Smoking, a matter of the heart, not just the lungs

“Smoking is the leading cause of preventable cardiovascular disease in South Africa, claiming three times as many lives as motor vehicle accidents.” Dr Jeff King, a specialist physician cardiologist in private practice at Sunninghill Hospital in the north of Johannesburg, explains further. “Smoking affects the heart and blood vessels at cellular level, causing damage to the lining of the arteries and veins. This damage has direct toxic effects, promoting inflammatory processes and predisposing smokers to muscle spasm and blood clotting. Inflammation caused by smoking drives the clotting, which is the primary pathway leading to complications such as heart attack, angina and stroke. It's a vicious circle, with the consequent decrease in blood supply to the heart and brain resulting in further cell damage and cell death.”

Given this, Dr King is especially concerned about the dangers of smoking to adolescents and even children. This is the vulnerable period during which the habit is acquired, with potentially devastating long-term health implications. However, further anti-smoking legislation is currently in the pipeline, which will make it more difficult for young people to gain access to cigarettes; it will also reduce their chances of being exposed to second-hand smoke as stricter measures against public smoking take effect. “Crucially, tobacco companies will no longer be able to target teenagers and in some cases children as young as 12 with their marketing,” says Dr King.

He feels that children and adolescents need to be educated about the dangers of smoking - dangers that go beyond cigarettes. “One of the newer party trends is the widespread use of the hookah, also known as the hubbly bubbly and the oka. There's a false perception that this is somehow safe, but that's not true. Those who use it are also inhaling the same vaporised nicotine and other particulate matter such as tar, which are what make cigarettes so dangerous and addictive. Youngsters need to be discouraged from trying it out. In addition to all the negative health effects of smoking, such as heart and lung disease and various cancers, including bladder cancer, the fact that there's a shared mouthpiece involved increases the risk of infectious diseases. These include hepatitis, HIV and even swine flu. While heart disease may be the number one killer worldwide, infectious diseases top the list in South Africa. Using the hookah essentially exposes you to the worst of all possible worlds.”

Dr King notes that because smoking is such a key factor in heart disease, the tougher new legislation should see the overall incidence decrease in years to come. “Some preliminary research suggests that this is already starting to happen, which is very encouraging.”

He concludes by pointing out that nicotine and the other harmful substances are the most important issues, and should not be clouded by debate over different modalities of smoking. The latter include the so-called ‘electronic cigarette', which purports not to be a tobacco product yet uses the same vaporised nicotine as the hookah. It is often touted as a smoking cessation tool. “All tobacco products are bad,” says Dr King. “Non-healthcare products can still put you at risk for heart disease and other smoking-related illnesses, even if they claim not to. When it comes to stopping smoking, you need to stick to legal medicinal products and use these under the supervision of a health professional.”