BY NURFARAHIN OKI and EDWINNIE EINSTEIN UNJI
KUCHING: Usage of tobacco has picked up since World War II and since then cigarettes containing tobacco have been around in one form or another.
Public Health Physician Associate Professor Dr. Helmy bin Hazmi said tobacco is the only legal consumer product that kills up to half of its users when used exactly as intended by the manufacturer and smoking is responsible for one third of cancer deaths globally.
Dr Helmy who is currently working at Universiti Malaysia Sarawak (Unimas) shared his insights with New Sarawak Tribune on the impacts of tobacco to human health and the environment as well as alternatives for smokers to stop tobacco usage.
New Sarawak Tribune: Why has smoking always been associated with lung cancer?
Helmy: Scientific studies have consistently shown a strong link between smoking and cancer across different research efforts.
From a biological and molecular understanding, tobacco, as a carcinogen, initiates cancer by damaging DNA, and alters proto-oncogenes and tumour suppressor genes, leading to the uncontrolled growth of normal cells into cancer cells.
The clear sequence of event shows that more exposure to tobacco will lead to higher risk of cancer cell growth.
How precisely does tobacco smoking impact different parts of the body, aside from the well-known problems like lung cancer?
The list is endless but let’s go by the system where almost every part of the body can be impacted by tobacco.
Nicotine can stain the mouth and fingers and the breath of tobacco users can smell bad.
Tobacco causes narrowing and hardening of the blood vessels to the heart and brain, leading to heart attacks and strokes and are already the leading causes of death in Malaysia as we speak.
Smoking could also damage the lungs, causing Chronic Obstructive Lung Disease (COPD), which is incurable, and the sufferers depend on bronchodilators to help them breathe.
The immune system will be suppressed and makes our body more vulnerable to harmful bacteria and viruses which then delays wound healing.
Patients with reflux diseases or GERD, and stomach ulcers would know that they need to avoid smoking to improve their symptoms.
To have strong bones at old age, you need to stop smoking now to at least delay osteoporosis.
For those planning to have children, smoking increases the risk of erectile dysfunction, can reduce sperm count, damages the genetic properties of the sperm, and negatively affects hormone production.
Expectant mothers who smoke or who inhale second-hand smoke are putting their unborn children at risk of stillbirth and premature birth, leading to low birth weight that leads to many complications for the baby.
Babies born may be at risk of cleft palates and sudden infant death syndromes, and smoke from tobacco products could also cause or aggravate children’s asthma.
What are the environmental consequences of tobacco waste?
Cigarette butts are not biodegradable and only 38 per cent of it decomposes after two years or so.
Second, they contain high amounts of tar and heavy metals that are known to be carcinogens or cancer-causing and it can seep into the ground and contaminate our water, enter our food chain, and finally reach us humans in very high concentrations because we are sitting on top of the food chain. This is called biomagnification.
How do tobacco cultivation and production affect local ecosystems and biodiversity in tobacco-growing regions?
Tobacco farming is often done on a massive scale and its plantation is not rotated with other crops, making it vulnerable to pests.
Hence, more chemicals, especially highly toxic ones, are needed to control pests and prevent diseases in tobacco plants.
Deforestation is also another issue with tobacco plantation as in tobacco growing countries, tobacco plantation accounts for five per cent of the national deforestation.
In Malaysia, tobacco farming is insignificant, and we have the lowest hectarage of tobacco plantation in Southeast Asia.
What do you envision for the future of tobacco control efforts?
We may have missed the opportunity to implement the Generational End Game (GEG) after it was decoupled from the Smoking Products for Public Health Bill.
I believe that the GEG was a game changer for the smoking problem in Malaysia in many ways.
Moving on, we need to think of ways to enhance the MPOWER package underlined in the WHO’s FCTC framework, to which Malaysia is a party.
MPOWER stands for Monitoring tobacco use, Protecting people from tobacco, Offering smoking cessation, Warning dangers of tobacco especially to the new generation, Enforcing rulings against tobacco advertising and sponsorship, and Raising taxes on tobacco.
In addition, I hope that we will ultimately reach the point where we have the political will to put health first at the forefront.
That will be the first step in many initiatives to halt the smoking menace in the community.
How does smokeless tobacco (such as chewing tobacco) affect health?
Smokeless tobacco is not too different from the conventional cigarette, and they still contain harmful heavy metals and nicotine that cause cancer and addiction, respectively.
Smokeless tobacco exposes the user to at least 25 known carcinogens, especially the tobacco-specific nitrosamines (TSNAs) which are commonly linked to the mouth, the oesophagus and pancreatic cancer.
Just like cigarette smoking, the risk for stroke and heart disease in pregnant mothers is the same.
In your opinion, what are the safer alternative versions of tobacco products?
None. Saying that an alternative version is safer is just humbug to justify the use of tobacco.
This should not be confused with Nicotine Replacement Therapy (NRT), which is intended to gradually reduce nicotine dependence and is used temporarily.
What are the ways that someone can help themselves to stop smoking?
First of all, the smoker needs to acknowledge that they have a smoking problem.
That is why continuous health promotion is important to provide them with awareness. There are many entry points to seek help.
Go to your local pharmacy or also check in at the local MoH’s health clinic for advice.
Other options include calling the quitline for smoking cessation at 03-88834400 or registering at https://jomquit.com/ to get help.
Doing it with the help of professionals is the best, and coupled with sheer determination, it could ensure a higher chance of success.
Stopping smoking cold turkey has been shown to be associated with a higher risk of failure.
