Tobacco kills: Can our health systems afford the burden of preventable heart disease?

Akanksha Sethi
A visit to any government health centre will make one realize how heavily (over)burdened are our health systems and how critically important it is to strengthen them. Is it not an irony that a significant burden on our public health system is of preventable diseases? On World No Tobacco Day 2016, let's hope we become conscious of the choices we make in our daily lives so that these choices may not increase the risk of preventable diseases. Tobacco use is a common and major risk factor for a range of life-threatening illnesses including cardiovascular diseases (CVDs) and diabetes.

Two-thirds of deaths are caused by non-communicable diseases (NCDs) prominent among which are cardiovascular diseases (heart disease and stroke), cancers, diabetes, respiratory illnesses among others. Scientific evidence shows the deadly synergy between tobacco use and tuberculosis (TB), diabetes and HIV!

While speaking to Professor (Dr) Rama Kant who is a WHO Director-General's Awardee and former Head of Surgery Department of King George's Medical University (KGMU), I came to know that stress and anxiety are also associated with diabetes and other NCDs.
Professor (Dr) Rishi Sethi from Department of Cardiology of KGMU agrees with Prof Kant. Prof Sethi said that mortality rate which is a result of consistent cardiovascular problems globally, has certainly risen over the last one decade by roughly 25% especially in the third-world countries.

Prof Rama Kant remarks that tobacco is not just a major cause of death but also preventable death! Why is the sense of urgency missing in ending game of tobacco? "Among the most harmful is what we call 'chhota pack' (small packet) which can be easily afforded by all, especially by those who come from lower socioeconomic sections of our society. Up to 90% of lung cancer deaths are attributed to tobacco use. We can avert every tobacco related disease and premature death if people who use tobacco, quit!

According to Prof Rishi Sethi who is also the national convener of the Cardiological Society in India's STEMI, the burden of cardiovascular diseases has been increasing tremendously over the years. “The four major risk factors would certainly be diabetes, hypertension, high cholesterol and smoking apart from many other minor ones as well. As compared to the other third world countries, India has not been able to put much effort, focus and education in the society to make people aware of these factors and what we see right now is a tsunami of cardio vascular diseases in people who are as young as 22 years old. Since population is increasing along with competition and the greed for survival, health has taken a back seat and the only ways we as a country can reduce the chances of cardio vascular diseases are firstly, keeping health as a priority and secondly, control your blood sugar, obesity and smoking. By doing this, we can control the cardio vascular diseases to a substantial rate.”

Therefore, the government has surely been taking a few efforts by establishing non-communicable disease centres in all the district hospitals. As far as the rural areas are concerned, a person should be on duty round the clock to check the possibility of heart attacks so that there is no delay in transferring the patient to the hospital. Prof Sethi also determines to establish Uttar Pradesh as a role state of a programme called ‘Hub and Spoke Model’. He, along with his entire team, plans to establish 2-3 hospitals in Lucknow that would work as a hub and be connected to other local and district hospitals. This would make it easier to transfer patients within a period of 90 minutes from the local hospital to more reputed hospitals having advanced treatment facilities in Lucknow like KGMU, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS) and Dr Ram Manohar Lohia Institute of Medical Sciences (RMLIMS).

Akanksha Sethi
31 May 2016 
(Akanksha Sethi is pursuing BA (Hon.) from Christ University, Bangalore. She wrote this article during her internship with Asha Trust)