Breathe Easy

CHRONIC CARE

breathe

easy Been puffing away for years?

Give up the habit, and you’ll have more energy for your family!

By SHERENE KANG

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WELLNESS FOR ALL

G

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iving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.” Those were the famous words by Mark Twain, the legendary American novelist, who was rumoured to have smoked 100 cigars a month, and who died of a heart attack.

The tongue-­‐in-­‐cheek quote by Twain will surely strike a chord with the many people who are struggling to fight the addiction of cigarette smoking. While quitting may be difficult, more people seem to be picking it up. The incidence of smoking in Singapore has gone up from 12.6 per cent of adults in 2004 to 14.3 per cent in 2010 according to a National Health Survey. A concerning trend is the increased smoking prevalence, by 33 per cent, among younger Singaporeans aged 18 to 29. This may indicate a surge in deaths caused by tobacco smoke in the years to come.

The fact that smoking increases your risks of severe ailments such as lung cancer and coronary heart diseases are well-­‐known, but are you aware of the chronic conditions that arise from smoking? According to the Ministry of Health, Chronic Obstructive Pulmonary Disease (COPD) is the seventh leading cause of death in Singapore from 2008 to 2010, ahead of complications arised from urinary tract infection and diabetes.

What is COPD? PHOTOS: Getty Images,Corbis Images

COPD, also known as Chronic Obstructive Lung Disease (COLD) is an umbrella term used to describe conditions such as chronic bronchitis and emphysema.

Chronic bronchitis happens when airways become thick and swollen, compressed by surrounding muscles or filled with mucus. Such

inflammation, if allowed to exist, causes the patient to cough and experience shortness of breath.

Emphysema is often a complementary condition to chronic bronchitis. In a sufferer, air sacs that contain air inhaled by the lungs lose their elasticity and become unable to trap and release air effectively. As such,

the body’s exchange of oxygen and carbon dioxide is blocked and patients may have persistent bouts of wheezing or in worse cases scenarios, stop breathing altogether and die.

In both cases, prolonged smoking is the underlying cause that damages the lining of the airways or air sacs, resulting in inflammation and airflow restriction.

Apr-Jun 19

CHRONIC CARE

DID YOU KNOW?

Who gets it?

According to Dr Jim Teo, a Respiratory Physician and Intensivist at Nobel Chest and Internal Medicine Centre at Mt Alvernia Hospital, “Studies have shown that people are typically diagnosed with COPD when they are above 45-­‐years-­‐old and have at least a 20 pack-­‐year of smoking history”.

Pack-­‐years refer to the number of cigarette packs smoked per day multiplied by the number of years of smoking, then divided by 20. Dr Teo also says that lung decline is accelerated when the patient continues to smoke as he ages.

Prevention and treatment Smokers are

10-20%

more prone to developing lung cancer compared to non-smokers.

What are the symptoms?

While it is easy to dismiss ‘smoker’s cough’ as a mild irritation to the throat, this is often the first symptom to develop in the early stages of COPD. Unlike normal coughing which quickly stops after toxins are expelled from the respiratory tract and lungs, a smoker’s cough is usually persistent as the lungs try to get rid of an accumulation of mucus.

This is because long-­‐term smoking destroys the protective cilia—hair-­‐ like structures that discharge harmful substances from the lungs.

Shortness of breath is another sign of COPD as the rate of decline in the lungs of a smoker can be three times faster than that of a non-­‐ smoker. This may first be experienced when you exert yourself, such as when climbing the stairs. But the degree of breathlessness often intensifies as the disease ensues. In advanced stages, you may even feel breathless even while resting.

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WELLNESS FOR ALL

The risk of developing coronary heart diseases is

2-4x

Depending on the stage of the condition, COPD can be treated with a variety of medications. Doctors may prescribe inhalers which help to relax the airways. Antibiotics may also be given to prevent bacterial lung infections since COPD sufferers are more vulnerable to these.

In moderate and severe COPD, the use of steroids may be used to subdue inflammation in the airways and reduce mucus production.

Whether or not you suffer from COPD, you should consider stubbing out your smoking habit. While it is not a walk in the park to quit by going cold turkey, you can seek professional help. Smoking cessation services are available at all polyclinics as well as various clinics and hospitals. Visit the Health Promotion Board’s website (www.hpb.gov.sg) for a list of places where you can seek help.

more likely for someone who smokes compared to someone who does not.

Male smokers are more susceptible to die from heart attacks and lung cancer compared to female smokers.

A month after you quit, you may notice that you are less tired.

Smokers who quit after years of smoking will reduce their risks of coronary heart diseases by half after just one year of quitting

GONE IN A PUFF We bust four myths about stubbing out that may be keeping you from quitting.

To help yourself quit, focus on the health benefits of a smoke-­‐free life.

Within two days, your sense of smell will improve. A month after you quit, you may notice that you are less tired.

Smokers who quit after years of smoking will even reduce their risks of coronary heart diseases by half after just one year of quitting.

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SWITCHING TO ‘LIGHT’ CIGARETTES WILL CUT MY RISK. While ‘light’ cigarettes claim to have lower levels of tar and nicotine, smokers inevitably inhale smoke more deeply or smoke more cigarettes to make up for this.

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QUITTING ‘COLD TURKEY’ IS THE ONLY WAY TO GO. Determination and willpower are essential to quit smoking successfully but this should not be mistaken for the need to resort to drastic measures. “Nicotine replacement therapy and oral medications are useful pharmological aids to help a smoker to quit and the success rate [of such methods] have proven to be higher than going cold turkey,” says Dr Jim Teo.

I’VE SMOKED FOR SO LONG; THE DAMAGE IS ALREADY DONE. It is never too late to quit smoking.

According to the American Cancer Society, up to 90 per cent of the risk of health problems from smoking can be prevented for smokers who quit before age 35. A smoker who quits before age 50 reduces his risk of dying over the next 15 years by half compared to someone who continues to smoke.

NICOTINE PRODUCTS ARE JUST AS UNHEALTHY AS SMOKING. Even though nicotine causes addiction to smoking, it is only a small component of tobacco. Research from the American Lung Association shows that cigarettes have 4,000 other compounds including more than 60 carcinogens.

Dr Jim Teo Yeow Kwan is a Respiratory Physician and Intensivist at Nobel Chest and Internal Medicine Centre at Mt Alvernia Hospital, Singapore. He is also a Visiting Consultant to Jurong General Hospital, providing specialised care in the Respiratory Medicine.

Apr-Jun 21