Nicotine is more addictive and deadlier than cocaine

May 31 is marked by the World Health Organisation as World No Tobacco Day, and this year’s theme is ‘Tobacco — a threat to development’.

To me, an oncologist and a child of parents who were both smokers, this day has a special significance. I lost my father to lung cancer in 1993, a reason that led me to take up oncology as a speciality. I saw a 72-year-old fiercely independent, strong individual, who was a leading metallurgy consultant of his time, become frail and vulnerable, to the point where he had to be bathed and fed. I watched him slowly die and there was nothing I could do even as a doctor. At the time, there were very few treatment options for lung cancer, as it was commonly diagnosed in advanced stages.

After his death, my mother who had smoked for 40 years gave up overnight. But 13 years after she quit, she started coughing up blood. A chest x-ray showed lung tumour just like my father’s. The risk of lung cancer even after smoking cessation never really comes down to zero. Luckily, her disease was confined to the lungs, and both, radiation therapy and chemotherapy helped her lead a near-normal existence for two years.

Tobacco is a deadly habit, and nicotine is even more addictive than cocaine. Tobacco also puts people at risk for Chronic Obstructive Pulmonary Disease (COPD), which severely compromises the quality of life as patients need oxygen, home care. It also makes working difficult. COPD kills more people in India than cancer and heart attacks put together. While smoking is bad for the lungs and the heart, it also effects non-smokers. Children, in particular, are very vulnerable, and their lungs damage quickly due to the 300 carcinogens in the cigarette smoke. In fact, five per cent of all lung cancers are contracted by non-smokers.

Chewing tobacco in forms such as paan, sopari, etc causes cancers of the tongue, cheek, various parts of the mouth and the throat. These oral cancers make up almost 25 per cent of all the male cancers in India. Lung cancers make up an additional 8 per cent. If tobacco were to be banned, we could prevent one-third of our male cancers. The WHO has projected that there will be a 500 per cent increase in the cancer burden in India by 2025 — 250 per cent due to tobacco use.

My advice as a doctor is to request people not to smoke. Now nicotine tablets, and patches are here to help you kick the habit. Also, it’s worthwhile for those over 40 who may have smoked, or lived around smokers to underdo lung CT scans (low radiation are now available) every year to ensure early detection of tumour.

(The writer is the head-medical oncology at Jehangir Hospital, Pune. She is engaged in cancer awareness, care and cure via her NGO Nag Foundation)

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