Health Ministry intensifies efforts to curb smoking
By Melanie Allicock
Kaieteur News
February 23, 2007

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The local Health Ministry has been intensifying its efforts to curb the incidence of smoking in Guyana .

This is against the realisation that in addition to the numerous health risks associated with this habit, it is also a main contributory factor to many socially unacceptable behaviours in society.

Just recently, senior functionary of the Amerindian People's Association, Jean La Rose, attributed its increased use in Amerindian communities as one reason for the increase in domestic feuds and by extension, a recent spate of suicides.

The use of alcohol has also long been established as a contributing factor to risky sexual behaviour.

Against this backdrop the Health Ministry may very well find that it has its work cut out, for while smoking is the biggest preventable cause of death, a considerable percentage of the Guyanese populace indulges in the habit.

And according to a census conducted by the Health Ministry and PAHO, this dangerous tendency is being practiced from a young age. The survey indicates that 32% of students between Forms 2-4 smoke cigarettes.

Worldwide, the rationale behind a person lighting their first cigarette varies from person to person.

A local mother of five recently related that as a single parent of school-aged children, smoking helps her maintain her sanity.

“In my case I would say smoking is stress related. If I don't smoke I would run mad. Having to care for these children by myself, two of whom are babies is not easy and rather than pull my hair out I would light a cigarette and calm my nerves. It's the only thing that keeps me rational.”

She said it was relentless stress in her life that caused her to smoke her first cigarette at the age of 17.

“I got pregnant at 17 and it was not a good situation. The father of the baby was not around and there was a lot of stress. I had a friend who smoked and one day I asked her for a cigarette and that was the beginning. At the time I was 2 months pregnant. That was 20 years ago. My daughter was born in perfect health though,” she added.

Another smoker related, “This country would make anybody smoke or drink… or both. It's a way to ease the mind in hard times and the times in this country hard.”

Two school-aged boys related that their sole reason for starting to smoke a year ago was because most of the boys in their class were doing it.

One of them observed “I don't think that anyone likes the taste of cigarettes the first time they try it. It tasted really awful to me, but I forced myself to continue and after a while I grew accustomed to it.” Questioned about his knowledge of tobacco-related diseases, the youngster replied, “Yes I hear that you can get lung cancer and so on from smoking, but that is after you smoke for a long, long time, and I might stop before then. Besides, with things like AIDS around, we young people may not live long enough to die of lung cancer from smoking. Also cigarettes are not that bad, it's not like marijuana or cocaine. Those would kill you faster, and like I said when I'm ready to stop smoking I will.”

My interest aroused; I questioned him on whether he knew that the nicotine in cigarettes is addictive and quitting the habit may be easier said than done. This youngster however felt differently:

“It's a mind thing; people can stop doing whatever they want to do, whenever they want to. Those people, who claim they have been trying to quit and can't, don't really want to.”

However many long-time smokers would no doubt dispel this suggestion as one based on youthful ignorance.

Many of them know only too well the difficulties involved in trying to kick the dangerous habit.

John, who has been smoking for the last 40 years, has relentlessly tried almost every possible method to quit smoking over the last six years. This determination was spawned by his physician's warning that if he did not stop, he would die since his health was failing. “I tried everything from the nicotine patches to the gums to using willpower, but the longest I managed to stay without a smoke was two weeks.”

Then there are those who have reported periodic successes but somehow cannot manage to kick the habit permanently.

One man related that through sheer determination, he hadn't touched a cigarette in 12 months. He decided to celebrate his milestone with a party at his home. The mistake he made was to invite smokers. He was coerced into taking a smoke to celebrate the victory and believing himself to be above the habit, he took a pull on a cigarette. It was back to square one.

But there are also quite a few Guyanese who have managed to overcome the inclination for tobacco.

Sharon is one such person. After years of trying a number of interventions during her ten years as a smoker, she recorded success by using the nicotine patch last year.

She however believes that while various clinical interventions may assist, the key to victory in this regard is in having the will to quit. This may very well be true since many smokers have reported using the very nicotine patches with little success.

Another deterrent to reducing the incidence of smoking locally may be the high cost attached to these efforts.

A complete course of nicotine patches or gums costs in the vicinity of $US50-60, with no guarantee of success.

However, Health Minister Dr. Leslie Ramsammy said tools to reduce smoking will be included in his strategy for addressing the problem.

He also disclosed plans of increasing education and awareness of tobacco use and the related diseases.

There are plans on stream also for the enforcement of smoke-free zones around the country since second-hand smoke is just as hazardous to non-smokers as the smoke inhaled from a cigarette by the smokers themselves.

Many persons related that this intervention could not come quick enough for them since on a regular basis; they are bombarded with cigarette smoke from insensitive smokers on public transportation and in public places.

Employees of a city private firm related the horrors endured by them on a daily basis in trying to get a colleague not to smoke in their air conditioned office. They reported that their requests are almost always met with verbal abuse from the worker.

I tracked this worker down in a quest to find out the reason for his seemingly insensitive behaviour towards his colleagues.

According to him, smoking is a constitutional right of his and he could do so anywhere he chooses.

When I pointed out to him that his co-workers also have a constitutional right to not have their bodies inundated with smoke, he replied that, “yeah but we both have equal rights and their right is not greater then mine.”

Minister Ramsammy acknowledged that such concerns would take time to address at a local level, for in meeting the criteria for the Framework Convention Tobacco Control (FCTC), it would involve human rights issues. He however called on persons to be receptive to each other's needs.

The results of the 2004 PAHO/Health Ministry survey also indicate that smoking seems to be a habit accepted by many parents since 44% of school-aged children report smoking at home.

It was reported that 35% of them visit the shops to purchase the items, but according to Minister Ramsammy, he will be making moves to ensure that the constitution is amended to prevent shop owners from selling cigarettes to minors.

At the World Health Assembly held in Geneva in 2004, countries committed to working together to solving much of the issues associated with the implementation of the FCTC.

One suggestion for the effective breakthrough in the anti-smoking campaign is to increase the taxation on cigarettes. However it was noted that this would lead to an increase in smuggling of the item.

To alleviate this, Guyana will be looking at placing markers on cigarettes, similar to those placed on fuel - to determine the method of entry into the country.

Noting that the tobacco industry contributes significantly to the economy of countries, the minister acknowledged that the task ahead will no doubt be a difficult one.

Tobacco claims 4.9 million lives a year worldwide, and if the present consumption patterns continue, the number of deaths will increase to 10 million by the year 2020, 70% of which will occur in developing countries, according to a WHO survey.

There are an estimated 1.3 billion smokers worldwide and half of them (some 650 million) are expected to die prematurely of a tobacco-related disease.

At the current rate, the number of smokers will rise from today's 1.3 billion to 1.7 billion by 2025.

Chemicals in tobacco smoke including nicotine and tar are deposited in the bronchi and the lungs. The other harmful chemicals are acetone, ammonia, carbon monoxide, carbon dioxide, hydrogen cyanide, methane and benzopyrene which are also considered major contributory factors for smoking-related diseases.

Long-term smoking has been linked to various health problems and has been found to aggravate existing health conditions.

Long-term effects of cigarette smoking, according to health authorities, include nicotine addiction and coronary artery diseases - smoking has been found to be responsible for more than 20 percent of deaths.

Heart disease is also a major health risk of smoking and can actually prompt persons in their 30s and 40s to have a heart attack. The risk of smokers getting a heart attack is five times higher than non-smokers.

It also results in hardening of arteries and complication of blocked arteries, hypertension and blood clots as well as stroke - a pack of cigarette a day increases the risk of stroke 2 ˝ times.

Smoking also causes peptic ulcers, a variety of lung diseases and chronic obstructive pulmonary diseases (COPD) such as chronic bronchitis and emphysema. In the 1990s, smoking accounted for 85,000 of COPD-related deaths.

Smokers are prone to oral cancer as well as cancer of the respiratory tract, oral cavity, nose pharynx, larynx, lung, cervix, urinary bladder, kidneys and pancreas. Eighty percent of all cases of lung cancer are smoke-related.

Diseases of the oral cavity such as irritation and infection of the teeth and gums, and delayed healing of wounds are also associated with smoking.

In women, long-term smoking has been found to cause reproductive disturbances (infertility) and problems during pregnancy like fetal abnormalities and even death and low birth weight in infants.

According to a survey, smoking will become the biggest killer in developing countries within the next 20 years, surpassing those deaths caused by AIDS.