Alcohol and smoking ban - A reply:

Civilized drinks are worse than Kasippu

by D. P. Atukorale

I refer to the letter to the editor by D. M. Balasuriya (D M B), Moratuwa (Sunday Observer 2006-07-16). I fully agree with DMB that smoking and consumption of alcohol are bad for health. I have come across thousands of heart patients who have left this world in the prime of their lives leaving behind their young wives and children, as a result of cigarette smoking, during my 36 years experience as a cardiologist. I also have come across a large number of patients suffering from lung cancer, bronchitis and other complications of smoking both in Sri Lanka and UK.

I do not agree with DMB that fumes emitted from vehicles, garbage burning and other gases produced by industry are more toxic to health than tobacco smoke.

There is a common misconception among some of the Sri Lankan laymen that vehicle fumes and other industrial fumes contain nicotine (which is the most poisonous chemical in cigarette smoke).

Cigarette smoke contains over 4000 chemicals which include nicotine, carbon-monoxide and tar which are harmful to our health. Unlike vehicle fumes and other industrial fumes, we can completely stop smoking and avoid these highly unnecessary deaths, following heart attacks, bronchial cancer (and other cancers) bronchitis, emphysema and respiratory complications if we give up smoking.

I fully agree with DMB that vehicle and other industrial fumes are harmful to health and affect especially those residing in urban areas and the government must do its best to reduce air pollution.

Todate there is not a single case of bronchial cancer or heart attack reported in Sri Lankan medical literature due to vehicle fumes or industrial fumes. As mentioned earlier, cigarette, beedi pipe and cigar smoking can be completely given up by those who smoke, unlike vehicle fumes which can only be reduced.

I know of a significant number of young wives who have developed heart attacks and angina following passive smoking (second hand smoke) due to their husbands' smoking. I always advise young females in their marriageable age to get married to a smoker if they want to become young widows.

I don't belong to any political party and my hats off to the present government for passing the anti-alcohol and anti-tobacco bill in parliament. We are very greatful to the JHU and all other political parties for the full support given for the above piece of legislation against alcohol and tobacco use.

As regards the "Kasippu" trade, I fully agree with DMB that consumption of Kasippu (which is the poor man's whisky) is dangerous to health and there have been a considerable number of deaths due to drinking Kasippu as a result of certain toxic substances introduced into Kasippu during its manufacture.

But most of the deaths (mortality) and morbidity due to consumptions of alcohol in Sri Lanka are due to consumption of the so called "civilized" type of alcohol such as arrack, whisky, brandy and beer and not due to "Kasippu" drinking.

In my experience as a clinician during the last 44 years, I have not come across a single case of alcohol cirrhoses, hypoglycaemic coma (ie coma, due to low blood sugar), alcoholic neuritis, Hepatic coma, liver failure, alcoholic hepatitis and alcoholic cardiomyopathy due to Kasippu drinking.

I contacted several of my friends (who are very highly qualified physicians) attached to Colombo National Hospital, Sri Jayawardenepura hospital, general hospital Galle and general hospital Kandy who agreed with me that the majority of patients with complications due to the consumption of alcohol treated both in government and private sector are due to consumption of the so-called "civilized" drinking (arrack, beer, whisky, brandy, gin etc) and not due to drinking "Kasippu".

Moreover alcoholic cirrhosis is quite common both among the rich and poor in the more developed countries such as England, France and USA where illicit alcohol such as Kasippu is not heard of.

Kasippu drinking which is dangerous to health, should be discouraged and if possible stopped, but most of the deaths due to alcohol consumption in Sri Lanka are due to "civilized" drinking. We Sri Lankans should be very greatful to the JHU and all other political parties and all authorities concerned for supporting the anti-alcohol and anti-tobacco bill.