 Impact of smoking on the heart -
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According to the American Heart Association, cigarette smoking is the leading preventable cause of early death. Although this statement may be more true in developed nations, data from WHO indicates that even in developing nations like India, smoking is a major cause of death.
Smoking can cause build-up of fatty deposits in the blood vessels of the heart and also the blood vessels of the legs. This can lead to heart attacks and pain in the legs that reduces the walking distance. Although smoking also increases the risk for cancers and damage the lung in the form of emphysema, among other things, we will keep the focus in this article on the impact of smoking on the heart.
While smoking, generally, is in the form of cigarettes in the developed world, in India, cigarettes are commoner in the urban areas, while bidis are the predominant form of smoking in the rural areas. Also, one cannot forget the chewable tobacco products such as pan, guthkas and dried tobacco leaf.
Smoking tobacco increases a person’s blood pressure and heart rate. The level of carbon monoxide in the blood increases. This carbon monoxide combines with the haemoglobin in the blood and prevents the normal binding of oxygen and haemoglobin. This in turn reduces the oxygen carrying capacity of the blood.
Smoking also increases the stickiness of a type of blood cells called platelets. The platelets are cells that are the major initiators of clot formation which is a critical step in the evolution of heart attack. The combination of all these effects increases the susceptibility of the smoker to heart attacks. It is well established that the risk of heart attack in a smoker is two to three times greater than that of a non-smoker.
One should be careful about the promotion of ‘light cigarettes’ or ‘low tar cigarettes’. The risk from smoking these alternative forms of cigarettes is almost as high as regular cigarettes, if not more.
What would surprise many of us is that research shows second hand smoke (smoking by somebody else in your vicinity and your inhaling of the smoke) also significantly raises the health risks and heart attack risks.
While cigars and pipe smoking are slightly less harmful than cigarette smoking, they still increase the risk for heart attacks.
Effects of quitting smoking:
Within 20 minutes after stopping smoking:
Blood pressure drops to normal
Pulse rate drops to normal
Within 8 hours:
Carbon monoxide level in blood drops to normal
Oxygen in blood increases to normal
Within 24 hours:
Short-term risk of heart attack decreases.
Within 2 weeks to 3 months:
Circulation improves
Walking becomes easier
Within one year of quitting smoking:
Excess risk of heart attack drops to about half that of an ongoing smoker.
In about 15 years:
Risk of heart attack is the same as in a non-smoker in the absence of other risk factors for heart attack.
According to the WHO, about 30 – 50 per cent of males over the age of 15 years, smoke in India. Thankfully, the smoking habit exists in less than 4 per cent of the female population. The worrisome facts are based on the WHO-backed GTYS Survey (Global Youth Tobacco Survey) conducted a few years ago. In this survey, 4,820 children in the age group of 13 – 15 years studying in class-8 to 10 were surveyed in Tamil Nadu. About 8 per cent of the male students and 5 per cent of the female students admitted to being smokers.
In a populous country like ours, these percentages can translate into large numbers and can quickly turn into monstrous health issues. Luckily, the Indian government is making a concerted effort to make it difficult for the cigarette manufacturers to target children and youth with advertisements. The national tobacco bill also makes it illegal to sell cigarettes to persons younger than 18 years of age. Although we need more effective measures, this is a good start. We could draw from the serious health and social consequences of smoking that have manifested in the developed countries and nip the problem early in India.
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Dr G Balachander
Cardiologist
Illinois, USA
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