Health effects of cigarette smoking:
Killing the fire
Use of tobacco is the chief preventable cause of deaths worldwide.
The culminative number of deaths due to the use of tobacco for the 20th
Century was 100 million. Of the 1.1 billion current smokers in the world
70 percent are in developing countries. The World Health Organization
(WHO) attributes four million deaths per year to tobacco, this is about
one in 10 of all adult deaths. By 2020 annual deaths due to smoking is
projected to rise to 8.4 million per year, 70 percent of these deaths
will be in the developing world. Half a billion of the world’s
population alive today will be killed by a smoking related disease, half
of them will be between 35-69 years.
* Damages heart and blood
* Causes in censes in blood
pressure and heart rate
* Leads to brain and heart
* Affects blood circulation
* Affects re-productory
* Causes lung cancer
* Leads to nose and sinus
* Leads to throat cancer
* Leads to pre-mature ageing
Most begin tobacco use before 18 years. Recent trends suggest an
earlier age of starting smoking and a rising smoking prevalence among
children and adolacents. Younger the age of starting smoking higher the
chance of addiction and greater the risk of dying from smoking related
Sri Lanka took part in The Global Survey in 1999. The survey was
conducted in 84 schools in children aged 13-15 years with 2,896 students
participating. Twelve percent of the children surveyed had smoked during
the 30 days prior to the survey, while 10 percent bought cigarettes from
a store and smoked at home.
Of those who smoked, 79 percent wanted to stop and had tried
unsuccessfully. Eighty four percent had been exposed to advertising
promoting smoking in the media or at sports events.
Only 15 percent had been exposed to anti-smoking literature. Fifty
six percent of the surveyed children were exposed to tobacco smoke at
Cigarettes contains over 4,000 chemicals - 200 are poisons, 63 of
which cause cancer. Nicotine compounds found in tobacco are the source
of addiction. Early smokers may not experience harmful effects of
smoking, giving rise to a false sense of security and increased and
prolonged use resulting in nicotine addiction. Over the years harmful
toxins build up in the body with the potential to harm virtually any
organ in the body.
Tar causes cancer stains teeth and nails, Metals such as arsenic,
cadmium and lead causes cancer, Vinyl chloride, used to make vinyl
products, on short-term exposure causes dizziness, headaches and
tiredness. Long-term exposure can lead to cancer and liver damage,
Creoste, a component of tar, when inhaled can cause irritation of the
respiratory tract. Formaldehyde, a preservative substance used in dead
bodies causes cancer in humans. Polonium 210, a radiative substance
cause cancer of the liver and bladder, stomach ulcers, leukemia amongst
other diseases. Bidis consists of 0,2-03 grams of sun-cured tobacco.
Wrappers have low porosity and poor combustibility. The smoker has to
puff longer and harder to keep the biddi alight and products of poor
combustibility are absorbed deeper into the lungs and circulation.
Cigars go through a long fermentation process. During the
fermentation process, high concentrations of cancer causing compounds
are produced. Cigar and pipe smokers are at an increased risk for lip,
mouth, tongue, and throat cancers.
Particles that make up sidestream smoke are much smaller than those
of mainstream smoke. This means that these smaller particles that float
in the air, will be inhaled deeper into the lungs and will be able to
reach the furthest and deepest corners within a person’s respiratory
system and therefore cause much more damage.
The impact of smoking
Heart and the circulatory system
Free radicals in cigarettes smoke causes damage to the lining of
heart and blood vessels. This leads to build up of fatty material such
as cholesterol in the walls of blood vessels. This results in hardening
of the walls and narrowing of the inner opening of blood vessels. Blood
flow through such narrowed blood vessels are sluggish depriving the
heart of vital oxygen and nourishment.
Also the heart has to work harder to pump blood through narrowed
hardened blood vessels leading to enlargement and thickening of the
walls of the heart. Smoking also causes an incenses in blood pressure
and heart rate.
Smoking increase in the clotting substances in blood. Such blood
clots can block already damaged and narrowed blood vessels. When this
happens in the blood vessels supplying the heart (coronary arteries) it
results in large parts of the heart muscle being deprived of oxygen and
vital nutrients ending in permanent damage.
Smokers are five times more likely to have heart attacks than
nonsmokers and are four times more likely to die while having a heart
attack, if smokers have other risk factors such as increased
cholesterol, diabetes or high blood pressure the risk of a heart attack
is 10 times more.
Similar changes in circulation to the brain can result in “strokes”
damaging large parts of the brain. Strokes can result in death or
serious disability. Longstanding changes in the circulation of the brain
can give rise to dementia.
Disturbed blood circulation to the legs will result in cramps and
pain on walking ending up even in gangrene of toes and amputation.
Impotence will result if blood flow to the penis disturbed.
Lungs and airways
Constant exposure of nose and upper air passages to toxins and cancer
producing substance in tobacco smoke causes serious and permanent damage
to these organs.
It results in an increase in infections of the nose and sinuses.
Sinusitis gives rise to headaches, “phlegm” in the throat, disturbance
in the sense of smell.
Smoking is responsible for 90 percent of lung cancer in men and 80
percent in women. Men who smoke are 23 times more likely to develop lung
cancer than non-smokers.
Smokers are at risk of blindness due to developing cataracts, macular
degeneration breakdown of the retina (light sensitive layer of the eye),
diabetics who smoke develop diabetic eye complications at an earlier
Cigarette smoke causes wrinkling of facial skin and pre-mature
Nicotine and tar causes staining of teeth, impairs sense of taste and
caused disease of the gums.
Smoking in pregnancy
It increases the risk of miscarriage. complications of pregnancy,
including bleeding during pregnancy, detachment of the placenta,
premature birth, and ectopic pregnancy and low birth weight. Babies born
to women who smoke are on average 200 grams (8 oz) lighter than babies
born to comparable non-smoking mothers. Premature and low birth weight
babies are more prone to illness and infections.
The economic impact
In the year 2002, 4700 billion cigarette sticks were consumed in Sri
Lanka per capita consumption of legally manufactures cigarettes was 251.
a single smoker above the age of 18 consumes four to five cigarettes per
Following the data gathered from the total population it can be
calculated that in the year 2003 a single person spent over Rs 1,597.40
on cigarettes. (this data is for legally manufactured cigarettes)
According to the Central Bank, tobacco taxes paid to the Government
accounted for seven percent of the total Government revenue in 2003.
This was eight percent in 2002.
Illicit cigarettes play a vital role in the black market of Sri
Lanka. The lack of taxes is the main reason behind the low price range.
The value of the confiscated illegal cigarettes in the year 2003 was Rs
In a developing country such as Sri Lanka much of the country’s
revenue is sent on treating the sicknesses caused by smoking. This money
could be more productively utilized for infrastructure development.
The writer is Consultant Chest Physician Central Chest Clinic