Anti Smoking Articles

Dr. Faheem Mahmood Butt
Consultant Pulmanologist
Shaukat Khanum Memorial Cancer Hospital & Research Centre

Tobacco & Smoking:
Smoking is a world wide hazard. It is a single most important cause of preventable premature death. According to WHO figures there are about 1.3 billion smokers in the world.  20 billion cigarettes are sold every day. Smoking is declining in US and many other western countries In USA smoking rate have decreased to almost half  over the last three decades but it is on the rise in developing countries like Pakistan,  India, Philippine, Thailand and Cambodia . In some developed countries in far East like Japan and China more than 60 % of male population smokes. One third of the world population smokes, 12 % of them are women and every day 100,000 kids are added to this number. Every year 5.6 million people die of tobacco/smoking related diseases. Every 6 second a current or former smoker dies. 70 % of smokers die younger than normal population. Smokers die 15 year younger than non smokers. In 21st century, 1.3 billion people will die of smoking.

Smoking cigarette, pipe, cigar, Huqua, Shisha  and other use of tobacco like chewing tobacco and tobacco sniffing all are dangerous and addictive. Nicotine present in tobacco smoke causes addiction by increasing the brain levels of chemicals like Dopamine and Endrophine. These chemicals give a sense of happiness hence there is craving for tobacco products. If a person tries to quit, withdrawal effects include irritability, anxiety, depression and lack of concentration.

Tobacco  and tobacco smoke have  about 4,000 chemicals , 200 of these  are poisonous and 60 of these chemicals  are known to cause cancer (carcinogens).  some of these chemicals are, benzene (a petroleum product), ammonia ( used in dry cleaning and toilet cleaning), formaldehyde (a chemical used to preserve dead bodies and ) and Tar. Tobacco smoke causes atherosclerosis (hardening of  the blood vessels) leading to hart attack and stroke. It also contains carbon mono oxide which decreases oxygen in the blood.

How smoking kills?
LUNG CANCER : 90% of people who develop lung cancer are current or former smokers. Risk for lung cancer increases with number of cigarette smoked (1 pack per day smoker is at higher risk  than half packs per day smoker) longer one has smoked more is the risk for lung cancer ( a person who has smoked for 20 years is at  a higher  risk than one who smoked for 10years). In USA, lung cancer causes more deaths than breast cancer, prostrate cancer and colon caner together

Smoking known cause of many other cancers like throat cancer, esophageal cancer, stomach cancer, cancer of pancreas, breast cancer, kidney cancer and prostrate cancer.

Other Lung Diseases:
Smoking  causes medical conditions called emphysema and bronchitis (COPD).  In these conditions the lung tissue is permanently damaged, as a result patient develops cough, difficulty in breathing and may develop symptoms which mimic asthma. Patient gets lung infections (pneumonia) easily. In this case, lung can not make enough oxygen which, ultimately, leads to  breathing failure and death.

Heart Attack: Tobacco  smoking is a leading cause of heart attack.  Smokers have  twice risk of fatal heart disease. Tobacco smoke has chemicals which causes hardening of the blood vessel with plaque formation (atherosclerosis) which blocks the blood supply to the heart muscle resulting heart attack and death.

Stroke: Smoking increases the risk of stroke.  Smokers have three fold risk of stroke. 15% deaths due to stroke are smoking related.

Other Adverse Effects of Smoking: Risk for Hip, due to tinning of bones (osteoporosis), stomach ulcer, early wrinkling of skin and sleep disturbance.

Second Hand Smoking is a serous business. A person who smokes not only harms himself but people around him like coworkers and family members who are at a high risk to develop cancers, heart disease, stroke and lung infections. Children of smokers are at risk of developing asthma, bronchitis, sinus infections and mental retardation.

Smokeless tobacco like chewing and sniffing tobacco also has poisonous and cancerous chemicals which cause mouth, gum and throat cancers.

“I CANT QUIT,” is the most common response when a smoker is asked to quit.

“YES YOU CAN QUIT,” should be the answer.


By understanding the ill effects of smoking and also that you are not only poisoning your self, but also your family and friends by giving them second hand smoke. There is help available in form of counseling by physicians, by nicotine products like nicotine patches, nicotine gum, and nicotine spray, and two drugs namely Bupropion and Varenicline. They help by preventing withdrawal symptoms by nicotine dependence. If a patient is motivated with the help of a physician, and one of these medications, he may able to quit.

Role of society and government:
Pakistan Government gets 0.7 % of its GNP from tobacco taxation. This amount is close to the amount spent on health care.

Being a big source of revenue, there is a lack of desire to discourage tobacco use. Society in general is not fully aware of smoking/tobacco related hazards. There is a dire need of aggressive anti-smoking awareness campaign, involving civil society, media, business community, school, college and university students. Government needs to strictly implement already exciting anti-smoking laws which prohibit smoking in public places.


Dr. Faiz ur Rehman
Consultant Cardiologist
Shaukat Khanum Memorial Cancer Hospital & Research Centre

Smoking and Heart Disease:

Pakistan Medical Research Council notes that 54% of men and 20% of women use some form of tobacco on regular basis in Pakistan. Approximately 80% smokers start smoking before 18-20 years of age. Cigarette smoking is estimated to cause over 5 million deaths worldwide each year and over 400,000 deaths each year in the United States, making it the leading preventable cause of death.

Cigarette smokers have a higher risk of developing several chronic disorders. These include fatty buildups in arteries (Atherosclerosis), several types of cancer and lung diseases. Atherosclerosis is the chief contributor to the high number of deaths from smoking. It is progressive hardening of the arteries caused by the deposit of fatty plaques and the scarring and thickening of the artery wall. Inflammation in the artery wall and the development of blood clots can obstruct blood flow and cause heart attacks or strokes.

Nicotine present in smoke decreases oxygen to the heart, increases blood pressure and heart rate. It is also damaging to the cells lining the coronary arteries and increases the clotting factors in the blood.

Smokers continue to increase their risk of having heart attack the longer they smoke. People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than non smokers. Patients who continue to smoke in the presence of established heart disease have increased risk of reinfarction and death including sudden cardiac death.

Smoking related coronary heart disease may also contribute to congestive heart failure. Smoking low-tar or low-nicotine cigarettes appears to have little effect on reducing risk of coronary heart disease. Smoking also increases Blood pressure and decreases exercise tolerance. Toxins in smoke also increase the risk of recurrent coronary heart disease after bypass surgery or angioplasty.

Women who smoke and use oral contraceptives (Birth control Pills) greatly increase there risk of coronary heart disease. Smoking also has adverse effect on Lipid content of blood by decreasing good cholesterol (HDL). Passive or second hand smoke is also risk factor for heat disease. Smokeless tobacco has been linked to cardiovascular mortality. It is important and encouraging to know that most smokers quit on there third attempt.

Smokers become conditioned to the pleasurable effects of tobacco use with environmental triggers such as their morning coffee. In- person counseling program generally involves gradual reduction of cigarette intake in preparation for quitting on a defined quit date. Interaction with the clinician with positive feed back is extremely important. Pharmacotherapy for smoking cessation aims to relieve the symptoms of nicotine withdrawal. Three categories of medications include Nicotine replacement therapy (NRT), buproprion and varenciline. Nicotine patches doubles the success of a quit attempt.  Most of the above mentioned medications are now available in Pakistan.

Quitting can prolong life; reduce your risk of cardiovascular and other smoking related diseases. Feel healthier with no coughing, no sore throats and increased in stamina. It also improves your skin, gets rid of stained teeth, improves your sense of taste and smell and saves a lot of money.