Mrs. Christy Efemena, 59, a mother of four children, had never smoked a cigarette in her life, just as Mrs. Joyce Adefila, 47, a mother of five had never done. Ironically, they were both victims of lung cancer and unfortunately, they were not able to survive the disease in spite of series of treatments, including chemotherapy, at home and abroad. Such cases tend to elicit some thought-provoking questions as to why non-smokers die of lung cancer in spite of the fact that smoking is adjudged to be one of the major causes of the disease.
However, Dr Abdulrasaq Oyesegun, an oncologist at the National Hospital, Abuja, says that there are other causes of the disease apart from smoking. The consultant, nonetheless, concedes that despite the fact that there are other predisposing factors to lung cancer; tobacco smoking still remains the major predisposing factor. Corroborating Oyesegun’s viewpoint, an online medical journal, Non-Communicable Diseases Alliance states that 71 per cent of lung cancer deaths worldwide are caused by tobacco smoking. It, however, notes that among women, 20 per cent of those who are afflicted with lung cancer have never smoked, reiterating that tobacco use is the leading risk factor for lung disease, killing 1.5 million women each year.
Sharing similar sentiments, Dr Angela Morris, the Technical Grants Officer, Tobacco Control, International Union against Tuberculosis and Lung Disease (The Union) in UK, says that smoking is the biggest factor behind lung diseases, cancer inclusive. She argues that the number of women smokers in low and middle-income countries is increasing, adding the marketing strategies of the tobacco industry are aggressively targeting countries where women are, perhaps, less-informed.
“So, we need to protect women from picking up the habit of smoking and help them to quit if they are hooked. We should also strive to protect them from second-hand smoke,’’ she says. Morris says that these days, the problem now relates to women smokers and those who are passive smokers — those exposed to second-hand tobacco smoke.
“Twenty years ago people were not aware that even being in an environment of cigarette smoke was quite harmful. “But now, we know that someone can contract lung cancer via inhalation of second-hand tobacco smoke. “This is also growing in low and middle-income countries as a direct result of breathing in other people’s smoke,’’ she observes. The arguments citing tobacco as the main cause of lung cancer disease notwithstanding, experts are of the view that other factors could predispose women to lung cancer.
For instance, Oyesegun insists that another predisposing factor to lung cancer in women is the environment in which they live. “People tend to inhale fumes which contain carbon monoxide, especially in the urban areas where everywhere is clustered together unlike the rural areas where there is enough space. “Also, studies have shown that people’s exposure to asbestos and tobacco smoke could increase their chances of contracting lung cancer. That is why people are refraining from using asbestos these days for their roofing,’’ he says.
Oyesegun, however, notes that lung cancer could also be hereditary, saying: “Many people inherit genes that may cause lung cancer, especially if it is in the family line. “So when such a person has these genes inherent in them and they are exposed to other predisposing factors such as tobacco, they can have lung cancer.’’
Moreover, Dr Chen-Yuan Chiang, the Director, Department of Lung Health, International Union against Tuberculosis and Lung Disease (The Union) in Taiwan, says passive exposure to tobacco smoke and indoor air pollution could also cause lung cancer in women. He says that an estimated two million deaths are caused by indoor air pollution, adding that majority of the victims are women since they do the cooking and other domestic chores.
He stresses that that the overall five-year chance of survival for patients diagnosed with lung cancer calls for pragmatic efforts aimed at its prevention. Nevertheless, Chiang insists that the most important strategy in lung cancer prevention efforts involves tobacco control, while the reduction of indoor air pollution might also be helpful. Still on air pollution, Dr Kingsley Osagie, a physician with the National Hospital, Abuja, says that about 79,000 preventable deaths occur in Nigeria every year due to prolonged exposure to firewood smoke.
“More than 70 per cent of Nigerians still live in the rural areas and more than 90 per cent of this group of citizens still depends on firewood as a source of fuel for cooking meals and heating their homes. “So, prolonged exposure to firewood smoke is more noticeable in the rural areas,’’ he says.
Osagie claims that firewood smoke has a lot of harmful substances, adding that experts have identified more than 30 harmful substances in such smoke. He says that prolonged exposure to smoke could affect the people’s respiratory organs, provoking diseases such as chronic obstructive airway diseases, asthma and lung cancer. He insists that if firewood or kerosene stoves must be used, they should be used in the open air and not indoors. All the same, Osagie says that alternative means of cooking such as gas should be made more available and affordable.
He also supports Chiang’s sentiments, saying that preventive measures should be initiated and aggressively implemented, especially in the area of tobacco control. In line with such recommendations, the National Assembly passed the National Tobacco Control Bill in 2011, empowering the government to regulate the sale and marketing of tobacco, according to World Health Organisation’s directive.
Supporting the bill’s passage, Dr Muhammad Pate, the Minister of State for Health, then said: “Tobacco control will save the lives of the youth and adults of this country in the years to come. “If we are able to get a tobacco control law that is effective in regulating the sale, marketing and access to tobacco, thousands of lives would be saved.’’ All in all, experts say that the public will be protected against lung cancer and other lung diseases if pragmatic efforts are made to reduce the people’s exposure to tobacco smoke and indoor air pollution.
Okeoghene Oghenekaro, Nigeria
Citizen News Service - CNS
(This article was first published by News Agency of Nigeria (NAN) and Nigerian Pilot, a daily newspaper in Nigeria)