Smoking and heart disease

It has long been recognised that tobacco smoking kills slowly. People may die 22 years earlier than the average life expectancy. The full extend of damage caused by smoking is still unknown. Everyday more diseases are being discovered to be caused by smoking.

The effects of passive smoking are as bad as that of active smoking. While 25 percent of people are affected due to direct smoking, 75 percent of the people get affected by inhaling the smoke released by the active smokers.

Cigarette smoking is a major cause of heart attack. It increases risk of heart attack by two to six times. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. It produces a greater relative risk in persons under age 50 than in those over 50.

People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease (and possibly stroke), but their risk is not as great as that of cigarette smokers. This is probably because they are less likely to inhale the smoke. Currently, there is very little scientific information on cigar and pipe smoking and heart disease, especially among young men.

Inhaling tobacco smoke causes several immediate responses within the heart and its blood vessels. Within one minute of starting to smoke, the heart rate begins to rise: it may increase by as much as 30 percent during the first 10 minutes of smoking. Carbon monoxide in tobacco smoke exerts a negative effect on the heart by reducing the blood's ability to carry oxygen. It increases blood pressure. Tar in tobacco contains dozens of chemicals that cause cancer. Tobacco smoke contains more than 4,000 chemicals, many of them known poisons. Non-smokers living with smokers have about a 25 to 30 percent increase in risk of heart disease.

Smoking tends to increase blood cholesterol levels. Furthermore, the ratio of high-density lipoprotein cholesterol (the "good" cholesterol) to low-density lipoprotein cholesterol (the "bad" cholesterol) tends to be lower in smokers compared to non-smokers. Smoking also raises the levels of fibrinogen (a protein which causes blood to clot) and increases platelet production (also involved in the formation of blood clots) which makes the blood more sticky.

In Bangladesh, overall 50 percent male and 3 percent female are cigarette smoker. In addition to that 16 percent male and 31 percent female population use oral smokeless tobacco.

Cigarette smoking is the most important preventable cause of premature death in the present world. Quitting smoking can prolong life, reduce risk of coronary artery disease / heart attack, feel healthier, look better, improve sense of taste and smell, save money and reduce risk of many other diseases.

There is no single way to quit that works for everyone. To quit smoking, you must be ready emotionally and mentally. You must also want to quit smoking for yourself, and not to please your friends or family.

Dr Md Habibe Millat MBBS, FRCS(Edin) is a Senior Specialist Registrar, Department of Cardiothoracic Surgery, Cork University Hospital, Republic of Ireland. Email. [email protected]