Passive Smoking and Cancer

Dr. A K Nanda       

MD Radiation Oncology

Introduction:-

        One day a 50 year old lady came to OPD with chief complaint of breathlessness. On investigation it was confirmed that she was having Lung cancer. After the diagnosis her son came to me and ask that his mother never smoke but how could she get a lung cancer. I usually observe that majority of patients who never smoke in life and develop a lung cancer have the same query. After hearing the question of the son I explain him, there are a number of other factors which cause lung cancer, but smoking is a major cause among those. Then I further asked him whether anybody else smokes in his house. And the answer was his father who often smokes in their house but in a separate room. Now the question is whether this may be a causative factor in this case. The answer may be yes. People usually don’t know what passive smoking is and what is its consequences. Even doctors often failed to take this history. This is the fact which every body should be aware about.

What is passive smoking ?

          Passive smoking is inhalation of smoke which is released to environment due to smoking of other persons. it is also called as Involuntary smoking or Second hand smoking. It may be due to smoking of cigarette, bidi, pipe, cigar or hookah. Passive smoking is either due to main stream smoke which is produced by exhalation of smoke by smoker or due to smoke produced at lit end.

          It is not true that nobody knows about this passive smoking. Some people know and some don’t. people who don’t know often present beside smoker in home, restaurants, shops, work places etc.. Best example in India is wife resides with smoker husband. But people who know also it is sometimes very difficult to avoid. If a boss is smoking an employee might not ask him/her to stop smoking. Often boys and girls of teen age can’t ask their friends or seniors to stop smoking by thinking that they will think about them as fool. Not only bars but also small hotels in village sell foods along with cigarette and bidi. Usually some take food there and some smoke in the same place.

Third hand smoking (residual tobacco smoke):-

second hand smoke particles settle in dust & on surfaces and remain there for months. It is seen that it can lead to human DNA damage in cell culture. It may cause diseases. There is no research yet that proves it can cause cancer. But we should keep in mind, there is also no research yet that can prove it doesn’t cause cancer.

Diseases cause by smoking:-

           Passive smoking causes same diseases that smoking causes. It is established in some cases like lung cancer that passive smoking is the causative factor for it. But in some cases like cervical cancer it is not yet clear that whether passive smoking can cause it, though it is established that it is associated with smoking. In these cases we should keep in mind that also there is no adequate studies that proves passive smoking dose not cause cervical cancer. Hence in the table we have quoted about the diseases which are caused by smoking. In most cases it is associated with passive smoking and in some cases it is yet to be proved. But unless proved association of these diseases with passive smoking can not be denied.

Things to know:-

• When a person smokes in a room even after smoking the smoke reside in the room for long hours. If someone even smokes in other room, it leaks to near by rooms. Smoke can pass through cracks in wall or even small space in door. Opening windows or doors do not clear up smoke from room. If somebody smokes in a room, even if it is closed, other person in other room can easily feel the smell, which proves the above statement.
• Car is a small space. If somebody smokes in car there will be a very high concentration of smoke remains in car which can be more hazardous.
• E-cigarette (vaping) releases negligible smoke. It is always claimed that it does not lead to second hand smoking. But it is a new thing and information about it, is limited.

From above table 1 out of 8 death is due to second hand smoking.

How to protect?

• The best way is to "QUIT SMOKING". But if not possible the following majors can be taken
• Never smoke in home, even in a separate room. Always smoke outside.
• Never smoke in car.
• Never smoke in public places.
• Ask others not to smoke in public places.
• Every smokers should take precautions not to smoke when people are around them.
• Do not go to restaurants which allow smoking.
• Do not go to parties where smoking is allowed.
• Smoking room in work places should not be near working areas. It must be in outdoors.

            When somebody smokes before you, do not hesitate to ask him ‘not to smoke’. Do not think, what he will think about you. Because if somebody smokes near you it reflects that he/she does not care about you because of his/her psychological as well as physical dependency. Again if you get a disease, it is only you who is going to suffer, your smoker family members, friends or colleagues may only spend some time for your disease or may get some trouble, but nobody will die with you.

[Nicotine Gums can be used in place of cigarettes while quiting smoking.]

• Cipla Nicotex Nicotine Gum - 2 mg (9x10 Pieces, Mint)
• STOP-NIC Nicotine Gum 2mg, Cool Mint, Sugar-free, Stop Smoking Aid, 10 Gums Per Blister, (Pack of 100 Gums)
• Nicotex Nicotine Gums Classic Fresh Mint, Paan and Mint Plus (Blue, 2 mg, Pack of 12)