Articles on smoking


Dr. N Praveen Kumar, General Physician
The Framingham study found an 18% increase in coronary events for males and a 31% increase for females for every 10 cigarettes smoked per day. There is more of an association between smoking and myocardial infarction than between smoking and stable angina. Smoking increases the risk of stroke, coronary heart disease, and peripheral vascular disease through a number of mechanisms (Table 1.11). Smoking is a major factor in the increased risk of coronary heart disease for women using oestrogen-containing contraceptive pills.Some effects of smoking1. Increased atherogenesis, probably by toxic injury to endothelial cells2. Hypoxia, resulting in intimal proliferation3. Thrombogenesis4. Reduction in HDL5. Oxidation of lipids6. Increase in fibrinogen levels Smoking cessation is associated with a rapid decline in death rates from coronary disease,probably because of smoking’s thrombogenic effects. Smoking seems less important as a risk factor in populations with low LDL levels.Smoking cessationMany strategies are available to help patients to give up smoking. These should all begin with an explanation of the reasons smoking cessation is worthwhile. Some explanation of the mechanism of its deleterious effects may be helpful. Patients who have recently presented with possible cardiac symptoms may be amenable to the advice of this nature. It is also especially important to give strong advice about smoking to patients with multiple existing coronary risk factors.The rapidity at which benefits begin to occur, and the risks and difficulties involved in further cardiac treatment (e.g. coronary surgery) for smokers, should be emphasised. The postoperative risk is considerably higher for smokers, particularly for serious chest infections. This risk falls quickly (within four weeks) once smoking is stopped.Nicotine replacement patches may be helpful and appear safe even for patients with ischaemic heart disease. The drug bupropion, which is a non-tricyclic antidepressant, is now available for patients who wish to stop smoking. This drug seems safe for patients with cardiac disease, at least for those without unstable symptoms. It does not cause conduction abnormalities increase the risk of ventricular arrhythmias. Patients should be advised to continue smoking when they first start the drug but plan to stop on a particular day after about a week of treatment. The drug is usually continued for at least seven weeks. The starting dose is 150 mg daily and then 150 mg twice a day.It is important to discuss strategies for smoking cessation with the patient and to try to establish a treatment plan that suits the individual Passive smokingEvidence of an increased cardiovascular risk from environmental smoke has been available for some years.20 The legislation is gradually reducing the risk for people in occupations associated with smoking (e.g. serving in bars and restaurants) but patients with existing ischaemic heart disease should be advised to avoid exposure.

Is Smoking Pulling You Down?

Ms. Raisa Luther, Psychotherapist
10 reasons to quit smoking, beyond the big health threat.If are a smoker, you must have already been urged to stop smoking by family and friends. You most likely know that smoking causes heart disease, stroke, cancer, emphysema, chronic bronchitis, and other killerdiseases. You might even know that smoking is the No. 1 cause of preventable death worldwide.But knowing these facts may not have made you quit. When you are young, it is hard to imagine the pain of life-threatening diseases that shall strike decades later.Moreover, quitting is hard. As many as 80% of smokers say they would like to stop. And it takes the average smoker five to 10 attempts before quitting successfully.For some smokers, it's the small things that motivate them to stop. Things like the smell it leaves on you and your clothes, the way people react when they find out you're a smoker, the stain on your fingers and teeth -- everyday irritants that can add up to a tipping point to kick the habit.Here are 10 common daily side effects of smoking that can create the motivation to quit1. The smell of smokeCigarette smell on a person is not pleasant – many don’t react favorably. You may ruin your chances in an interview, meeting or social situation. Smokers are conscious of the foul smell in their mouths, clothes and hair – and this also leads to low self-esteem.2. Dulling of sense of smell and tasteSmoking dulls your smell of smell and taste. Smokers can't appreciate the taste of many foods as well as they did before starting smoking. Actually, but it's the loss of the sense of smell that reduces the ability to taste. Breathing in the fumes of tobacco smoke is toxic to the senses.Some smokers don’t even realize that their sense of taste is affected, since the decline is gradual. However, quitting brings back the senses of taste and smell swiftly. The pleasure of eating can be restored dramatically in a short time after the person stops smoking.3. Premature ageingOne of the main causes of premature ageing of the face is smoking. Leathery skin and deep wrinkles are more likely in case of smokers. According to dermatologists, smoking causes biochemical changes in the body that speeds up the ageing process. For instance, smoking reduces oxygen supply to living skin tissue caused due to constriction of blood vessels caused by smoking. Also, the burning tar in cigarettes causes stains on the hands and skin on face – a common sign of smokers.4. Social pressuresSmokers are increasing feeling marginalized. Offices, malls, airports and even streets forbid smoking. Smokers have to leave their companions and seek smoking zones, which are increasingly getting scarce. Almost all public places are now smoke-free zones. Smokers get impacted socially and emotionally when they have to leave a gathering or place to smoke. It weakens their self-image and social standing.5. Impact on relationshipsIt’s difficult to find and keep a relationship if you are a smoker. People don’t want to date or marry someone who smells like a dirty ashtray. Some people may find mates who are themselves smokers. Then it becomes difficult for any one of the partners to quit, as there are too many relapse triggers around to be able to successfully quit.6. ImpotenceSmoking dramatically increases your chances of impotence. It also affects blood vessel dilation and may lead to erectile dysfunction. This can be a powerful deterrent for young men to start smoking, or quit if they are already smoking.7. Increased infectionsIt’s a fact that smokers are more susceptible to falling ill – they get frequent colds – because they get frequent viral and bacterial infections. Our respiratory tracts have tiny hairs called cilia that are designed to protect us. Cilia are constantly waving and capture bacteria and viruses that get into the trachea and push them up so that we cough them out, or swallow them so that they get destroyed by our stomach acids.The toxic smoke of cigarettes paralyses the cilia, thereby destroying our protection. That’s the reason smokers fall sick so often.8. You're a danger to othersDid you know there are more than 4,500 chemicals in a single puff of tobacco smoke – out of which are over 40 are known carcinogens. It is estimated that second-hand smoke causes 50,000 deaths every year!It takes very little second-hand smoke to trigger a heart attack or stroke in someone who is predisposed to that condition. The ingredients in smoke cause platelets, the material in our blood that helps it clot, become sticky. This increases the risk of heart attacks. There have been a number of studies to show that when a community goes smoke-free the proportion of heart attacks seen at the hospitals goes down by 20% or 30%.9. Impact on physical activitySmokers experience a diminished ability over time to comfortably do things as simple as climbing a set of stairs or enjoying sports activities they once easily took part in such as volleyball or jogging. Even young athletes in otherwise top physical condition don't perform as well if they smoke because, over time, smoking causes the lungs and heart to work harder, thereby putting extra strain on them.10. Smoking costs money – lots of itIt's a fact you can’t ignore - smoking is downright expensive. The price of a pack of cigarettes varies depending on the brand. Let’s look at one of the most popular Indian brands - Gold Flake – it costs Rs. 246 for 20 sticks. That’s a lot of money. Add to that the fact that an average smoker gets 18% less productive and has increased health-related treatment costs. Taken year on year, it adds up to a huge cost.Get help to quitSmoking is a chronic disease, like any other addiction. Though it may be tough to quit, it has been successfully done by many persons.You can take professional help – it increases your chances of success.It’s time to stop smoking. And start living!

How to Quit Smoking

Dr. Himani Sanwaria, Dentist
It’s a well known fact that smoking is injurious for health, most importantly for your mouth, teeth and gums. And it is not only cancer that you have to think of. Smoking is the cause of many oral problems such as mouth sores, gum disease and tooth decay. That is why it is imperative for everyone to quit smoking.Yes, it is hard and most of the time impossible to just quit smoking. But, “if there is a will there is always a way”... that is why the National Institute of Dental and Craniofacial Research came up with few things that you can do to help you quit smoking today and they are as follows:Make up your mind to quit smoking. Develop a mental attitude that says you are ready, you are willing to quit, you are ready to do anything to quit, and most of all, you really really really want to quit.The best way to convince yourself 100% of this fact is to write the reasons why you want to quit. Whether it is a  health reason, hygiene reason, protection of your near and dears or for self improvement, it doesn’t matter what as long as this list will be able to motivate you to quit.Set a target date for  quitting . Don’t rush yourself and make this day today. You can choose to quit tomorrow or next week or at most next month. Make it an important day, something for which you have to prepare for. And while you are waiting for the arrival of this big day, cut your nicotine intake. If you smoke one pack a day, aim to reduce it until you only smoke one cigarette in a day.Remember, be sure not to stress yourself out for this quitting date.Don’t be alone on this. You will need to support yourself with people who support you on this decision.  These people can be your significant other, family or friends. And if you know someone wants to quit smoking, you can quit with him or her too. Your dentist can also help you with this decision.Substitute is a good idea. If you find yourself craving for a cigarette you can substitute it for something else, like nuts or grams. Go and ask your dentist or doctor about patches and nicotine gums to help ease the process of quitting smoking.If you feel you want to smoke, call a friend, do some exercise or deep breath and wait till the craving goes off. In this way you can divert  your mind from smoking.Make sure you do not substitute food for a cigarette. Try to avoid fatty and junk  foods, if you have to, then choose healthy options.Know your triggering factor. You have to discover what triggers you most to smoke. Find the patterns when and how you smoke so that you can prevent yourself from doing it. Develop a reward system for yourself. When you have already stopped smoking, you can pat yourself on the shoulder and treat yourself for the job well done. Stay active and create a new habit or change your daily routine. Exercise will do miracles for you.Take notice and enjoy the benefits you experience from not smoking like the cleanliness of your clothes, freshness of your room, the freshness of your breath and of course, the savings you add up to your account. And finally, you have to maintain proper oral hygiene with brushing and flossing, and regular dental visits with your dentist.Schedule an appointment with your dentist to get your teeth cleaned professionally to remove all the stains that have built up from smoking. If desired, you can even get a teeth whitening done to have that beautiful million dollar white smile.

Smoking and Infertility

Dr. Sonu Balhara Ahlawat, Gynecologist/Obstetrician
•Available data indicate that up to 13% of infertility may be attributable to cigarette smoking.•Smoking appears to accelerate the loss of reproductive function and may advance the time of menopause by 1 to 4 years.•Evidence indicates that semen parameters and results of sperm function tests are 22% poorer in smokers than in nonsmokers and the effects are dose-dependent, but smoking has not yet been conclusively shown to reduce male fertility.•Smoking is associated with increased risks of spontaneous abortion and ectopic pregnancy.•Gamete mutagenesis is one possible mechanism whereby smoking may adversely affect fecundity and reproductive performance.•Smokers require nearly twice the number of IVF attempts to conceive as nonsmokers.•Nonsmokers with excessive exposure to tobacco smoke may have reproductive consequences as great as those observed in smokers.•Cessation of smoking can be facilitated by providing education, monitoring, and consistent individualized support.                                                                                                                                                                        Source -

The Effects of Smoking on Oral Health

Dr. Parag M. Khatri, Dentist
When you see the warning on cigarette packages — "Quitting smoking now greatly reduces serious risks to your health." — What smoking-related diseases come to mind? Lung cancer, probably. Emphysema, maybe. But, did you know that half of periodontal (gum) disease in smokers is caused by smoking? Chronic (long-term)gum disease can lead to the loss of your teeth.Studies conducted to examine the effects of smoking on oral health have found that tobacco use may be one of the biggest risk factors in the development of periodontal disease.Not only does smoking increase the chance that you will develop gum disease, it makes treatment much more difficult and less likely to be successful. Smoking also lessens your mouth's ability to heal, so much so that many of the treatments you may want and need will not work well if you continue to smoke.For example, crowns and bridges in a person who has gum disease will not look very good because the gum disease will cause bone loss and receding gums around the crown edges. Implants are much more likely to fail in people who smoke. Popular cosmetic procedures, such as porcelain laminates, also will not be successful in a person who smokes.Periodontal (gum) disease is a bacterial infection that destroys soft tissue and bone that anchors your teeth to your jawbones. The bacteria found in dental plaque that forms in the pockets around your teeth and your body's reaction to the plaque contribute to the breakdown of soft tissue and bone.Smoking tobacco products can make gum disease get worse more quickly. In early stages of the disease, you may notice that your gums bleed when you brush or floss. As the infection worsens, your gums begin to break down and pull away from your teeth, forming pockets.Later, the pockets between your teeth and gums deepen as more of the supporting structures are destroyed.Ultimately, your teeth may become loose and painful and may even fall out.Studies have shown that smokers have more calculus (tartar) than nonsmokers. This maybe the result of a decreased flow of saliva. Smokers have more severe bone loss and more deep pockets between their teeth and gums than nonsmokers. Among specific findings, smokers were 2.6 to 6 times more likely to have gum destruction than nonsmokers, and severe bone loss was 4.7 times greater among current or former heavy smokers compared with people who never smoked."Smokers have less gum bleeding and redness, which can lead to the false impression that the gums are healthy. It is therefore very important that tobacco smokers have regular dental exams to evaluate their oral and gingival health," Dr.Albert says.Researchers still are studying just what smoke does to oral tissue, but it appears to interfere with basic functions that fight disease and promote healing. Researchers have found that smoking affects the way gum tissue responds to all types of treatment."It is believed that the chemicals contained in tobacco interfere with the flow of blood to the gums, leading to a slow down in the healing process and making the treatment results less predictable and often unfavorable," Dr. Albert says.One reason smokers are more likely than nonsmokers to lose their teeth if they get gum disease is that smoking can slow the healing process after periodontal treatment or any kind of oral surgery. One study found that smokers were twice as likely as nonsmokers to lose teeth in the five years after completing periodontal therapy. Additionally, the American Academy of Periodontology reports that in most studies of nonsurgical periodontal treatment, smokers showed less improvement than nonsmokers. Smokers also responded less favorably than nonsmokers to surgical treatment."It is not just cigarette smoke that contributes to periodontal disease," Dr.Albert says. All tobacco products, including pipe tobacco, smokeless tobacco and cigars, can affect the health of your gums.In a study conducted at Temple University and published in the Journal of Periodontology in 2000, researchers reported that 17.6% of former cigar or pipe smokers had moderate to severe gum disease.In addition, experts say pipe smokers experience similar rates of tooth loss as cigarette smokers, and smokeless tobacco can cause the gums to recede,increasing the chance of losing the bone and fibers that hold teeth in place.The only good news about smoking and the health of your teeth and gums is that the Surgeon General's warning holds true — quitting now does greatly reduce serious risks to your health. A recent study reported that the likelihood of having periodontal disease was not significantly different among former smokers who had quit 11 years before and people who never smoked.Even reducing the amount you smoke seems to help. One study found that people who smoked more than a pack and a half per day were six times more likely to have periodontal disease than nonsmokers, whereas those who smoked less than a half pack per day had only three times the risk."The dental office is a good place to visit for help with quitting. Your dentist can show you the effect of smoking on your mouth and teeth. She or he can help you set a quit date and provide you with advice on which medications can help you quit, such as nicotine patches or gum," Tobacco use may pose the greatest threat to your health as a risk factor for oral cancer. The American Cancer Society reports that:Implant FailureImplants can be used to replace lost teeth in people who smoke, but smokers should know they are at increased risk for the procedure to fail.Studies that have examined dental implants in smokers and nonsmokers have consistently found that patients who smoke have more implant failures.  "As a result, it is important that patients who smoke and who are considering having a dental implant placed be made aware of the fact that their tobacco use increases the chance that the implant will fail.They should be encouraged to quit smoking before undergoing the procedure and should be provided with tobacco-cessation counseling and support," he says.

Prevent Cancer by Helping Others to Quit - Facts About Passive Smoking

Dr. Sunny Jain, Oncologist
Since last two decades, there has been a growing number of evidence regarding the harmful effects of smoking on non-smokers. This shows that passive smoking or second-hand smoking is an absolute health hazard and can be detrimental for public health.Second-hand smoke is a combination of the smoke exhaled by a smoker and the smoke that comes out from the burning tip of a cigarette or cigar. This smoke when inhaled by a non-smoker is known as passive smoking. We all know the bad effects of passive smoking; however, the extent and intensity of damage it cancause is much more.Passive smoking is a need to worry aboutNon-smokers who are exposed to this second-hand smoke increase their risk of lung cancer.If someone you live with constantly smokes and you are exposed to tobacco smoke, you increase your risk of lung cancer by 20% to 30%.Second-hand smoking can lead to premature death in non-smokers.Passive smoke contains about approximately 4000 chemicals of which 69are known to cause cancer.Passive smoking increases the risk of coronary heart diseaseChildren and passive smokingPassive smoking is very harmful for children and it puts them at a high risk for many diseases.Children who are exposed to second-hand smoke are at an increased risk for:Cot death or sudden infant death syndrome (SIDS)Developing asthmaRespiratory and breathing illness such as pneumonia and bronchitisRecurrent colds and coughsMiddle-ear infections.In fact, children who grow up with either of their parents smoking are three times more prone to start smoking as well. Besides, individuals exposed to passives moke show a tendency to show either of these symptoms such as irritation of eyes, nose, throat, cough, dizziness, chest pain or shortness of breath.Studies have shown that second-hand smoke is the third leading cause of preventable death after smoking and alcohol abuse. This has led to ban of smoking in public places for safety of public health and promotion of a healthy environment. Environmental tobacco smoke ranks high as a source of indoor air pollution.Furthermore, studies have also suggested that passive smoke contains more number of chemicals than present in active smoking. As the size of particles in passive smoke is much smaller, so they can easily float in the air, which, in turn, is detrimental to the lungs. Usually, a smoker takes in only 15% of tobacco smoke and the remaining is exhaled out into the surroundings. This means, a passive smoker if present in a smoky room for two hours would be equivalent to have smoked four cigarettes.Thus, even though active smoking is much harmful than passive smoking, second-hand smoke also contains numerous harmful chemicals and carcinogens.If you are exposed to second-hand smoke, here are certain steps you can take to avoid exposure:Ask your guests to smoke outside the house.When you with children, visit non-smoking places.Sit away from smoking areas in public places.Educate others about ill effects of passive smoking.

World No Tobacco Day- Self-Help Tips to Quit Smoking!

Dr. Naveen Jayaram, Psychiatrist
Why should you quit smoking?Tobacco consumption kills about 8 lakh people every year in India. Cigarettes contain addictive nicotine and 4000 chemicals which are known to cause cancer. 40% of people detected with cancer in India are due to tobacco use. Smoking causes long lasting lung and cardiovascular diseases.To begin with:Think of your smoking behaviour, introspect about it, why I have got addicted to it.Do not deny that you are not addicted to smoking. Accept it as a problem.Over confidence about quitting is not good.Affirm yourself that “ though quitting is a problem I can leave it anytime.”Decide a quit date. Do not postpone. Be determined.Take help of family members/ friends/colleagues, they would be very happy to support you.Always remember you have to take a step, do not blame others or stress as a cause for your addiction. “A Journey of healthy and happy life begins with a single step.”Our mind has the capacity to overcome any addiction.How to reduce the quantity:Keep a record of amount and frequency of cigarette use.Change to brand of cigarette you don’t like.Decrease the number of puffs while smoking.Do not inhale deeply.Do not buy cigarette packs and keep a stock, buy less cigarette.How to handle the urge/craving to smoke:Delay the urge by 1 or 2 hrs or by counting numbers. Distract yourself. Remember urge will last only for few minutes. You can use nicotine gums, chewing gums, toffee when the urge is very strong.Manage the stimulus associated with smoking, i.e. drink coffee or juice instead of tea etc.Remove things which remind you about smoking from your house and office (ashtrays, lighters etc.)Take deep breaths, it will calm you.Drink small sips of water.After Quitting Smoking:Feel good about your behaviour.Talk to people about your achievement, it will boost your self esteem.Say no to smoking offers from colleagues or friend.Avoid the company of smokers and try not to take a single puff.Practice relaxation techniques- deep breathing, listening to music, exercises etc.Know about withdrawal symptoms like, irritability, decreased concentration, headache, restlessness.These symptoms are temporary and last only for few days.Do not get disheartened if you fail, keep trying.Quitting is a process and relapse is common, you need to be aware of it.If you are unable to quit in spite of multiple attempts, seek medical help. Medication course is available to make your quit process easy.Always remember with conscious determination you can achieve anything.Smoking Cessation is the single most important step that smokers can take to enhance the length and quality of their lives. Choose life, not tobacco. Happy quitting!!

Smoking Effects on Teeth and Oral Cavity

Dr. Swasti Jain, Dentist
It is widely known that smoking can have a great number of adverse effects on the health of the smoker. Due to the nature by which the action of smoking is performed, it is only natural that oral health would be one of the areas most negatively affected by the act. It is very important, therefore, that a smoker take extra care of his/her mouth and teeth. There are ways in which a smoker can help to keep the damages of smoking from doing further harm through proper oral care.Oral Health Problems Caused By SmokingAmong the most common oral problems, smokers are at an increased risk for gum disease. Smokers are four times more likely of developing this problem than non-smokers.Due to the excess of harmful chemicals in cigarette smoke, smokers are twice more likely to suffer tooth loss than non-smokers.Smokers are at a higher risk for developing leukoplakia, leading to throat, lung, and oral cancers. It can cause the salivary glands to become inflamed and contribute to deterioration of bone structure. Smokers also have a harder time recovering from dental procedures such as periodontal treatments, dental implants, and tooth extraction. Smokers are at a greater risk of developing dry socket from tooth extraction procedures. When dry socket occurs, the patient experiences severe pain in the affected area due to the bone and nerve endings being exposed.In addition to these medical ailments, smoking can also cause vanity issues impacting the teeth and mouth. Due to an increased and steady buildup of plaque and tarter, the teeth of a smoker are less attractive in appearance. Smoking also stains the teeth and can cause bad breath. In some smokers, the tongue can develop a condition known as black hairy tongue, due to a growth that may grow as a result of tobacco use. The condition causes the tongue to become yellow, green, black, or brown, and give the appearance of being hairy. Smokers may also lose the sensation of taste and smell.Dental Hygiene Tips to Improve Oral HealthWhile quitting smoking is the most effective way to ensure better oral healthHaving a proper oral hygiene plan is extremely important for smokers. Smokers should be brushing, flossing, and using a tongue cleaner and mouthwash on a regular basis, at least twice daily. By staying on top of regular dentist visits, smokers can also benefit from professional cleanings.People who smoke should also check for recurrent bleeding in the mouth, lesions, swelling, and lumps. White, red, or dark patches on the inside of the mouth, under the tongue, and on the cheeks that last more than two weeks should be brought to the attention of a dentist. Lumps on the lips and gums can also indicate a more serious problem, as should numbness or pain in any part of the mouth.

Smoking Is Injurious to Your Eyes Too!!!

Dr. Manoj Rai Mehta, Ophthalmologist
Smoking causes damage to the visual function as well.  The spectrum is wide, from simple redness of eyes to profound loss of vision!  It has been found that chances of developing blindness in old age are four fold in the smoking population than the non smokers.Tobacco smoke contains reactive free radicals that cause oxidative damage to the body cells. There are two different populations of free radicals- one in the tar phase that are relatively stable and the other in the gas phase that are unstable and highly reactive. Free Radicals react with the DNA in the cells causing molecular injury.Smoke causes irritation to the surface tissues of the eye leading to dilatation of blood vessels, puffiness of lids and watering.  Pre- existing Dry Eye Disease gets aggravated by smoking and is also an important cause of the same.Cataract chances in a smoker are two times that of a non smoker.  Lens proteins get coagulated due to free radical injury.Uveitis, inflammation of inner, vascular coat of the eye is also twice as common in smokers as compared to the normal population.Glaucoma, a disorder of optic nerve often characterised by high pressures in the eye is associated with tobacco smoking.  Smoking further damages the already compromised optic nerve!Detachment of Retina has been found two times more often in smokers. Incidence of Age Related Macular Degeneration (ARMD) is three times more in the smoking population. Cyanide in tobacco smoke can cause irreversible damage to the Optic Nerve, a condition known as tobacco amblyopia.Unfortunately tobacco use in forms other than smoking also causes damage to the visual function in the same way!The tobacco related damage is significant to the structure and functioning of delicate eye tissues. It is a matter of choice alone to prevent this much avoidable damage.   Stop smoking now...and forever!