Fight against tobacco

What is tobacco?

Tobacco contains an alkaloid, nicotine, it's main addictive agent, which results in physical and psychological dependence.
Nicotine is a deadly poison in high doses. One drop (70 mg) can kill an average adult.
Apart from nicotine, tobacco contains 230 toxic chemicals that play a role in the onset of cancer.

Forms of Tobacco
Tobacco can be classified into smoking and smokeless tobacco.

Smoking
In India , tobacco is smoked in various forms like cigarettes, bidis, cheroots, chuttas, dhumtis, chillums, hookahs, etc.

Cigarettes

1 billion cigarettes are smoked every day in India.
Cigarettes in the Indian market have higher levels of tar & nicotine content than those found in developed countries.
Every cigarette takes 7 minutes of your life.

Tobacco smoke contains over 4000 chemicals

Smokeless Tobacco
Smokeless tobacco is consumed in the following ways:

Chewed: gutkha, pan, mawa, mainpuri tobacco, khaini, click, etc
Applied on gums, and teeth: mishri, gudhaku, bajjar, tooth paste
Inhaled: snuff
Smokeless tobacco is not a safe alternative to smoking. Smokeless does not mean harmless.
Chewing tobacco is far greater health hazard than filtered cigarettes as the concentration of tobacco is significantly higher.
Studies have shown that pan masala causes a condition called oral submucous fibrosis that makes it 400 times more likely for a person to develop cancer than normal people. This is true even if the pan masala does not contain tobacco.

Gutkha
Gutkha leads to Oral sub-mucous fibrosis (SMF), a pre-cancerous disease that is a first step to cancer. SMF has been linked to the chewing of areca nut (supari), one of the main components of gutkha along with tobacco.

Bidi

Bidi is the most popular form of tobacco used in India.
Bidis are made by rolling a dried rectangular piece of the temburni leaf into a conical shape and securing the roll with a thread.
Bidis contain a small amount of coarsely ground tobacco (o.15-0.25 gramms) compared to 1 gram of finely cut tobacco in cigarettes.
Bidis deliver as much as 45-55 mg tar compared to 18-28 mg in an Indian cigarette.
Bidis deliver more nicotine than Indian cigarettes.
Bidis contain high concentration of several toxic agents such as HCN, CO, NH3 and certain phenols.

Pan (betel quid) with tobacco

Pan chewing is an ancient habit dating back to more than 2000 years.
Pan consists of betel leaf, areca nut, slaked lime and catechu.
Areca nut which is a vital component of pan drastically affects oral health.
Pam contains nitrosamines which are carcinogenic in animal systems.

Pan masala

Pan masala is similar to pan and mainly contains tobaccoa and leads to oral damage.

Mawa

Mawa is a Gujarathi preparation made from shavings of areca nut with the addiction of tobacco and slaked lime.
Mawa is sold by tobacco vendors in cellophane papers tied like a small ball.
Mawa when chewed excessively and kept in a place causes oral cancer.

Passive smoking

2/3 of smoke from a burning cigarette does not reach the smoker's lung but instead goes directly into the air. The effects of this smoke are similar to smoke inhaled by active smokers. Inhaling of air containing tobacco smoke is called passive smoking.
An increased risk of lung cancer has been shown in wives of husbands who smoke.
The risks of passive smoking do not stop with cancer. There is an increased incidence of heart disease in passive smokers. Children of parents who smoke have an increased incidence of cough, bronchitis, ear infection and pneumonia. Children exposed to their parents cigarette smoke have six times the number of respiratory infections.

Tobacco and women
There has been an increase in prevalence among females for both smoking and smokeless tobacco.
Women who consume 3 cigarettes per day double their risk, not only of heart attacks but also of death from other causes
Mishri use, which is common in women can lead to low birth weight babies and a reproductive effect of lower male to female sex ratio.
When pregnant women smoke, carbon monoxide and nicotine passes into their lungs and bloodstream, reducing the oxygen supply to their unborn baby. This means that their babies are:
- more likely to suffer from asthma attacks, chest infections and
colds in later life
- more likely be born prematurely
- more likely to be born underweight
Paan chewing among women in India has made oral cancer more common than breast cancer.

Smoking and Skin Aging

'Smoker's face' and other horrors

A "smokers face" – can be identified as gray, pale and wrinkled skin.

So how does smoking speed up skin damage?

It all starts with the 'free radicals' formed in your body by the exposure to tobacco smoke. Free radicals are highly unstable and powerful molecules that can cause disease and damage to cell DNA. The cells of your body start behaving erratically producing a range of responses that make your skin age faster. The most serious damage to skin is caused by:

restricted blood flow through the capilliaries (tiny veins near the skins surface) preventing oxygen and nutrients getting to the skin
increased production of an enzyme which breaks down the supply of collagen to the skin's structure. Collagen supply is vital to the skin's elasticity. It decreases with age but smoking cigarettes accelerates this process.
smoking reduces the body's store of vitamin A which provides protection from skin damage
smoking gets in the way of absorption of vitamin C - a vital antioxidant for skin protection and health
continual puckering from drawing on a cigarette and squinting in reaction to the cigarette smoke create deeply wrinkled skin around the eyes and mouth - classic signs of 'smoker's face'
Smokers' may also develop hollow cheeks through repeated sucking on cigarettes. This is particularly evident in under-weight smokers and can cause smokers to look gaunt.

What does a smoker’s skin look like over time?

dull appearance to the skin - loss of skin glow and vitality
discolored skin (an ashy look on white skins)
deeper wrinkles around the mouth and eyes
loss of tone and elasticity more than with the normal aging process

Five dangers smoking poses to skin health:

1, Smoking causes wrinkles, not only because of the exaggerated facial motions of inhaling and exhaling and of the special facial contortion required - pursing of the lips to hold a cigarette in your mouth, but also because cigarette smoking constricts the outermost blood vessels that feed oxygen and nutrients to skin cells. "Smoking also damages collagen and elastin, the fibrous substances that give skin its strength and elasticity. As a result, skin begins to sag and wrinkle prematurely.

2. Smoking discolors the skin, partly because of the lack of oxygenation at the skin's surface. Facial skin can also become sallow or yellowish due to repeated close exposure to the heat and smoke of lit cigarettes.

3. Smoking can cause skin irritation, due to the more than 4,000 chemical compounds in cigarette smoke. Most are irritants, many are toxic, and at least 40 are known carcinogens, or cancer-causing chemicals. simple irritation, itching, burning and rashes - particularly in more sensitive areas such as around the eyes or lips - can occur from exposure to smoke.

4. Smoking prematurely ages more than just facial skin. The skin of the inner arms of smokers (which is not exposed to the sun - the main culprit in premature aging of the skin) to that of non- smokers. They found that the amount of premature skin aging and wrinkling correlated to how much each study participant had smoked and for how long. The study, which was published in the March issue of the Archives of Dermatology, concludes that the skin on the entire body ages prematurely due to the blood vessel constriction and lack of oxygenation associated with smoking.

5. Smoking triples the risk of developing a skin cancer called Squamous Cell Carcinoma a dangerous form of skin cancer that can metastasize to other parts of the body if not treated promptly Those who smoked more than a pack a day, in fact, had four times the rate of Squamous Cell carcinomas than non-smokers.

Smoking And Skin: Poor Results

Why Smoking Hurts And Ages Skin

Smokers tend to get “smoker's face”, a condition that was identified in 1965. The skin has a grey tint to it, and it is pale and has more wrinkles. That is because smoking causes the blood vessels near the surface of the skin to narrow. So the skin is getting less blood flow, and consequently less oxygen and important nutrients. Smoking also damages the fibers that help the skin stay elastic and strong – those are the elastin and collagen in the skin. That means the skin starts to sag and wrinkle before it otherwise would. And then there is also the issue of the facial expressions that smokers make – the pursing of the lips to hold the cigarette and the squinting of the eyes to avoid the cigarette smoke – adds up to even more wrinkling. All in all, the skin of a smoker loses its glow and healthy appearance.

Another problem with skin and smoking is the damage from the depletion of vitamins A and C. Smoking restricts the body from utilizing these vitamins as they should. Vitamin A is involved in repairing skin, and Vitamin C is an antioxidant and helps the body absorb iron. Consequently, many smokers become anemic. Also the body tends to become dehydrated from smoking, and the skin becomes dry, with flaking or cracked lips. Because of the damage that smoking does to skin, and the thinner skin with diminished oxygen supply.

Smoking and skin cancer also have a link. Smoking more than triples the risk of developing skin cancers – primarily squamous cell carcinoma – because of the thinner skin from smoking.

Another major skin issue for smokers is that of psoriasis. Psoriasis is a chronic skin condition that is not life-threatening or contagious. The person with psoriasis has red raised patches (sometimes scaly) that are itchy and often embarrassing. It is a condition that those who have it wish they could get rid of it once and for all. Smoking hurts the skin and makes it much more prone to having psoriasis than non-smokers. Depending on the amount that the smoker smokes, and the number of “pack-years”, and whether or not they are still smoking, the increase in risk ranges from 20% more likely to get psoriasis to 72% more likely. One study shows that those who smoke more than a pack of cigarettes per day are twice as likely (than those who smoked 10 cigarettes or less a day) of having severe psoriasis.

What the toxins in cigarette smoke are doing to your skin now!

Cigarette smoke contains more than 4000 toxins many of which are absorbed directly into the bloodstream and are taken by the blood right into the structure of your skin.

Smoking cigarettes reduces the efficiency with which the skin can regenerate itself – smoking causes the constriction (narrowing) of the blood vessels at the top layers of the skin which in turn reduces blood supply (to the skin). It is the reduced blood supply which causes a reduction in the availability of oxygen (which is necessary for all living cells) and the removal of waste products, dead cell fragments etc… which provide the necessary environment for regeneration.

Cigarette smoking causes the blood vessels at the top layers of the skin to constrict and so reducing the oxygen level in the blood there. This thickens the blood and reduces the levels of collagen in the skin (it is actually because of this that smoking is also associated with slow or incomplete healing of wounds).

In fact, smoking a single cigarette can produce cutaneous (pertaining to the skin) vasoconstriction (decrease in the calibre of blood vessels) for up to 90 minutes. One study suggests that blood flow in the thumb decreases about 24% after smoking one cigarette and by 29% after two cigarettes. Another study suggested that digital (finger) blood flow fell by an average of 42% after smoking one cigarette. A further study found that smoking for 10 minutes decreases tissue oxygen tension for almost an hour and concluded that the typical pack-a-day smoker would remain hypoxic* for most of each day. (Smith and Fenske, Journal of the American Academy of Dermatol)

*hypoxic – a reduction of oxygen supply to a tissue below physiological levels despite adequate perfusion of the tissue by blood.

Quit Smoking:
Smoking, Can it Harm my Skin?

Yes it can harm it in several ways. Here are more reasons to quit smoking now.

Skin is fed from within. The foods we eat are broken down into nutrients and waste. The nutrients are absorbed by the bloodstream, which transports them around the body to the various organs, the largest of which is the skin. Oxygen is also transported and delivered in the same way. The cells absorb the oxygen and this is vital for the health of the organs and the life process itself. This whole process takes place automatically when we breathe. . .

Except when we are breathing in smoke!

When we inhale the smoke from a cigarette the carbon monoxide from the smoke is absorbed by the hemoglobin in the blood. Carbon monoxide is a colorless odorless highly toxic gas also found in the smoke from car exhausts. The blood can absorb carbon monoxide 200 times as fast as oxygen so a lot of the oxygen is displaced by carbon monoxide. The organs including the skin are starved of life giving oxygen and slowly poisoned by the carbon monoxide.

But that's not the end of it. Cigarette smoke also contains the following deadly cocktail of chemicals: Ammonia, hydrogen cyanide, butane, nicotine, carbolic acid, collidine, formic aldehyde, lutidine, parvoline, prussic acid, pyridine, arsenic and cadmium. This list is by no means complete.

The effect on the skin of all these is catastrophic. The liver goes into overdrive trying to expel these chemicals from the body and cannot perform its normal functions properly. The skin loses its healthy glow and takes on a yellowish-gray cast. The more cigarettes smoked, the worse your skin will look.

Smoking also causes premature aging in two ways. It uses up vitamin C in the body, about 35mg for each cigarette. Vitamin C is an unstable vitamin and cannot be manufactured by the body. One of its functions is the preservation of the collagen in the skin, the substance that gives skin its plump and youthful appearance. The collagen breaks down causing premature wrinkles around the eyes and mouth.

If you’ve decided to start smoking to look glamorous or older, you might want to rethink that position. The negative effects of smoking on the skin will make you look older, especially if you smoke for an extended period of time. In a few years you’ll probably look older than your non-smoking peers, and the effects of smoking on the skin will continue to age you, and create skin problems.

Smokers who have smoked for longer than ten years may notice what is called the smoker’s face, one of the negative effects of smoking on the skin. In smoker’s face, a condition first described in 1985, several characteristics are common. Skin may take on a red, grey or yellowish cast. Wrinkles around the eyes and mouth become prominent, and skin may be dry or flaky. Dry or chapped lips is another effect of smoking on the skin.

Aside from the obvious reasons not to smoke (lung cancer, emphysema, heart disease), there are a few reasons why smoking is risky from an appearance standpoint. First, one of the effects of smoking on the skin is that smoking cuts down on the production of collagen, an extremely valuable chemical produced by the body that helps skin look young. As collagen supply decreases, wrinkles form and the skin loses its elasticity.

The effects of smoking on the skin are noticeable because smoking decreases the amount of oxygen supplied to the skin. Oxygen is one of the most helpful molecules to promote skin healing. When less oxygen is supplied to the skin, the skin is more likely to become damaged, is easily scarred, and is more vulnerable to other aging factors like sun damage.

Another of the effects of smoking on the skin is its depletion of vitamins A and C. Vitamin A is vital for skin self-repair. Vitamin C is an antioxidant, and also helps us better absorb iron. Many smokers show signs of anemia which is often manifested by dry, flaking or cracked lips. Smoking may dehydrate the body too, depriving the skin of needed moisture.

Smoking may affect the skin's layers, essentially leading to thinner skin. This can greatly increase risk of developing skin cancers, most commonly, squamous cell carcinoma. Though this form of skin cancer usually doesn’t spread to other parts of the body, it can create deep scarring when the cancers are removed, since they often sink deep into the skin's layers, necessitating removal of several under-layers of skin.

o how does smoking do its damage? In a couple of ways. One, it messes with the microvasculature (the circulatory pathways nourishing, oxygen rich blood uses to get around) of your skin. After a regular smoker has a cigarette, it takes about five minutes for this system to recover. Researchers speculate that this constant assault, sort of like suffocating your skin from the inside, adds to the smoker’s face phenomenon.

Researchers in both England and Germany have also found that smoking triggers matrix metalloproteinase 1, or MMP-1, an enzyme that destroys collagen. Collagen, which makes up about 70 percent of your skin’s weight, is the elastic, spongy network of fibers that essentially creates the skin’s structure. When you destroy collagen, you wreck the architecture of your skin and what you are left with is a ruin of sagging and wrinkling.

Just the physical action of smoking, pursing your lips around the cigarette and squinting your eyes to protect them from the smoke, over and over and over, pack after pack, adds up to lines creeping out around your lips and crows feet radiating out from around your eyes. The nicotine in cigarettes can also act as a diuretic, draining your skin of moisture leaving it looking parched and drawn.

Perhaps the most damaging effect smoking can have upon your skin is the formation of squamous cell carcinoma, a serious form of skin cancer. Researchers at the Leiden University Medical Center in the Netherlands studied about 1,000 people and discovered that those who smoked more than a pack a day saw their squamous cell carcinoma risk more than quadruple. Think you are in the clear if you don’t finish off a pack every day? Think again. The study showed that if you polish off a half to a full pack your risk triples versus a non-smoker. Those who just dabble, smoking ten or fewer cigarettes a day, bumped up their risk two and a half times. Quitting can help dial down your risk. Former smokers had just under twice the risk factor as those who didn’t smoke at all.

While the study didn’t show an increase in the scarier form of skin cancer, melanoma, squamous cell carcinoma is still a dangerous situation, and having the lesion removed is no walk in the park and can leave a scar or worse.

If you’re also baking yourself in the sun hoping for a nut brown tan while lighting up a cigarette there’s even more bad news. Researchers published a study in the Lancet that looked at the usually-in-the-dark buttock skin of volunteers and found that the smokers’ skin was already producing MMP-1, the collagen destroying enzyme also thought to be responsible for sun damage, before their skin was even exposed to damaging ultraviolet light. That’s right, they were basically creating sun-damaged skin without the sun. The upshot is that if you are tanning and smoking (remember each year of smoking is 1.4 years of aging), you are compounding the situation.

What can you do to undo the damage wrought by smoking? Well, the first thing is, obviously, to quit. Within hours, even minutes, your body’s functions begin to return to normal which benefits your skin by supplying it with plenty of oxygen and nutrients. You may be able to tackle some of the finer lines and wrinkles with various exfoliating peels and rejuvenating moisturizers that speed up the skins turnover rate (like alpha hydroxy acids or Retin-A). If you’ve deep furrows or your lips are punctuated with lots of feathery lines, check with your dermatologist about deeper peels or injectable fillers that can plump up those areas again.

Does smoking help stress?

nMany people think that smoking cigarettes helps to calm them down. Nicotine is a stimulant and acts as a 'pick-me-up'. It releases chemicals in your brain, called neurotransmitters and it is thought that these can improve mood and make you feel better. However, this only lasts for a short period of time because withdrawal from nicotine gradually makes you feel worse and your good mood is only restored when the craving is satisfied with another cigarette.

Impotence:

Because erections are mainly due to the blood flowing into the penis through arteries, artery blockage actually deprives erection and therefore affecting a smoker’s sex life.

Nicotine actually also restricts blood flow. It has also been studied that long term use of nicotine can permanently damage the arteries. Since a man’s erection depends on blood flow, smoking can cause softer erection even with just 2 cigarettes.

Studies has also discovered that carbon monoxide affects the production of testosterone which create sex drive.

How does smoking cause impotence?

For your penis to become erect the following process happens.

When you become stimulated chemicals release in your brain sending signals through your body to your penis. Another chemical is released causing your penile muscle to relax so blood can rush into this area causing an erection. When you have an erection the blood is kept within the penis by it’s complicated mechanism where the blood rushing into the penis from the arteries restricts the blood flowing out of the penis through the veins.

Smoking causes impotence as it affects this process in different stages for a variety of different reasons.

Smoking can be an attributing factor in the build up of fatty deposits in the arteries that can restrict the flow of blood to the penis.

Cigarettes contain nicotine which can cause rapid contractions in penile tissue, it does this by stimulating the brain, affecting the chemical release that occurs when you become excited so the brain cannot properly send signals which cause your penile muscle to relax, this causes a restriction of blood flowing into the penis.

Nicotine also affects the mechanism that keeps the blood within the penis to maintain an erection. This happens because Nicotine travels in the blood stream impairing the bodies’ ability to trap blood in the penis making it difficult to keep an erection for long enough periods for sexual activity.

As you can see smoking can cause impotence in 3 different ways, it isn’t just a simple answer of smoking causes impotence.

As well as the possible cause if impotence smoking also causes a reduced volume of ejaculation, lower sperm counts, abnormal shaped sperm and impaired sperm mobility.

Reduce your chances of impotence

To reduce your possibilities of becoming impotent you should find a way to stop smoking. To quit smoking is not as easy as it sounds, many smokers become addicted because of the chemicals that make the ingredients in a cigarette like nicotine and caffeine. If you are serious about wishing to stop smoking then ask for help, it is not an easy task on your own but having support can help improve your chances of achieving your goal.

Summary

Impotence is a silent condition as those who suffer with it do not wish others to know, a huge amount don’t even consult a medical professional about the issue. Remember the affects smoking has on your body before lighting up that next cigarette.

WAYS TO QUIT TOBACCO

Before you quit tobacco, try wrapping your tobacco with a sheet of paper . Every time you want tobacco, unwrap the pack and write down what you are doing, how you feel and think of what tobacco will do to you. Do this for a couple of days.
Many smokers feel that cigarettes give them energy. Such people should try modest exercise, a brisk walk or a new hobby.Most smokers tend to put on weight, so not start eating rich foods.
If cigarettes help you to relax, try meditating & some new social activity.
Try choosing an opportune time to quit, such as when you are ill with a cold or flu and have lost your taste for tobacco.
On a 3"x5" card, make a list of what you dislike about smoking. Add to it and refer to it daily.
Make a short list of things you have always wanted to buy. Next to each, write its cost. Convert each cost into number of packs of cigarettes. If you save the money each day, you will now be able to buy these items.
Telephone somebody when you get craving for tobacco and talk until the craving subsides.
Try to find the company of people who do not use tobacco.
Always ask yourself, "Do I really need this tobacco or is it just a reflex?"
Try to help someone else stop consumption of tobacco.
Keep your hands occupied. Try a musical instrument, knitting or puzzles.
Make a major change in your habits. Seek new activities or perform old ones in new ways. Think of different ways to solve problems. Do things differently.
Get out of the house if you tend to consume tobacco more at home.
Keep to places where smoking is not allowed, libraries, theatres, department stores or just go to bed early during the first few days when you are trying to give up smoking.
Take a shower or do something where you cannot smoke.
Brush your teeth frequently to get rid of the tobacco taste and stains.
Visit your dentist after you quit and have your teeth cleaned to remove tobacco stains and stale tobacco taste.
When you have a craving for tobacco, take 10 deep breaths, hold the last breath while you light a match and blow it out with the exhaled breath. Then immediately start another activity.
After you quit, start using your lungs. Increase your activities and start moderate exercise, such as walks.
Place a bet with someone that you can quit.
If you are depressed or have physical symptoms that might be related to your smoking, discuss it with a doctor. It is easier to quit when you are aware of your health status.
After you quit, decide on someone who you can call when you crave for tobacco. Never face the situation of craving a tobacco alone.

Say NO! to tobacco

Places which will help you in leaving tobacco:

Tata memorial hospital
Department of Preventive Oncology
Dr E. Borges Road,
Parel, Bombay 400 012.
Appointment : 9.30 A.M. to 5.30 P.M. (Mon. to Fri)

Tel: 022-24154379

Dr.S.ShyamsunderMD (USA)
Diplomate of the American Board.
Hon. Consultant,
Quit Smoking Clinics
South Bombay - Bombay Hospital. Room 116. Tel:2067676; extn 546 .
Bombay Hospital
Bandra - Tel: 6423236.
Juhu - Tel: 6126332.
Mobile - 9869019125.
(The patients will get a more than 50% discount on medicines and consultation expenses.)

Dr Jagruti Chasmawala
102, Vikram Apartments,
Bhagat Road,
Mahim
Bombay 400 016
Tel 24375637 Res:- 24304813
(For appointments call between 3 to 7.30 p.m. Mon - Sat)