Protect children from the dangers of tobacco and e-cigarettes

PV: Could you please tell us more about the harmful effects of tobacco on human health and socio-economic life in general?

Doctor Le Anh Tuan:Tobacco is a product made entirely or partly from tobacco ingredients, processed in the form of cigarettes, cigars, tobacco shreds, pipe tobacco or other forms... Cigarette smoke contains about 7,000 chemicals, of which 69 are carcinogenic.

According to the World Health Organization, smoking causes many chronic and incurable diseases; is the leading cause of death in both men and women and is the cause of 25 different groups of diseases, including 11 types of cancer, cardiovascular diseases, respiratory diseases and affects the reproductive health of both men and women.

It is estimated that 1 in 2 smokers will die prematurely, with half of these deaths occurring in middle age (39-65 years old). Tobacco use causes 8 million deaths each year worldwide, including 1.2 million deaths from diseases related to passive smoking. The World Health Organization predicts that if no timely preventive measures are taken, the total number of deaths from diseases caused by tobacco will reach 1 billion in the 21st century.

In addition to health risks, tobacco use also causes economic losses to individuals, families and society, including expenditures on smoking, costs for medical examination and treatment of smoking-related diseases, loss of/loss of working capacity due to illness and premature death, and fires and explosions. According to estimates by the World Health Organization, the global economic loss caused by tobacco is 1,400 billion USD each year.

In Vietnam, it is estimated that tobacco causes hundreds of thousands of chronic diseases and kills more than 40,000 people each year. The number of deaths due to tobacco is estimated to increase to 70,000 cases per year by 2030, if tobacco harm prevention measures are not implemented promptly. The economic loss caused by the five main groups of tobacco-related diseases (lung cancer, upper respiratory tract cancer, chronic obstructive pulmonary disease, myocardial infarction, stroke) is estimated to have caused a loss of up to 1% of GDP (equivalent to 67,000 billion VND/year).

PV: Currently, there are new generation cigarettes on the market. What are the nature of these cigarettes and what are their harmful effects?

Doctor Le Anh Tuan:Besides the productscigaretteCigars, tobacco, new products are appearing on the market, the most popular areelectronic cigaretteand heated tobacco products. Both types of e-cigarettes use an electronic device to heat a liquid or tobacco material to create a vapor that the user inhales.

Electronic cigarettescontains nicotine, a highly addictive chemical, which is a cause of cardiovascular, respiratory, digestive diseases, and has the ability to promote and form tumors. In addition to nicotine, e-cigarette solution also contains propylene glycol, which can form propylene oxide - a carcinogen when heated and vaporized. Toxic substances found in the aerosol (smoke) of e-cigarettes include Ethylene Glycol, aldehydes, polycyclic aromatic hydrocarbons, especially carcinogenic nitrosamines, Formaldehyde found in pesticides, and car exhaust. Therefore, e-cigarettes are harmful to users and those around them.

To create attractive flavors to attract users, especially young people, manufacturers also use many types of flavorings such as mint, apple, orange, lemon, etc. in e-cigarettes. There are currently about 20,000 types of flavorings, many of which have not been fully evaluated for their harmfulness to health. In addition, e-cigarettes can be used to mix drugs and other addictive substances.

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According to the World Health Organization, all tobacco products are harmful to health. Using e-cigarettes quickly causes addiction to users, causing acute and chronic diseases such as cardiovascular disease, stroke, respiratory disease, digestive disease, poisoning, epilepsy, dental disease and cancer. Passive exposure to nicotine in these products also has adverse effects on maternal and fetal health, adversely affecting the brain development of fetuses, children and adolescents.

Specialist Doctor 2 Le Anh Tuan - Head of Department of Non-communicable Disease Prevention, Center for Disease Control of Nghe An province.

PV: It is known that in Nghe An today, smoking and violating the law on tobacco harm prevention are quite common. Can you elaborate on this situation?

Doctor Le Anh Tuan:In Nghe An, we have not had official statistics on the smoking rate. It will not be until the end of 2024 that Nghe An will conduct statistics. Nghe An will be one of 46 provinces nationwide to conduct a survey on the current status of tobacco use among adults and implement the Law on Tobacco Harm Prevention.

However, from December 2023 to May 2024, the Center for Health and Population Initiatives and the Center for Disease Control of Nghe An province conducted a survey on compliance with the Law on Tobacco Harm Prevention and Control and the smoke-free environment policy in a small area of ​​Vinh city. The survey results showed that smoking behavior in places such as medical facilities, educational facilities, state agencies, food establishments, accommodation establishments, public areas and public transport points is very common.

Accordingly, all 7 locations mentioned above observed violations of the Law on Tobacco Harm Prevention regarding regulations on smoke-free environments. The fewest violations were in educational establishments (30.5%) and public service establishments (34.5%). The most violations were in public transport locations (80%), food establishments (62.4%) and accommodation establishments (60.2%). The situation of not having no-smoking signs was still common in food establishments (2%), public service locations (19%), accommodation establishments (21.5%), and educational establishments (22.9%).

The current issue of e-cigarette smoking is also very worrying. The Tobacco Harm Prevention Fund (Ministry of Health) reported: The rate of e-cigarette smoking among adults increased 18 times (from 0.2% in 2015 to 3.6% in 2020). The rate of e-cigarette use among students in 2019 was 2.6%; in 2022, this rate was 3.5%. It can be seen that after only 3 years, the rate of e-cigarette use among students has increased significantly. The situation of e-cigarette smoking among students in Nghe An is also part of this general trend.

PV: Can you tell us about the solutions to prevent and combat the harmful effects of tobacco that Nghe An is implementing and what are the obstacles and challenges?

BDoctor Le Anh Tuan:Implementing Plan No. 861/KH-UBND of the Provincial People's Committee on implementing the National Strategy on preventing and combating the harmful effects of tobacco by 2030, Party committees at all levels, authorities, departments, branches, unions, and social organizations in the province have included the content of preventing and combating the harmful effects of tobacco in the annual work plans of the People's Committees at all levels, included the regulation prohibiting smoking in the workplace in the internal regulations of agencies and units; included the content of preventing and combating the harmful effects of tobacco in village, hamlet, village, and residential group conventions; built pilot models such as: restaurants, hotels, public places, medical facilities, etc.

Along with that, propaganda, mobilization and education of all classes of people on tobacco harm prevention and control have been promoted. The provincial police, the Market Management Department, local departments, branches and functional units have advised on the establishment of interdisciplinary inspection teams or integrated the inspection of the implementation of the Law on Tobacco Harm Prevention and Control into the inspection programs and plans of the agencies. Most recently, on August 20, 2024, Nghe An conducted training on tobacco harm prevention and control inspection and control. After this training course, the work of inspection, control and handling of violations of the law on tobacco harm prevention and control will be promoted.

Currently, the work of preventing and combating the harmful effects of tobacco is still facing many difficulties and challenges. Because the special consumption tax on tobacco in Vietnam is still low and there are no regulations on licensing the management of points of sale, tobacco products are easy to access and are sold everywhere. Controlling the advertising, buying and selling of tobacco products, electronic cigarettes, heated tobacco and shisha online is very difficult.

PV: What is the nature of tobacco addiction? What advice do you have for people who want to quit smoking? And what should parents do to help their children stay away from new generation cigarettes?

Doctor Le Anh Tuan:Tobacco addiction is a psycho-physical state that occurs when the body interacts with nicotine in cigarettes, manifested by the urge to smoke cigarettes continuously and regularly to achieve the pleasant feeling of smoking, while avoiding the unpleasant feeling of not smoking. Psychological addiction, behavioral addiction and physical addiction are the three components that make up tobacco addiction.

There are many smokers who know the harmful effects of smoking but they cannot quit smoking, they try to quit but fail. This can be explained by the mechanism of addiction. When a smoker stops smoking, it will cause withdrawal syndrome. Withdrawal syndrome makes the patient very tired, uncomfortable, struggling, lethargic, unable to do anything... To quit smoking depends on many factors, including: Willpower, determination of the smoker, whether they really want to quit smoking or not. Next, they need the support of family, relatives, friends, and colleagues.

To help young people stay away from new generation cigarettes, parents need to recognize early 5 signs of children using e-cigarettes, as follows: One is that children may have respiratory symptoms such as coughing, shortness of breath, difficulty breathing. Two is that children change their behavior; often show signs of anxiety, irritability, and a tendency to participate in risky behaviors. Four is detecting strange smells (e-cigarettes often have a fruity scent that attracts children.) Five is suspicious behavior or conversations with friends.

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Parents need to pay attention, educate closely and spend more time accompanying their children, especially when they enter puberty, because this is the stage when children's psychology and physiology change dramatically, easily fall, learn from friends, and incomplete understanding can easily make children learn inappropriate behaviors. In particular, smoking is a behavior that children think shows their sophistication and maturity without knowing that it will seriously affect their health in the future.

PV: Thank you doctor!