Smoking – the ‘forgotten’ risk factor

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‘Diet and health – I get it – but what else is there?

Most of the posts I write are focused on the dietary aspects of metabolic health. I pay particular attention to sugar in our diets, debunking the myths around fat and cholesterol and so on. Add to this I have written about insulin resistance, fasting, and exercise (how important exercise is but not as a weightloss tool as “we can’t outrun a bad diet”) as well as other health-related issues. I have also taken a brief look at some of the ‘big ticket’ diseases of the metabolic syndrome like high blood pressure, cancer, heart disease, Type 2 diabetes and, more recently, Alzheimer’s disease.

‘…the leading preventable cause of death in the USA’

An article in a recent edition of the British Medical Journal Heart reminded me, however,  that I have paid scant attention to a most significant cardiovascular risk factor: smoking. In this post I will try and put the record straight. The authors of the Heart article studied the effects of smoking on what is known as ‘acute STEMI’ which is medical jargon for a full blown heart attack. Most of us will know that smoking is strongly associated with a number of cancers. What may not be commonly known is that a number of other diseases including STEMI appear to be associated with smoking. The Center for Disease Control (‘CDC’) in the USA  have gone so far as to call smoking “…the leading preventable cause of death in the United States”.

Legal & yet deadly

The CDC reported that “…cigarette smoking causes nearly one in five deaths…causes more deaths each year than the following causes combined HIV, illegal drug use, alcohol use, motor vehicle injury and firearm- related incidents…more than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States during its history.” Unbelievable isn’t it, especially as tobacco continues to be openly and legally sold in the USA, and all over the rest of the world.

What about other diseases associated with smoking? Well, I’m going to let the following image, courtesy of the CDC,  speak for itself.

smoking-risks

If I said ‘this in not all’ then you could be forgiven for saying ‘No way!’. But there is more.  Again from the CDC: “Smoking can make it harder for a woman to become pregnant and can affect her baby’s health before and after birth… can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage….affects the health of your teeth and gums and can cause tooth loss… is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than non-smokers. Smoking causes general adverse effects on the body, including inflammation and decreased immune function.” Enough said!

No country really cares

I taught a class at a University, a few years ago,  on the role of self-care in the prevention of chronic diseases of lifestyle. As part of the assessment process, I asked the students to write a paper on what they saw as the most important aspect of preventive healthcare in the context of these chronic diseases. I have not forgotten one paper in particular, which focused on the role of tobacco in chronic disease. The student ended this paper with a comment that in her opinion no country is serious about health care simply because no country has ever banned the use of tobacco. If we are to reflect on the overwhelming evidence that shows a significant association between smoking and disease, disability and death, then we are faced with no other option but to agree that no country is really serious about the health of its people. This is a very uncomfortable truth.

I want to end this post by quoting from the conclusion reached by the authors of the Heart study: “Smoking was associated with an eightfold increase in the risk of acute STEMI (aka ‘heart attack’) in younger smokers, when compared to ex- and  never smokers. Further efforts to reduce smoking in the youngest are needed”.

At UpForIt, our mantra is Preventing People From Becoming Patients. If you would like our help to stop smoking or, more generally, help in your fight to prevent some of the ravages of chronic disease, then please pop me an email to askdrhill@upforit.co.za.

I’m Dr Peter Hill for UpForIt.

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