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Health
Compiled by shanika sriyananda

Putting the lid on passive smoking

With the Framework Convention on Tobacco Control coming into force today (February 27) compelling signatory member countries to tighten anti-smoking laws and the Sri Lankan government drawing up plans to ban smoking, the Sunday Observer takes a closer look at passive smoking, which is equally harmful to the health as direct smoking.



Pic: by Chinthaka Kumarasinghe

It is a silent crime and a violation of a basic human right - the right to breathe fresh air. But how many of us, if any, have been strong enough to voice a protest, say 'NO' and save ourselves, from becoming victims of passive smoking? The question is moot, but new anti-tobacco legislations, scheduled to come into effect shortly, will give non-smokers the right to a smoke-free environment.

Passive smoking is when sidestream (smoke from the burning tip of a cigarette) and mainstream (smoke that has been inhaled and exhaled) smoke is released from a smouldering cigarette or other smoking devices (cigar, pipe or beedi) and diluted with ambient air, compelling non-smokers to inhale carcinogens and other toxic components.

Several scientific researches by developed countries on the potential threat of tobacco smoking have identified smoking as the second major cause of death in the world. Over five million deaths every year are due to tobacco smoking and according to the World Health Organisation if the current rate of smoking continues, it will cause some 10 million deaths each year by 2020. Half the people who smoke today (about 650 million people) will die prematurely due to tobacco.

Apart from the direct impact, mounting scientific evidences also show that people who are compelled to breathe air polluted with tobacco fumes are also at risk of suffering from a range of ailments from eye irritation, headache, cough, sore throat, dizziness and nausea to life threatening sickness like cancer and even death.

Adults with asthma can experience a significant decline in lung function when exposed to passive smoking.

Latest research on passive smoking has also shown that half an hour's exposure to tobacco smoke by non-smokers is enough to adversely affect cells, lining the coronary arteries. The dysfunction of these endothelial cells leads to the narrowing of arteries and a reduction in blood flow.

Non-smokers, especially wives and children, who are exposed to tobacco smoke in their houses, have a 25 per cent increased risk of heart disease and lung cancer. The research also found that passive smokers are more prone to respiratory disease, cot death, middle ear disease and asthmatic attacks in children.

Though deaths due to passive smoking is still not estimated they are gradually rising in keeping with the increasing number of cigarettes that burn annually. According to a UK based research, domestic exposure to secondhand smoke, causes at least 3,600 deaths annually from lung cancer, heart disease and stroke while exposure at work leads to approximately 700 deaths.

Children's exposure to tobacco smoke is high because of their fathers, who are strongly addicted to cigarettes. Research by the WHO shows that passive smoking increases the risk of lower respiratory tract infections such as bronchitis, pneumonia and bronchiolitis in children.

This also reduces the proper functioning of lungs and increases severity in the symptoms of asthma in children, while making them susceptible to middle ear infection, cardiovascular impairment and behaviourial problems. Infants of parents who smoke are more likely to be admitted to hospital for bronchitis and pneumonia in the first year of their life.

According to the WHO, over 700 million children are exposed to tobacco smoke due to exposure of adults who smoke and passive smoking is a cause for bronchitis, pneumonia, coughing and wheezing, asthma attacks, middle ear infection, cot death, and possibly cardiovascular and neuro-biological impairment in children.

Exposure to passive smoking during pregnancy has also resulted in low birth weight. More than 50 studies published over the past 25 years indicate that passive smoking causes lung cancer among non-smokers.

Passive smoking is one major cause for respiratory problems, including increased coughing, phlegm production, chest discomfort and reduced lung function, among non-smoking adults,

The California EPA report also identified a link between passive smoking and spontaneous abortion (miscarriage), adverse impact on learning and behaviourial development in children, meningococcal infections in children, cancers and leukaemia in children, asthma exacerbation in adults, exacerbation of cystic fibrosis, decreased lung function and cervical cancer.

Every child has a right to grow up in an environment free of tobacco smoke, while every non-smoker has a right to breathe fresh air. It is also time to encourage the parents who are expecting a child to quit smoking through awareness or imposed bans and strict legal actions.

However, the WHO Framework Convention on Tobacco Control (FCTC) would be a timely road map for the entire world, including the 40-member signatory countries to implement or strengthen the laws against tobacco smoking. The FCTC, the ground-breaking international health treaty, coming into force today (Feb. 27) to protect billions of people from the devastating impact of tobacco consumption and exposure to tobacco smoke.

The provisions in the FCTC set international standards on tobacco price and tax increases, tobacco advertising and sponsorship, labelling, illicit trade and second-hand smoke.

The treaty obliges member states to adopt and implement (in areas of existing national jurisdiction as determined by national law), or promote (at other jurisdictional levels), effective measures providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places. It also has provisions to prohibit advertising, sponsorship and promotion tobacco products through sports events, music events, films, fashion where the tobacco industry can target potential new smokers.

Sri Lanka where over 27 per cent males and one per cent females smoke cigarettes while thousands of non-smokers are prone to tobacco related diseases, ratified the FCTC in 2003.

Director Non-Communicable Diseases Dr. Lakshmi Somatunge said that Sri Lanka, which played a positive role from the beginning of the negotiation process of the FCTC is the first country in the SAARC region and the fourth country in the whole world to ratify the FCTC.

"This is a very important public health treaty which has vital provisions to eliminate passive smoking. " Everybody has a right to breathe air free of toxics. The FCTC has granted this basic right", said Dr. Somatunge, who has been holding public awareness programs to voice their rights, to educate the public to protect themselves from noxious tobacco fumes and the importance to cut down tobacco use.

Meanwhile, a survey, on children exposed to tobacco smoke in their own houses, funded by the WHO is going on.

Professor of Toxicology of the University of Colombo Prof. Ravindra Fernando opined that tobacco smoke should be banned in public places like in the West, as tobacco related diseases and deaths are on the increase. " Wives and children of those who smoke tobacco are highly vulnerable to tobacco related diseases.

It is now evident that passive smoking is also harmful.

"People who have never smoked have a 30 per cent increase in the risk of coronary heart disease and 24 per cent increase in the risk of lung cancer, if they live with a smoker", he said.

A smoke free 2006?

Health and Nutrition Minister, Nimal Siripala de Silva told the 'Sunday Observer' that laws to ban tobacco smoking would be introduced before the end of this year. " The final draft of the Tobacco Control Bill is now with the Legal Draftsman", he said adding that it would be submitted to Cabinet soon.

He also said that Sri Lanka was now obliged to implement a comprehensive legislation under FCTC provisions. According to Minister de Silva, tobacco smoking would be banned in public places and within 100 metres of schools. " Restrictions would be introduced in advertising and sponsorships under new legislations.

It's Toxic

Toxic 'ingredients' in tobacco smoke - It contains over 4000 chemicals in the form of particles and gases.

* Many potentially toxic gases are present in higher concentrations in sidestream smoke than in mainstream smoke and nearly 85 per cent of the smoke in a room results from sidestream smoke.

* The particulate includes tar, nicotine, benzene and benzo (a) pyrene.

* The gas includes carbon monoxide, ammonia, dimethylnitrosamine, formaldehyde, hydrogen cyanide and acrolein.

* Some of these have marked irritant properties and some 60 are known or suspected carcinogens (cancer causing substances).

According to the Environmental Protection Agency (EPA) USA environmental tobacco smoke is similar to class A carcinogen along with asbestos, arsenic, benzene and radon gas.

FCTC in a nutshell

Article 8 of the WHO Framework Convention on Tobacco Control, adopted by all WHO Member States reads:

"Protection from exposure to tobacco smoke

1. Parties recognise that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.

2. Each Party shall adopt and implement in areas of existing national jurisdiction as determined by national law and actively promote at other jurisdictional levels the adoption and implementation of effective legislative, executive, administrative and/or other measures, providing for protection from exposure to tobacco smoke in indoor work-places, public transport, indoor public places and, as appropriate, other public places."


Call to regulate GM food imports

by Rohan Mathes

Environmentalists have urged the government to regulate the influx of genetically modified imported food items into the country if it is to avert the impending and imminent danger of Sri Lankans becoming laboratory mice.

Over 70 odd imported food items sold in the super markets, especially those that come from the west, are believed to be contaminated with genetically modified organisms (GMO), according to a survey by the Environmental Foundation Ltd. (EFL).

These items include soya, cooking oils, chocolates, cheese, corn flakes, cereals, sauce, french fries, potato chips, canned soft drinks, corn and tomato products among others.

Sri Lanka's deficiency in the technical knowledge that is required to ascertain whether any specific food item contains Genetically Modified (GM) ingredients or not, places the general consuming public in a dilemma, as they are clueless of what they consume for their food.

Leading environmental lawyer Jagath Goonewardena when contacted by the Sunday Observer said, "Although regulations were drafted in 2001, they had been subsequently suppressed indefinitely by the health ministry, by the then Health Minister John Senevirathna.

A committee report and a new set of regulations had also been formulated, but yet not gazetted formally, for effective implementation."He pointed out that the Environmental Ministry Bio Safety Project of Dr. Athula Perera, had also recommended that legal and policy issues on GMO food should be regulated.

The suppliers should be able to prove beyond doubt that the food they import, is harmless. The food items in question should be controlled, monitored and banned if necessary, under the 'Food Act' or the 'Consumer Affairs Authority Act', Jagath Goonewardena added.


Taking the wheel with cell phone

by Brian Handwerk

Young drivers who use cellphones at the wheel drive like the elderly-with slower reaction times and an increased risk of accidents-a new study shows. And what's more, hands-free phones are no safer than handheld ones, scientists behind the study say.

"If you put a 20-year-old driver behind the wheel with a cell phone, their reaction times are the same as a 70-year-old driver who is not using a cell phone," said David Strayer, a University of Utah psychology professor and principal author of the study.

"For five years or so we've been interested in what happens when someone picks up a cell phone and starts to drive," Strayer said.

One thing that appears to happen is that phone-using drivers of all ages have significantly diminished reaction times. They are slower to hit the brakes and more likely to get into accidents.

Subjects took "freeway drives" in a simulator, using a hands-free mobile phone for half of the drive.

"We're seeing an 18 to 20 per cent slowing [of reaction times]," Strayer explained. "That means if someone is talking on a phone, it takes them longer to hit the brakes. They are more likely to get into an accident, and if they do get into one, it might be more severe, because they won't be able to decelerate as much. What you've effectively done is making the reactions of a 20-year-old comparable to those of a 70-year-old."

The deteriorating responses can have serious repercussions-results of this and previous simulator-based studies show that the number of rear-end collisions are double for phone-using drivers.

Perhaps to compensate for slower reaction times, cell phone users also increased the distance between their cars and cars ahead of them by some 12 percent.

Elderly drivers saw similar declines in reaction times when they took the wheel with phones. In a bit of a surprise, however, their reactions did not deteriorate at a greater rate than those of their younger counterparts.

"We see in the lab that older adults tend to have slower reaction times in general and also sometimes have difficulty in multitasking relative to maybe a 20-year-old," Strayer said. But in the study the 20 older subjects (average age: 70) suffered no greater impairment than their 20 younger colleagues (average age: 20).

Phone users of all ages also took 17 per cent longer to return to the speed of traffic after braking.

Such sluggish driving can affect the likelihood and severity of rear-end collisions and help to create gridlock, especially when many drivers display such behaviour.

Strayer and co-author Frank Drews, assistant professor of psychology, published their findings in this winter's issue of the journal Human Factors.

- National Geographic News

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