Mobilising a Nation Against Tobacco- Related Heart Diseases

Tobacco use is a significant public health problem, causing devastating consequences worldwide. The World Health Organisation reports that over 8 million people die yearly from tobacco consumption, while second-hand smoking kills around 1.2 million people worldwide. In India, the burden of tobacco-related illnesses remains alarmingly high, particularly in cardiovascular disorders. Every year, tobacco-related heart diseases claim the lives of over a million adults in India, accounting for a staggering 9.5 per cent of the global death count. Additionally, India faces a dual burden of smoking and smokeless tobacco use, with prevalence rates of 10.3 per cent and 21.3 per cent, respectively. This alarming statistic highlights the urgent need for comprehensive efforts to address the tobacco menace.

Throughout the past 50 years, it has been proven beyond doubt that tobacco use has severe adverse effects on cardiovascular health. The harmful chemicals in cigarettes, including tar, as well as nicotine, can directly damage the inner layer of our blood vessels2/5?called the endothelium. This layer protects the blood vessels like a Teflon coating on a pan. When a person smokes, this layer begins to deteriorate, leading to a process known as endothelial dysfunction. Bad cholesterol then starts to accumulate, causing blockages over time. These blockages can rupture, creating a clot inside the vessel and ultimately resulting in a heart attack or myocardial infarction (MI). Similar problems can occur in the brain, leading to a stroke or cerebrovascular accident (CVA), and in the legs, leading to peripheral vascular disease (PVD), which can cause non-healing ulcers or gangrene.

Additionally, smoking puts individuals at a higher risk of developing an enlargement in the body's main blood vessel, the Aorta, which can lead to an aortic aneurysm. If this aneurysm ruptures, it can result in loss of life. Smoking also worsens hypertension, which can accelerate the dangerous effects of smoking if left uncontrolled. The impact on theSouth Asian population, especially Indians, is far more susceptible to cardiovascular disease than matched counterparts in the West. Smoking is India's largest preventable cause of heart attacks, strokes and cancers.

India must move beyond simple awareness to meaningful action to effectively address tobacco-related heart disease. The following strategies can help mobilise the nation and achieve tangible progress:

Strengthening Policy Framework:

India has ratified the WHO Framework Convention onTobacco Control (WHO FCTC) and made significant strides in implementing measures such as health warnings in the public domain and cessation programs. However, enhanced monitoring and enforcement are needed. In addition, stricter regulations, advertising bans, and promoting smoke-free environments can reduce public tobacco consumption and its associated health risks. Stricter regulations must be enacted to restrict tobacco advertising, sponsorship, and promotion, especially targeting vulnerable groups such as children and adolescents.

Targeted Interventions:

To address the heterogeneity of tobacco use among different segments of the population, targeted interventions are crucial. These interventions should focus on vulnerable groups, such as youth, women, and rural communities. In addition, mass educational campaigns, addiction-counselling services, and access to affordable cessation aids can empower individuals to quit tobacco and adopt healthier lifestyles.

Collaboration and Partnerships:

Tackling the tobacco epidemic requires a collaborative approach involving governments, healthcare professionals, civil society organisations, and the private sector. Active participation in public health initiatives can facilitate the exchange of knowledge, resources, and best practices, leading to more effective interventions. In addition, engaging key-opinion leaders, communities, schools, and workplaces can amplify the impact of awareness campaigns and mobilise a tobacco-free culture.

Research and Innovation:

Investing in research and innovation is essential for combating tobacco-related heart diseases. Research can provide insights into the effectiveness of different interventions, identify emerging trends, and inform evidence-based policies. In addition, by disseminating such information through various channels such as television, radio, social media, and community outreach programs, we can reach a broader audience and foster a sense of urgency in tackling this grave health issue.

Leveraging the power of AI:

Capitalising on technology and digital health solutions can enhance access to tobacco cessation programs, support remote monitoring, and deliver personalised interventions. Technology has emerged as a powerful tool in the fight against tobacco consumption, offering innovative solutions to help individuals quit and stay tobacco-free. Mobile applications and online platforms can provide personalised support, delivering evidence-based interventions, motivational messages, and progress-tracking features. These digital tools can serve as virtual coaches, offering guidance on quitting strategies, coping mechanisms, and relapse prevention. Telehealth services can play a significant role by connecting individuals with healthcare professionals remotely, ensuring access to expert advice and counselling from the comfort of their homes. By harnessing the potential of technology, we can overcome distance barriers, improve convenience, and empower individuals with the tools they need to break free from tobacco addiction.

Robust Healthcare Infrastructure:

Integrating tobacco control efforts into the existing healthcare system is crucial. Healthcare professionals should receive comprehensive training on tobacco cessation strategies, allowing them to offer guidance and support to patients who wish to quit. By incorporating tobacco cessation services into primary healthcare facilities and ensuring access to affordable medications and counselling, we can empower individuals to make positive lifestyle changes and reduce their risk of heart disease.

The burden of tobacco-related heart diseases in India demands immediate and sustained action. By implementing comprehensive tobacco control measures, targeting vulnerable populations, fostering collaboration, and investing in research and innovation, we can drive meaningful change and reduce the devastating impact of tobacco on individuals, families, and communities. Working together, we as a nation can make significant progress in reducing the burden of tobacco-related heart diseases in India.

Disclaimer : This article was first published on ET Healthworld . Authored by Dr. Charit Bhograj, Founder and CEO Tricog Health