DRUG addiction, a phenomenon that has today turned out to be Guyana’s biggest menace, waging an unprecedented and debilitating onslaught on the minds of the vast majority of its users, in many cases started off with cigarette smoking.
This fact was revealed in interviews with persons who are known recovering substance abusers in Guyana and who have shared stories of the thrill they experienced, at an early age, on taking that first ‘puff’ then inhaling it again, and just how difficult it was to ever break off the habit.
Taking a smoke break
And yes, tobacco is culpable, since it is a carrier of the highly addictive drug, nicotine. Similarly, addiction is characterised by compulsive drug seeking and abuse. Once the person smoking tobacco gets a
taste for nicotine, it can quickly become a lifelong addiction. Nicotine, a nitrogen-containing chemical (an alkaloid) is made by
several types of plants, including the tobacco plant.
And although many persons were introduced to smoking by starting off with tobacco, they later moved on to feeding far more expensive forms of addiction with narcotics. For this reason, the major challenge facing developing countries such as Guyana, is that young smokers and low-income adults who cannot afford to graduate to narcotics, invariably remain hooked on tobacco smoking, thus being made vulnerable to all the risks associated with it.
DANGERS OF TOBACCO
So dangerous is tobacco smoking to human health, that when tobacco smoke is inhaled, nicotine is absorbed through the lungs, and
reaches the brain in about seven seconds, thereafter sparking irreversible damage. This applies for both active smokers and passive (non-smokers who passively inhale the second-hand smoke). Second-hand smoking may adversely affect children’s growth and cause childhood illness, especially respiratory diseases; ear problems and severe asthmatic attacks.
The most common forms of tobacco-related diseases are respiratory complications and include chronic obstructive pulmonary disease and respiratory infections, such as bacterial pneumonia or pulmonary tuberculosis.
In addition, tobacco smoke has been designated as a known human carcinogen (cancer-causing agent) and research has found that the really harmful substances are the burnt carcinogens in tobacco.
According to the National Institute of Health (NIH), cigarette smoking increases the risk for many types of cancer, including cancers of the oral cavity, pharynx, esophagus, stomach, pancreas, larynx, lung, cervix, urinary bladder, and kidney.
The NIH has also warned that: “Smoking is a major risk factor for peripheral vascular and coronary artery disease, increasing the risk for cardiovascular disease (CVD) complications, including myocardial infarction and stroke.”
Meanwhile, the Center for Diseases Prevention and Control (CDC), has also sounded a warning bell that smoking is estimated to increase the risk:
o For coronary heart disease by 2 to 4 times
o For stroke by 2 to 4 times
o Of men developing lung cancer by 25 times
o Of women developing lung cancer by 25.7 times
Further, more women die from lung cancer each year than from breast cancer. Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths in men and women leading the Guyana Chest Clinic to declare that: “Smoking damages the body from head to toe.”
But the stark reality, according to the CDC, is that smoking causes more deaths each year than all of the following conditions combined:
o Human immunodeficiency virus (HIV)
o Illegal drug use
o Alcohol use
o Motor vehicle injuries
o Firearm-related incidents
GLOBAL TOBACCO SMOKING
Tobacco smoking is the leading preventable cause of death in the USA, claiming more than 480,000 lives annually, while second-hand smoking claims about 42,000 lives. Globally, one person dies every six seconds from tobacco use and this habit costs the global economy in excess of $2 Billion each year. Because smoking is an acquired behaviour that is chosen by individuals, all morbidity and mortality caused by smoking is preventable. High-burden countries include China, Russia, India, Bangladesh and Indonesia
The World Health Organization had earlier estimated that tobacco would kill nearly 6 million people worldwide each year (5.4 million active smokers and 600,000 non-smokers). But its most recent extrapolation is that the global annual death toll could reach 8 million by 2030.
The local PAHO office, in its ‘World No Tobacco Day 2014’ message, observed that paradoxically, tobacco is the only legal consumer product that kills up to half of its users when used exactly as intended by the manufacturer.
‘World No Tobacco Day’ provides an opportunity to start or enhance collective action to reduce the burden of disease, death, and economic consequences caused by tobacco use and exposure to second-hand smoke globally, PAHO Resident Representative to Guyana, Dr. William Adu Krow said.
This year’s theme for ‘World No Tobacco Day’ was: ‘Raise Tobacco Taxes, Lower Death and Disease’. It aims to encourage governments and civil society around the world to raise taxes as a strategy to reduce smoking, particularly among teenagers and low-income people.
WHO FCTC
Concerned at the impact of tobacco smoking on the health of nations worldwide, the World Health Organization charted what is known as the WHO Framework Convention on Tobacco Control (WHO FCTC).
The treaty entered into force in February 2005 was signed by 168 of the 192 WHO member states, and more than 170 WHO member states (including Guyana) have become parties to the convention.
The FCTC was developed in the recognition that a global strategy was needed to confront a global epidemic that countries cannot address through domestic legislation alone. It is the first international public health treaty negotiated under WHO auspices, and reaffirms the right of all people to the highest standard of health.
In essence, the FCTC ‘recognises the need for countries to give priority to their right to protect public health, the unique nature of tobacco products and the harm that companies that produce them cause.’
The FCTC provides an internationally co-ordinated response to combating the tobacco epidemic, and sets out specific steps for governments addressing tobacco use, including to:
• Adopt tax and price measures to reduce tobacco consumption;
• Ban tobacco advertising, promotion and sponsorship;
• Create smoke-free work and public spaces;
• Put prominent health warnings on tobacco packages;
• Combat illicit trade in tobacco products.
Guyana signed on to the treaty in 2005, and according to former Minister of Health, Dr. Leslie Ramsammy, that was the biggest leap Guyana has ever taken in public health. He referred to tobacco as ‘an addictive and killer product’.
In the ensuing years, his successor, Dr. Bheri Ramasaran approached the problem with the same zeal and optimism and together with PAHO’s Resident Representive, Dr. William Adu Krow, has been working passionately at sensitizing the nation on the dangers of tobacco smoking and the role we can each play in bringing about a change for the better.
Statistics from a Tobacco Data Dissemination Workshop in Georgetown in 2011, revealed that 15 percent of the local population are smokers, 7 percent of whom are women. The current prevalence rate has shown no decrease compared to the figure then.
But given the drastic implications of tobacco smoking – both in terms of morbidity and mortality, when it comes to implementing the strategies agreed on for reducing this scourge, it cannot be business as usual. There should be a constant evaluation of progress on the specific steps (as per the FCTC) to be taken by policy makers, in an effort to combat the tobacco epidemic.
CONCERTED APPROACH
What is needed is a concerted and synergistic approach to the task in hand, involving all stakeholders, not only policy makers but at the individual level; the media; the Church; health facilities; in the field, office, factory and across the spectrum. The holding of public consultations could also serve useful in getting a sense of how the public feels about the matter and finally setting up a feedback mechanism to evaluate their participation and commitment.
Where information is to be disseminated, a list of the key audiences needing the data should be drawn up and specifics as to how the data is to be used. Likewise, wherever the electronic media is used to get information to the people, the timing should be strategically set, aiming for prime time, so as to ensure the messages reach the target audience and are not aired at times that people are least likely to be watching television or listening o the radio.
(By Shirley Thomas)