Nicotine, the primary ingredient in tobacco products, ranks second among addictive substances, only after heroin. It is the reason why smokers remain bound to its use.
The use of any kind of tobacco product, including the newer electronic and heated nicotine-releasing products, inevitably leads to addiction and dependency. Contrary to current unsubstantiated claims flooding the internet, there is no safe level of smoking, and no tobacco product is safe.
Each year, approximately 8,000,000 people worldwide die from smoking, 1,200,000 of whom die from passive smoking, including 65,000 children.
As terms like epidemic, pandemic, morbidity, and mortality rates have recently become prominent in our lives, we understand that these figures essentially describe a continuous epidemic—predictable, treatable, and preventable. This epidemic has quietly persisted for decades, differing mainly in that it is not transmitted from person to person and thus does not disrupt the constant rhythm of modern, primarily Western, society and its systems. However, the morbidity and mortality caused by passive smoking—the exposure to the smoke of fellow citizens, colleagues, and parents—could be considered to have a transmissible dynamic from smoker to non-smoker via smoke.
The World Health Organization classified smoking as a chronic disease in 2008, correctly labeling it as the greatest epidemic of all time.
Smoking is a multisystem disease, as its impacts are not limited to the respiratory system. The micro-particle pollution generated by smoking, enters into the bloodstream, damaging even distant organs.
The effects on pregnant women, fetuses, infants, and children are particularly significant, as is the environmental impact. Pollution from cigarette butts, chemicals, pesticides, and tobacco industry waste, leaves a negative mark on ecosystems and water sources.
Especially today, in the context of the COVID-19 pandemic, smokers are even more vulnerable. Chronic obstructive pulmonary disease (COPD) and its frequent comorbidities make smokers prone to infections in general, and SARS-CoV-2 in particular, increasing the risk of complications and adverse outcomes of the disease.
The classic hand-to-mouth motion of smokers is believed to facilitate the transfer of SARS-CoV-2 to the entry points (mouth, nose), raising the risk of infection. Moreover, staying at home as part of protective measures against COVID-19, combined with the accompanying anxiety, increases the likelihood of passive exposure for family members.
Smoking cessation, although challenging and strenuous, is the only way forward for smokers, who will enjoy the benefits from the very first moment, gaining symptom reduction and well-being as they move further away from their last cigarette.
Many smokers attribute their smoking to stress, claiming it calms them, an argument also used by many teenagers. The truth is that they indeed feel some relief when they smoke, not due to stress reduction, but due to the alleviation of withdrawal symptoms satisfied by the effect of nicotine on the deprived brain of the smoker.
Since prevention is better than cure, and smoking cessation, though feasible, involves difficulties, it is crucial to act proactively and invest in prevention. We must start early, from childhood, to equipp young children and teenagers with knowledge, enhance their self-esteem, teach them creativity and stress management and highlight the role of physical exercise in their lives. By offering them a multifaceted education on an academic, social, and personal level, we will provide them the necessary tools to consciously make healthy choices, and effectively solve problems rather than create them.
The SMOKE FREE GREECE Initiative has been carrying out this work to date, having developed a methodology for smoking prevention interventions in the school community, successfully applied in schools across country since 2009. It is planning for the future: “The new generation is coming, smoking is leaving.”
ANNA S. TZORTZI MD, FCCP
PNEUMONOLOGIST