Dr Prasad Narayanan, Senior Consultant — Medical Oncology, Cytecare Cancer Hospitals, shares his insights on how COVID-19 pandemic has been an eye-opener for most people locked up at home, while the world fights a deadly battle against the virus
Over the years, I’ve heard patients make emphatic excuses for not kicking the butt. Tobacco becomes a coping tool – often without users realising the extent of their growing addiction. The COVID-19 pandemic has been an eye-opener of sorts for most people locked up at home, while the world fights a deadly battle against the virus.
It’s amazing to see the number of people who have managed to quit smoking during the lockdown. For some, it was simply a matter of unavailability that led to abstinence, while others were encouraged by the isolation from social circles where tobacco use is the norm. The temporary ban on the sale of tobacco products was perhaps only part of the reason. The bigger push, perhaps, came from introspection in the face of an unprecedented global crisis that brought the world to a standstill.
Reasons galore
Cancer is the second-leading cause of death globally, accounting for 9.6 million deaths in 2018. According to the World Health Organization (WHO) report on cancer (2020), nearly 2.4 million cancer deaths occur every year due to use of tobacco products. While there are numerous risk factors for different cancers, studies find that tobacco use is responsible for a whopping 25 per cent of all deaths caused by cancer.
The numbers are daunting. Every year, on World No Tobacco Day – introduced by the WHO to spread awareness about the harmful effects of tobacco use – there are compelling messages asking tobacco users to quit the hazardous habit. Most appeals fall on deaf ears though.
A review of studies by public health experts across the globe has found that smokers are more likely to develop severe disease when infected by COVID-19, as compared to non-smokers.
It’s well-established that tobacco is a major risk factor for a gamut of health conditions, such as cardiovascular disease, respiratory disease, type 2 diabetes, stroke, and, of course, cancer. Research shows that smokers and other tobacco users are at an increased risk of developing lung cancer, leukaemia, bladder cancer, kidney and pancreatic cancer, mouth and throat cancer, and cervical cancer in women.
The WHO says that more than seven million global deaths are from direct tobacco use, while 1.2 million are due to exposure to second-hand smoke. Children are especially susceptible to the harmful effects of second-hand smoke, leading to an increased risk for ear infections, lung disease, asthma and other respiratory diseases.
Tobacco-free advantage
A stimulating study, published earlier this year in the British scientific journal Nature, shows how the human lungs have an incredible ability to repair the damage caused by smoking, provided one manages to kick the habit. The study found that in people who quit – including those who had smoked a pack a day for decades – up to 40 per cent of their cells looked just like those from people who had never smoked. The cells had grown and replaced the damaged cells in the lungs.
The implications are encouraging, especially for lung cancer patients in whom DNA mutations in the cells have traditionally been considered to be permanent. Given that lung cancer is largely preventable, almost nine out of ten lung cancers can be prevented if tobacco users quit using the substance. We know that 80-90 per cent of lung cancer deaths – the most fatal of all cancers – is caused due to tobacco exposure. There are 60 carcinogens in cigarette smoke that directly damage and mutate the DNA, gradually transforming them from healthy to cancerous.
If quitting tobacco doesn’t just stop, but also reverses the process, then there’s every reason to quit. Did you know that elevated heart rate and blood pressure drop in no time once the body is free of tobacco? It takes less than three months for the blood circulation and lung function to improve. In addition, for those who manage to persist – despite the challenges of overcoming nicotine dependence – the cancer risk decreases substantially.
In other words, the most effective risk factor reduction strategy for cancer is saying no to tobacco; and contrary to popular perceptions, there is no safe way to use tobacco. Vaping and e-cigarettes are just as harmful to users as well as non-users who are exposed to second-hand aerosols.
So, this World No Tobacco Day, let’s take a pledge to adopt a tobacco-free life. There’s no better time than now. As the world’s second biggest consumer of tobacco, India can turn the current crisis into an opportunity to reduce tobacco consumption in the country and ease its mounting healthcare burden.
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