularly appealing to adolescents and young adults.  Part of this is because they are perceived to be less harmful compared to conventional tobacco products. 

Although long-term health data around the use of e-cigarettes is not yet fully understood, it is well established that they produce multiple toxic substances, which are known to have harmful effects on cardiovascular health, respiratory health and increase the risk of cancers.

Like conventional tobacco, most e-cigarettes contain nicotine in varying amounts. Research shows nicotine exposure in adolescents and young individuals can have long-term impacts on their developing brains, leading to increased risk of mental health conditions, attention deficits and cognitive impairment.  Nicotine use in pregnant women can impact the developing brain of a foetus.

Another important aspect to consider is the easy access of obtaining these products amongst children and adolescents who otherwise may have never considered use of tobacco, and thereby increasing the risk of them experimenting with other forms of addictive products.

In summary, both tobacco products and e-cigarettes are associated with adverse health risks and the safest approach is to use neither.  Individuals trying to quit should use the steps described above.

References:

1. https://www.who.int
2. https://www.heart.org
3. https://www.cancer.org
4. Goriounova NA et al. Cold Spring Harb Perspect Med. 2012 Dec 1;2(12):a012120