Cigarette Smoke gets in your lungs
Action to protect the public against the damage done to so many of them by cigarette smoking would have more effect upon public health than anything else that could now be done in the whole field of preventive medicine." So begins the latest report on smoking from the Royal College of Physicians, a report which contains nothing to brighhten the rapidly shortening lives of the world's smokers.
According to the RCP, "cigarette smoking is now as important a cause of death as were the great epidemic disseases of the past". In fact, in the words of Muiris X. FitzGerald, newly appoinnted Professor of Medicine at UCD, "so great has been the impact of the srnokking-related diseases on mortality rates, that adult life expectancy has not immproved in the Developed World since the start of this century. Virtually all the advances of modern medical science have been effectively negatived by the counter-efforts of the tobacco innd ustry."
The major smoking-related illnesses are lung cancer, bronchitis, and coroonary heart disease. Between them, these three ailments currently account for nearly 35 per cent of all deaths in the Republic of Ireland. Smoking is not the only cause of these illnesses, but the facts pointing to the strength of the relationship are frighteningly concluusive:
• Lung cancer is now the only form of cancer claiming an increasing number of lives and is 20 times more common among heavy smokers (25 cigarettes or more daily) than among non-smokers.
. Susceptibility to bronchitis, which causes more medical absenteeism than any other ailment in Western Europe, is five times greater among smokers than among non-smokers.
.Depending on age, heavy smokers are estimated to be between five and IS times more likely to suffer' from a fatal attack than non-smokers.
Of the hundreds of known constiituents of cigarette smoke, the most immportant from a medical point of view are nicotine, tar, and three different kinds of cancer-prod ucing substances.
The amount of nicotine from one small cigar injected. intravenously would be enough to kill anybody. Inhaled in tobacco smoke, this potent drug causes hardening and narrowing of the arteries of the heart, and it also increases the tendency of the blood to clot. The' commbination of these two effects greatly inncreases the risk of thrombosis, which is the blockage of an artery by a blood clot.
Tar and the irritants it contains are known to produce serious alterations in the lungs of heavy smokers, Breathhlessness, smoker's cough, and chronic bronchitis are among the results. Emphysema, the structural deterioraation of the lungs, is now virtually unnknown among non-smokers, but remains a major cause of disability and death among the smoking population.
Of the cancer-prod ucing constituents of cigarette smoke, the most important are known as the N-nitroso compounds. In food and drink, these compounds are regarded as a potential health hazard at concentrations of one part per billion.
In cigarette tobacco, concentrations of 9,000 per billion are not unusual.
The publication of the first Royal College report on smoking and health in 1962 initiated the most remarkable deecrease in the use of tobacco in the Briitish Isles since the end of the Second World War. According to the latest reeport, the downward trend continued until 1965. Since then there has been a steady upward movement. However, this overall increase in the consumption of cigarettes disguises a number of immportant tendencies.
While men are now smoking less, women have more than doubled their consumption. Among unskilled worrkers, men smoke as much as they ever did and women are smoking more. Among professionals, there has been a 20 per cent decrease in the number smoking cigarettes, and among doctors the decrease has been slightly more than 35 per cent. The net result of all these tendencies has been a mere 3 per cent decrease in the smoking population of the British Isles since 1962.
Several estimates have been made of the costs of cigarette smoking to the Health Services. I n 1971, the Brit ish Department of Health considered the figure of £ I 12 million per year to be conservative. By 1975, the estimate from the same source was more than £250 million per year. Estimates for the Republic of Ireland suggest that the care and treatment of sufferers from smokking illnesses annually costs between £20 million and £30 million.
As Dr. Keith Ball commented wryly at the Irish Heart Foundation's Summposium on Preventative Cardiology, the only way to make economic sense of such costs is to set against them the money saved through not having to pay pensions to smokers who die before retirement..