If you were asked to describe the relationship between “tobacco smoking” and “cancer,” you might immediately think of lung cancer. It’s true that smoking tobacco products (including cigarettes and cigars) causes almost nine of every ten cases of lung cancer, but smoking can cause cancer almost anywhere in your body, including in the
Tobacco is a product prepared from the leaves of the tobacco plant by curing them. The plant is part of the genus Nicotiana and of the Solanaceae (nightshade) family. In 2008, the World Health Organization named tobacco as the world's single greatest preventable cause of death.
An estimated 1.1 billion people, and up to one-third of the adult population, use tobacco in some form. Smoking is more prevalent among men (however, the gender gap declines with age), the poor, and in transitional or developing countries
During the 1950s, the evidence was clearly sufficient to establish the carcinogenicity of tobacco smoking . By the end of the 1950s, convincing evidence linking smoking with lung cancer and other cancers had been obtained from case–control and cohort studies, carcinogens had been identified in tobacco smoke, and cigarette smoke condensate had been shown to cause tumors when painted on the skin of mice. Since then, the numbers of deaths attributable to tobacco smoking have sharply increased, reflecting the heavy smoking patterns of previous decades. It has been estimated that tobacco smoking is currently responsible for approximately 30% of all cancer deaths in developed countries .tobacco smoking is estimated to account for approximately 4–5 million deaths a year worldwide.
International Agency for Research on Cancer (IARC) in 1986 to the updating The evidence now available shows that tobacco smoke is a multipotent carcinogenic mixture that can cause cancer in many different organs,exposure to secondhand tobacco smoke (i.e., involuntary or passive smoking by persons who do not smoke) is also carcinogenic for the human lung.
Use of smokeless tobacco products is common worldwide, with increasing consumption in many countries. Although epidemiological data from the USA and Asia show a raised risk of oral cancer
Tobacco is the world's single most avoidable cause of death. The 10 million fatalities per year by 2030.
Among the 250 known harmful chemicals in tobacco smoke, at least 69 can cause cancer. These cancer-causing chemicals include the following :
Smoking also causes heart disease, stroke, aortic aneurysm (a balloon-like bulge in an artery in the chest), chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, and cataracts, and worsens asthma symptoms in adults. Smokers are at higher risk of developing pneumonia, tuberculosis, and other airway infections . In addition, smoking causes inflammation and impairs immune function .
Smoking makes it harder for a woman to get pregnant. A pregnant smoker is at higher risk of miscarriage, having an ectopic pregnancy, having her baby born too early and with an abnormally low birth weight, and having her baby born with a cleft lip and/or cleft palate . A woman who smokes during or after pregnancy increases her infant’s risk of death from Sudden Infant Death Syndrome (SIDS) . Men who smoke are at greater risk of erectile dysfunction .
Smoking is highly addictive. Nicotine is the drug primarily responsible for a person’s addiction to tobacco products, including cigarettes. The addiction to cigarettes and other tobacco products that nicotine causes is similar to the addiction produced by using drugs such as heroin and cocaine . Nicotine is present naturally in the tobacco plant. But tobacco companies intentionally design cigarettes to have enough nicotine to create and sustain addiction.
The amount of nicotine that gets into the body is determined by the way a person smokes a tobacco product and by the nicotine content and design of the product. Nicotine is absorbed into the bloodstream through the lining of the mouth and the lungs and travels to the brain in a matter of seconds. Taking more frequent and deeper puffs of tobacco smoke increases the amount of nicotine absorbed by the body.
The immediate health benefits of quitting smoking are substantial:
tobacco is a potent multisite carcinogen with a substantial worldwide impact, causing cancers of the lung, upper aero-digestive tract (oral cavity, nasal cavity, nasal sinuses, pharynx, larynx, esophagus), pancreas, stomach, liver, lower urinary tract (renal pelvis and bladder), kidney, and uterine cervix, and causing myeloid leukemia. Both cigarette smoking and smoking other forms of tobacco, including bidi, pipe, and cigars, can cause cancers in multiple organs.
The worldwide consequences of tobacco smoking are dramatic and are likely to worsen in the near future. Tobacco smoking is currently responsible for approximately 30% of cancer deaths in developed countries, and for an increasing proportion of the cancer deaths in developing countries. Furthermore, smoking causes more deaths from vascular, respiratory, and other diseases than it does from cancer. Of all lifetime users of tobacco, half will die because of their habit, and half of these individuals will die in middle age. If current smoking patterns persist, then in the 21st century there will be more than 1 billion deaths attributed to smoking.
A balanced public health strategy is therefore needed that not only prevents young individuals from starting to smoke, but also helps adults stop smoking
Around in 1980 prominent epidemiologists estimated that about 30% of all cancer cases are attributable to dietary habits.more than 25 years later American Institute of Cancer Research came to the similar conclusion.
About one third of the most common cancers in higher income countries and about one fourth in lower income countries could be prevented through eating healthily,being physically active,and maintaining a healthy weight.
Overweight is one of the most important risk factors for cancer: it convincingly increases the risk of colonic cancer,breast cancer, endometrial, esophageal, pancreatic and kidney cancers. It is not simply overweight,but the distribution of fat mass which appears to influence the risk. Abdominal fat and possibly visceral fat is convincingly associated with a 70% increase in risk of colon cancer and probably increases the risk of postmenopausal breast cancer,pancreaticcancer,and endometrial cancer.
The risk of cancer attributable to excess body mass index(BMI).AICR advises to be as lean as possible within the normal range of body weight.
A healthy weight is best achieved by choosing diets based on foods with low energy density,avoiding surgery drinks,and being physically active throughout life.
Independently of the effect on body fatness, physical activity convincingly decreases the risk of colon cancer, probably protects against post menopausal breast cancer and endometrial cancer.
Being moderately physically active means 30 minutes of active walking,biking,and or gardening per day.when overweight is already present 60 minutes physical activity is advised.
Most diets that are protective in nature are from plant origin.Consumption of non-starchy vegetables protects against cancers of mouth, pharynx,larynx,oesophagus and stomach.
Allium vegetables probably protect against stomach cancer. Garlic probably protects against cancers of colon and rectum. Fruits decreases the risk of mouth, pharynx,larynx,oesophagus lung and stomach cancers.
The beneficial effects of vegetables and fruits could be due to dietary fibre,specific vitamins or other bioactive compounds.
AICR recommends to eat at least five portions(400 gms) of a variety of vegetables and of fruits per day,and to consume unrefined grains and pulses at each meal.
Consumption of red meat( beef,pork, lamb,horse) and processed meat(red meat preserved by smoking,curing,salting and by adding preservatives, such as ham,bacon,salami,sausages,etc.) convincingly increases the risk of colorectal cancer.
Increasing the consumption of red meat by one intake per week increases the risk of colorectal cancer by about 40%, for processed meat the risk of colorectal cancer increases by about 20% with each 50gm per day.
It is the heam iron content of red meat , which irritates the colonic mucosa may lead to carcinogenesis.
Other compounds responsible are heterocyclic amines,N –nitroso compounds and poly cyclic aromatic hydrocarbons.
AICR recommends to limit the consumption of red meat to 500 gms per week.
Alcoholic drinks are a cause of several cancers,ie.cancer of oral cavity,breast,colorectal cancers in men is convincing.IN western Europe 10% of cancers in men and 3% of cancers in female are estimated to be attributable to alcohol consumption.
However the modest amount of alcoholic drinks are likely to protect against coronary heart diseases,the AICR recommends one drink for female,two drinks for men per day when alcohol is consumed.
Some methods of food preservation,processing and preparation affect cancer risk.Salt and salt preserved foods are probably a cause of stomach cancers.
Foods contaminated with aflatoxins, such as cereals and pulses are a cause of liver cancer.
Aflatoxins are produced by moulds when foods are stored too long at warm temperatures.
AICR recommends to avoid salt preserved, salted or salty foods to ensure an intake of less than 6 gm(2.4gms sodium) a day.
The main risk factors for cancer associated with food,nutritions,and physical activity are known and recommendations to decrease ones risk of cancer are available.
Cancersahayalso provides Palliative Care services. This is a very necessary yet ignored branch of medicine and majority of the terminal ailing patients are deprived of Palliative care.
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