Smoking causes type II diabetes

Fifty years since the first U.S. Surgeon General’s Report in 1964 clearly stated that cigarette smoking was a health hazard, the 32 Surgeon General’s Report released recently has shown that we are yet to fully understand the real magnitude and extent of tobacco’s diverse adverse effects on the human body. The Report expands the list of diseases and adverse health effects of smoking.

If the 2004 report of the Surgeon General concluded that smoking affects nearly every organ of the body, the latest report provides much more evidence to support this conclusion made 10 years ago.

The most important finding for Indians is that smoking is a “cause” of type II diabetes, and the risk of developing diabetes is 30 to 40 per cent higher in smokers compared with nonsmokers. Also, the risk increases with the number of cigarettes smoked. It is already known that smoking “complicates the treatment” of diabetes.

Another revelation is that liver and colorectal cancers are caused by smoking. In effect, the list of cancers caused by smoking has become even longer. Smoking is found to cause rheumatoid arthritis too.

“Smoking is a cause of AMD” (age-related macular degeneration) it notes. The macula of the eye that enables sharp vision gets gradually destroyed leading to loss of central vision. While quitting smoking helps in reducing the risk of AMD, the benefits would not show up for 20 or more years after quitting.

The report clearly notes that the number of diseases causally linked to smoking is ever expanding.

Also, the evidence of increased risk to many diseases and adverse effects in those exposed to secondhand smoke is rising. For instance, the increased risk of suffering from stroke has been positively found to be linked to smoking.

Higher risk in women

The notion that women are less vulnerable than men when it comes to cardiovascular disease has been disproved. The risk of dying from coronary heart diseases in women aged 35 years and more is actually “higher than in men,” the report notes. “Women who smoke now have about the same high risk of death from lung cancer as men,” it adds.

For the last fifty years tobacco companies have been continuously altering their strategies to sell their improvised wares to attract youth and ensure a steady supply of new customers and not to lose existing ones. Low tar cigarettes, menthol cigarettes, light cigarettes, cigarettes with filter to cut the amount of nicotine inhaled are some of the new products launched by them.

Thanks to the tobacco companies, smokers today are at a greater risk of developing lung cancer than they did 50 years ago. While the incidence of squamous cell carcinoma of the lung — the kind of lung cancer most often found in smokers — has declined, the incidence of another kind of cancer — adenocarcinoma — has increased “dramatically.”

“Changes in the design and composition of cigarettes since the 1950s have increased the risk of adenocarcinoma of the lung, the most common type of lung cancer,” it notes.

Evidence suggests that smokers tend to inhale more vigorously when they smoke cigarettes with “ventilated filters.” As a result, they tend to draw the carcinogens much more deeply into the lungs. This has resulted in the shift in the type of carcinoma of the lungs during the past 50 years.

However, the risk of dying earlier gets reduced if a person quits smoking. While it is known that smoking shortens life expectancy by 10 years, quitting by 40 years of age results in 90 per cent reduction of that risk. It is nearly 40 per cent if a person quits by the age of 60 years. Reducing the number of cigarettes smoked a day is “much less effective than quitting entirely.”

Published in The Hindu on February 6, 2014

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