World No Tobacco Day-I: Tobacco firms always in search of new victims to boost their market

2010
By Syed Akbar

Women and young girls are increasingly emerging as the new victims of tobacco use with tobacco firms now shifting their focus from men to women. In India tobacco is increasingly being associated with heart diseases, apart from cancers and drastic changes in reproductive health.
As the world observes the No Tobacco Day on Monday, the World Health Organisation has turned its focus on "gender and tobacco with an emphasis on marketing to women". With many women in India exposed to either direct smoking or second-hand smoke, cancer experts, cardiologists, dermatologists, reproductive health experts and pulmonologists warn that the tobacco epidemic will show drastic health complications if urgent measures to curb use of tobacco were not
initiated.
India is fast emerging as the capital of heart diseases, mainly because of two reasons: one, genetic and second, acquired. While one cannot do much about genetic causes, certainly much can be done to stop acquired habits, particularly smoking, or second-hand smoke.
"About 40 per cent of  heart attacks are because of smoking and in young almost all are because of smoking. Nowadays nearly 20 per cent of women in India smoke for various reasons. Passive smoking or second hand smoke at home and office also increases heart attacks. By
quitting smoking, risk of heart attacks can be brought down by 36 per cent, one year cessation of smoking can reduce the risk by 50 per cent," says Dr Shiv Kumar, senior cardiologist at Apollo Hospitals, Secunderabad.
The Central government has implemented the WHO's recommendation on pictorial warning on tobacco products, but the World Health Organisation warns that the tobacco industry constantly and aggressively seeks new users to replace the ones who quit and the current users - up to half - who will die prematurely from cancer, heart attack, stroke, emphysema or other tobacco-related disease.
Says cancer specialist Dr Nalini, the aggressive promotion of tobacco amongst women projects smoking as female beauty, empowerment, luxury, and sign of liberation. On the contrary, tobacco enslaves and disfigures women.
"The advertisements put women to greater risks and promote heart attacks, strokes and cancers amongst women. The risk of cervical and breast cancers has increased besides, the lung and throat cancers. Younger women are more prone to addiction to smoking. Infertility, premature delivery and new born deaths are more in smokers especially during pregnancy," warns Dr Nalini.
While the WHO and health experts battle it out with the tobacco industry, breast cancer specialist Dr P Raghu Ram points out that there's growing evidence to suggest that active smoking increases the risk of pre-menopausal breast cancer.
"The rate of breast cancer has been increasing world-wide keeping pace with the rapid increase in the number of women smoking since the middle of 20th century," adds Dr Raghu Ram, who heads KIMS- Ushalakshmi Breast Centre.
The tobacco industry may be focusing on women to make a fast buck, but senior gynaecologist Dr J Bandana observes that once women take to tobacco, they become addict to it, more than men. "Research has revealed that women might be more susceptible to the addictive properties of nicotine and have a slower metabolic clearance of nicotine from their bodies than men. Also, women seem to be more susceptible to the effects of tobacco carcinogens than men".
It's estimated that the fertility of smoking women is 72 per cent that of non-smokers, while smoking also causes women to enter menopause sooner and leads to menstrual irregularities.
The WHO has also taken a serious note of second-hand smoke or passive smoking holding it responsible for an equal number of deaths or health complications. According to Dr Arun Diwan, head of internal medicine, Batra Hospital, second hand smoke is particularly worrisome
for women. "Especially in women long-term exposure to tobacco causes multi-organ damage. These women patients are  predisposed to chronic diseases, strokes, hypertension and heart diseases."
Women, if exposed to tobacco at an early age, will report severe health complications including deprivation of oxygen to vital organs. Says senior consultant paediatrician Dr Sanjeev Bagai, "early exposure of tobacco in adolescence causes hypertension, kidney and lung diseases. Tobacco smoke contains high levels of carbon monoxide, which affects the heart by reducing the amount of oxygen the blood is able to carry."
Dr Anil Dhall of Artemis Hospital says one out of every two women smokers, who start at a young age and continue smoking throughout their lives, will ultimately be killed by a tobacco-related illness. "Half of these will die in middle age, losing around 22 years of normal
life expectancy. With prolonged smoking, smokers have a death rate about three times higher than non-smokers at all ages starting from young adulthood".