This year, World Health Organization (WHO) chose that „Tobacco and Heart Diseases“ would be in the focus of the World No Tobacco Day 31 May 2018. The campaign will highlight the risks of tobacco use on cardiovascular disease of people worldwide as well as the measures that countries should undertake to reduce cardiovascular risks due to tobacco use.
There are more than 1 billion smokers worldwide, and tobacco epidemic kills more than 7 million people each year, among them 900,000 non-smokers exposed to second-hand smoke (SHS). Data also indicate that heart diseases kill more people than any other cause of death worldwide; in 2015 more than 15 million people, and among them 10% to 12% because of smoking and exposure to tobacco smoke. Tobacco is the second leading cause of death from cardiovascular disease, after high blood pressure.
Tobacco is a significant risk factor for coronary heart disease and myocardial infarction, cerebrovascular disease and stroke, and peripheral arterial disease. Even in younger persons aortic aneurysm can be developed. Exposure to second-hand smoke is also a cause of death for almost 900,000 non-smokers, two third die from cardiovascular diseases (63%). Risk for coronary heart disease in non-smokers exposed to SHS increases 25%-30%, and for stroke 25%.
Biology of changes on heart and blood vessels due to tobacco use are numerous. Cigarette smoking and exposure to SHS in older than 15 can be a cause of atherogenic disease i.e., thickening of endothelium, followed by increased risk of thrombosis, increase in triglycerides and decrease in HDL cholesterol, increase in the levels of carbon monoxide and decrease in oxygen, etc.
Countries should implement WHO tobacco control measures MPOWER, in line with the Framework Convention of Tobacco Control to reduce tobacco use and protect people from non-infectious chronic diseases, such as cardiovascular diseases. The MPOWER measures are as follows:
- Monitor tobacco use, health consequences and prevention policies;
- Protect people from exposure to tobacco smoke by creating completely smoke-free indoor public places, workplaces and public transport;
- Offer help to quit tobacco (cost-covered, population-wide support, including brief advice by health care providers and national toll-free quit lines);
- Warn about the dangers of tobacco by implementing plain/standardized packaging, and/or large graphic health warnings on all tobacco packages, and implementing effective anti-tobacco mass media campaigns that inform the public about the harms tobacco use and second-hand smoke exposure;
- Enforce comprehensive bans on tobacco advertising, promotion and sponsorship; and
- Raise taxes on tobacco products and make them less affordable.
Data suggest that reduction in the number of cigarettes smoked do not reduce the risk for heart diseases, smoking cessation has short-term and long-term beneficial effects:
- within 20 minutes heart rate and blood pressure drop,
- after 12 hours concentration of carbon monoxide drops to normal,
- in 2 to 12 weeks circulation improves,
- 1-year risk of coronary heart disease is about half that of a smoker’s,
- in 5 years stroke risk is reduced to that of a nonsmoker 5 do 15 years after quitting, and
- in 15 years the risk of coronary heart disease is that of a nonsmoker’s.
Legislation that completely ban smoking at all public and workplaces, and public transportation reduces incidence of myocardial infarction and addition to the hospital in persons less than 65.
Goals of the World No Tobacco Day 2018
The aims of the World No Tobacco Day 2018 is to highlight the link between the tobacco use and cardiovascular disease, to raise awareness within the public on hazardous health effects, particularly on cardiovascular system, of smoking and exposure to SHS and to encourage countries to implement all proved and efficient tobacco control measures.