World No Tobacco Day : Tobacco and Heart Disease
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World No Tobacco Day : Tobacco and Heart Disease

Tobacco use is falling, but not fast enough

World No Tobacco Day: How smoking impacts your financial health
A heavy smoker loses more than a crore, if he smokes for 30 years and pays higher premiums on life and health insurance plans, as insurers charge smokers a higher premium compared to non-smokers.

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Tobacco use has declined markedly since 2000, according to a new WHO report, but the reduction is insufficient to meet globally agreed targets aimed at protecting people from death and suffering from cardiovascular and other non-communicable diseases (NCDs). – World No Tobacco Day

For  World No Tobacco Day 2018, WHO has joined with the World Heart Federation to highlight  the link between tobacco and cardiovascular diseases (CVD) –  the world’s leading causes of death, responsible for 44% of all NCD deaths, or 17.9 million deaths annually.

Tobacco use and second-hand smoke exposure are major causes of cardiovascular diseases, including heart attacks and stroke, contributing to approximately 3 million deaths per year. But evidence reveals  a serious  lack of knowledge of the multiple health risks associated with tobacco.

“Most people know that using tobacco causes cancer and lung disease, but many people aren’t aware that tobacco also causes heart disease and stroke – the world’s leading killers,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This World No Tobacco Day, WHO is drawing attention to the fact that tobacco doesn’t just cause cancer, it quite literally breaks hearts.”

 While many people are aware tobacco use increases the risk of cancer, there are alarming gaps in knowledge of the cardiovascular risks of tobacco use. In many countries, this low awareness is substantial; for example in China, over 60% of the population is unaware smoking can cause heart attacks, according to the Global Adult Tobacco Survey. In India and Indonesia, more than half of adults do not know smoking can cause stroke.

“Governments have the power in their hands to protect their citizens from suffering needlessly from heart disease,” says Dr Douglas Bettcher, WHO Director for the Prevention of NCDs. “Measures that reduce the risks to heart health posed by tobacco include making all indoor public and workplaces completely smoke-free and promoting use of tobacco package warnings that demonstrate the health risks of tobacco.”

World off track to meet tobacco reduction target

Tobacco kills over 7 million people each year, despite the steady reduction in tobacco use globally, as shown in WHO’s new  Global Report on Trends in Prevalence of Tobacco Smoking 2000-2025. The report shows that worldwide, 27% smoked tobacco in 2000, compared to 20% in 2016.

However, the pace of action in reducing tobacco demand and related death and disease is lagging behind  global and national commitments to reduce  tobacco use by 30%  by 2025 among people aged 15 and older. If the trend continues on the current trajectory, the world will only achieve a 22% reduction by 2025.

Other main findings from the new report include:

  • Change in smoking: There are 1.1 billion adult smokers in the world today, and at least 367 million smokeless tobacco users. The number of smokers in the world has barely changed this century: it was also 1.1 billion in 2000.  This is due to population growth, even as prevalence rates decline.
  • By sex: For males aged 15 and over, 43% smoked tobacco in 2000 compared to 34% in 2015. For females, 11% smoked in 2000, compared to 6% in 2015.
  • Smokeless tobacco: around 6.5% of the global population aged 15 and over use smokeless tobacco (8.4% of males and 4.6% of females).
  • Country response: Over half of all WHO Member States have reduced demand for tobacco, and almost one in eight are likely to meet the 30% reduction target by 2025. But countries must do more to monitor tobacco use in all its forms – not only tobacco smoking. Currently, one in four countries have insufficient data to monitor their tobacco epidemic.
  • Youth: Worldwide, about 7%, or just over 24 million children aged 13–15, smoke cigarettes (17 million boys and 7 million girls). About 4% of children aged 13–15 years (13 million) use smokeless tobacco products.
  • Developing countries: Over 80% of tobacco smokers live in low- and middle-income countries (LMICS). Prevalence of smoking is decreasing more slowly in LMICs than in high-income countries, and the number of smokers is on the increase in low-income countries.

Dr Svetlana Axelrod, WHO’s Assistant Director-General for NCDs and mental health, says: “We know what policies and actions can increase tobacco quit rates, prevent people from starting using tobacco, and reduce demand. We must overcome obstacles to implementing measures like taxation, marketing bans and implementing plain packaging. Our best chance of success is through global unity and strong multisectoral action against the tobacco industry.”

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Smoking destroys your health and happiness and also burns a big hole in your pocket. The price of a single cigarette can cost around Rs 15-17, with a packet of 10 cigarettes costing around Rs 150-180. A person smoking five cigarettes a day spends Rs 75 daily, or Rs 2,250 a month. A cool Rs 27,000 a year is just by smoking five cigarettes a day.

A heavy smoker will have to pay higher premiums on life and health plans as insurers charge smokers a higher premium compared to non-smokers. Just look around and see the warning signs: Cigarette smoking is injurious to your health.

The mildest form of smoking could result in bronchial problems, while heavy smoking could lead to severe asthmatic attacks, chronic obstructive pulmonary disease (COPD), diabetes, heart diseases and even lung cancer. Hospitalisation and high medical bills can empty your pockets. Make a resolution never to smoke again and say no to the silent killer on No-Tobacco Day.

1. Let’s compare a financially healthy non-smoker versus a financially unhealthy smoker

The biggest problem a smoker faces is the price of cigarettes. If a single cigarette cost Rs 15 and you smoke a packet of 10 cigarettes a day, you would incur Rs 150 a day, Rs 4,500 a month, or Rs 54,000 a year. Just think, a non-smoker saves all this money.

Cigarette prices are not constant and generally rise by an average 15-20 percent each year. If you smoke just 5 cigarettes a day, and each cigarette costs Rs 15, you would have spent Rs 2,250 a month, or Rs 27,000 a year. Assuming a conservative estimate of a 10 percent rise in cigarette prices, one would spent more than Rs 44 lakh over 30 years.

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A non-smoker saves all this money, simply because he doesn’t smoke. If the money that a heavy smoker spends on cigarettes was invested each month in a financial instrument that offered 9 percent returns a year, the money would grow to more than a crore in 30 years. A non-smoker becomes a crorepati in this time, just because he doesn’t smoke.

It doesn’t take a genius to figure out that if you smoke, you could suffer from a number of diseases, the mildest being bronchial problems. Even if a smoker avails life and health insurance plans, he has to pay a high premium compared to a non-smoker.

The bottom line: A heavy smoker loses more than a crore if he smokes for 30 years. So, why not quit smoking this No Tobacco Day?

2. The different ways smoking can impact a person’s financial health

On an average a smoker spends Rs 500 more on health treatment each month compared to a non-smoker. Costs of hospitalisation and medical treatment are rising and a smoker spends a lot of time in hospitals.

Medical inflation is close to 20 percent. Even if you assume a 15 percent rise in medical costs each year, a smoker will spend around Rs 26 lakh over a 30-year period.

Smoking and health insurance are arch-enemies. If you smoke, insurers will charge a higher premium. Can you lie and escape?

If the insurer finds that you are suffering from a smoking-related disease and you have not disclosed that you are a smoker in the insurance proposal form, the claim will not be settled.

What about life insurance? A smoker is charged 10-15 percent higher premiums on a term life insurance plan, compared to a non-smoker. If you are a smoker, it would seem a good idea not to mention this in the insurance proposal form, just to escape the higher premium.

Sadly, if a smoker meets an untimely end and the insurer finds out about the smoking habit, the claim will not be settled. His family will be in deep distress as there is no money to meet daily expenses.

3. Recommendations towards a healthier financial future

Statistics reveal that tobacco use causes 1 death every 6 seconds. Any better reason to give up smoking this No Tobacco Day?

If you cannot quit at least try to reduce smoking by joining a smoking cessation program. The effects on financial health are clear.

• Some insurers offer smoking cessation programmes that could lower the cost of health insurance premiums. If you stay without smoking for at least 2 years, you could see health insurance premiums fall.

• Make sure you avail health and term life insurance even if you are a smoker. Mention that you are a smoker in the insurance proposal form. Even if you are charged a higher premium, at least the claims will be settled, keeping your family far from financial worries.

• Cigarette smoking causes cancer, heart diseases and even a stroke which can empty your pocket. Stay far from cigarettes.

• Smoking can cost you a job. A smoker loses a lot of money in absenteeism and sick leaves. Quit smoking before it is too late.

• Women smokers are steadily increasing in India, affecting their reproductive health and earning capacity. If a woman quits smoking, chances of conceiving a baby improve. Chances of coronary heart disease and lung cancer are low, saving lakhs of rupees. Be wise, get rich.

World No Tobacco Day: India among top 4 users of tobacco

Tobacco is one of the most common and preferred forms of addiction. Even though scientific evidences have revealed its harmful health effects, the use of tobacco in different forms has seen a dramatic increase, especially in the developing countries.
This year’s theme for World No Tobacco Day is the impact of tobacco on cardiovascular health.

This potentially lethal substance is responsible for more than 1 in 10 fatalities globally, with India featuring among the top four users of tobacco. About 11.2 percent smokers worldwide are Indian.

Despite decades of research and strong initiatives for controlling diabetes carried out globally, the number of tobacco users in the world has not seen a declining trend.

Besides cancer, the use of tobacco in any form is also a leading cause of Type-2 diabetes, the most common type of the disease as seen in adults. Research shows that smokers are 30 percent to 40 percent more likely to develop diabetes as compared to non-smokers. This risk doubled with the number of packs of cigarettes smoked per day.

“Naturally occurring tobacco does not have much sugar, the processed forms have added sugars in high amounts. Hence, tobacco raises blood sugar levels and makes it more difficult to manage diabetes. This was not the only problem. While nicotine may seem harmless, it plays havoc on your body by changing the natural cell processes, thus affecting insulin response leading to a condition called insulin resistance. People with insulin resistance need larger and more frequent doses of insulin to control the blood sugar levels in their body,” said Sujata Sharma, Diabetes Educator, BeatO.
“Thus, smokers with diabetes are at a higher risk of developing serious complications such as heart disease, neuropathy or nerve damage in extremities and poor blood circulation to limbs and genitalia leading to gangrene, infections and possible disability and infertility. Retinopathy leading to blindness is another common complication associated with diabetic tobacco users,” added Sharma.

A Global Adult Tobacco Survey (GATS-2) report shows that India is the second largest consumer of tobacco products with 28.6 percent of the population addicted to it in any form. Of this, 10.7 percent smoke, and 21.4 percent use SLT. Of the 346?million global SLT consumers, India alone has 152.4?million consumers with a substantial increase across all age groups.

“Many smokers tend to use Smokeless Tobacco when quitting cigarette addiction. Vaping, as the use of e-cigarettes is called, is also considered as an alternative and at only 10 percent of nicotine compared to a cigarette, it may seem relatively less harmful. But this is not so. Smokeless tobacco poses just as many health risks,” said Dr Ramananda Srikantiah Nadig, Head of the Clinical Advisory Board, healthi.

Snuff and chewing tobacco also contain nicotine, which is responsible for tobacco addiction. Though it is absorbed at a slower pace than that from cigarettes, the absorbed amount is three to four times and remains in the bloodstream longer.

“Due to the presence of nicotine and other chemicals, prolonged use of SLT causes serious health issues such as cancer and heart disease. It also increases the risk of oral and oropharyngeal cancer. Sometimes, there may be white patches on the gums, tongue, or lining of the mouth called leukoplakia. Though this is noncancerous, it could evolve into a fully blown cancer of the mouth. Lung, stomach, bladder, pancreatic and esophageal cancer are some of the other cancers associated with smokeless tobacco addiction,” added Dr Nadig.

Another form of tobacco, called smokeless tobacco and sheesha, release high levels of carbon monoxide. By reducing the amount of oxygen circulating in the blood, these raise a person’s heart rate and blood pressure putting undue stress on the cardiovascular system.

“Apart from this, frequent tobacco users also stand the risk of cardiac arrests, elevated blood pressure levels, strokes, hemorrhages, blood clots, and other heart-related ailments. It is imperative for people who are at risk or those with a history of cardiac ailments to discontinue using snuff or other smokeless tobacco products after an attack, failing which it can become life threatening,” said Dr Rajiv Agarwal, Cardiologist, Lybrate.

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