Nicotine is dangerous, no matter how you ingest it

Manjula Ramakrishnan

“Smoking is responsible for 12.84 per cent of total national and expat male mortality within the UAE, killing 52 men each week – so it’s easy to see why there is a need for continued public health strategies and education campaigns to discourage people in the UAE from using tobacco in various forms as tobacco consumption has increased drastically in recent years,’’ says Dr Monthir Alfetlawi, consultant interventional cardiologist at Sheikh Khalifa Medical City, Ajman, while speaking to Panorama.

Quitting smoking improves health regardless of age or how long the person has been smoking for, as tobacco use can harm nearly every organ in the body, causing many diseases and cancers. Most pronounced are its effects on the cardiovascular and respiratory systems. Cigarette smoking causes acute cardiovascular events such as sudden death by adversely affecting the balance of myocardial demand for oxygen, nutrients and coronary blood flow, causing heart attacks and stroke. Smoking also affects the respiratory system by contributing to emphysema, bronchitis, asthma and lung cancer. Tobacco use is also frequently linked with tooth decay, diabetes, eye damage and pregnancy complications. Despite the devastating harms of tobacco, knowledge among the local population that tobacco is one of the major causes of cardiovascular death (CVD) is low.

Can smoking provide comfort/relaxation?

This is a common misconception, and so many patients turn to cigarette smoking at times of stress as a form of self-medication. Cigarettes contain nicotine which causes the release of dopamine in the brain. However, cigarette smoking also causes an increase in heart rate and blood pressure and overall makes the heart and cardiovascular system work harder. 

Is vaping an effective method to quit smoking?

Some advocates of vaping would say it is a way to help kick the habit as it is a replacement source of nicotine, and recent studies have found this to be successful. However, there is a great deal of misinformation surrounding vaping. Using e-cigarettes is definitely not harmless – and many users are unaware of the nicotine content. Moreover, research has shown the chemicals in the vaping fluid can be damaging to health, and can have significant cardiovascular effects, leading to heart attacks and coronary artery disease. Moreover due to the nicotine, the use of e-cigarettes can be addictive.

Dr Monthir Alfetlawi, consultant interventional cardiologist at Sheikh Khalifa Medical City, Ajman

What lifestyle changes can be implemented to quit the habit?

There are several different methods used by patients to quit smoking, including behavioural, pharmacological, psychological, and alternative approaches. Due to the high level of nicotine dependence many patients build up, nicotine replacement therapy (NRT) can reduce cravings and withdrawal symptoms as they provide a controlled dose of nicotine without exposing the patient to the other harmful chemicals found in cigarettes. NRTs can be in the form of patches, chewing gum or lozenges. There are also prescription medications available to minimise cravings and withdrawal symptoms. Some patients benefit from behavioural therapy which assesses different triggers and can help patients avoid cravings.

Does exercise help stub the habit?

Exercise is a good way to distract patients in the process of giving up smoking as it can keep them busy until the craving passes. Some studies have also found that even moderate exercise markedly reduces nicotine withdrawal symptoms. Exercise also promotes weight loss, improves mood from release of endorphins and can help patients cope with stress.

Are there support groups to help quit the habit?

Many clinics and hospitals hold smoking cessation programmes that aim to support patients quit the habit through a combination of a clinical action plan, healthcare professional support and modern techniques. However, we want to drive a communitywide effort in the UAE to urge healthcare professionals, policy makers, government and other stakeholders to drive more CVD focused prevention programs.

What are the government initiatives in the UAE to prevent smoking?

The UAE government has in place many strict laws on the sale and consumption of tobacco, such as banning smoking in some public areas, restricting advertisements and banning the sale to those under the age of 18. Importantly, reducing the consumption of cigarettes and other tobacco products is a key performance indicator of the UAE National Agenda 2021. This initiative aims to reduce tobacco consumption from 21.6 per cent to 15.7 per cent among men by the year 2021. By incorporating laws and regulations on the use of tobacco, we will aim to achieve the lowest possible level of tobacco prevalence and the highest level of protection from second-hand smoke.