The shocking revelation by the Education Minister that schoolchildren found to be addicted to drugs and smoking has raised serious concerns among health officials.
The Sunday Observer spoke to Senior Professor of Forensic Medicine, General Sir John Kotelawala Defence University (KDU), Prof. Ravindra Fernando who has been closely involved in the campaign against smoking to share his expertise on how smoking if begin at an early age can have long lasting and damaging impacts on the smoker.
Excerpts
Q: Last month, the Education Minister made the startling revelation in Parliament that 81 schoolchildren have been directed to rehabilitation due to drug addiction within January 2022 up to now. Even more shocking was the news that three of the school children were below 14 years, and the others between 15 and 19 years. As a long-time activist against drugs and smoking abuse especially when this toxic mix began early in life, what are your observations regarding this disturbing revelation?
A. During the past few decades, not only in Sri Lanka, an increase in trends of smoking and substance abuse among adolescents has been reported worldwide. The behaviour is associated with various social, biological, economical, and psychological issues such as violence, crime, injuries, diseases, increased school dropout rates, and sadly, deaths in extreme cases.
Q: According to a Global School based survey conducted nearly a decade ago, more than 6,000 children (10-14 years old) and 17,2500 adults (15+ years old) continue to use tobacco each day and that the smoking prevalence among aged 13-15 years in Sri Lanka was believed to be around 2 percent Is the number the same today? Or has it increased?
A. No recent statistics are available in Sri Lanka, but the numbers have increased according to media reports and police reports.
Q: What are the 1) short term and 2) Long term health consequences of tobacco smoking on the human body, given the fact that there are more than 7,000 chemicals in cigarette smoke, many of them harmful?
Q: A recent study in 2021 has shown that more than 70 of those chemicals are linked to cancer. Do you agree?
A. Yes. Cigarette smoke releases over 5000 chemicals and many of these are harmful - we know at least 70 can cause cancer. The harmful chemicals enter our lungs and spread around the entire body. DNA is found in all our cells and controls how they behave. Even one cigarette can damage DNA. However, chemicals in cigarettes make it harder for cells to repair any DNA damage. They also damage the parts of DNA that protect us from cancer. It is the build-up of DNA damage in the same cell over time that leads to cancer.
According to recent studies smoking causes more deaths each year than the following causes combined: Human immunodeficiency virus (HIV), Illegal drug use, Alcohol use, Motor vehicle injuries and Firearm-related incidents. Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths. More women die from lung cancer each year than from breast cancer.
Q: Chronic Obstructive Pulmonary disease (COPD) is said to be one of the commonest outcomes of smoking with fatal results as well. Do you agree?
A. Yes. Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD). Smokers are 12 to 13 times more likely to die from COPD than non-smokers.
Q: Are men and women affected equally?
A. Cigarette smoking increases risk for death from all causes in men and women. Estimates show smoking increases the risk:
- For coronary heart disease by 2 to 4 times
- For stroke by 2 to 4 times
- Of men developing lung cancer by 25 times
- Of women developing lung cancer by 25.7 times
Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.
Q: So what you are saying is that it affects one’s overall health?
A. Yes. Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and costs.
Q: What are its impacts on the respiratory system and in what way does smoking impact on our ability to breathe normally?
A. Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.
Lung diseases caused by smoking include Chronic Obstructive Pulmonary Disease (COPD), which includes emphysema and chronic bronchitis.
If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
Q: How vulnerable are those who have had Covid-19 or any other lung infections to diseases like Pneumonia, due to their weakened immunity?
A. Covid-19 is a respiratory illness caused by the virus SARS-CoV-2. The virus infects your airways and damages your lungs. To fight off the infection, your immune system causes inflammation, which can also cause damage and allow fluid to leak into the small air sacs of your lungs. This is called pneumonia.
Covid pneumonia is an infection in your lungs caused by SARS-CoV-2, the virus that causes Covid-19. You can get pneumonia as a complication of being sick with Covid-19. As your immune system attacks the infection in your lungs, they get inflamed and fill with fluid, making it hard to breathe. The type of pneumonia associated with Covid-19 is almost always in both lungs at the same time (bilateral). Interstitial tissue is what surrounds your lung’s air sacs, blood vessels and airways. Interstitial lung disease causes scarring or other lung damage. Bilateral interstitial pneumonia in Covid-19 is lung damage on both sides as a result of Covid-19-related pneumonia. This usually happens after the initial (infectious) phase, often in people who have long Covid (post-acute sequelae of SARS CoV-2, or PASC).
Q: I have seen many chain-smokers aging faster than non-smokers. How does this happen?
A. Smoking does indeed age you. A recent scientific study on this very subject by Researchers in Ohio USA who studied the physical differences between the faces of nonsmokers and their twins who smoked and confirmed this.
Q: What other parts of his body can be affected by chain smoking? Eyes? Heart?
A. Chain smoking is the practice of smoking several cigarettes in succession, sometimes using the ember of a finished cigarette to light the next. The term chain smoker often also refers to a person who smokes relatively constantly, though not necessarily chaining each cigarette. The term applies primarily to cigarettes, although it can be used to describe incessant cigar and pipe smoking as well as vaping. It is a common indicator of addiction.
Chain smoking can cause some cancers, including mouth, throat, stomach, liver and kidney cancer to name a few.
It causes heart disease, strokes, damage arteries and blood vessels, pneumonia, fertility issues (for both men and women) and impotence in men.
Q: The importing or selling of both smoked cigarettes like, beedi, cigars and smokeless cigarettes in Sri Lanka was banned as far back as in2016. Yet smokeless tobacco products such as Babul, Beedi, Mawa, Pampara, and Gurkha are still available in the market. What are the health impacts of these smokeless products? Are they better or worse than smoking cigarettes or cigars?
A. Smoking them is equally bad.
Q: Myths about cigarette smoking you wish to debunk? Many people continue to underestimate the danger of second-hand smoking. They believe that being in the close proximity of a person who is smoking won’t harm them if they don’t smoke themselves. Your comments?
A. There is no safe level of exposure to secondhand smoke (SHS); even brief exposure can cause immediate harm. Health problems caused by secondhand smoke in adults who do not smoke include coronary heart disease, stroke, and lung cancer, as well as adverse reproductive health effects in women, including low birth weight.
Because the secondhand smoke is already contaminated and you are inhaling it, and it is already contaminated by the person who is smoking. So, that’s even worse, because you’re being doubly contaminated, more than smoking it.
Even if you are not a smoker, you are not spared if you are exposed to second-hand smoke as it contains toxic metals, carcinogens and poisonous gases. Those exposed to second-hand smoke are at high risk of suffering from most of the diseases and health complications associated with first-hand smoking.
Q: Can cigarette smoke remain in the environment even after the smoker has stopped smoking? If so, for how long and in what way?
A. Cigarette smoking causes environmental pollution by releasing toxic air pollutants into the atmosphere. The cigarette butts also litter the environment, and the toxic chemicals in the residues seep into soils and waterways, thereby causing soil and water pollution,. Animals and plants that come into contact or absorb the toxic substances from the cigarette residues are affected as well. Carbon dioxide, methane and other noxious chemicals are present in second-hand smoke, which causes air pollution through smoking.
Although methane and carbon dioxide are not deadly to smokers, the gases do add to the general atmospheric pollution.
Smoking globally emits nearly 2.6 billion kilograms of carbon dioxide and 5.2 billion kilograms of methane into the atmosphere each year. This provides a clear picture of how smoking alone contributes to climate change. Second-hand smoke, as discussed earlier, also poses indirect and serious health risks such as cancer to non smokers and even animals, who ingest them as they can remain in the environment for many hours.
Q: So what is the best solution to halt a further spread of dangerous drugs and smoking among school children and teenagers? Better educational opportunities? More emphasis on Life skills and Vocational education to help early school drop outs find more jobs and keep them off the streets?
A. Education of the harmful effects of smoking and dangerous drugs from childhood is the best way to prevent spread of smoking. The earlier we teach children that smoking is bad for their health the better. Also, parents should act as role models by abstaining from smoking themselves and thereby not have double standards that confuse the child..
Q: The Police and Army are now carrying out surprise raids on schools, to check if children are addicted to smoking by getting them to open their mouths and examining their teeth, in order to . see if they are stained with nicotine. Do you think that this is a sufficient deterrent to keep them from smoking? What happens when they leave the school premises? Won’t they be tempted to smoke on the sly? Your comments?
A. It is difficult to stop students addicted to smoking once they leave the school premises. So parents have to be constantly vigilant . Unless parents supervise and monitor their movements and friends, they may smoke on the sly.
Q: What do you see as a long-lasting solution to halting this emerging trend among school children?
A. Parental supervision is the only solution to halt the emerging trend of smoking.
Q: Your message to parents of young smokers?
A. Please check and monitor what students are doing after school. Be vigilant always and check on your child’s friends and acquaintances.