In The Year Of The Lung: Breathe, Live And Learn

(Based on an interview given exclusively to CNS by Dr. Dean Schraufnagel, Vice president of The Union, and Professor of Medicine and Pathology, University of Illinois College of Medicine, during the 41st Union World Conference on Lung Health, which was held in Berlin during 11--15 November,2010)
The connection between breath and life is fundamental, yet lung health does not seem to be high on the public health agenda. Around 10 million people (especially the poor, old and the weak) die every year, due to lung diseases, including tuberculosis, asthma, pneumonia, influenza, lung cancer and chronic obstructive pulmonary disorder (COPD) which is soon going to become the number one killer. Read more

One common factor which links all these diseases is consumption of tobacco. Tobacco use remains legal, although it kills more than 5 million people each year, including more than 1.3 million who die of lung cancer, which is the number one cancer that kills. Apart from this, thousands of others suffer due to exposure to second hand smoke. There is direct evidence in the US of heart disease cases dropping dramatically with a ban on smoking.

With an increase in awareness about ill effects of smoking in the developed countries, tobacco companies are shifting base to developing countries in a big way. They are making subtle and nefarious ways to get youngsters hooked to tobacco, in order to sustain their own livelihood. They are offering candy flavoured chewing tobacco (which is called gutkha / pan masala in India) and herbal/mild cigarettes to lure especially women and children, who are mislead to believe that these lethal addictions are harmless. There is a strong debate worldwide to ban flavoured and herbal cigarettes.

We have to remember that all types of tobacco are bad- whether chewing or inhaling, whether herbal or mild- as the key ingredient in all of them is nicotine, which is highly  addictive and harmful.

Social awareness is the key to success of controlling tobacco use. A change in our thought process, coupled with appropriate legislative action can bring down the epidemic of lung diseases to a large extent. The process has already begun. Smoking at airports, and inside hospitals is now unthinkable. But there should be no special smoking zones anywhere, in the same way as it is ridiculous to have urinating and non urinating zones in a swimming pool. As water will flow from one part of the pool to another, the cigarette smoke will mix and mingle with the air and travel far and wide.

In the words of Dr Schraufnagel “I am a lung specialist and hence have to deal with this problem directly. In USA there has been a perceptible fall in smoking, though it has not signed the FCTC. When I ask my patients, especially women patients, if they smoke they say they used to earlier but no longer now, because of children and social non acceptability.

Some studies have shown a direct link between price and cigarette usage—an increase in taxes brings down cigarette consumption.  But social awareness and attitudinal changes will be permanent effective tools. It is here that we can use the expertise of kids to force parents to quit. Children’s persuasive powers are strong and cannot be underestimated.”

He gave an example of a place near Chicago which they were trying to make smoke free. But restaurant owners opposed it vehemently, saying that they would lose their customers who would insist on smoking. It was later found that tobacco companies had bribed the restaurant association heavily to achieve this. But strangely, one restaurant owner, who was one of the strongest votaries of tobacco, went smoke free. When I asked him the reason for this, he said that his grand children had refused to come to his restaurant because of cigarette smoke.

Dr Schraufnagel strongly feels that, “Each one of us should remember that we are involved with each other’s health. If a person smokes, he/she is jeopardising the health of those in the vicinity, due to second hand smoke. And we have no right to play with the health of others, though we may be naive enough to play with our own. Whenever anyone suffers from tobacco related, or any other disease the rest of the society pays for it in some form or the other (public health, private insurance, free govt health schemes, etc). So smoking cannot be an individual’s choice. We need to turn the tables on tobacco companies by creating social/attitudinal changes throughout the countries. This, along with raising taxes and outlawing smoking/chewing tobacco would work fine.”

I personally have seen many  smokers on the roads of European cities like Italy, London and Berlin-- perhaps because smoking has been banned inside offices/buildings. But what we  need is a change of habit, and not merely a change of place. A lethal item should not be used anywhere.

The International Union Against Tuberculosis and Lung Disease (The Union) has been very involved with its efforts to ban smoking/tobacco use throughout the world. It offers widespread support to the more than 160 nations that have ratified the first-ever international public health treaty – the WHO Framework Convention on Tobacco Control – and calls upon the remaining countries to do so;

The challenge is to put ‘Lung In Action’ to ensure that each one of us understands the risks and symptoms of lung diseases and how to keep lungs healthy, because lung health is essential to life.

We are together in this fight for a cleaner and healthier breath.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. She was supported by the Stop TB Partnership to write from the 41st Union World Conference on Lung Health, Berlin, Germany (11-15 November 2010). Email: shobha@citizen-news.org, website: www.citizen-news.org) 


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