Source: www.npr.org
Cigarette smoking kills nearly six million people each year. In Malaysia alone it is often reported as 10,000 lives lost annually. For every death by smoking, it has been reported that at least three others are left with health consequences of smoking. These include heart and lung diseases mostly, though many other body parts can be equally affected, as noted in a previous article.
As a recap, it is the act of smoking and the smoke from cigarette smoking which is dangerous. This act of combusting (burning) tobacco, which has often been ‘treated’, releases a raft of poisonous chemicals which are also found to be carcinogenic, meaning cancer causing. To date 7000 poisonous material have been identified; the likes of arsenic, benzene and others, of which 1% of these are cancer causing. This combusted material is often referred to as ‘tar’. Tar is often implicated in the health consequences of smoking together with the polycyclic aromatic hydrocarbons released in tobacco smoke itself. The first study to implicate tar was scientist ‘painting’ tar onto the back of rats, resulting in cancer formation which was dose dependent i.e. more tar leads to higher risk of cancer. As a result, low tar and filtered cigarettes were designed to reduce this risk, but the risk is still prevalent. Imagine the harm to your own skin (lips and gums) as a result of tar!
In the past two decade there has been an acceptance that second-hand smoking is equally dangerous. Second-hand smoking occurs when non-smokers (either by choice or situation) end up indirectly smoking the cigarette smoke of smokers around them. A study involving 192 countries found that a third of non-smokers end up being second-hand smokers. These individuals include both men and women who were non-smokers and those who are usually unable to fend for themselves; children. In this same study, 1% of deaths as a result of smoking were attributed to second-hand smoking.
More recently there is increasing interest in what is referred to as third-hand smoking. In this situation the residue of cigarette smoking is left behind on everyday items such as car upholstery, house curtains and beddings and other furniture. Once there is ‘enough’ smoking residue available, it can either cause health problems on its own or by ‘off-gassing’ whereby these residues are released back in the air as gases. Both result in cigarette smoke causing harm long after the smoker has completed his or her smoking. As a result of these ‘gases’ being released into the air, it can then interact with other gases and continue to cause harm, for example nitrous oxide interacts with third-hand smoking to create nitrosamines, a known carcinogen. Conversely, the discussion on third-hand smoking is relatively new, but has potential for added harm. Therefore, it is best to avoid as much as possible.
Why is this important?
The main intention of this article is to inform and make aware that cigarette smoking causes harm to both user and those around them. The tobacco industry often cites personal choice as a reason to allow ‘business as usual’. For adults reading on the harm of smoking, indeed, they can make a personal and informed choice to continue smoking, however, for children this choice is absent. With second and third-hand smoking now known and shown to be harmful, we should try hard to avoid being addicted lest we cause harm. Childhood asthma and God forbid, sudden infant death syndrome SIDS, have been associated with cigarette smoking. In addition, in the Legacy Tobacco Document Library, a digital library containing internal documents from major tobacco companies as part of the Master Settlement Agreement of 1998, the industry has been reported to have once circulated their marketing strategy as;
“We don’t smoke that shit. We just sell it. We reserve the right to smoke for the young, the poor, the black and the stupid”.
– RJ Reynolds executive, June 1992
What can be done to avoid second and third-hand smoking?
The most obvious thing that you can do for yourself is to quit smoking. This is especially important for those living with other people, be it family or friends.
The next best thing for those who continue to smoke or have family members who smoke and are not considering to quit just yet, make both your home and car smoke free. Have a ZERO TOLERANCE policy in this matter, meaning do not allow anyone including yourself, family or friends to smoke in your house and car.
For the advocates amongst us, ensure that your work place is smoke free. Similarly, have a ZERO TOLERANCE policy on this too.
For consumers especially patrons of restaurants and hotels, ensure that these establishments respect your right not to be harmed by tobacco smoke which is not your doing! It’s a personal and choice to smoke as the tobacco industry likes to tell us, so let’s make it known that it’s a personal choice NOT to smoke and make it known that our rights (which is majority) is equally respected.
Finally, together everyone achieves more. With that said, to the smokers amongst us, consider quitting and if this is not possible at this point, avoid harming others. For those who are non-smokers, start demanding your right to live in a smoke free Malaysia. #smokefreemalaysia
Dr. Amer Siddiq Amer Nordin is a senior lecturer with the Department of Psychological Medicine, at a local university. He is also a consultant psychiatrist (Addiction Medicine) and certified smoking cessation specialist and trainer. Among his administrative duties include being the coordinator for the Nicotine Addiction research group of University Malaya Centre for Addiction Sciences (UMCAS). He is also pursuing his PhD at the National Addiction Centre, University of Otago, Christchurch in New Zealand.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]
Reference:
- Eriksen, M., Mackay, J., & Ross, H. (2012). The Tobacco Atlas (Fourth edition ed.). New York, NY: World Lung Foundation.
- Öberg, M., Jaakkola, M. S., Woodward, A., Peruga, A., & Prüss-Ustün, A. (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet, 377(9760), 139-146. doi: 10.1016/s0140-6736(10)61388-8
- Becquemin, M. H., Bertholon, J. F., Bentayeb, M., Attoui, M., Ledur, D., Roy, F., . . . Dautzenberg, B. (2010). Third-hand smoking: indoor measurements of concentration and sizes of cigarette smoke particles after resuspension. Tobacco Control, 19(4), 347-348. doi: 10.1136/tc.2009.034694