British scientist Richard Peto, a world authority on the study of tobacco use and social impact of smoking has uses an example to explain the risks that smokers take. Take a coin, throw it in the air and pick it up with the palm of your hand. Heads or tails: that is the risk that habitual smokers have of dying because of tobacco (50%). So simple and forceful.
These data are the result of a follow-up study conducted over 40 years among British male smokers and reflects that 1 in 2 regular cigarette smokers will die from tobacco. In Spain, it is estimated that, as a result of tobacco, there are more than 55,600 deaths per year.
Cigarette smoking is the main public health problem in developed western countries, among which we are located, being also the largest preventable cause of disease and death.
We also know that quitting smoking produces important immediate health benefits for men and women of all ages, whether or not they have tobacco-related diseases. Quitting smoking decreases the risk of lung cancer, other cancers, myocardial infarction, cerebral thrombosis and respiratory problems.
The human, health, social and economic costs of tobacco consumption and exposure to smoke are known to everyone, but in our country the consumption of tobacco continues to be socially accepted: smoking is still well regarded by society. The latest statistical data showed that 34.4% of the adult population smokes with a clear tendency for consumption to decrease in men and increase in women.
Social impact of smoking is an addiction, a learned behavior and a social dependency. A complete view of the problem of smoking can help us to understand definitively why people smoke.
Nicotine, present in tobacco, is a powerful chemical that produces pleasure, increases attention, decreases hunger, improves mood and calms nicotine withdrawal symptoms. In addition, it can act as a stimulant and relaxing.
Nicotine comes in 7 seconds from the lungs to the brain and binds to different brain areas. An average smoker repeats this process about 200 times each day (73,000 puffs per year) and this leads to addiction to tobacco. Among the evidences that show that smoking is a dependency are that more than 90% of smokers smoke daily, that the symptoms of smoking abstinence are calmed when nicotine is administered, and that there is difficulty in quitting with frequent relapses.
Nicotine stays in the blood for about two hours, so when nicotine levels are below a smoker’s comfort levels, withdrawal symptoms appear. These symptoms include anxiety, inability to concentrate, irritability, inability to rest, urgent need for a cigarette, decreased pulse, headache and insomnia. When smoking is stopped, most symptoms of withdrawal syndrome reach their maximum intensity 24 to 48 hours after quitting and gradually decrease in intensity in 2 or 3 weeks. However, other symptoms, such as the urgent desire to smoke, particularly in difficult situations, persist for months or even years.
Social impact of smoking is a learned behavior
Most people start smoking before they are 20 years old. Little by little, the situation in which smoking is habitually associated with the reinforcing effects of nicotine. Drinking coffee, resting in the middle of work or going out with friends are situations that are associated with a cigarette, and make it very difficult for smokers to abandon their addiction. The conditioning that occurs in such a context is one of the most important causes of relapse.
Other factors associated with a cigarette are the social environment and many key moments of life in our society: weddings, christenings, or any type of social celebrations, including sports. Smoking remains a symbol of initiation into adult life and an element of identification with the group. On the other hand, aspects of personality also influence, such as rebelliousness, the tendency to risk or affective instability. In the same way, the symbolic role that sometimes smoking habit is important is also important, since for many adolescents and pre-teens, smoking is “adult-like”, sophisticated, or confers personal appeal.
As in other diseases, the best strategies to deal with the social impact of smoking are those of prevention and control, which must cover two aspects: one of social approach – decreasing the social pressure to smoke and another of support to the detoxification of tobacco addiction. The first is achieved through policies of smoke-free spaces, free of advertising, and controlling the promotion of smoking behavior, which is carried out from advertising. It is also important to carry out a deployment of measures that ensure real protection of minors against access to tobacco, together with the establishment of a fiscal policy that reinforces prevention. The second should provide effective help to people to stop smoking, minimizing the risk of relapse.
The consumption of cigarettes is a fundamentally social problem, whose solution requires a global approach, which must be raised from the political framework. Already in 1981 Sir George Young, Minister of Health of the United Kingdom, pointed out that “the solution to smoking will not be found in research laboratories, or in the operating rooms of hospitals, but in the parliaments of democratic nations.”
The prevention and control of the tobacco epidemic go through the awareness and social commitment of all. Only in this way, we will be able to change the social impact of smoking to achieve better health for all.