Tobacco and lung health : a deadly combination 

Year after year, tobacco is killing a huge number of people across the globe. It is becoming a major risk factor for respiratory illnesses. Statistics show that globally, tobacco is killing more than 7 million people each year. In Mauritius also, the situation is alarming. Lung cancer is considered to be among the top five cancers, especially pertaining to men. 80% of smokers run the risk of dying from cigarette-related diseases. 

On the 31st May like every year, the WHO and global partners celebrate World No Tobacco Day (WNTD). This year’s theme focuses on “Tobacco and Lung Health.” It is estimated that more than 6 million of those deaths result from direct tobacco use while around 890,000 are those of non-smokers being exposed to second-hand smoke. According to World Health Organization, 165,000 children die before the age of 5 due to lower respiratory infections caused by second-hand smoke and 700 million children in the world breathe in polluted environment caused by passive smoking. In Mauritius, statistics demonstrate that the prevalence of tobacco is at 19.3%. The prevalence among the young generations (18-24 years) is above 45%, as revealed in the Global Youth Tobacco Survey 2016. For the same year, among the teens, the prevalence is at 13.6%. 

Effects of smoking on health 

Dr Sahiboullah Sohawon, Oncologist and Palliative Care Specialist from Clinique Darné, explains that smoking has both short- and long-term effects. For instance, he lists the short-term effect as bad breath, alteration in taste/smell, more focused on certain problems, increase in heart rate, less stressed (depending on the psychological profile of each smoker). The long-term effects include: Addiction to nicotine, dental and parodontal (gum) problems and withdrawal effects such as irritability, mood changes and tremor. The doctor reveals that the lung is most affected through disease like chronic bronchitis, asthma, pneumonia, COPD (Chronic Obstructive Pulmonary Disease), lung cancer (bronchiolo-alveolar carcinoma).

Similarly, Dr Rajiv Kumar reveals that the lung is one of the main important organs and people need to be aware of its importance. He states that there are two main diseases related to tobacco: Lung cancer and Chronic Obstructive Pulmonary Disease. “Our lung is a vital organ. As soon as someone begins smoking, it starts affecting the lung, after some time followed by coughing repeatedly and emitting phlegm. As time passes, the individual feels tired easily and finds it difficult to inhale. The lung is gradually destroyed and the person starts lacking oxygen. At this time, inhalers or oxygen masks are seriously needed to alleviate these side effects.” 
Furthermore, the doctor states that 90% of smokers are more likely to get lung cancer. “Depending on the number of cigarettes a person smokes and the years he has been smoking, he is at risk of developing lung cancer. We should not forget that cigarettes contain dangerous chemicals. So, if a person has been smoking for more than 15 to 20 years, the risk of lung cancer increases with time. At such a stage, there is no reversal for the individual.”    

Passive Smoking 

Not only are smokers at risk but passive smoking is also very much dangerous. Dr Sahiboullah Sohawon reveals that passive smoking is recognised as a health hazard. “Children develop allergies, chronic bronchitis, asthma and increased risks of throat/pulmonary infections. Adults may develop pneumonia, coronary artery diseases and even lung cancer.”

Additionally, Dr Kumar avers that many people are facing respiratory issues due to second hand smoking. “Smoking does not only affect the smokers but also people in their surroundings. For instance, their children and spouses. The same applies to pregnant women who smoke during pregnancy, hence affecting the health of their babies.”   

Preventions 

In the country, we have seven tobacco cessation clinics. According to statistics, in 2017, there have been 2,671 persons seeking help at the cessation clinic. Dr Sahiboullah Sohawon highlights that tobacco cessation is possible in all active smokers. “There are two main and complementary approaches to quit smoking, nicotine replacement therapy and cognitive behavioral psychotherapy. There are nicotine pills, chewing gums, lozenges and patches together with special antidepressant medications which reduce significantly the crush for nicotine, some are unfortunately not yet available on the Mauritian pharmaceutical market. As for the psychological part, a smoker has to be guided/coached by either a tobacco-cessation specialist or a trained psychologist in the field of cognitive behavioural therapy.”

Sanjay R. Bandu, Vice President of La Ligue Vie et Santé proposes the Five-Day Plan. “This program takes participants through a five-day step-by-step program to change daily habits and achieve their goal to quit smoking. Through psychological motivations (such as affirmation statements) and physical changes (such as dietary modifications), the Five-Day Plan works to break the participant’s smoking routine and eliminate cigarette cravings. The plan also addresses issues such as weight gain and symptoms associated with nicotine withdrawal, along with alternative activities to overcome such concerns and remain smoke-free.” 

He reveals that the major difference with quitting smoking on your own, as compared to attending a group that is giving up smoking altogether, is that alone you do not have the dynamics of a group. “In part, you can make up for this by enlisting the dynamics of one or two other smokers who also want to quit or who are not smokers but who have already quit and are willing to provide interaction and contact similar to a group or class. Ask a buddy at work or any other acquaintance who would be willing to talk to you by phone once a day or someone that you see daily who would be willing to hold you accountable for your decision to stop smoking and to provide you feedback and someone to listen to you and to be there when you want to talk.” 

This Five-Day Plan to stop smoking is so successful because it is a total plan, she adds. “Along with the decision to stop smoking needs to be the decision to follow the suggestions in all areas of life for five days at least. Smoking has been part of your total life before you quit. The more things you change about your life right now, as suggested during these five days, the more easily you will kick the smoking habit. The dietary suggestions are designed to eliminate smoking poisons from your body as rapidly as possible. The skin is the largest organ of elimination your body has. For this reason, bathing or showering often is an important aid to rid the body of smoking toxins as well as a powerful mood calmer and soother.”

Law : Fine for those who smoke in public places 

The laws are very severe when it comes to tobacco in Mauritius. For example, according to the The Public Health Act, no person shall smoke a tobacco product in a public place, while preparing, serving or selling food on any premises where the public has access or while driving or traveling in a private vehicle carrying passengers. If a person is caught smoking in a public for the first time, he is subjected to a fine between Rs 5,000 to Rs 8,000. For a second offence, he needs to pay Rs 8,000 to Rs 10,000. If he continues to commit such offence, the person is subjected to a sentence not less than 12 months. Moreover, enforcement visits are carried out by sanitary inspectors and officers. For the period January to April, 927 visits have already been made. In 2017, 4,669 visits were done and 4,753 in 2018. 

Anwar Husnoo underlined that cannabis-based medical care is limited

A series of activities were launched officially by the Minister of Health, Anwar Husnoo, on Thursday morning at Simadree Virahsawmy SSS in Rivière du Rempart. The Minister of Health stated that cannabis-based medical care is limited. “You have to understand well. Cannabis contains chemicals. It is possible that one of these chemical agents could cure some patients, but not all of them! It does not mean we will smoke cannabis. Smoking weeds can bring another kind of addiction. We do not encourage smoking Cannabis.” 

Laurent Musango, representative of the World Health Organization (WHO) in Mauritius, on his part, highlighted that there is still a controversy surrounding cannabis. “WHO’s position was clear. Even though cannabis has been authorized for the production of drugs, its use as a product that could be used as cigarettes has not been allowed.” 

Activities 

In the context of World No Tobacco Day 2019, the Ministry of Health and Quality of Life is organizing programmes on television and radios on the ill-effects of tobacco use, the existing tobacco control policies and the existence of the Tobacco Cessation Clinics around the island for the benefit of smokers, regular talks on healthy lifestyle and harmful effects of smoking in the community, in schools and at workplaces.