July 2009, Volume 59, Issue 7
Letter to the Editor
Madam, the present era has witnessed extensive scientific advancements which has lead to improved health care. To further improve the quality of life, however, it is imperative to address the preventable risk factors on human health of which second hand smoke, also called as passive, involuntary and environmental tobacco smoke is an important and avoidable risk factor.
In contrast to an active smoker, passive smoker is exposed not only to the smoke exhaled from the smoker but also to a side-stream smoke which constitutes about four-fifths of the total smoke. It has been estimated that smoke emitted from the tip of a cigarette contains about twice the concentration of nicotine, 3 times the concentration of Benzopyrene (a potent carcinogen), 5 times greater Carbon monoxide and fifty times larger ammonia levels than the active smoke.1
Environmental tobacco smoke is associated with a greater risk of Coronary artery disease and acute Myocardial Infarction.2 The manifestations of passive smoke on respiratory system range from exacerbation of Asthma and chronic respiratory problems to increased incidence of Lung cancer from continuous exposure.3
Effects of involuntary smoking during pregnancy include low birth weight, sudden infant death syndrome, acute and chronic respiratory symptoms, asthma and ear infections.4 This assumes great importance as it has been estimated that more than half of pregnant women in Pakistan are frequently exposed to indoor involuntary smoking and more than 17,000 children under five years of age in developed countries alone are hospitalized each year due to reasons associated with passive smoking.
The Article 8 in WHO convention on tobacco control adopted by the member states in 2003, states:
1. "Parties recognise that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.
2. Each party shall adopt and implement in areas of existing national jurisdiction as determined by the national law and actively promote at other jurisdictional levels the adoption and implementation of effective legislative, executive, administrative and/or other measures, providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places."5
In Pakistan "Prohibition of smoking and protection of non-smokers health ordinance" was passed in 2002. Implementation of these laws can not only protect the life of non-smokers but can also encourage smokers to quit or smoke less frequently. Collaboration between governmental and non-governmental organisations can address this issue before the menace poses more burdens on our health system. Haris Riaz,1 Talha Riaz,2 Syed Wajahat Kamal3 ,4th Year Student,1,3 5th Year Student,2 Dow University of Health Sciences, Karachi, Pakistan.
References
1.Stefanadis. C. Exposure to second hand smoke and cardiovascular health: Time to act. Hellenic J Cardiol 2008; 48: 63-4.
2.Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004; 328: 977-80.
3.The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General.
4.Luschchenkova O, Fernandez E, Lopez M, Secondhand Smoke Exposure in Spanish Adult Non-Smokers Following the Introduction of an Anti-Smoking Law. Epidemiology and prevention 2008; 61: 687-94.
5.World Health Organization. (Online) Cited April 6, 2009. Available from URL: http://www.who.int/tobacco/research/secondhand_smoke/en/index.html
Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees:
