Reporter:Why did the World Health Organization choose May 31 every year as World No Tobacco Day? In response to this message, what specific propaganda activities has Nghe An province had in recent times to reduce the number of smokers, Doctor?
Doctor Nguyen Thi Trang:In 1987, members of the World Health Organization (WHO) decided to choose May 31 every year as World No Tobacco Day (WNTD) to attract attention and raise public awareness of the harmful effects of tobacco.
In Nghe An, in recent times, the health sector has carried out diverse, in-depth, extensive, frequent and continuous propaganda activities to all classes of people. This has contributed significantly to raising public awareness of the harmful effects of tobacco and the Law on Prevention and Control of Tobacco Harms. Over 90% of agencies and units have implemented tobacco harm prevention and control activities.
In addition to the achieved results, the work of preventing and combating the harmful effects of tobacco is also facing many difficulties and challenges due to the appearance of electronic cigarettes, heated tobacco products, shisha... targeting young people; cheap cigarettes are sold everywhere, and the awareness of complying with the legal regulations on preventing and combating the harmful effects of tobacco among a part of the population is still low. If we do not continue to implement strong and timely measures to prevent and combat the harmful effects of tobacco, electronic cigarettes, heated tobacco products, shisha, the rate of tobacco users will increase again, especially among young people and women.
To continue to strengthen the work of preventing and combating the harmful effects of tobacco and responding to World No Tobacco Day on May 31, National No Tobacco Week from May 25 to 31, 2023, on May 11, 2023, the Ministry of Health issued Circular 11/2023/TT-BYT regulating the implementation of smoking-free areas; immediately after that, the Steering Committee of the Tobacco Harm Prevention Program of Nghe An province also issued an official dispatch requesting departments, branches, sectors and organizations, media agencies, People's Committees of districts, towns and cities to step up propaganda on the Law on Prevention and Combating the Harm of Tobacco; the harmful effects of tobacco and the theme of World No Tobacco Day. Promptly issue regulations to prevent the use of electronic cigarettes, heated tobacco, shisha in agencies, units and educational institutions. Organize activities in response to World No Tobacco Day, National No Tobacco Week and communication forms appropriate to practical conditions and situations. Strengthen inspection activities and strictly handle cases of buying, selling and using electronic cigarettes, heated tobacco, shisha because these products are currently not allowed to be imported, traded and circulated in Vietnam...
Reporter:Can you tell us more about the harmful effects of smoking, especially the effects of cigarette smoke on the human respiratory tract, directly affecting the patients you are treating?
Doctor Nguyen Thi Trang:Cigarettes cause many diseases to humans, most directly to active and passive smokers. A typical disease is lung cancer. Smokers are 25 times more likely to get lung cancer than non-smokers. In addition, cigarettes also cause many other cancers to smokers, such as nasopharyngeal cancer, laryngeal cancer, leukemia, kidney cancer, etc.
The earliest manifestation is that cigarettes destroy the lungs of smokers, causing respiratory infections, pneumonia, chronic obstructive pulmonary disease, bronchial asthma... increasing the risk of tuberculosis. Smoking also creates high risks of cardiovascular disease and stroke for smokers (Smokers have a 2-4 times higher risk of cardiovascular disease and stroke than non-smokers).
For pregnant women, if they smoke actively or passively, they are more likely to give birth prematurely and have birth defects in the fetus. For children, if they are exposed to cigarette smoke a lot, they will also suffer from respiratory infections, recurrent pneumonia, etc. In addition, cigarettes also cause many other diseases of the teeth, skin, bones, and decreased sexual ability. In general, cigarettes cause diseases from head to toe and are the leading cause of death in Vietnam as well as in the world.
75% of patients coming to Nghe An Lung Hospital for examination and treatment are related to smoking. From smoking, these patients suffer from chronic obstructive pulmonary disease, bronchial asthma, recurrent pneumonia... There are patients admitted to the hospital with difficulty breathing, chest tightness, and prolonged coughing and phlegm. Many patients coming here have to be given oxygen and have emergency breathing tubes inserted.
It must be said that treating patients with tobacco-related diseases is difficult, because most of these diseases are chronic. For patients with mild cases, treatment is mainly preventive at home. For patients with severe cases requiring ventilators, treatment may take months, even several months… There are some people who, despite the best efforts of doctors, cannot be cured.
Reporter:One of the most powerful images in the fight against smoking is that of a patient having to open a hole in his throat to be able to breathe and survive. Can you tell us more about this image?
Doctor Nguyen Thi Trang:These are patients with very severe chronic obstructive pulmonary disease, requiring a tube to be inserted into the airway for invasive mechanical ventilation. During treatment, if the patient cannot be weaned off the ventilator, cannot remove the tube, cannot breathe naturally, the doctors will prescribe a tracheostomy, creating a hole in the trachea and bronchi to help the patient breathe for a long time.
The underlying cause of tracheostomy is that when the patient smokes, toxic substances enter the airways and bronchi. When the concentration and content of the toxic substances are high enough, they will block and narrow the airways, making it difficult for the patient to breathe, unable to breathe through the nose and mouth as usual. Therefore, the doctor needs to create an airway for the patient.
How long the tracheostomy lasts depends on the patient's condition. If the condition improves, the hole can be closed, otherwise it must be left for life. If the patient is in the hospital, the tracheostomy will be cleaned daily. If the patient goes home, he or she must clean it himself or herself. The risk of infection and inflammation is very high. The patient may be readmitted to the hospital many times.
Reporter:The theme for World No Tobacco Day 2023 is “We need food, not tobacco”. This theme clearly shows the correlation between tobacco and poverty. So how does tobacco affect the economic living conditions of smokers?
Doctor Nguyen Thi Trang:We need to see that smokers need money to buy cigarettes. There are many types of cigarettes such as traditional cigarettes (pipe tobacco, filter) and new generation cigarettes (shisha, electronic cigarettes, etc.). There are expensive types, and there are different types of cheap ones. However, no matter how cheap they are, the amount of money that smokers spend on buying cigarettes over a long period of time is still very large.
Second, continuous smokers will develop many diseases. Treatment for these diseases is extremely expensive. In addition to having to buy preventive medicine every day at home, which costs money. When patients have to be hospitalized due to an acute episode, it is even more expensive. The costs include treatment, food, accommodation, and costs for relatives to take care of them. In the hospital, some patients have to stay on a ventilator for a long time. After deducting the costs paid by health insurance, the remaining amount they have to pay themselves is also very large. Some people have to pay hundreds of millions of dong in hospital fees.
Next, patients who smoke often have poor health, cannot live, work, or do other activities normally. Relatives also have to take care of the patients... Statistics show that the vast majority of patients with smoking-related diseases who are hospitalized at Nghe An Lung Hospital have extremely difficult economic lives. The frequency of hospitalization is very high, sometimes 2-3 times a month, so their finances are exhausted. Many people are very poor, they don't even have money for food. The hospital and the department must support them.
Reporter:The harmful effects of traditional cigarettes are clear, but what about the harmful effects of new generation cigarettes?
Doctor Nguyen Thi Trang:There are currently two main types of new generation cigarettes: electronic cigarettes and heated tobacco. However, the nature of new generation cigarettes is no different from traditional cigarettes with nicotine, tar, etc. In addition, there are also some flavoring substances to stimulate users. These substances are addictive, very toxic, and cause cancer to users.
Advertisements all say that the addictive content in new generation cigarettes is lower and less toxic, but in reality they are just as toxic as traditional cigarettes.
Reporter:Why is it so difficult to quit smoking? What advice do doctors have for smokers to successfully quit?
Dr. Nguyen Thi Trang: 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 smokers stop smoking, they will experience withdrawal syndrome. Withdrawal syndrome makes the patient very tired, uncomfortable, restless, unable to do anything... However, just by smoking another cigarette, the person quitting regains their spirit and state as before. Withdrawal syndrome makes it difficult for smokers to quit smoking.
Quitting smoking depends on many factors, including: Willpower and determination of the smoker, whether or not they really want to quit smoking. Next, they need the support of family, relatives, friends, colleagues, etc. Doctors advise people who want to quit smoking to do light exercise to forget the cravings; use some drugs (with the advice of a doctor) to reduce cravings. It is also important to note that quitting smoking suddenly is very difficult. People who want to quit smoking can gradually reduce their use until they completely stop.
Reporter:Thank you doctor!