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Tobacco and cancer: 18 parts of the body at significant risk

SmokerThe link between tobacco and lung cancer is well known. Less known is the dangerously unhealthy link between tobacco and cancer in 17 other parts of the body.

“There are 5000 chemicals in tobacco and 60 carcinogens. They are inhaled into the lungs, but they are also swallowed and enter the body,” explains Dr. Drew Bethune, a thoracic surgeon, head of the Capital Health Cancer Care program in Halifax and past President of Smoke Free Nova Scotia.

The risk of smokers getting lung cancer is eight times that of non-smokers. However, smokers are also two times more likely to develop cancer of the stomach and pancreas and 1.4 times more likely to have colorectal cancer,” says Dr. Bethune.

Nova Scotia’s Chief Public Health Officer Dr. Robert Strang adds that both active smoking and being exposed to second-hand smoke also increases a woman’s risk of breast cancer. “Research shows that women who smoke are increasing their risk of being diagnosed with both pre and post-menopausal breast cancer,” says Dr. Strang. “The association between second hand smoke and increased risk of breast cancer in pre-menopausal women who have never smoked is also strong.

“Since tobacco smoke is one of the few risks for breast cancer we can control, it’s important that all women, and young women in particular, understand the increased risk they are placing themselves in if they smoke or are exposed to second hand smoke.”

Dr. Bethune says that together tobacco causes one third of all cancer deaths,” “It’s extremely important,” he adds, “to get the word out there about the link between tobacco and other cancers. The more people who quit smoking the healthier they will be – and the better our health care system will be.”

The message is getting out. Fewer Nova Scotians are smoking today than in the last decade. In 2000, 30% of people in this province smoked. Last year, that number was 21%. Of particular importance are the numbers for young people aged 15 to 19. In 2000, 25% of this group were smokers. Last year, only 16% were smokers.

“We know that if people don’t start smoking when they are younger, they are less likely to begin later in life,” notes Dr. Strang.

While the news is generally positive, there is no room for complacency. “Overall we have made significant progress, but when you look closely at the rate of smokers in this province, you’ll see it hasn’t changed since 2005,” says Dr. Strang. “Our progress has stalled.”

Nova Scotia’s updated tobacco control strategy, which was released in 2011, is intended to kick-start new and renewed action in several key areas. Final details of the plan are currently being developed but important initiatives are currently underway. These include holding the tobacco industry accountable (the concept of a manufacturers’ fee that would be directed to tobacco control is being explored; Nova Scotia is also working with other provinces in joint legal action to recover smoking-related health care costs); strengthening cessation efforts; continuing to build tobacco-free environments with a focus on the outdoors; and increasing the number of apartment buildings that offer smoke-free residences.

The strategy also identifies the need to reduce disparities related to tobacco use. “We know who is smoking the most. Often these are poorer individuals, people with mental health issues, and Aboriginals. We need to develop specific programs for these three groups,” says Dr. Strang.

But he adds that everyone has a role to play. “Smoking continues to be the number one cause of death. We need to remain vigilant. It’s easy to forget about this. For many of us, if we don’t see others smoking around us, it becomes a non-issue.”

Health care professionals, particularly family doctors, are also central to reducing the rate of smokers in Nova Scotia. “A family physician asking about smoking and offering counselling has a tremendous effect,” says Dr. Bethune. “When you bring up the issue, it often starts the smoker thinking about quitting. Doctors can further help by having a strategy in place to help their patients butt out.”

Together our combined efforts under way will have a tremendous impact, stresses Dr. Strang. “Over time Nova Scotia will have fewer people addicted to tobacco.”

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