Prior to World Heart Day, cardiologists from Dubai Health Authority (DHA) are advocating the importance of lifestyle management and tobacco cessation by highlighting statistics that directly link tobacco use to heart attacks.
According to Rashid Hospital statistics, one in two patients who have heart attacks are smokers. Moreover, studies have shown that in the Middle East, the average age for patients with heart attacks is at least ten years younger than in many western countries.
In 2014, DHA introduced the latest TAVI technique for interventional heart procedures for heart attack patients at Rashid Hospital. Specialists predicted that ten procedures would be performed in one year, but the hospital eventually performed 50. Year-on-year, the number of heart attack cases is increasing at the hospital and, while lifestyle factors are to blame, tobacco use tops the list of triggers. “Tobacco consumption is directly linked to heart attacks,” says Dr Fahd Baslaib, Head of Cardiology at Rashid Hospital.
“Compared to others, smokers carry up to four times the risk of getting a heart attack.”
However, the worry is that people do not take preventive measures and most of those who register with the cessation clinic have already suffered the ill-health effects of tobacco cessation, he says.
“In DHA’s Primary Health Care services sector, we have two smoking cessation clinics — Al Barsha and Al Towar Health centres — and we receive up to 300 smokers annually,” explains Dr Hanan Obaid, Head of Acute and Chronic Diseases Unit at DHA’s Primary Health Care Services Sector. “Most come to us as referrals from Primary Health Care Centres, hospitals and direct from the community. While this reflects the strong referral system that we have in place, it is also highly unfortunate that people only think of quitting after they have suffered the dire health consequences of tobacco use.”
According to the World Heart Federation, six million people who die because of cardiovascular diseases are direct or second-hand smokers. By 2030, this number is expected to rise to eight million. Tobacco use is the leading preventable cause of death in the world. It kills half of all lifetime users, and half of those die in middle age (35-69). Tobacco is a risk factor for six of the eight leading causes of death in the world. Tobacco kills approximately one person every six seconds, accounting for one in ten adult deaths.
Those who suffer the health consequences of smoking are mainly young adults and this is one of the reasons DHA has further strengthened its smoking cessation services.
About 300 smokers visit the Al Towar and Al Barsha smoking cessation clinics annually.
The clinics’ success rate in 2016 was 15.5 per cent. In 2015, 14.7 per cent of participants kicked the habit and in 2014, there was a 16.9 per cent success rate. In 2013, 14 per cent of smokers quit, up from just over 11 per cent in 2012. Globally the quitting rate is in the range of 10 to 20 per cent.
“The patients we see are from the age group of 15 years to 80 years, but most are in the age group of 25 to 45 years and it’s really unfortunate that they have already gone through so much in terms of their health,” says Dr Obaid. “At the centres, we provide a holistic approach to help smokers stub the habit. Tobacco dependence is a behavioural, cognitive and physiological phenomenon and therefore we provide medical, psychological and social support. The clinic reaches out to smokers to help them cope with nicotine withdrawal symptoms, which is a factor that often dissuades them from stubbing the habit.”
She adds that patients need most support when they experience these symptoms, which can include nervousness, irritability, headaches, insomnia and tiredness. To help them successfully quit tobacco requires follow-up visits and a long-term plan. Therefore the centres offer a one-time package for patients. “We have developed a smoking cessation package so that smokers who visit the cessation clinic receive all aspects of medical care to help them stub the habit,” says Dr Obaid.
“The package includes blood investigations urea creatinine, LFT, CBC, ECG, CXR, spirometry test that measure the lung function test and a Smokerlyzer test to measure the levels of toxic carbon monoxide inhaled from tobacco smoke. The clinic also provide medical and psychological support to smokers and offers four consultations as part of the package.”
Dr Obaid says smokers who quit can begin to experience the immediate health benefits of tobacco cessation. “Tobacco smoke is a mix of more than 4,000 chemicals, of which 250 are toxic and at least 50 are known to cause cancer. People who quit smoking have a lower risk of lung cancer but their risk is higher than the risk of people who never smoked. Yet, it is important to note that quitting tobacco at any age can lower the risk of cancer and other chronic diseases.”
Dr Obaid adds that common misconceptions in society are that the smoking pipe is better than smoking a cigarette and second-hand smoke is not really harmful. “These misconceptions in society really need to be addressed. Smokers should be considerate about their friends and family members especially children and pregnant women. Passive smoking is very harmful, especially for small children who are still in the developmental stages of their life.
"According to the WHO, almost half the children in the world regularly breathe air polluted by tobacco smoke in public places. And as far as the myth regarding pipe smoking goes, pipes are more alkaline, more addictive and cause substantially higher risk of chronic obstructive pulmonary disease and the relative risk of lip and oral cancer is also higher as compared to cigarette smoking.”
Dr Obaid says, “As a smoking cessation specialist, my message to smokers is to think about themselves and their family members. Almost 95 per cent of smokers who come to our centre are men who are fathers and husbands and have a responsibility towards their family and especially their young children. Smoking cessation is possible — they just have to take the first step towards it.”
Interested in quitting tobacco? Here are your health provider options
The Smoking Cessation Clinic at Al Barsha provides quitting programmes and counselling every Tuesday morning and Monday afternoon. For more information, call 04 502 3300 or 04 502 3302. The Al Towar Centre provides cessation programmes and counseling every Wednesday afternoon and Thursday morning. For more information, call 04 502 2101/2. Al Badaa Health Centre provides cessation programmes and counseling every Sunday afternoon.
For more information call 04 508 1000.