Tobacco use: Sucking the youth from the youngsters

Dr Sophia Thomas, CNS Correspondent, India
I met Somu (name changed) during one of my dental outreach camps in the outskirts of Bengaluru city. He was a bright 14-year-old boy, who wanted to grow up to be a police officer. Upon examination, Somu was found to have stains on his teeth, suggestive of smoking tobacco.

During our conversation Sonu hesitantly admitted to smoking cigarettes along with his friends. What started as a peer-pressured experience soon turned into an addiction, giving him a ‘cool guy’ status. Somu knew very well that smoking is a health hazard, but that did not stop him from crushing the crave.

Tobacco and Youth

This is just one of the many similar stories of teenagers, who take to smoking, often due to peer pressures, and eventually fall prey to the addiction. WHO campaign - No Tobacco Day - provides an opportunity to throw some light on this problem. India is home to 126 million youth (13-17 years) who make up 9% of its total population. They are the future workforce of our country who are expected to help our country scale newer heights. But alas! Tobacco use and cigarette smoke (direct or second hand) is slowly sapping them of their health and wealth. The Global Youth Tobacco Survey (GYTS) 2009 reveals that 19% boys and 6.3% girls in the age group 13-15 years use tobacco. This is a serious cause of concern, given that tobacco use is responsible for 10 lakh deaths annually in India. As per WHO data, the GATS 2016-2017 survey reveals that 28.6% of Indians over 15 years of age (42.4% men and 14.2% women) consume tobacco in some form or the other, while 39% of them are exposed to second hand smoke at home. Most people start early, with the mean age of initiation of daily smoking being 18.7 years, which increases the risk of several diseases, including heart disease, in younger people.

This World No Tobacco Day (WNTD) 2019 rings the theme of ‘tobacco and lung health’ worldwide. Health experts speaking at a recent webinar organised by Citizen news Service (CNS), emphasized upon Endgame of tobacco for health justice.

During the webinar, Dr. Surya Kant, Head of Respiratory Medicine Department, King George's Medical University (KGMU) noted the strong addictive nature of tobacco along with its high mortality rate — all of which is preventable.

Effect of Smoking in Young People

In-line with the theme of this year’s WNTD, it is well-worth looking at the effects of tobacco on the lung health of its users. Some of the ways in which smoking impacts lung health among youth: It (i) increases the risk of lower lung functions as compared to non-smokers; (ii) reduces the rate of lung growth; (iii) ups the risk of lung cancer; (iv) hurts their physical fitness in both performance and endurance.

Moreover, teens who smoke are 3 times more likely than nonsmokers to use alcohol, 8 times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is associated with a host of other risky behaviours, such as fighting and engaging in unprotected sex.

Emerging trend of E-cigarettes

Tobacco companies are now alluring the youth with newer smoking or vaping products called Electronic Nicotine Delivery Systems (ENDS), like e-cigarettes and heat not burn IQOS (I quit ordinary smoking) products, and touting them as safer alternatives to smoking and even a gateway to quitting. However, majority of the e-cigarettes contain nicotine, which is highly addictive and can harm adolescent brain development, continuing into early adulthood. Apart from nicotine e-cigarettes can contain other harmful substances like ultrafine particles that can be inhaled deep into the lungs, flavorings such as diacetyl (causes popcorn lungs), volatile organic compounds, cancer-causing chemicals, heavy metals such as nickel, tin, and lead. There is some evidence suggesting that young people who use e-cigarettes may be more likely to smoke cigarettes in the future. These cigarettes come in a variety of designs and have fruity and sweet flavors — all of which appeal to the younger age-groups. As per a new study, common e-cigarette chemical flavourings may impair lung function and cause what are called popcorn lungs.

In a white paper released on this year’s World No Tobacco Day, the Indian Council of Medical Research (ICMR) has recommended complete ban on e-cigarettes and other electronic nicotine delivery systems, based on currently available scientific evidence. It said that e-cigarettes adversely affect the cardiovascular system, impair respiratory immune cell function and airways in a way similar to cigarette smoking and are responsible for severe respiratory disease. They are also harmful to non-users and have adverse health impacts even when people are exposed to second-hand vapours.

What influences tobacco consumption in the youth?  

The youth are vulnerable to several factors which might nudge them towards tobacco use. Some of the factors include: peer-pressure; seeing their parent(s) and/or family members use tobacco products; smoking to relieve depression, anxiety, and stress; lower economic/educational status; easy accessibility and affordability of tobacco products; surrogate advertising of tobacco products.

Tobacco use starts early - Nip it in the bud                                   

Preventing tobacco product use among youth is critical to ending the tobacco epidemic. An addictive habit, tobacco use has its beginnings early in life, with lasting impact in adulthood. Most of them start using tobacco before they are 18 years of age. This exposes them to multiple risk factors, all of which increase their vulnerability to a host of diseases. it is imperative for the stakeholders at different levels to be cognizant and act together. As the Big Tobacco tries to entrap the youth with their devious marketing tactics, there is an urgent need to protect their welfare not only in our country, but globally.

Dr Sophia Thomas, Citizen News Service - CNS
June 8, 2019