In India, the walls of public places and offices are very badly decorated with colored spit of quid from a “pan”. If spittoons are provided at places, it is not aesthetic to pass in it’s side for the bad smell and sight. Cigarette butts are also found in abundance at public places. After feasts, it is a custom to offer a pan or cigarette to the the guests in India. Interestingly, when the western people are going to leave the habit, Indians try to patronize it. The make-shift shops keep packets of flavored tobacco hanging to attract the customers. Even this habit is being seen in school going children. Recently, the regulation of banning use of tobacco and tobacco products at public places has been revisited and reinforced, but without a concrete enforcing strategy. Volumes have been written and talked about the bad effects of tobacco, it will be appropriate to recapitulate those here in a nutshell.
Diseases caused by tobacco are multi systemic in nature. It may cause-
- Initiate atherosclerotic patches in both small and large arteries. In heart smoking is a major cause of myocardial infarction and angina.
- In extremities, specially legs may be affected by Burger’s disease, where there is blockade of blood supply in large arteries leading to dry gangrene( death of tissue ), that may terminate in an amputation.
- Small calibered arterial blockade may be responsible for retinal changes in eye leading to blindness called tobacco amblyopia.
- Tobacco itself may get deposited in the cornea of eyes.
- It may be the cause of quid cancer in mouth, tongue cancer, submucosal fibrosis in the inner layer of cheek, esophageal cancer, stomach cancer, cancer of lungs and wind pipe etc.
- Stomach and duodenal ulcers may be caused.
- Bronchitis and other lung diseases are also caused by smoking.
- Smoker mothers may give birth to abnormal children.
- Tobacco chewing causes dental caries and attrition. The taste buds are also destroyed.
Smoke from cigarette contains nitrosamines, carbon monoxide, nicotine, radioactive substances and several other harmful chemicals. Passive smokers are also equally affected as the smokers.
It may be difficult but not impossible to quiet tobacco smoking and chewing. Many support treatments are available. A new drug in this group is varenicline in addition to already existing bupropion and nicotine
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