From Smog To Smokers---Broadening The Attention-Scape

Delhi and its air have been hogging headlines for quite some time now with speculations galore on the quantum of cigarette smoke people in the capital are breathing in. And what’s concerning is rather than thinking of solutions, we have only been sensationalising this, be it across media or social media. From a health perspective, this is alarming, and immediate measures must be taken to address the issue. For now, with an average AQI hovering between 350-400, there is no better alternative for people in the city than staying indoors whenever possible while resorting to the use of air purifiers.

However, this phenomenon is a temporary affair every year in Delhi and parts of the country during winter months which is not quite the case for those who smoke, breathing in anything between 10-15 cigarettes smoke directly every single day. One wonders why there is little chatter or conversation around it because it is high time a movement gets started to empower better health for smokers. While the Ministry of Health and Family Welfare’s recent initiative, directing all state-run and private hospitals to establish Tobacco Cessation Centres is laudable, we must understand smokers better.

Empathy towards smokers could be a game-changer in empowering them

Understanding smokers, acknowledging their problems and empathising with them is the first step towards helping them. As family members, friends and even medical practitioners, we often dismiss smokers as people who have made a deadly choice and deserve to suffer. This rigid approach is what poses a bigger risk not only to them but to their families. As a society, it is imperative we understand how smoking often becomes a compulsive habit, thanks to stress and other psychological issues. The immediate need of the hour is to acknowledge the psychology of smoke addiction and empower smokers to move towards cessation or better options. 

Key damages caused by smoking---Some lesser-known problems

1. Premature Aging
   Smoking doesn’t just damage the lungs; it visibly ages you. Smokers experience dull, wrinkled skin due to reduced blood flow and collagen breakdown, leading to earlier onset of sagging and fine lines. This premature ageing isn’t confined to the skin—it affects your entire body, including your lungs and internal organs, accelerating the natural ageing process.

2. Reduced Fertility
   Smoking harms fertility in both men and women. In women, it reduces egg quality and accelerates ovarian ageing, leading to early menopause. Men who smoke have lower sperm counts, reduced sperm motility, and higher rates of DNA damage in their sperm, contributing to infertility and increased risks of birth defects in offspring.

3. Chronic Fatigue and Poor Energy Levels
   Many smokers report constant tiredness due to reduced oxygen supply throughout the body. Smoking causes carbon monoxide to bind with haemoglobin, impairing oxygen delivery to muscles and organs, and leaving smokers feeling lethargic and less capable of handling daily physical tasks.

4. Slower Wound Healing
   Smokers are at higher risk of delayed recovery from surgeries and injuries. Smoking reduces blood flow and nutrient supply to tissues, making it harder for wounds to heal properly. This increases the chances of infections and poor outcomes after surgical procedures.

Second hand smoke---a lesser-known evil

Second-hand smoke has silent but serious repercussions on family and friends. It increases the risk of life-threatening conditions like lung cancer and heart disease, but the daily challenges are often overlooked. Loved ones may develop chronic coughing, recurring respiratory infections, or worsening asthma symptoms. Pregnant women exposed to second-hand smoke are at greater risk of premature delivery, low birth weight babies, and pregnancy complications. Protecting non-smokers means keeping shared spaces smoke-free and limiting exposure wherever possible.

Ensuring Cessation and Exploring Innovative Alternatives for Those Struggling to Quit

While quitting smoking is the best option, and resources like Nicotine Replacement Therapies, therapy, and exercise can be very effective, there are also ways to reduce risk if you're not ready to quit:

• Safer Nicotine Products: Using nicotine patches, gum, pouches, or lozenges can help satisfy cravings while avoiding many of the dangerous chemicals found in cigarettes.
• Managing Stress: Smoking is often linked to stress. Techniques like therapy, support groups, yoga, meditation, and mindfulness can help manage stress and break the smoking cycle.
• Digital Health Interventions: Mobile apps, virtual counselling, and gamification strategies provide accessible, engaging, and personalised support for smokers trying to quit.

Nurturing a wellness first future

Having said that, we might need to broaden the ambit of alternatives for smokers, given many find giving up smoking almost impossible despite various cessation methods. Many just don’t have the patience to continue and stay consistent, ending up coming back to the same repetitive loop. And as someone who treats COPD, I feel it is imperative we contain health harm more than anything else. That is exactly where we need to rethink interventions and explore new possibilities with increased investments in medical research while also trying to borrow from some of our Western peer nations. At the end of the day, empathy coupled with innovation is the only befitting response in a country that has a huge smoke burden and access to options, driven by knowledge, is key towards co-creating a better, brighter future. 

Dr Pavan Yadav

Guest Author Lead Consultant at Aster RV Hospital, (Interventional Pulmonology and Lung Transplantation)