Tobacco is toxic and addictive | Sunday Observer

Tobacco is toxic and addictive

5 June, 2021

Anti tobacco activists and health officials came together last week to raise awareness on the dangers of tobacco smoking. The Sunday Observer spoke to Emeritus Professor of Forensic Medicine and Toxicology, University of Colombo and the Senior Professor of Forensic Medicine, at the Sir John Kotelawala Defence University Professor Ravindra Fernando to give us more insights into this problem.


Q. World No Tobacco Day which we observed last week ( May 31) shone its spotlight on a subject that is still a cause of concern to health authorities despite their interventions over the past three decades.

As one who has been involved in such efforts tell us what initially prompted member states of the World Health Organisation ( WHO) to draw global attention to this problem initially in 1987? A The aim was to ‘’draw global attention to the tobacco epidemic and the preventable death and disease it causes.’’

World No Tobacco Day on May 31 every year became a big day for health and community workers to go all out and help people quit tobacco.

Q. What is the theme of the World No tobacco Day this year?

A. This year the theme of World No Tobacco Day is –“ Commit to quit.” To create environments conducive to quitting tobacco, WHO has worked with partners and countries around the globe to implement tobacco control measures that effectively reduce the demand for tobacco.

It has called on all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit emphasising the fact that strong cessation services improve health, save lives and saves money.

Q. It is said that some 14.5 percent or 1.2 million Sri Lankans are smokers and that if this number could be reduced to 10 percent it would no longer be a public health issue. Do you agree?

A. The problem is how to reduce the number of smokers to 10 percent. A recent study has shown that with legal and illicit tobacco products combined, Sri Lanka’s annual tobacco consumption in 2018 will be around 8.57 billion sticks; up 16 percent over the previous year’s figure of 7.38 billion.

At present the male smokers’ percentage in Sri Lanka is 26 percent. Various interventions by the state will be necessary to reduce smoking in the next few years.

Q. If these interventions don’t succeed what will be the fallout health wise for future citizens

A.Tobacco kills half of its users, with smoking and smokeless tobacco killing nearly six million people worldwide.

According to the WHO, tobacco use has killed 100 million people in the 20th century and could increase to one billion in the 21st century! Hospital medical wards have patients with coronary heart disease, strokes, chronic obstructive pulmonary disease (COPD) and cancer caused by smoking.

Q. We are now living amid the Covid-19 pandemic. How vulnerable are smokers to this virus especially as they could have upper respiratory problems due to smoking?

Q. What are the main reasons that drive people to smoking ?

A. Smoking is not simply a bad habit. It is an addiction. The drug inside tobacco that people are addicted to is called “nicotine”. Just like with other addictions, people who are addicted to cigarettes have a compulsive need to smoke. Their body craves for regular doses of nicotine.

When someone smokes, it will often lead to changes in their brain and nervous system. These are real physical differences, and the brain will now be dependent on the nicotine, and has ‘rewired’ itself. Withdrawal from smoking and nicotine is often uncomfortable. It has many physical symptoms and some people are not able to handle these feelings. They may also find the cravings for nicotine too hard to resist.

Q. Tobacco is said to have several chemicals of which many are harmful to our health and contain chemicals which are carcinogenic. Is this true?

A. Tobacco smoke is both toxic and addictive. In fact, tobacco smoke contains around 7,000 chemicals! Many of these are poisonous and over 60 are known to be cancer causing (carcinogenic). Apart from nicotine, there is Tar. ‘Tar’ is the term used to describe the toxic chemicals found in cigarettes. It’s a sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer.

Q. Any other harmful ingredients that affect the smoker’s health?

A. There is carbon monoxide. When it is inhaled it enters the blood stream and interferes with the working of the heart and the blood vessels. Up to 15 percent of a smoker’s blood can be carrying carbon monoxide instead of oxygen. Other chemicals include arsenic, ammonia, acetone, toluene, methylamine, methanol and pesticides.

A number of pesticides (toxic chemicals used to kill pests, usually insects) are present in cigarette smoke. These pesticides find their way into cigarettes because they’re used on tobacco plants as they are growing.

Q. I understand ten top priority areas have been listed by the WHO with regard to the adverse effects of cigarette smoking. Name some of them.

A. Type two or adult type diabetes, weakened immune system, vision problems, poor oral hygiene, unhealthy skin and hair, and cancers

Q. What about the effects of cigarette smoking on our respiratory system?

A. Smoking cigarettes affects lung health because a person breathes in not only nicotine but also a variety of additional chemicals mentioned above. Cigarettes are responsible for a substantial increase in the risk of developing lung cancer. Cigarettes are also linked to developing emphysema and chronic bronchitis. They can also trigger or exacerbate an asthma attack.

Q. In what way does it affect our lungs?

A. Smoking can cause lung disease by damaging the airways and the small air sacs (alveoli) found in our lungs.

Some changes such as colds and pneumonia are sudden, lasting just a short time. More chronic changes like emphysema happen slowly and can last a lifetime. When you smoke, the cells that produce mucus in your lungs and airways grow in size and number. As a result, the amount of mucus increases and thickens. Lungs cannot effectively clean out this excess mucus. So, the mucus stays in our airways, clogs them, and makes us cough. This extra mucus is also prone to infection.

Q. Can it harm the smoker’s reproductive system?

A. Smoking can damage a female’s reproductive system and make it more difficult to get pregnant. This may be because tobacco and the other chemicals in cigarettes affect hormone levels. In males, there is a higher the risk of erectile dysfunction. Smoking can also affect the quality of the sperm and therefore reduce fertility.

Q. According to recent studies it also the cause of Chronic Obstructive Pulmonary Disease or COPD. Your comments?

A. Smoking is the leading cause of Chronic Obstructive Pulmonary Disease (COPD). Smoking is also a trigger for COPD flare-ups. Smoking damages the air sacs, airways, and the lining of the lungs. Injured lungs have trouble moving enough air in and out, so it is hard to breathe.

Q. What about the skin and eyes?

A. A person who smokes may experience prematurely aged, wrinkled skin. They also have a higher risk of skin cancer, especially on the lips. Smoking can cause the hair and skin to smell of tobacco. It can also contribute to hair loss and balding.

Q. Can it damage the heart?

A. Smoking can damage the heart, blood vessels, and blood cells. The chemicals and tar in cigarettes can increase a person’s risk of atherosclerosis, which is the build up of plaque in the blood vessels. This build up limits blood flow and can lead to dangerous blockages.

Q. It has been said tobacco smokers are up to 22 times likely to develop lung cancer in their lifetime than non smokers. Is that true ?

A. Yes. It is estimated that lung cancer causes more than one million deaths. The most important risk factor for lung cancer is tobacco smoking, and the data supporting this relationship are compelling. Compared with non-smokers, smokers have as much as a 30-fold increased risk of developing lung cancer.

Q. What is second hand smoking? I understand smoking not only harms the smoker but the people around him. It has been said that they could be at greater risk than the smoker. Is this true?

A. Second hand smoke is the combination of smoke from a burning cigarette and smoke exhaled by a smoker. There are two types of second hand smoke; side stream smoke comes directly from the burning tobacco product, and mainstream smoke is the smoke that the smoker inhales. The smoke that burns off the end of a cigarette or cigar actually contains more harmful substances than the smoke inhaled by the smoker, as there is no filter it must pass through.

Q. For how long does cigarette smoke remain in the environment even after the smoker has stopped smoking?

A. Cigarette smoking causes environmental pollution by releasing toxic air pollutants into the atmosphere. The cigarette butts also litter the environment and the toxic chemicals in the remains seep into soils and waterways therefore causing soil and water pollution.

Q. Are there any new laws to track down traffickers of illegal imports? What is the penalty in Sri Lanka?

A. Increasingly, the illicit tobacco network is becoming a threat to national law and order as well as security. Benefitting from access to new markets with different legal and cultural conditions, organised crime has expanded its engagement in illicit trade significantly. A recent report on the tobacco industry stated that the trade is used extensively by organised crime groups to profit. Given softer penalties compared to higher profits, criminals have developed sophisticated mechanisms to smuggle goods to Sri Lanka.

Q. What is your message to all young people tempted to take their first smoke?

A. It is very important to advise and educate those on the verge of taking their first smoke on the harmful health effects of smoking so that they can make an informed choice.

Q. To parents?

A. Parents must be open to talk to children and educate and discuss with them the lasting damage that smoking has on their bodies. They should also be role models for their children by not smoking so that their message will be more credible to their children.