Cut down in the prime of their life- Smoking is no joke!

Dr Terry Baker, Contributor

I face the unenviable task of explaining to the 42-year-old gentleman and his wife of six years that he has lung cancer, which has spread to both lungs, and that his chances of recovery are unlikely.

He undergoes chemotherapy, tries holistic therapy, but gets progressively weaker, has difficulty breathing, eating or walking and then passes - leaving behind a young wife and daughter to grieve.

While many patients with lung cancer are older, often above the age of sixty-five, it is not uncommon to find younger persons diagnosed with the disease. In younger persons, lung cancer is usually more aggressive; chances for survival beyond five years are low.

Cigarette smoking is the number one cause of lung cancer. However, not only is the smoker at risk, but so, too, are persons who are in frequent and constant exposure to exhaled smoke, which is known as second-hand smoking. These persons, including children, are innocent victims of someone else's choice of a bad habit.

With a diagnosis of lung cancer, there is often a prolonged course of illness associated at times with severe, intractable pain and other debilitating symptoms which may be a challenge to control. This often leads to the person being unable to work and provide for themselves and their families and a dependence on others for financial support and eventual assistance in caring for themselves.

Cigarette smoking is also linked to cancer of the lips, tongue, voice box (larynx), oesophagus, stomach, breast, pancreas, testes, uterus, and cervix. This is no surprise as cigarette smoke contains over 4,000 chemicals, at least 50 of which are known to cause cancer. Formaldehyde, nickel, tar, arsenic, cadmium, cyanide, benzene, sulphuric acid, freon, carbon monoxide, and ammonia are just a few of the chemicals in cigarettes.

Considering the plethora and toxic mix of chemicals and carcinogens in cigarettes, coupled with the rising rates of cancer, why would anyone even consider putting a cigarette in their mouth? Do we consciously eat or drink substances that are known to cause cancer? Recognising the addictive power of cigarettes, there is a real need to help persons who smoke to stop doing so.

Some persons believe it takes years for cancer to develop, and they will stop smoking before the damage to the lungs or any other organ occurs. They may feel they are immune or too young to get cancer. However, with smoking being a risk factor for many types of cancers, it is a game of Russian roulette to continue smoking, not knowing if and when which cancer may occur. It is not unusual to see a patient, who stopped smoking years ago, develop cancer.

OTHER DISEASES THAN CANCER

For persons who may think their chance of developing cancer is small, it is worth remembering that cigarette smoking causes other diseases than cancer. Deaths owing to cancer often start at about age 35. Smoking causes emphysema and chronic bronchitis and the worsening of asthma symptoms.

Cigarette smoking is strongly linked to heart disease, including high blood pressure, heart attacks and heart failure. There is the increased risk of stroke and peripheral vascular disease. Smoking also causes stomach ulcers, gastritis, and pancreatitis.

In men, smoking often leads to lower sperm count, impotence and infertility. Women who smoke are at an even higher risk of getting cancers and other diseases when compared to their male counterparts.

One cigarette is never enough for a smoker. The nicotine from cigarette smoke reaches the brain in seven-10 seconds and, after binding to the brain, triggers a temporary sensation of pleasure. Nicotine is highly addictive. Once a person starts to smoke, it is very difficult for them to stop, and the person becomes a slave to the drug.

Teenagers often feel that they are young and all "this stuff won't happen to me". However, for teens, smoking is often the gateway to the use of other drugs. Teens come under increased and often conflicting pressure from peers, home and teachers. It can never be attractive or considered cool to have smokers' breath, discoloured yellowed teeth, and stained fingernails.

With all of these facts and information, it makes one wonder why someone would even begin smoking, or not seek help to stop smoking?

Tobacco companies make their advertisements attractive, enticing to teens, associating smoking with glamour, success and popularity. What the companies don't do, however, is list on their packets all the substances found in the cigarette smoke. Neither have they come forward with the information of some of their very own models in advertisements (like the Marlboro Man) who have died from lung cancer.

Cigarettes are one of the few substances that can be sold legally, and, if used as intended, will cause harm and even death.

It has been estimated that every cigarette smoked reduces life by 11 minutes, and every carton reduces life by a day and a half. Every year a person smokes a pack a day, his life is shortened by about two months.

I reflect once again on the many persons I've known on whom the consequence of smoking has wreaked such havoc, upheaval and sadness in their lives and that of their loved ones.

I think of the 21-year-old man, my youngest patient to have been diagnosed with lung cancer. I remember the engineer who at age 52 years was paralysed because of the spread of the cancer to his spine.

I remember, too, my own father, who died at age 51 years from laryngeal cancer, and before his death, was confined to bed, receiving meals by a tube and unable to breathe on his own. He could no longer speak.

All these persons were in the prime of their lives and have not survived to share the joys of life with their loved ones.

It makes me wonder if, as a member of the health fraternity, and also as a country, we have done enough to prevent people from smoking, to protect those who are victims of second- and third-hand smoke, particularly children, who have the risk of getting ill and not developing as they ought to.

Have we made available, accessible and affordable to smokers the persons and tools to help them quit?

Our decisions determine our future.

You are what you choose, so choose wisely.

Dr Terry Baker is an internist and pulmonologist.

- Smoking