Smoking: A risk you don’t want to take

Here's to your Health

With Dr Jacqueline E. CAMPBELL

Monday, October 11, 2010

IN the 1550’s when Jean Nicot, the French diplomat, promoted the importation and cultivation of tobacco because of its perceived medicinal properties, little did he know that he was helping to unleash one of the greatest poisons on mankind.

Tobacco use is now one of the biggest public health threats the world has ever faced and is the leading preventable cause of death in the United States.

In the Caribbean, it has been estimated that about 15 per cent of youths and 10-15 per cent of the population over age 15 use tobacco.

There is an increase in the number of girls who smoke cigarettes. The WHO report, Women and health: today’s evidence, tomorrow’s agenda points to evidence that tobacco advertising increasingly targets girls. Data from 151 countries show that about seven per cent of adolescent girls and 12 per cent of adolescent boys smoke cigarettes.

Women comprise about 20 per cent of the world’s more than one billion smokers. They are a major target of opportunity for the tobacco industry. Recognising the importance of reducing tobacco use among women, and acting upon that recognition, would save many lives.

Smoking and disease

Cardiovascular disease: Smoking is a major cause of coronary heart disease among women. The disease risk increases with the number of cigarettes smoked and the duration of smoking. Women who smoke have an increased risk for ischemic stroke (blood clot in one of the arteries supplying the brain) and subarachnoid haemorrhage (bleeding in the area surrounding the brain). Smoking cessation reduces the excess risk of coronary heart disease, no matter at what age women stop smoking. The increased risk for stroke associated with smoking begins to reverse after women stop smoking. About 10 to 15 years after stopping, the risk for stroke approaches that of a women who never smoked.

Chronic Obstructive Pulmonary Disease (COPD): Cigarette smoking is the primary cause of COPD (chronic bronchitis and emphysema) in women. The risk increases with the amount and duration of tobacco use.

Cancer: Cigarette smoking contributes to developing several different kinds of cancer (lung, oropharynx, larynx, oesophagus, kidney, bladder, liver, colorectal, pancreas). Women who smoke are more at risk for cervical and breast cancer.

Oral contraceptive use: Women smokers who use oral contraceptives are at increased risk of developing blood clots, heart attacks and strokes. This risk increases with age and women over 35 who smoke should not use oral contraceptives.

Pregnancy: Smoking is especially dangerous to pregnant women. Mothers who smoke are more at risk for miscarriage. Babies born to mothers who smoke are often born with birth defects and low birth weights. In addition they often experience withdrawal symptoms during the first week of life. Studies show a link between smoking and the risk of sudden infant death syndrome (SIDS) among the offspring of women who smoke during pregnancy.

Infertility: Women who smoke typically have reduced fertility. Studies suggest that women who smoke have around 72 per cent of the fertility of non-smokers.

Pelvic inflammatory disease (PID): This occurs with 33 per cent more frequency in smokers than in non-smokers.

Osteoporosis: Smoking contributes to bone loss, increasing a woman’s risk for developing osteoporosis.

Menstruation and menopause: Studies suggest that cigarette smoking may alter menstrual function by increasing the risks for painful periods, amenorrhoea (absence of menstruation), and menstrual irregularity. Women who start smoking during their teenage years are more at risk for developing early menopause than nonsmokers and they may experience more severe menopausal symptoms.

Smoking cessation

Women who stop smoking greatly reduce their risk of dying prematurely. There are many methods you can adopt to help you quit smoking. If you relapse, do not give up. Many smokers quit a few times before achieving success. Contact your healthcare provider for help.

Dr Jacqueline E Campbell is a family physician and author of the book A Patient’s Guide to the Treatment of Diabetes Mellitus.

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Smoking: A risk you don’t want to take