Subh-e-Nau Magazine

Escaping from the Dangers of Tobacco and Nicotine 

Smoking is a key public health concern which kills and injures millions of people across the globe. What can we, and especially the youth escape from this highly addictive activity? Awareness is a key solution and illuminating starting point. 

Born in Michigan (USA) on July 19TH, 1960, Terrie Hall was known as a playful cheerleader at her high school after moving to North Carolina. She started smoking cigarettes when she was just 17 years old. She continued to smoke in the following 23 years until being diagnosed with cancer in 2001. At the age of 40, Terrie Hall had to go through laryngectomy to treat her throat cancer. This painful surgery removes the patient’s larynx, more commonly known as the ‘voice box’. After showing some signs of recovery, her cancer returned. She had been diagnosed with cancer again 10 times. She lost her voice, had to wear a wig after losing hair and everyday tasks had become challenging for her. Smoking had ruined her life but she refused to give up. Ms. Hall decided to speak out despite losing her voice. She soon became a famous anti-smoking and anti-tobacco advocate traveling across the United States educating teenagers and young people about the lethal effects of smoking. She spent her last 13 years in agonizing pain. On September 16th, 2013, Terrie’s daughter and grandson helplessly watched their mother died of cancer in North Carolina hospital. She was just 53 years old woman at the time of her death. You can search Terrie Hall Anti-Tobacco Advocate on the internet to know more about her work of social activism.
Terrie Linn McNutt Hall was just one of the few smoking victims who received media attention. Nearly 6 million victims from around the world silently die premature and painful deaths every year as a result of smoking and using tobacco products. Media does not feature or broadcast them because they are considered ‘natural deaths’ most of the times. Despite global scale anti-tobacco campaign, the smoking trend is on the rise and it is particularly affecting the developing countries more. 

Where Does Tobacco Come From?

Refined tobacco is derived from the leaves of the Nicotiana Tabacum plant. Tobacco, which is native of America, is now commercially cultivated around the world. Dried tobacco leaves are used to produce smoking (cigarettes, cigars etc.) and smokeless products (chewing tobacco, snus etc.). More than 5.4 trillion cigarettes worth U$ 699.4 billion were sold to over one Billion smokers around the worldwide making it one of the most profitable industries. China is the world’s top tobacco producers with 2800 metric tons production followed by India and Brazil producing 760 and 675 metric tons respectively. Pakistan has ranked 8th in world’s largest tobacco producer countries list with 116 metric tons annual production. Here’re some of the tobacco products available in the markets to consumers with ‘health hazard warning’:
  • Filtered Cigarette: Tobacco rolled into a paper with a synthetic filter at one end. It is the most popular tobacco product in the world.
  • Cigar: It is a rolled bundle of fermented tobacco leaves. It contains more tobacco which makes it costlier than a regular cigarette.
  • Hookah/Shisha: an instrument for vaporizing and smoking flavored tobacco. The vapor is passed through a water basin before inhaling tobacco smoke.
  • Naswar: This is moist, powdered tobacco snuff popular in South Asia and Central Asia including Pakistan, India, Russia and Tajikistan etc.
  • Chewing Tobacco/Gutka: This smokeless tobacco product is made of crushed areca nut, tobacco, paraffin wax mixed with savory flavorings. Originated from India is now being consumed by people in Pakistan and other neighbor countries.
  • E-Cigarette: Also known as ‘Vape Pen’ is a relatively new product which is increasingly becoming popular in developed countries. An electronic cigarette is a battery-powered vaporizer which simulates the feeling of smoking without burning tobacco.

Why do people start smoking?

There are several psychological, social and environmental factors which can turn people to smoking. Young teenagers are more vulnerable to tobacco addiction. The following are some of the key influences responsible for making people tobacco addict:
  • Curiosity: As we grow up watching people smoking cigarettes and consuming tobacco, we continue to get more curious about it. Despite being told that smoking is injurious to health and it kills, some kids want to try smoking or smokeless tobacco just for fun. It is true you cannot die or get seriously ill by just smoking a cigarette or two. Nevertheless, research reveals that more than 60% of teenagers who try their first cigarette eventually become regular smokers.
  • Stress Relief: A large number of people start smoking to cope with depression, post-traumatic stress disorder (PTSD) symptoms and anxiety of daily life. Although smoking may relieve stress at first, but medical experts believe that smoking tobacco can only make your mental health problem worse in the long run.
  • Cheap cigarettes freely available: Young children are more likely to start smoking even before turning 18 in countries where cigarettes are inexpensive and underage tobacco sale laws are not strictly enforced.
  • A smoker family member: Children and young teenagers are more vulnerable to become a tobacco addict if there is a smoker in the family. This is particularly for two reasons; firstly, they get curious and want to try how it might taste or feel to smoke a cigarette, and secondly, they can steal it without having to struggle to get one through illegal resources.
  • Social smoker friends: Smoking is considered a ‘cool’ practice in different societies. Even the non-smoker people do not hesitate to light a cigarette when they are with the smoker friends in parties and social gathering.
We asked a few smokers in Islamabad to share their stories of how and when they started smoking. All participant names have been changed to pseudonyms to protect their privacy because people who smoke are hesitant to openly talk about smoking in our society.
Umar, a 43 years old businessman, smoke 10 cigarettes a day. “I tried my first cigarette when I was 15 years old but I did not like it and never smoked again until I turned 28”, Umar recalled his first ever smoking experience. “I got married and everything was going fine when my mother suddenly died of cardiac arrest. It was an awful tragedy and this is when I bought a pack of cigarettes and started smoking”, says Umar. He has admitted that smoking is adversely affecting his life but he finds it more difficult to quit smoking than living with health problems.
Kamran, 24 is a student and he also works as a part-time cab driver. “I belong to a small village in central Punjab where smoking Hookah is a very common practice”, he said. “My father, grandfather, elder brother and even one of my grandmothers also smoke Hookah at home. It was available all the times and I secretly started smoking when I was in 6th grade”, Kamran revealed. He moved to Islamabad a few years ago and switched to cigarettes as smoking traditional Hookah is hard in modern cities. “Smoking is strictly forbidden at my campus and on-demand cab service also has stringent anti-smoking rules. However, I always find a way to take ‘smoking break’; sometimes I smoke in my school lavatory and there are some passengers who ask me if they could smoke in my cab. I happily allow them and both of us enjoy smoking during the ride”, he added. Kamran still considers smoking ‘safe’ because none of his family members have suffered a serious health problem despite smoking tobacco.
Farhia, 27 is an IT professional who quitted smoking years ago after trying it for fun. “My mother is a family physician, she hates cigarettes and none of our relatives smoke tobacco”, she said. “It all started when I was visiting a hill station with my college fellows. One of the girls took a strange pen out of her bag and started smoking in the bus”, Fariha recalled the moment when she saw a vape pen (e-cigarette) for the first time in her life. “She told me that it’s a modern smoking device which is a ‘safer’ alternative to regular filter cigarettes”, says Fariha. “I was very excited. She let me inhale some flavored tobacco. It felt so good and I gave her some money to get one for me as well which she did”. Fariha continued to smoke until her vape pen broke. “I wanted to buy another one but I could not and this is how I quit smoking just after trying it for a few weeks. My family is still unaware and now I’m satisfied with quitting something which could have ruined my health”, she added.

Why is it difficult to quit smoking?

Everyone starts smoking by his/her choice but quitting is not that easy. Giving up even after smoking for a shorter period becomes a lot harder for average smokers. This is because of nicotine found in tobacco which is a very addictive drug. Nicotine can cross your blood-brain barrier within seconds after you inhale tobacco smoke. Your brain then releases adrenaline which creates a short-term feeling of pleasure and energy. It does not last long and you may feel tired or depressed and smoke another cigarette. Once a human body builds up a high tolerance to nicotine, it needs to smoke more cigarettes. When people cannot smoke, they suffer from painful withdrawal symptoms because their bodies struggle to live without nicotine. Many smokers cannot overcome the painful withdrawals without professional help and they continue to waste their health, time and money on smoking.

Smoking is injurious to the environment and public health too

It is an undeniable fact that nicotine is toxic to human health but lesser people may know that the hazards of cigarette smoking are far more serious than we may think. It is not just injurious to smokers’ health but also adversely affects the environment, wildlife and general public health in different ways.
  • Cigarettes and all other smoking tobacco products are notoriously known to ruin indoor air quality. Besides it is harmful to non-smoker people living in a building or traveling in a vehicle filled with contaminated fumes, most of the people don’t like unpleasant tobacco odor.
  • A 2017 WHO report,Tobacco and its environmental impact: an overview”, reveals tobacco production is a damaging process for the environment from start to end. Tobacco cultivation and cigarette roll preparation are responsible for deforestation and several harmful chemicals are produced during raw tobacco processing.
  • When the cigarettes are disposed of after consumption, toxic chemicals leach out of their butts. These chemicals can pollute the entire ecosystem by entering the food web.
  • Another serious smoking hazard is the risk of fire accidents. Tossing a lit cigarette can cause deadly fires in house, office, car or even the entire forest! You should never smoke but smoking in the bed makes it even more dangerous. People have been killed after falling asleep while smoking which resulted in fatal fires.
  • Small children, wildlife and pets may swallow improperly disposed cigarette butts out of curiosity or mistaken for food and may chock to death.

Is there any SAFE alternative to smoking?

Most of the smokers and tobacco companies claim that their products are relatively ‘safer’ than other ‘substandard’ products. One may question if there’s a safe way to smoke without risking your health. An honest answer to this question is, not at all! Smoking is injurious to health no matter which way you may choose to smoke. A recent study conducted by the National Cancer Institute has confirmed that there is no safe level of smoking, it always is risky.
  • Hooka is considered ‘safer’ than smoking cigarette which is a myth. Other than inhaling toxic nicotine, hookah/shisha smoker also risk carbon monoxide poisoning from burning charcoal and spread of infectious diseases if the pot is not properly cleaned.
  • Light Cigarettes, cleverly marketed as ‘low tar’, are not safer than regular. These cigarettes are just as harmful to health. Using the special filter and more porous paper roll to reduce tar yield has been found to be very little or no effective at all in reducing the toxins. In addition, since regular smokers are not satisfied with ‘light filters’ and they may end up smoking even more cigarettes than the regular ones.
  • Vape Pens are not only injurious to health but they may also overheat and explode causing serious injuries to the smoker. In May 2018, an exploding E-Cigarette killed a young man in Florida, USA. Mr. Tallmadge D’Elia, 38 was the first ever person killed by vape explosion. Nearly 200 battery operated cigarette explosions have been reported from 2009 to 2016 only in the United States. At least 38 people have suffered serious injuries requiring hospitalization. Another key potential danger of vaping is that teens and younger parts of the population are taking this up due to its vast range of flavors, and medical experts are concerned that this may introduce nicotine addiction and act as a gateway drug for the young including opening pathways to usual cigarette smoking.
  • Smokeless Tobacco is generally considered safer than smoking equivalent which is not true. The use of this type of tobacco such as Naswar or Gutka is linked to lung, stomach and mouth cancer and it may also cause bronchitis, kidney, heart and other diseases. Chewing tobacco is also bad for oral health as it can irritate gums and causes bad breath.

Legislation vs. Enforcement to control tobacco consumption in Pakistan:

Several attempts have been made at national level to control tobacco usage in Pakistan. Besides printing large graphic health warning on cigarette packs, the government has recently proposed a new ‘health tax’ on cigarettes sale to discourage smoking. Nevertheless, we still have a long way to go; requiring more stringent enforcement and more public awareness against tobacco addiction in the country. Here is what has been done so far to protect public health from smoking hazards:
  • There is a strict ban on tobacco consumption (including smokeless) and sales near all educational institutions. However, small grocery stores located near the schools and colleges still continue to sell cigarettes in most of the small towns and cities.
  • In 2008, smoking in public transport was made a criminal offense punishable by a fine up to 100,000 Rupees. It is still not strictly enforced even 10 years later. The law is often violated by drivers of public transport vehicles and police are reluctant to take action against them.
  • Removing cigarette commercials from TV, Newspapers and Billboards has been helpful. Now the tobacco companies can only use posters and online resources to advertise their products.
  • It is illegal to sell cigarettes to children under 18 but many retailers would not mind checking valid IDs of young boys who come to buy cigarettes from them. There are no proper laws to restrict minors from buying chewing and snuff tobacco (Naswar/Gutka).
  • Selling Indian Gutka has been outlawed several years ago but enforcement is not very strict. It is not hard to buy a pack of this cancer-causing smokeless tobacco product in Karachi, Lahore and other big cities of Pakistan.

Smoking Kills!

Tobacco Companies Kill their Best Customers!
Smoking even one cigarette a day for a few months can still be damaging for human health. For those who smoke more than 10 cigarettes a day for years are at significantly higher risk of cancer and cardiovascular diseases. It is not technically wrong to say that tobacco tycoons actually ‘kill’ those people who are their best customers. Smoking can cause different types of cancers including the cancer of the liver, lung, oral cavity and throat, voice box, stomach, kidney, and acute myeloid leukemia. Other than causing cancer, smoking is also a major risk factor for heart diseases. Smokers may suffer around a 70% higher death rate from coronary artery disease than do nonsmokers. Another health hazard of smoking is it speeds up aging. Nicotine restricts blood flow to your skin causing it to turn dry and wrinkled.
Here are some additional facts:
  • Worldwide, tobacco use causes nearly 6 million deaths per year
  • 1 in 10 cancer survivors still reports smoking. They consume an average of 15 cigarettes per day
  • Tobacco caused 100 million deaths over the course of the 20th century (World Health Organization)
  • Cigarettes are far more addictive than alcohol and opiates. The American researchers found that about 18% alcoholics were able to quit drinking, and more than 40% of drug addicts were able to quit cocaine, but only 8% were able to quit smoking tobacco.
  • 5% deaths from 12 different types of cancers are linked to tobacco smoking (American Cancer Society).

Writers: Sultan Kiani / Prof. Farrukh Chishtie 

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How to Use Gas Safely at Home

In winters, the risk of gas explosions and asphyxiation accidents increases. Here are some tips to keep these dangers at bay.   

A newlywed couple on their honeymoon died of asphyxiation as a result of leaking gas earlier in December 2018. Syeda Fatemi, an Assistant Director at the Foreign Office, was staying in a hotel room with her husband where gas leakage claimed their lives. As this tragedy indicates, such dangers are clearly present especially during winter times. Here are some safety tips for you to consider.
Heating gas (methane/propane) is a cleaner alternative to kerosene oil, wood and coal but it needs to be handled with care. Using a faulty gas appliance or poor ventilation system can lead to fatal disasters. Here are some easy and practical tips to use gas safely at home all year long:

Check for Gas Leaks

This safety inspection should often be carried out, particularly before the winter season and when you move into a new house. Minor gas leakage may remain unnoticed during summer as we leave our windows open allowing it to escape. Since leaking gas does not reach a ‘Lower Explosive Limit’ in your house,  there is no explosion and sufficient ventilation also prevents it to cause suffocation. However, as the winter season kicks in, we have to shut the windows to stay warm and this is when leaking gas may reach ‘Lower Explosive Limit’ either causing a deadly explosion or asphyxiating the inhabitants. Therefore, we should never ignore even the slightest sign of gas leakage. Call a qualified plumber to fix any leaky pipe at home. Never light a matchstick to check for gas leakage, always use soapy water to look for leaky joints. Repeat the test after fixing the faulty joint without turning on the gas appliance or lighting a matchstick.

Pay Attention to Rubber Tubing

Do you know most of the accidents caused by gas leakage happen as a result of using faulty, ill-fitted or worn out rubber hose? High quality rubber tubing should be your first choice, you may have to pay a little more but it is not worth taking the risk. Always use clamping ring on both sides of rubber tube i.e. the appliance nozzle and ball valve nozzle. Push the clamping ring to the end of the gas tube and tighten the screw with a screwdriver. Do not forget to replace tubing every 2 years, earlier if you notice any cracks, holes and porosity especially at the ends.

Cheap Gas Appliances could Prove Costly

Faulty and poor quality gas appliances are one of the leading causes of accidents. Always buy good quality gas stoves, room and water heaters, grills and ovens etc. Spending little more on high quality products makes more sense because they are safer, more reliable and last longer than cheaper and substandard products.

Water Heater Safety

We cannot live without warm water in cold weather. Water heater installation should only be carried out by a trained technician. Make sure your geyser has a functional pressure release valve or it could cause a massive explosion in case of thermostat failure. People often make a mistake of installing a tankless or instant water heater inside their bathrooms. No gas appliance should ever be installed in a very small confined space like a bathroom. Try installing it just outside the bathroom with proper ventilation to minimize the risk of gas explosion and asphyxiation.

Watch out Caron Monoxide Poisoning

The gas is produced from burning fuel such as space and water heaters and hot plates etc. Unlike carbon dioxide (CO2), the gas is extremely toxic to humans. Carbon monoxide (CO) is also known as ‘silent killer’ because it can kill people before they can detect it. You should never ignore the following symptoms of CO poisoning to stay safe:
  • Headache
  • Fatigue
  • Nausea and vomiting
  • Stomach and chest pain
  • Confusion
  • Visual problems
  • Shortness of breath
If you do not reduce the level of carbon monoxide to safer limits, you could lose consciousness. Immediately turn all the gas appliances off, and open your doors and windows to let the accumulated gas escape. Move the affected person to well-ventilated place and call an ambulance for help if s/he fails to regain consciousness.

CO & Gas Leak Detector

Safety alarms are a strong second line of defence against the risk of fire and carbon monoxide poisoning. Similar to a smoke detector which can help you detect fires, a gas leak detector is a safety gadget which automatically detects flammable gas leakage in confined spaces and rings alarm before it reaches the lower explosive limit and may cause a deadly explosion or suffocation. These safety detectors are easily available in Pakistan; you can visit an electronics shop, safety gadget store or buy online. You can buy a gas leakage and carbon monoxide detector in 4000 Rupees or less. It is very important to use a good quality battery in these safety detectors and replace them very often.

General Safety Tips to Remember

  • Do not use any gas heater in a room with poor ventilation.
  • Limit your exposure to a radiant gas heater. Do not keep your young children too close to the heater.
  • Do not leave a gas heater unattended or when there is a small child alone in the room.
  • Never leave any gas heater running overnight. Always shut the valve off before you sleep or when the flame goes out.
  • Never lit a matchstick or lighter if you smell gas. Instead shut off all controls, open the doors and windows, do not touch any light switch and then call a gas technician to fix it.
  • The best way to minimize indoor pollution and the risk of carbon monoxide poisoning is to install a proper vent pipe system.
  • If you cannot install a proper vent, then it is highly advisable to keep your room ventilated by slightly opening a window.
  • Keep curtains and other flammable items at least 2 feet away from radiant heaters (follow this advice for electric heaters as well).
  • Imported gas fan heaters are a better alternative to conventional radiant heaters. They are safer for children and automatically shut off when gas pressure drops.
Writer: Sultan Kiani


Sweet Burden 

The father neither feels offended nor choked by the massive surge of the gummy babies nor does he gargle to wash his mouth…. 

No one has yet heard a fish speak to the offspring during training at cradle or in adolescence, nor has any one understood with any amount of certainty the mode of transmission of massage to the youngsters, but we know that all surviving fries get highly trained in the art of survival, to play in the aquatic courtyard, to swim for the joy of life, gambol in sheer ecstasy or hide and lurk at the approach of danger, just like their parents were trained by an apparently silent code of socio cultural equilibrium, manners and mode by their ancestors.
Yet, when we watch a small, fresh water Cichlid (tilapia is one) we get a glimpse of the cryptic enigma. The papa opens his mouth at the approach of period which is a signal for the toddlers to rush in to the big mouth for refuge. The father closes his lips without puffing his cheeks or showing any sign of discomfort. There is no sound or commotion in the buccal cavity. The crowded gang lies dormant in a brotherly clasp, huddled in a fleshy castle, ears cocked if all is well, as they are impatient to emerge once more.
When the danger passes, the door opens at which the youngsters pour out again, I am sure, giggling and jostling, fish-fashion, as children do to resume hop-skip-and-jump from a point where they left it a while ago.
The father neither feels offended nor choked by the massive surge of the gummy babies nor does he gargle to wash his mouth. He is immensely happy that he has saved his brood from destruction and slaughter and at the same time passed on to them the technique of defense so that his grand children and their future progeny may live in peace.
This part of the upbringing must be a mother’s responsibility, as is usual in higher strata, but oddly enough here, she watches the dutiful husband in admiration, smug and content, that the bothersome brats have left her alone to forage, frolic (after all she also is a fish) given her time for leisure and relaxation by a refreshing chit-that with the neighboring ladies.
Cichlid-fathers are not the only heroes sharing the sweet burden; there are others in several categories, spread all over the globe in various groups concentrating most in Australia where a board of animals carry their young ones in a protective pouch over their bellies, wherein they cuddle and suckle, sleep and snore, rest and dream, some in slumber, some in day light.
The Kangaroo tops them all. Whether mamma nibbles at the grass, leaps or bounds, jumps or jogs, the baby is safe and warm; jostled by the violent muscular movements nor feeling stifled or chilly. The pouch is a marvel, neither too shallow nor too deep, custom made, correct to the millimeter.
The baby neither gets thrown out by the thump when the air-borne mother lands on the ground nor does its milk-teeth clang by the impact. The feathery pouch, soft and gentle has a loving-mother’s touch. As it were, it has thus two mothers simultaneously: the real one out and away and the other close and all around exuding compassion, all the while.
The list is long and each more interesting than the other like the papa frog of Surinam who carries the eggs laid by his wife on his back where they incubate and hatch. The bears, the monkeys, baboons and chimpanzees carry their babies on their humps clasping the mamma by a strong grip of a fold of skin and hair.
The opossums have a prehensile tail with which the young ones, a crowd of unlucky thirteen (the mother has only that many nutritional supplies) ride mamma’s back while she looks for lunch.
But the strangest amongst this bunch is a sea fish that has the fins of a fish, gills to breath, a posterior that tapers like a tail and the face of a horse.
This novelty, as an object inviting great curiosity in marine aquaria, measures less than two inches, from head to foot. Devoid of the speed of a steed or a bushy tail to swipe at the annoying flies, it neither neighs nor stampedes, but seems to hang in the air if the water is crystal clear, hardly swimming like a fish and is very aptly called the Sea Horse.
The ‘mare,’ if we call her by this name, as she lays her minuscule eggs, picks them up with his beak and puts them in a pouch at his front where they incubate and hatch. When the babies ate ready to emerge, he feels their movements upon which the pregnant pouch is pressed and the young ‘colts’ are pushed out in the, cool, safe medium where they start a fresh life, eating like the papa not the grass and oats of the horse but minute plankton that they can see without; knotting their eyebrows for a close look.
Writer: Dr. A. A. Quraishy
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