No Tobacco Day was on May 31. Doctors tell you how to be tobacco free to boost immunity during Coronavirus pandemic

Tobacco consumption happens in two forms- either chewing tobacco in the form of smokeless tobacco (pan masala, gutka & khaini) or smoking (cigarettes & beedi). Tobacco consumed in any form is extremely addictive because of nicotine and three hundred cancer causing carcinogens. Chewing tobacco accounts for major consumption of tobacco in India, making head and neck cancers the most commonly reported forms.  Smokeless tobacco is usually a mixture of aromatic betel leaves and nuts that the user keeps in the mouth and chews on it for hours. When these leaves are chewed upon constantly for long durations, nicotine is released in the mouth along with other flavours, that causes the mouth to produce excessive saliva. Users generally end up spitting this out.  While smoking tobacco, nicotine is released in the lungs and effects the other organs, tobacco when chewed stays in the mouth. Development of tartar can lead to gum disease and can negatively impact saliva flow in the mouth. It makes it easier for bacteria to stick to teeth and gums. Repeated consumption causes various damage to the oral health:

Impacts on oral health

Bad breath: This is the most initial and primary impact of repeated consumption of smokeless tobacco, happens due to the residue of smokeless tobacco is left in the mouth and stained teeth.

Gum infections: Smokeless tobacco can irritate your gums, causing gum (periodontal) disease.

Tooth decay or dental caries: Sugar is often added to enhance the flavor of smokeless tobacco, increasing the risk for tooth decay. The main ingredients of smokeless tobacco are sand and grit, that wear down teeth, causing erosion and sensitivity

Leukoplakia- Thick white patched inside the mouth, are known to be early signs of mouth cancer

Oral submucous fibrosis: A chronic disease affecting any part of the oral cavity leading to stiffness of the oral mucosa, causing reduced opening of the mouth and inability to eat.

Oral and throat cancers: Head and neck cancer is the most life-threatening health risk linked with smokeless tobacco.

Each time a person chews tobacco, poisons are released in the mouth putting them at a greater risk of mouth cancers.

Ingredients like betel nuts made from betel leaves and slaked lime, present in smokeless tobacco, put people at a risk of cancers of the mouth, pharynx (throat), oesophagus (gullet), stomach and pancreas. Cancers of the lip and cheek are also common, as the tobacco is pressed against the lining of the mouth.

The writer is Dr Nikhil Modi, Senior Consultant, Respiratory, Critical care & Sleep Disorder, Institutes of Critical Care, Indraprastha Apollo Hospitals, New Delhi

The most common cause of lung cancer is smoking. Risk of lung cancer is up to 30 times higher in long term smokers compared with lifetime non smoker. Moreover, tobacco smokers may be more susceptible to contracting COVID-19, as the act of smoking involves contact of fingers with the lips, which increases the possibility of transmission of viruses from hand to mouth. Smoking shisha or hookah, often involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the COVID-19 virus in communal and social settings

                — Dr Vikas Goswami, Senior Consultant Medical Oncologist, Max Hospital

Say no to tobacco

Even from studies before COVID-19 crisis, extensive proof underlining the deleterious impact of tobacco use on lung health and its causative connotation with respiratory diseases is all over healthcare research papers. The effects are damaging to the immune system of the smokers too and they are twofold more susceptible to influenza than non-smokers. Furthermore other severe symptoms along with a higher mortality rate were reported in smokers in the preceding MERS-CoV outbreak.

Now we know well that tobacco use is damaging to our respiratory system, with or without COVID-19. Moreover, COVID-19 has made the previously deleterious effects of tobacco, lethal. If you want to quit smoking, no time can be better than this. Research also support that the effects of smoking starts to subside as soon as the habit is controlled. Near normal body system settings can soon be restored.

There have been several studies reiterating the deadly effect of smoking on lungs.

Chemicals present in tobacco smoking causes irritation of windpipe, voice box and other parts of respiratory tract.

Excessive mucous is secreted as a response to the irritation. It also deposits in the alveoli of lungs reducing lung function and causing distressed breathing.

Gradually the entire air way reduces in size.

You are already aware of the chemicals found in tobacco harmful and cancer causing for both users and passive smokers.

The writer is Dr Anshuman Kumar, Senior Consultant & Director, Surgical Oncology at Dharamshila Narayana Superspeciality Hospital