31 May 2019: Consumption of tobacco has been a cultural practice for a long time but it is only in past few decades that we have started becoming aware of its ill effects. It is one substance that respiratory diseases, the leading causes of death globally, and tobacco is a major risk factor. Smoking tobacco is the most common cause of lung cancer, causing roughly 1.2 million lung cancer deaths every year. Besides, tobacco is also responsible for other serious respiratory and lung diseases such as tuberculosis, asthma, and chronic obstructive pulmonary diseases (COPD). Lung cancer is the gravest form of tobacco-influenced disease that caused 67,795 new cases and contributed to the death of 63,475 people in India. The mean age for contracting lung cancer in India is 54.6 years and most lung cancer patients are over 65 years. Men are 4.5 times more likely to contract lung cancer than women – the male : female ratio is 4.5:1. It increases progressively up to 51-60 years and varies with age and smoking status.
“India has a high incidence of respiratory and cardiovascular diseases and not to speak about oral and lung cancers. The major causal factor is consumption of tobacco. Approximately 22.73 percent (250 million) of the world’s 1.1 billion smokers live India. Smoking and chewing tobacco are the biggest contributors to lung and oral cancers. According to the Indian Council of Medical Research (ICMR), lung cancer accounts for one of the highest mortality rates among all cancers, with one out of five cancer deaths. Oral cancer accounts for over 30 percent of the reported cases of cancer, and with an age adjusted rate of 20 per 100,000, thus highly prevalent across the country. Cancer is not the only risk smokers face. Smoking also clogs the blood vessels, causing heart attacks, strokes, and peripheral vascular diseases. According to a joint study by the International Tobacco Control (ITC) Project and WHO, it was reported that more than half of the smokers in India did not know that smoking causes strokes, and over a third didn’t know that it causes heart disease. This is highly worrying since tobacco use is responsible for over 10 percent of all deaths due to cardiovascular diseases. It makes no sense to nurture a habit where you spend money to shorten your life at best, and bring on a painful death at worst” said Mr Rajesh Ranjan Singh, Chief Operating Officer of Wadhwani Initiative for Sustainable Healthcare (WISH).
Globally, an estimated 1,65,000 children die before the age of 5 due to lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.
“India is one of the hotbeds of tobacco-related diseases, facilitated by the large number of smokers. The smoke emanated from tobacco adds on to the existing high-level of pollution. Smoke caused by tobacco is a major source of indoor air pollution and is a very dangerous: it contains over 7,000 chemicals, 69 of which are known to cause cancer. For a smoker, 1 pack of cigarettes increases the chances of lung cancer up to 30 to 40 per cent while in those who are above 40 years of age, this increases to 60 to 100 per cent“ said Dr. Divesh Goyal, Consultant, Medical Oncology, Fortis Escorts Hospital, Jaipur.
Apart from themselves, smokers caused an irreparable to the non-smokers around them who become the victim of passive smoking. Passive smoking, exposure to carcinogenic toxins like asbestos and radon, radiation and air pollutants are other causes of lung cancer. Though the number of women who smoke is lower than men in India, they often suffer due to second-hand smoking that adds on to the fossil fuel used for cooking and other heating needs. Second-hand smoking affects children, even an unborn one, and elderly the most.
The symptoms of lung cancer usually do not appear until the disease is fairly advanced and in a non-curable stage. Some of the most telling symptoms of lung cancer are cough, pain in the chest, shortness of breath, weight loss, blood in sputumand loss of appetite.
For diagnoses, doctors may suggest blood test, chest X-ray, positron emission tomography (PET scan), CT scan and biopsy. Depending on the results that shows the severity of the problem, treatment is usually done in 3 stages: while stage 1 mainly offers surgical removal of the cancerous cells, stages 2 and 3 include chemotherapy and radiotherapy. In stage 4, doctors suggest chemotherapy, immunotherapy and other treatments.
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