World Anti-Tobacco Day: Indians need to be especially wary of smoking

India accounts for 60% of the world's heart disease burden, despite having less than 20% of the world's population

On the occasion of the WHO's ‘World No Tobacco Day,’ doctors at Asian Heart Institute share their knowledge on the threats of tobacco to one's heart and suggest measures to reduce the consumption of heart diseases posed by tobacco.

The World Health Organisation’s (WHO) research states that tobacco causes almost 3 million deaths from Cardiovascular diseases every year on a worldwide scale. While tobacco usage is known to be the leading single preventable cause of deaths worldwide, developing countries like India tend to be increasingly prone to this threat.

India accounts for 60% of the world's heart disease burden, despite having less than 20% of the world's population. The Indian Heart Association has identified a reduction in smoking as a significant target of cardiovascular health prevention efforts.

Tobacco Consumption and Cardiovascular health:

Tobacco consumption is known to reduce the oxygen flow to the heart, raise blood pressure, speed up the heart rate and increase the risks of blood clots.

Shares Dr Ramakanta Panda, cardiovascular thoracic surgeon and vice chairman, Asian Heart Institute, “The lining of the blood vessels of the heart can be damaged through the chemicals in cigarette smoke, leading to inflammation and narrowing of the vessels. This, in turn, increases the chances of angina, a heart attack or a stroke.”

Worldwide research suggests that a person's chance of heart disease increases with the number of cigarettes they smoke and the number of years they have smoked. If you have a pack of cigarettes a day, your risk of having a heart attack is four times than that of someone who doesn’t smoke.

“Women who take birth control pills and smoke cigarettes increase their risk of heart attack, stroke, and peripheral vascular disease greatly. On smoking tobacco, the people around you are at risk of having health problems too. This is especially true for children,” adds Dr Santosh Kumar Dora, Consultant Cardiology and Electrophysiology, Asian Heart Institute. The Centers for Disease Control and Prevention (CDC) asserts that even briefly breathing second-hand smoke can damage the lining of blood vessels and cause the blood to become stickier, thus resulting in a deadly heart attack.

“Indians need to be especially wary of smoking as we genetically have smaller arteries as compared to our Western counterparts. Smoking is also one of the major risk factors for multi-vessel coronary disease,” cautions Dr Panda.

Despite the common understanding, smoking bidis or tobacco cigarettes with lower levels of tar or nicotine does not curb the risk of acquiring cardiovascular diseases.

Here are a few tips to end tobacco addiction:

• Analysing the possible triggers that cause you to consume tobacco. Mindfulness helps tackle addiction more effectively.
• Identifying a more personalised reason to stop smoking tobacco, like that of protecting your children from passive smoking or in order to look or feel younger.
• Despite the common belief that eventually decreasing the number of cigarettes will help you quit smoking tobacco, you need to stop instantly and completely or it will never happen.
• Plenty of support may be needed when you decide to kick this addiction. For this, involve your family and friends who can encourage you to stay the path.
• Consulting a doctor for help, who can recommend methods that will be helpful. Nicotine-replacement therapy (nicotine gum or lozenges or patches), medications, counselling, support groups.
• Apart from smoking tobacco, find other ways to relax like listening to music, connecting with friends who do not consume tobacco in any form.
• Distract yourself with work and timelines or find yourself a new hobby.
• Exercise regularly. This can help curb the craving for nicotine and can also help reduce symptoms of withdrawal. Exercising will also assist in avoiding weight gain as you quit smoking.

Tobacco consumption related statistics in India according to the WHO's 2018 factsheet:

In India, Tobacco kills more than 1 million people each year, accounting to 9.5% of all deaths.

4,49,844 Cardiovascular (CVD) deaths in India are caused by tobacco use, which accounts for 16% of all CVD deaths each year

The most common way tobacco kills is from CVDs, accounting for 48% tobacco-induced deaths in India.

Most people start early, increasing the risk of heart disease in young people. The mean age at initiation of daily smoking remains as low as 18.7 years.

The highest amount of deaths caused by tobacco occurs between age groups 30-44 years, reaching up to a 26% high in this age group

The percentage of people who quit tobacco use is as low as 16.8% (Former daily smokers) and 5.8% (Former daily smokeless users).

26.88 million current tobacco users and a substantial number of people exposed to secondhand smoke are at increased risk of CVDs

Tobacco is thus often referred to as the ‘Golden Leaf,' especially in developing countries like India due to the enormous amount of distribution. According to the Centers for Disease Control and Health’s office, the risk of Cardiovascular Disease increases with the amount of tobacco consumed in a day, especially over its continuation over several years.

Tobacco control is thus essential for preventing and controlling deaths and disability caused by CVDs.

The Tobacco quitter’s timeline to a healthier heart as suggested by World Health Organisation:

Within 20 mins of quitting tobacco, your heart rate and blood pressure drop to normal.

Within 12 hours, the carbon monoxide level in your blood drops to normal.

In about 2-12 weeks, blood circulation improves, leading to increased lung functioning.

Within 1-9 months, symptoms such as coughing and shortness of breath decreases.

In a year’s time, the risk of coronary heart disease is about half that of smokers.

In 10 years, your risk of cancer falls to about half compared to that of a smoker's risk of cancer.

In about 15 years, the risk of coronary heart disease is as low as that of a nonsmoker.

- Dr Ramakanta Panda

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