Sunday, 27 May 2012 02:30
By Dr. Jerry Simon
Antigua St John's - As I listened to a popular radio personality's account of the recent burning of confiscated marijuana and other drugs, I could not help but have a chuckle.
There was the clichéd joke of scores of Rasta men calling the Met office to find out the wind direction. Of course, most of it was the broadcaster's extra active imagination. But I could not help seeing the image, in my mind's eye, of a crowd of people downwind getting high.
However, on a more serious note, I am wondering why there was no tobacco on that fire. I am being a bit cruel, for not only would people be getting high, they would be dying. While we criminalize marijuana, we ignore another substance that causes more preventable deaths than any other thing in Europe, North America, and quite a number of other countries.
Tobacco use is the leading cause of death in the United States, killing about 450,000 people yearly, and accounting for more than US$75 billion in direct medical costs. It is projected by 2015 that tobacco use will be responsible for 10 percent of all deaths worldwide.
Nicotine, the principle addictive chemical in tobacco, is a natural killer. It naturally occurs in many plants as a rather potent insecticide. Imagine the damage that would be done if you go into the smallest room in your house, lock all windows and doors, spray several cans of Baygon until empty and inhale for half an hour. It is more addictive that alcohol, heroin, cocaine, or marijuana.
Historically, tobacco was cultivated by Amerindian peoples in the Caribbean and continental America for hundreds of years. Around 1600, it was first exported to Europe. Some of us might have heard the story of people in Europe throwing water on colonists as they exhaled tobacco smoke.
The World Health Organization estimates that one out of every three people in the world smokes tobacco. Although in some countries smoking is declining, globally the rate of tobacco smoking increases every year. Tobacco use is one of the few causes of death that is increasing worldwide.
Nicotine owes its potent addictive qualities to several factors. When it is inhaled, from smoking a cigarette for example, it takes about 20 seconds to reach the brain. It gets there before any metabolism takes place (that is, in an unchanged state). This rapid arrival at delicate and vulnerable brain tissue, of a large bulk of nicotine, contributes greatly to the capacity of cigarettes to cause addiction.
It accumulates rather easily in body tissues (including the brain) while smoking; and this accumulation can persist for another eight hours after smoking, even during sleep. It even has the ability to chemically displace medications one may be taking for conditions such as hypertension, diabetes, and mental illness and hence reduces their effect.
Another reason for its addiction is what is known as drug-associated memories (or conditioned cues). This occurs as the desire for a cigarette becomes associated with everyday events such as waking from sleep, taking a meal, talking on the phone, driving a car, taking a break, reading and watching TV. The quantity and power of this conditioning is unique to cigarette smoking and further makes it so difficult to quit.
Among drug dependent people who try to break their habit, tobacco smoking has the highest relapse rates. Studies show that about 75 percent of adults who smoke want to stop. About one third actually try to stop each year, but less than three percent are successful.
While among patients who experience heart attacks, chronic bronchitis, emphysema, throat surgery, and other serious medical consequences of smoking, more than 50 percent return to smoking cigarettes within days or weeks after leaving the hospital.
So what is so bad about cigarette smoking ?
Tobacco smoke is composed of about 4,000 different chemicals. Of these, at least 50 are known to be cancer causing. Therefore, while the nicotine makes cigarettes addictive, there are a host of other chemicals that actually make you sick or die.
These chemicals cause your blood to clot unnaturally easy, raise or overly depress your blood pressure, raise the so-called bad cholesterol, and constrict and block the arteries to your heart and brain. Eventually, this leads to heart attack and stroke, or may cause emphysema, chronic bronchitis and the ever-present smokers' cough.
Further, cigarette smoking causes yellow staining of fingers, and destroys small blood vessels in the skin, making the face gnawed and wrinkled. It contributes to many forms of cancer especially of the lungs, lips, mouth, and throat.
In women, cigarette smoking is associated with lower estrogen levels, early menopause, and increased risk of osteoporosis; in men it causes erectile dysfunction and reduces the potency of sperm. Also, women taking oral contraceptives should stay away from cigarettes, as smoking may cause excessive blood clotting leading to heart attack, stroke, and deep vein thrombosis.
It damages the eyes by causing dehydration, macular degeneration, and cataracts. It dehydrates the muscles making them prone to injury. And it contributes to the formation and delayed healing of ulcers in the stomach and intestines.
Smoking during pregnancy nearly doubles the risk of a low birth-weight infant, and increases the risk of spontaneous abortion and prenatal deaths by about one third.
Exposure to secondhand smoke is associated with heart disease, lung cancer, nasal sinus cancer, and eye and nasal irritation in adults. It is associated with asthma, bronchitis pneumonia, poor growth, and Sudden Infant Death Syndrome in children and infants.
Studies found that more than 95 percent of office workers exposed to second hand smoke exceeded the significant risk level for heart disease mortality, and more than 60 percent exceeded the significant risk level for lung cancer mortality established by the US Occupational Safety and Health Administration.
In the United States, about 40,000 deaths per year are attributed to secondhand smoke. This is eight to 10 percent of all smoking related deaths.
It is estimated that each pack of cigarettes sold in the United States costs the country more than seven US dollars in medical care expenditure and lost productivity. On average, male smokers lose more than 13 years of their life and females almost 15 years.
However, there is some good news. There are benefits when you quit. Studies show that people who manage to quit smoking reduce their cardiovascular risk immediately and may return to the risk levels of people who never smoked in about 10 to 15 years. But the message here is to never start; and if you have started quit now.
Although there is a health risk warning on most cigarette boxes and there are no cigarette commercials on TV in many countries, tobacco smoking is still widely promoted every day. It is glorified in movies, theatres, sitcoms, soap operas, sporting events and magazines.
While tobacco might not be an illegal substance like marijuana is, that does not lessen its ability to kill. So next time we are having a public burning of happy grass, add some killer grass to the fire too; but please no Bald-head or Rasta downwind.
Dr. Jerry Simon (NSA Medical Surgical Rehab Centre, 268 4620631,