Thursday, February 09, 2012
   
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EYE Focus - Smoking May Cause Blindness

“Smoking is dangerous to your health.”  “Smoking kills.”  Do smokers truly understand what these warnings mean?  Do they realize that one of every two regular smokers will die prematurely?  That the lifespan of chronic smokers is shorter by an average of 10 years compared to non-smokers?

Smokers are also at least twice as likely as non-smokers to lose their sight in later life, yet most people are not even aware of this additional reason to stop smoking.

CHEMICALS IN TOBACCO

Tobacco smoke contains more than 4000 chemicals, including more than 200 which are toxic, and at least 69 which are cancer-causing, as well as gases like carbon monoxide, which affects the body’s ability to deliver oxygen to the heart and brain.  The long list of carcinogenic and toxic substances that have been identified in tobacco smoke includes: tobacco-specific N-nitrosamines (TSNAs), ammonia (added to cigarettes to enhance the absorption of nicotine), benzene, formaldehyde, acetone, arsenic, butane, hydrogen cyanide (used as a genocidal agent during World War II), lead, mercury, methane, naphthalene, and even Dichloro-Diphenyl-Trichloroethane (DDT) and at least 3 other pesticides known to be unsafe and carcinogenic for humans.

Tobacco smoke has thus been classified as a human carcinogen.   It is also damaging to the blood supply, exposing the body to free radicals, which cause cellular damage and resulting in poor circulation to vital organs, including the eye, brain, and heart. Smoking oxidizes cholesterol, causing fat to build up in the arteries, while carotenoid levels and vitamin-C blood concentrations are substantially reduced. Carbon monoxide from cigarette smoke also creates hypoxia or oxygen deficiency.  All this leads to hypertension, heart attack, stroke, chronic lung disease, defects in fetuses, impotence, and premature wrinkles (in addition to cancers of the lung, mouth, larynx, and many other body organs).

Normal fundus photo of the eye

In the eye, this combination of free radicals, fat build-up, and hypoxia results in cataract, age-related macular degeneration (AMD), degradation of night vision, worsening of diabetic retinopathy and thyroid-related eye disease, and increased risk for permanent ischemic injury to the retina (arteriolar and venous occlusive disease)

CRVO CRVO FA

and optic nerve (ischemic optic neuropathy).

AION AION disc pallor

Unfortunately, all these eye diseases can be severe and, with the exception of cataract, cause permanent, irreversible blindness.

In particular, the link between smoking and AMD is as robust as the link between smoking and lung cancer, yet few people know this or have even heard of AMD, which is a leading cause of devastating visual loss.  Smoking is the only proven cause of AMD that people can do anything about, yet research shows that only a small percentage knows this.

Smoking kills, and smoking blinds.  Smokers should not wait till it’s too late before they stop smoking.

Second-hand smoke also affects non-smokers in the same way.

Second-hand smoke (SHS), or environmental tobacco smoke, is a complex mixture of thousands of gases and fine particles emitted from the burning end of a cigarette or from other tobacco products usually in combination with the smoke exhaled by the smoker.  It can linger for more than 2 hours, and may be invisible and odorless.

If there's one thing Filipinos can do to improve their general health, including the health of their eyes, it is to stop smoking and to prevent exposure to second-hand smoke.

We all have the right to good health and good eyesight.  Workers and employees have the right to work in an environment that does not endanger their health.  Children especially have a right to grow up in a healthy environment, one free from exposure to second-hand smoke.

SMOKE FREE ENVIRONMENT

Article 8 of the WHO Framework Convention on Tobacco Control (FCTC), a global public health treaty that has been ratified by over 160 countries, calls for the adoption and implementation of effective legislative, executive, administrative and/or other measures, providing for the protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and other public places.  In July 2007, Guidelines for Article 8 implementation that called for 100% smoke-free public places were unanimously adopted at the second Conference of the Parties to the FCTC.

Based on the vast body of available scientific evidence, cost-effective protection from tobacco smoke is provided only by 100% smoke-free environments.  Ventilation and designated smoking areas or smoking rooms do not provide adequate protection (especially for workers who enter such areas), confuse the public’s perception of safety, and burden businesses with extra cleaning and maintenance costs and the risk of fire.

Because there is no safe level of exposure to second-hand smoke, only 100% smoke-free environments can effectively protect people from second-hand smoke.

In a smoke-free environment:

  • Air pollution levels go down.  Air quality drastically improves because the amount of toxins and fine particles in the air are greatly reduced.

  • There is increased productivity in the workplace, and less health and building maintenance and cleaning costs.

  • Workers and employees previously exposed to second-hand smoke have less respiratory illness and symptoms.

  • There are less heart attacks and strokes, less asthma attacks.

  • Children grow up healthier, and are less likely to start smoking as they grow older.

  • Even smokers benefit – they may smoke less, and less often, or quit smoking altogether.

With 100% smoke-free environments, everyone, including smokers, is protected from the dangers of second-hand smoke.

For more info, contact: Ulysses Dorotheo, MD, FPAO | This e-mail address is being protected from spambots. You need JavaScript enabled to view it | This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Dr. Dorotheo is a neuro-ophthalmologist and also FCTC Program Manager for the Southeast Asia Tobacco Control Alliance (www.seatca.org) and Regional Coordinator for ASEAN and the Western Pacific for the Framework Convention Alliance (www.fctc.org).  He is also a founding member of the FCTC Alliance, Philippines (www.tobaccocontrol.ph).