by Reynold Hewitt 11.DEC.09

Environmentalist and Public Health Specialist

(Editor’s note: The first part of this article was published last week on page 8. It should have continued on a later page, but the printer’s devil was at work. We now publish the article in full. We apologize to our readers and Mr. Hewitt for the error)

It will make you feel like a man, give you good health, happiness, fitness, wealth, power and sexual success. This is how smoking is portrayed by the sellers and manufacturers. This is what every living human wants in life. It was the ideal style/habit for celebrities and persons in authority, it is cool.{{more}}

Smoking is one of the most disgusting habits any individual can ever practice as a hobby. In World War II, and even in modern wars, many men and women took up the habit to cope with pressure and the long hours of fighting and because cigarettes were free.

Today if you ask a man or woman why they smoke, they will say “to cope with the pressure of life”. But to really understand why people smoke will involve a comprehensive examination of their background.

Most adults who smoke began at an early age and continued into adulthood simply because a family member smoked or they were influenced by a friend. What many youngsters don’t know is that cigarette smoking is very addictive. Once you light up three to four times you become addicted; you are hooked.

Data from the World Health Organization indicates that one billion men smoke – 35 per cent of men in developed countries and 50 per cent of men in developing countries. In St.Vincent and the Grenadines, 20 to 29 per cent of adult men smoke cigarettes. That is high for a small state like ours with a population of 106,000. (WHO statistics)

Cigarette smoking is also prevalent among females; there are approximately 250 million women in the world who are daily smokers. About 22 per cent of women who smoke tobacco are in developed countries and 9 per cent in developing countries. In St. Vincent and the Grenadines, about 10 per cent of the women smoke. It is bad to see men smoke but it is worse to see a woman smoke cigarettes or marijuana.

In 2007, I conducted research among teenage boys between ages 13 to 17 in four secondary schools in Kingston, Jamaica. The survey revealed a smoking prevalence rate of 41 percent among this cohort of students. This was consistent with other studies on teenagers in the same age group in other countries. (X2 =0.003: p<0.030) What was surprising to me were some of the reasons given by the students for smoking. Students indicated that they were pressured to smoke by their peers (87%). It made them feel good. Students from one school said to have an experience: 37.4%; friends outside of school introduced them: 74 or 36%; their parents smoked so they did it, (focus group discussion) to rebel, to do better in exams, to cope with pressure of school work and home. However, the fact that those students see people at home smoke: 67 or 26%; saw people smoke on the street or corner: 150 or 85% of respondents. If young people have low self-esteem, don’t know what they believe and how an activity will affect them, they will engage in harmful activities. This was the situation with some of these teenagers; they were exposed and became hooked for life on cigarette and other smoking paraphernalia. Interestingly, many students, 175 or 72%, indicated that there are no benefits to be gained from smoking cigarette. Tobacco smoke contains chemicals that are harmful to both smokers and non-smokers. Breathing even a little tobacco smoke can be harmful. Of the 4000 chemicals in tobacco smoke, at least 250 are known to be harmful. The toxic chemicals found in smoke include hydrogen cyanide, used in chemical weapons; carbon monoxide, found in car exhaust; formaldehyde, used in chemical, used as embalming fluid, ammonia, used in household cleaners; toluene, found in paint thinners. Among the 250 known harmful chemicals in tobacco smoke, more than 50 have been found to cause cancer. These cancer causing chemicals include: Arsenic- a heavy metal toxin, rat poison
Benzene-a chemical found in gasoline
Beryllium-a toxic metal
Cadmium-a metal used in batteries
Chromium-a metallic element
Ethylene oxide -a chemical used to sensitize medical devices
Nickel -a metallic element
Polonium-210-a chemical element that gives off radium
Vinyl chloride- a toxic substance used in plastics manufacture
Nicotine- insecticide/addictive drug
Hydrogen cyanide-use in gas chamber

Smoking affects nearly every organ of the body and diminishes a person’s overall health, causing cancer of the lungs, oesophagus, larynx, mouth, throat, kidney, pancreas, stomach, and cervix. Smoking also causes heart attack, stroke, chronic bronchitis, and emphysema.

Smokers are at high risk for developing pneumonia and other respiratory infections.

Evidence of adverse health effects of passive smoking is increasing. Involuntary smoking occurs when nonsmokers are exposed to the tobacco exhaled by smokers in an enclosed or open environment. Tobacco smoke in the environment is derived from two sources:

1. Main stream smoke emerging into the environment after being drawn through the cigarette filtered by the smoker’s lungs and then exhaled.

2. Side stream smoke arising from the burning end of the cigarette and entering directly into the environment.

However, the components of the types of smoke are the same. They include oxide, nicotine, tar, carbon monoxide, carcinogens and co carcinogens. However, undiluted side stream smoke has a higher PH, smaller particles and higher concentration of carbon monoxide and of many carcinogens. Side stream smoke contains a higher concentration of potentially dangerous gas-phase constituents and accounts for about 85% of the smoke in a room with smokers. However, because of dilution, non-smokers are exposed to smaller doses of the products of tobacco combinations than active smokers.

Among healthy adults, the most common complaints after exposure to passive smoking are eye irritation 69%, headache 33%, nasal symptoms 33%, and cough 33%. Exposure to tobacco smoke precipitates and aggravates allergic attacks in some individuals with respiratory allergies and exacerbates other symptoms associated with allergies such as eye irritation nasal symptoms, headache, cough wheezing, sore throat and hoarseness.

Studies conducted in 1985 by three independent bodies, the U.S Public Health Services, National Research Council and Interagency Task Force on Environmental Cancer, Heart and Lung Cancer, considered the health impact of passive smoking. There was overwhelming consensus that a substantial number of lung cancer deaths among nonsmokers can be attributed to involuntary smoking.

The National Research Council review estimated the true relative risk for nonexposed nonsmokers married to smokers and for nonexposed nonsmokers married to nonsmokers as 1.41 to 1.87 and 1.09 to 1.4, respectively. These estimates mean that between 2500 and 8400 of the approximately 12200 annual lung cancer deaths in the U.S not caused by smoking are attributable to environmental tobacco smoke.

Because cigarette smoking and tobacco use are acquired behaviors or activities that people choose to do, many who have achieved long term abstinence have done so without the help of any formal programmes or clinical interventions. Smoking is the most preventable cause of premature death in our society.

There are numerous control measures that can be used to stop smoking. Ninety (90%) of smokers wish to stop and the majority of smokers have tried to stop one or more times. There are several reasons why an individual may want to stop smoking. These include health problems, family pressure from spouses and children, peer pressure from friends and co-workers, cost of cigarettes, impact on children and concern for cleanliness and social appearance.

The research I conducted in schools in Jamaica indicated that “stopping the importation” of cigarette will stop teenagers from smoking. “All teens are curious; the only way to stop teens is to stop the production of cigarette because once it is there they are going to experiment”. The use of a model person with symptoms of the effects of smoking will influence teens to stop smoking”.

A sustained comprehensive school health programme can ensure that the numbers continue to drop despite social problems in the community. This is possible because it involves a variation in activities and methods that will involve the community and schools in integrated programmes to enhance health. The programme will see health as a way of life, and will also allow them to have discussions about other ways to cope with social and academic stress.

Adults may require different strategies such as smoking cessation classes that have an organized program with a health educator or psychologist. For an individual to stop smoking they must first see themselves at risk for serious health complication and social problems.

All these strategies can be more effective if strengthened by legislation. Many of our Caribbean countries are afraid to implement no smoking laws and to declare all public areas as no smoking. If these laws are passed they would help to reduce the burden on the health system and the scarce financial resources and in the long run improve environmental health.