Smoking in moderation also carries significant risk: World No Tobacco Day

Tobacco and heart disease

Every year, on 31 May, WHO and partners mark World No Tobacco Day (WNTD), highlighting the health and other risks associated with tobacco use, and advocating for effective policies to reduce tobacco consumption.

The focus of World No Tobacco Day 2018 is “Tobacco and heart disease.” The campaign will increase awareness on the:

• link between tobacco and heart and other cardiovascular diseases (CVD), including stroke, which combined are the world’s leading causes of death;
• feasible actions and measures that key audiences, including governments and the public, can take to reduce the risks to heart health posed by tobacco.

World No Tobacco Day 2018 coincides with a range of global initiatives and opportunities aimed at addressing the tobacco epidemic and its impact of public health, particularly in causing the death and suffering of millions of people globally

 Tobacco endangers the heart health of people worldwide

Tobacco use is an important risk factor for the development of coronary heart disease, stroke, and peripheral vascular disease.

Despite the known harms of tobacco to heart health, and the availability of solutions to reduce related death and disease, knowledge among large sections of the public that tobacco is one of the leading causes of CVD is low.

Facts about tobacco, heart and other cardiovascular diseases

Cardiovascular diseases (CVD) kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 17% of all heart disease deaths. Tobacco use is the second leading cause of CVD, after high blood pressure.

The global tobacco epidemic kills more than 7 million people each year, of which close to 900 000 are non-smokers dying from breathing second-hand smoke. Nearly 80% of the more than 1 billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.

• Of the nearly 7 million who die each year due to tobacco-related causes, 6 million die from direct tobacco use
• Another 890,000 are victims of second-hand smoke
• Roughly half of those who lose their lives to tobacco each year succumb to cardio vascular diseases

Tobacco kills almost 7 million people across the world every year and nearly a million of them are not even smokers. It also costs the world about $1.4 trillion annually in healthcare costs related to tobacco-attributable diseases and in lost productivity due to death and illness.

Of the nearly 7 million who die each year due to tobacco related causes, 6 million die from direct tobacco use while another 890,000 are victims of second-hand smoke, according to the WHO estimates. Roughly half of those who lose their lives to tobacco each year succumb to cardio vascular diseases. In fact, tobacco is one of the major causes for heart diseases accounting for about 17% of all deaths due to them.

This is also true of non-smokers who die from exposure to tobacco smoke. Of the economic costs, around $400 billion is in direct medical care costs and nearly $1 trillion is in indirect costs, representing the value of lost productivity due to premature death and morbidity from exposure to second-hand smoke, the study estimated. The WHO material on tobacco has findings that may come as a surprise to many, particularly to those who use tobacco. For instance, it says that while there is some relationship between how much tobacco you smoke each day and the risk of heart diseases, it is not a linear one.

Thus, smoking even just one cigarette a day incurs half the risk of developing heart disease and stroke incurred by smoking a pack of 20 each day. In short, the idea of smoking in moderation is largely a myth. Similarly, the WHO concludes that there is no evidence to show that electronic nicotine delivery systems like e-cigarettes or vape pens are less harmful than smoking cigarettes in terms of the risk of heart disease.

This is despite the fact that on the whole such devices do contain fewer toxicants. The same caveats hold also for what are called heat-not-burn tobacco products. Another sobering fact is that despite tobacco being a major cause of heart attacks and stroke, a significant proportion of adults in several countries surveyed either do not know this or do not believe it. In India, for instance, 36% did not know or believe that smoking can cause heart attacks while 51% had similar disbelief or ignorance when it came to strokes. China was even worse with 61% of adults disclaiming knowledge of or belief in the connection between smoking and heart attacks and 73% in the connection with stroke. Like smoking, smokeless tobacco too is harmful and carries similar risk of cardio vascular diseases and stroke.
While smokeless tobacco is not a major issue in most parts of the globe, it is a widely prevalent form of tobacco use in parts of the sub-continent, like India and Bangladesh. Thus, while the prevalence of tobacco smoking is lower in India (particularly among women) than in many other large countries, those countries have virtually no use of smokeless tobacco. In India, in contrast, over a quarter of the adult population uses some form of smokeless tobacco.