CIGARETTES: PLEASURE OR ADDICTION?

REASONS TO GIVE UP SMOKING

Most smokers are nicotine addicts; typically they search for this substance and make compulsive use of it, in spite of the negative consequences on their health.

According to the Pan American Health Organization (PAHO), smoking is the main preventable cause of premature death, in a worldwide scale. More than 5.000.000 people die each year, a number that could double by 2030 if measures tending to counteract the situation are not applied.

In addition, according to information provided by PAHO, there is a noticeable shifting of the epidemic towards less developed countries or those which policies involve weak regulations regarding tobacco products. Nicotine addiction is considered a chronic disease in which smokers fluctuate in between multiple periods of remission and relapse. This is due to the strong addiction generated by nicotine.

During an interview to a team of medical specialists, who take part in the program GRANTAHI (Grupo Antitabaquismo del Hospital Italiano de Buenos Aires – Antismoking Group of the Italian Hospital of Buenos Aires), Dr. Verónica Schoj, head of the team, when asked about it, denies the idea that “smoking be a pleasure” and advises smokers to embrace healthier life habits other than cigarettes.

Many smokers believe and assert that smoking is a pleasure, but the truth is that nicotine (one of the substances present in cigarettes, among others) is the main tobacco alkaloid; it is a tertiary amine that acts strongly on the central nervous system (CNS). It creates a triple addiction: physical, psychological and behavioural; these, far from being a pleasure, generate a clear dependence on tobacco, together with multiple kinds of health deterioration. Nicotine is even more addictive than heroine, cocaine, or alcohol, Dr. Schoj emphasized.

When asked if tobacco use had dropped in Argentina, this is what Dr. Espinosa (also part of GRANTAHI) answered: in Argentina, numbers continue to be alarming. Even though there has been an important decrease in the use of tobacco, regarding previous years surveys, we are still far from reverting the situation. Nowadays, 37% of smoking population are adults; 40% are young people in between the ages of 15 and 18, and 23% are teenagers in between 12 and 14 years. A strong increment shows as regards females and earlier ages.

Surveys carried out in primary schools showed that the age at which teenagers start smoking gets lower and lower. The average varies in between 11 and 12 years. Moreover, results revealed that in most of children smokers' homes, one of the parents is also a tobacco user.

The contest “Give up and win” is one of the national policies implemented by the government. To be able to take part in this contest, smokers have to sign a contract with the smoking cessation specialist and make a commitment not to smoke during the period established by the contest. When it starts, and at different stages, they are monitored through blood tests and spirometries (a test for measuring lung function). This allows them to verify improvement in lung function as compared with the beginning of the contest, thus influencing their decision to give up smoking completely, specialists argued.

As regards passive smokers, rates are also very high and the serious matter is that tobacco users do not respect non-smokers, lighting cigarettes in enclosed spaces like offices, working places, elevators, restrooms and many other places shared by all. Although the tobacco user can choose whether they smoke or not, passive smokers don't have a choice, neither do they have the awareness to have others respect their right to breath smoke-free air. Implementation of “Smoke-Free” areas is limited. According to the JAMA study, carried out on June 2004, our country presents the highest levels of exposure to other people's tobacco smoke in Latin America, and, even today, we haven't been able to improve these results.

When asked to leave a message for nicotine addicts, they said: don't be naive, don't wait till you are sick to make the decision; you may find other pleasures without putting your life in danger, and give priority to the benefits on your health if you quit. Also, adding physical activities and a healthy diet as a life habit is highly recommendable. Giving up smoking is not easy, we are aware, but it is possible and achieving this goal is up to them. These days, we have very effective first-line and second-line pharmacological treatments, which facilitate cessation process and imply scarce side effects.

Greater control and lower consumption

Due to the worldwide implications of tobacco consumption, the World Health Organization (WHO) has brought forward, for the first time in history, an international public health legal document, to control tobacco use. This document, written by the Framework Convention on Tobacco Control (FCTC), was signed by 168 of the 192 member states of the World Health Assembly (WHA). After having been ratified by 40 countries, the treaty will come into force at worldwide level. Argentina has already signed it, ratification is still pending.

In the meantime, more than 40.000 argentines die each year as a consequence of diseases related with direct tobacco use. This information was supplied by the Ministerio de Salud y Medio Ambiente de la Nación (Ministry of Health and Environment). In addition, health expenditure is remarkably higher than tax-collecting numbers coming from tobacco industries. Loss for lack of productivity originated by death or inability of ill smokers should be considered as well.

Among prevailing tobacco-related death causes, those which stand out are cardiovascular and respiratory diseases and cancers; lung cancer being one of the first illnesses directly identified with cigarette consumption. Mostly, deaths are associated with ischemic cardiopathies and cerebrovascular accidents. Smokers are more likely to suffer mouth, larynx, pharynx, stomach, pancreatic or bladder cancer, as well as certain types of leukemias.

As regards women, tobacco use is associated with a higher risk of suffering cervix and breast cancer, involving a high death rate. As regards men, it causes premature sexual impotence, on account of the damage to the arteries that irrigate the penis. Chances of developing asthma are higher in children and teenagers exposed to cigarette smoke for a longer time.

Cigarette is also the main cause for the “chronic obstructive pulmonary disease” (COPD), emphysemas, premature ageing, mouth sores and gingivitis among others.

Even though the national government has taken initiatives to counteract this issue, for instance creating “smoke-free” environments, raising the price of cigarettes, and forbidding media campaigns for promoting tobacco, so far these measures don’t seem to be efficient enough to cut down consumption.

Regardless of Medicine taking care of healing and health prevention, currently argentines face a double challenge: understanding that smoking tobacco, far away from being a pleasure, is a disease that may lead to death; as a consequence, changes have to be generated so that possibilities of a healthy life be guaranteed for the whole of society.