KOCHI: World No Tobacco Day is celebrated every year on May 31 with various themes to raise awareness about the harmful effects of tobacco use. This year the theme is ‘We need food, not tobacco’.
At present, India has the most number of oral cancer among men, even outnumbering lung cancer. Whereas in women, oral cancer ranks third after breast and cervical cancer. The usage of tobacco in several forms, alcohol consumption, areca nut chewing, and viral infections are some of the causes of oral cancer. If detected early, the condition can be cured completely.
The formation of a group of lesions, also called precancerous lesions in the oral cavity, is one way to identify oral cancer. The common type of lesions are leukoplakia, erythroplakia, and oral submucous fibrosis. Leukoplakia appears as a painless white lesion whereas erythroplakia is red. Any ulcer even if it’s painless and persists without healing for more than two weeks needs an examination by a dentist. Therefore, daily self-examination of the cheeks, tongue, lip, etc., while brushing is essential.
Using any type of tobacco puts you in a catastrophe. Smoking has been linked to various types of cancer, including cancer of the lung, mouth, throat, larynx, pancreas, bladder, cervix and kidney. Chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don’t use tobacco, exposure to secondhand smoke might increase the risk of lung cancer.
Smoking can also lead to gum disease. People who smoke are more likely to produce bacterial plaque, which leads to gum infection. Smoking causes a lack of oxygen in the bloodstream, so the infected gums will not heal properly. The common signs of any gum disease are bleeding and redness, however, in smokers, these signs get masked and they will identify only when the disease advances and when teeth start shaking.
Tobacco use cessation
If you need help quitting tobacco, ask your doctor about tobacco cessation programmes, products and other strategies for quitting. The five major steps to intervention are the “5 A’s”: Ask, Advise, Assess, Assist, and Arrange.
Ask — Identify and document the tobacco-use status for every patient at every visit.
Advise — In a clear, strong, and personalized manner, urge every tobacco user to quit.
Assess — Is the tobacco user willing to make a quit attempt at this time?
Assist — For the patient willing to make a quit attempt, use counselling and pharmacotherapy to help him or her quit.
Arrange — Schedule follow-up contact, in person or by telephone, preferably within the first week after the quit date.
Nicotine replacement therapy is another method that helps in bringing an end to smoking. Nicotine is the main addictive substance in tobacco. So, when a person quits tobacco, they also quit nicotine, which can cause unpleasant withdrawal symptoms.
In nicotine replacement therapy (NRT), nicotine without the other harmful chemicals in tobacco will be given in the form of gum, patches, sprays, inhalers, or lozenges. It can help relieve some of the physical withdrawal symptoms so you can focus on the psychological aspects of quitting.
Side effects of such products include nausea, vomiting, abdominal pain, diarrhoea, headache, and local irritation depending on the delivery method. Long-term use of nicotine replacement products does not cause any harmful effects and the risk of dependence on such products is small.
The other way of quitting tobacco is by providing advice. Even a brief verbal exchange can increase cessation rates. Also, raising awareness using printed self-help materials increase quit rates. Counselling has also proved to be effective. There are FDA-approved drugs available for tobacco cessation, but it mainly focuses on the neurochemicals in the brain, it can be used if other strategies are found to be ineffective.