World No Tobacco Day 2019: How tobacco affects your lung health and common misconceptions around it

Tobacco use is one of the most preventable risks that many of us take despite its ill-effects on our health and mortality. It is a serious public health challenge which is presently causing over a million deaths yearly in India i.e., one death every six seconds.^[1] Yet, Indians are the second largest consumer of tobacco products in the world with nearly 267 million users, right behind China. Even globally, tobacco use continues to wreak havoc on public health, resulting in over 6 million deaths every year, and if the trends continue, the annual mortality will exceed 8 million by 2030.^[2]

In order to counter this threat, every year, on 31 May, the World Health Organization (WHO) and various global partners, including governments, observe World No Tobacco Day. The annual campaign, which started nearly thirty years ago, aims to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure and to dissuade people from consuming tobacco in any form. For 2019, the theme of World No Tobacco Day is "tobacco and lung health."^[3] This year’s campaign intends to increase awareness about the negative impact that tobacco has on people’s lung health -  from cancer to chronic respiratory diseases - and the critical part healthy lungs play in our well-being. World No Tobacco Day also promotes effective policies to curtail tobacco use and engaging participants across multiple sectors, including health insurance companies, in the fight against tobacco addiction.

In what ways tobacco use jeopardise the lung health of people?

Lung cancer: Increased tobacco use is one of the leading risk factors in the rising cases of lung cancer. In fact, according to the WHO, tobacco users account for over two-thirds of lung cancer deaths globally.

Chronic respiratory diseases: Once again, tobacco use, especially smoking, is among the primary causes of chronic obstructive pulmonary disease. Moreover, smoking also aggravates conditions like asthma, pneumonia and allergies.

Across the life-course: According to the American Lung Association, there are close to 600 ingredients in a cigarette, which when burned produce more than 7,000 chemicals. At least 69 of these chemicals are toxic and carcinogenic. If an infant is exposed to tobacco smoke in-utero, either through maternal smoking or secondhand smoke, there is a good chance that they will experience diminished lung growth and function through their life-course. Even young children exposed to second-hand smoke are vulnerable towards asthma, pneumonia and bronchitis, and may encounter frequent respiratory infections.

Tuberculosis: Tuberculosis (TB), a bacterial disease which damages the lungs, is a grave public health problem in India, with the largest number of TB cases in the world. TB causes nearly half a million deaths in the country with almost a million new patients every year. Tobacco smoking and chewing increase the chances of a person falling will with TB and worsens the condition. As per WHO, people who smoke are twice as likely to fall victims of the Mycobacterium tuberculosis bacteria.

Air pollution: Although it seems slightly implausible, but WHO lists tobacco smoke as a dangerous form of indoor air pollution due to the toxins and the cancer-causing chemicals. While you may think that your air freshener and the fan have done their job, the smoke can linger in the air for up to five hours, putting you and your family at an increased risk of lung cancer, chronic respiratory diseases, and cardiac diseases.

Even though smoking and tobacco consumption is considered to be the bane of lung health there are various myths related to the topic. On this World No Tobacco Day, lets emphasize on debunking some of the myths and misconceptions associated with lung cancer and tobacco use.

Myth 1: Only smokers can get lung cancer
While there is no doubt that smoking is the leading cause of lung cancer, it is not just a smoker’s disease. Air pollution, second-hand cigarette smoke and carcinogenic dust such as asbestos can cause lung cancer amongst non-smokers. In fact, it has been noticed that among the total number of sufferers of lung cancer, 10% of the patients are non-smokers. So, even if you are not a smoker, it is prudent to ensure that your health insurance plan covers critical illnesses like cancer.

Myth 2: There are no measures for reducing lung cancer risk.
As with everything else in life, when it comes to health, there are some factors that we can control and others that are beyond us. For instance, if smokers or tobacco consumers reduce or stop, it will go a long way in safeguarding them from this deadly disease. In fact, those who stop smoking see their chances of getting lung cancer reduced to half within a decade. Other factors such as pollution and carcinogens in the atmosphere can be addressed through mass awareness and community level commitment.

Myth 3: “Light” cigarettes are less harmful
The so-called ‘light’ cigarettes are just as harmful to health as ‘regular’ brands, but most smokers remain misinformed about this fact. Most of us think that the terms ‘light’ and ‘ultra-light’ refer to low-tar/low-nicotine cigarettes. However, there is no standard definition of what constitutes a light or ultra-light brand and mostly these terms refer to the perceived taste and flavour of cigarettes, not their chemical content. For all intents and purposes, remember that one light or ultra-light cigarette provides the same amount of tar as a regular cigarette, and is equally harmful.

Myth 4: Lung cancer is primarily a men’s disease
There is a common misconception that various forms of cancer are more likely to affect a particular gender, with lung cancer seen primarily as a men’s disease. Earlier, that may have been true, but that's far from the case today. For example, in the US, from 1975 to 2013 the rate of new lung cancer incidents dropped 32% for men, but rose 94% for women, according to the SEER Cancer Statistics Review. [4] With tobacco usage rates in men and women becoming more similar, the fairer sex is equally susceptible to lung cancer. Therefore, whether you are a man or a woman, you must make sure that your health insurance has an inbuilt cancer plan as well.

Myth 5: Lung cancer cannot be treated
While treatment for lung cancer is based on the stage of the disease and the category, it is certainly treatable. Depending on the category and the stage of lung cancer, treatment may involve various combinations of medication, surgery, chemotherapy, radiation, targeted treatments, and immunotherapy. However, these treatments are fairly expensive and must be covered under your health insurance plan or critical illness plan.

Many of the myths that surround smoking are the result of a misapplied understanding of what might seem to be common sense. It is the need of the hour to find novel ways to both communicate the harmful effects of tobacco, and to counter the various myths and misconceptions that drive people to start smoking or chewing tobacco and reduce their odds of quitting.

To sum up, there is no safe level of tobacco use. To people who use any type of tobacco product, it is strongly recommended that you quit as those who quit smoking, regardless of their age, have substantial gains in life expectancy compared with those who continue to smoke. Even quitting smoking at the time of a cancer diagnosis reduces the risk of death. As parents and members of the community, not only should we take measures to promote our own health, but also of our future generations by protecting them from the harms caused by tobacco.  

Sources:
¹ https://apps.who.int/iris/bitstream/handle/10665/272672/wntd_2018_india_fs.pdf;jsessionid=84DDD0AA7625BB4B730543BFB13293AE?sequence=1
² https://www.hindustantimes.com/world-news/8-million-people-will-die-annually-of-tobacco-related-deaths-by-2030-report/story-nsyCIbj66lXLU1fSy49RaP.html
³ https://www.who.int/tobacco/wntd/en/
⁴ https://seer.cancer.gov/archive/csr/1975_2013/results_merged/sect_15_lung_bronchus.pdf

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