UHS Medical Times 1
Newsletter | December 2017
TOBACCO SMOKE
STOP IT! BEFORE IT BURNS YOUR WORLD Tobacco products are products made entirely or partly of tobacco leaves as raw material, which are intended to be smoked, chewed or sniffed. All contain the highly addictive psychoactive ingredient, nicotine. Tobacco use is one of the main risk factors for a number of chronic ailments, including cancer, lung and cardiovascular diseases. Despite this, its consumption is common throughout the world. A number of countries have legislation restricting tobacco advertising, and regulating who can buy and use tobacco products, and where people can smoke.
TOBACCO KEY FACTS BY THE WORLD HEALTH ORGANIZATION
Tobacco kills up to half of its users.
Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890,000 are the result of non-smokers being exposed to second-hand smoke.
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Newsletter | December 2017
SHOCKING
SMOKING FACTS IN
UAE 21% of the UAE population are into smoking and 15 percent of them are teenagers under the age of 18. – Federal National Council An average of 27 people die in the UAE every week from tobaccorelated diseases. – 5th World Tobacco Atlas One woman on average is killed due to tobacco every week. 5th World Tobacco Atlas
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TYPES OF SMOKING There is no such thing as safe tobacco. In fact, tobacco hurts and kills people. There are abundant data and statistics available to evidently prove this. No matter what type of smoke you use, they contain the same of cancer-causing substances found in cigarettes. Below are the common types of smoke that are available in the market.
LIGHT, HAND-ROLLED, NATURAL, HERBAL CIGARETTES Many smokers believe that this kind of cigarettes are more natural and thus are less harmful than manufactured cigarettes. The recent results suggest that this is not the case. In fact, hand-rolled cigarettes are no safer than the commercial brand of cigarettes. MENTHOL CIGARETTES This type of cigarette is easier to smoke they said. The additional menthol avor creates a cool feeling in the mouth and throat when smoke is inhaled. This will lessen the cough reex and the dry feeling in the throat that usually smokers have. Smokers using this type tends to inhale deeper and hold the smoke for long time. Thus, this type could be even more dangerous than thought to be not. CIGARS Cigars are made up of fermented tobacco leaves rolled into different sizes to smoke. The fermentation method causes substances and bacterial reactions that change the tobacco making it taste and smell differently. Full size cigars can have as much nicotine as an entire pack of cigarettes. Cigarettes have an average of about 8 milligrams (mg) of nicotine, but only deliver about 1 to 2 mg of nicotine to the smoker. Larger cigars have between 100 and 200 mg or even as many as 444mg of nicotine.
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KRETEKS OR CLOVE CIGARETTES This type of cigarette is imported from Indonesia and typically contains a combination of tobacco, ground cloves, clove oil and other additives. Kreteks are mostly used by youngsters. They are advertising this type of cigarette as clean, natural and safer than regular cigarettes but it is not safer than a normal cigarette. It might even inflict more harm. Researchers are trying to find if cloves might result in additional health problems. BIDIS OR FLAVORED CIGARETTES Originated in India and other Southeast Asian countries, this unfiltered cigarettes are hand-rolled unprocessed tobacco, tendu or temburi leaf tied in colorful strings. Bidis have all the same health risks as of the regular cigarettes even though it has less tobacco than regular cigarettes. Some people think they are safer than regular cigarettes but bidi smokers have much greater risks of heart attacks, lung problems including emphysema and chronic bronchitis and not to mention cancer according to research and studies. HOOKAHS OR SHISHA (WATER PIPES) This type began in Asia and Middle East wherein water-pipes allow you to smoke flavored tobacco such as honey, mint, licorice and fruits as it is bubbled through water. The tobacco mixture which is called shisha is heated using charcoal. The smoke inhale originates from charcoal too. Charcoal contains several toxic substances, including carbon monoxide, heavy metals and tar. There are newer forms of hookah being sold in the market including the use of steam stones that have been submerged in fluid and are used in replaced with tobacco and battery powered hookah pens. Hookah pens work the same as electronic cigarettes. Hookahs are not safe alternative to cigarettes contrary to what being advertised. Aside from the hazardous smoke that hookah contains that can cause serious health problems like lung cancer, heart ailments, dental problems and osteoporosis, there is also a risk of passing infections while sharing hookah.
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CHEWING TOBACCO OR CHAINI KHAINI This type is recognized as a prohibited substance in UAE. This tobacco comes as loose leaves, plugs, or twists of dried tobacco that may be avored. Administered by mouth, it has chemical effects on the oral mucosa and direct impact on the cheek and tongue. The user spits out or swallows the brown saliva that has soaked through the tobacco thus the nicotine is absorbed through mouth tissues. It is known to destroy the mucosa and cause gingivitis, inammation of oral mucosa and bad breath, gum and mouth cancer, nicotine addiction and agitation.
ELECTRONIC CIGARETTES/VAPE PENS E-cigarettes are from of electronic nicotine delivery system or ENDS. They are battery operated devices that look like cigarettes. E-cigarettes are often used as a way for a smoker to get nicotine in place where smoking is prohibited thus leading to dual users. Dual users are people who uses ENDS and traditional tobacco products. ENDS when heated releases known toxins like acetaldehyde and formaldehyde. It has been shown in some studies that ENDS can cause short-term lung changes that similar to regular cigarettes.
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HARMFUL AND POTENTIALLY HARMFUL CONSTITUENTS IN TOBACCO PRODUCTS AND TOBACCO SMOKE: ESTABLISHED LIST BY US FOOD AND DRUG ADMINISTRATION The Food and Drug Administration or FDA in USA has established a list of harmful and potentially harmful constituents (HPHCs) in tobacco products and tobacco smoke (the established HPHC list). Take note that each chemical component has its own specifically indicated damaging effect on health. The established list of 93 HPHCs is included in the notice and in the table below. ESTABLISHED LIST OF THE CHEMICALS AND CHEMICAL COMPOUNDS IDENTIFIED BY FDA AS HARMFUL AND POTENTIALLY HARMFUL CONSTITUENTS IN TOBACCO PRODUCTS AND TOBACCO SMOKE
CONSTITUENT
CARCINOGEN (CA), RESPIRATORY TOXICANT (RT), CARDIOVASCULAR TOXICANT (CT), REPRODUCTIVE OR DEVELOPMENTAL TOXICANT (RDT), ADDICTIVE (AD)
CONSTITUENT CADMIUM
CARCINOGEN (CA), RESPIRATORY TOXICANT (RT), CARDIOVASCULAR TOXICANT (CT), REPRODUCTIVE OR DEVELOPMENTAL TOXICANT (RDT), ADDICTIVE (AD)
ACETALDEHYDE
CA, RT, AD
ACETAMIDE
CA
CAFFEIC ACID
CA
ACETONE
RT
CARBON MONOXIDE
RDT
ACROLEIN
RT,CT
CATECHOL
CA
ACRYLAMIDE
CA
CHLORINATED DIOXINS/FURANS
CA, RDT
ACRYLONITRILE
CA, RT
CHROMIUM
CA, RT, RDT
AFLATOXIN B1
CA
CHRYSENE
CA,CT
4-AMINOBIPHENYL
CA
COBALT
CA,CT
1-AMINONAPHTHALENE
CA
COUMARIN
BANNED IN FOOD
2-AMINONAPHTHALENE
CA
CRESOLS (O-, M-, AND P-CRESOL)
CA, RT
AMMONIA
RT
CROTONALDEHYDE
CA
CA, CT, RDT
ANABASINE
AD
CYCLOPENTA[C,D]PYRENE
CA
O-ANISIDINE
CA
DIBENZ[A,H]ANTHRACENE
CA
ARSENIC
CA, CT, RDT
DIBENZO[A,E]PYRENE
CA
A-α-C (2-Amino-9H-pyrido [2,3-b]indole)
CA
DIBENZO[A,H]PYRENE
CA
BENZ[A]ANTHRACENE
CA,CT
DIBENZO[A,I]PYRENE
CA
BENZ[J]ACEANTHRYLENE
CA
DIBENZO[A,L]PYRENE
CA
CA, CT, RDT
2,6-DIMETHYLANILINE
CA
BENZENE BENZO[B]FLUORANTHENE
CA,CT
ETHYL CARBAMATE (URETHANE)
CA, RDT
BENZO[K]FLUORANTHENE
CA,CT
ETHYLBENZENE
CA
BENZO[B]FURAN
CA
ETHYLENE OXIDE
CA, RT, RDT
BENZO[A]PYRENE
CA
FORMALDEHYDE
CA, RT
FURAN
CA
BENZO[C]PHENANTHRENE
CA
BERYLLIUM
CA
1,3-BUTADIENE
CA, CT, RDT
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Glu-P-1 (2-Amino-6methyldipyrido[1,2-a:3',2'd]imidazole)
CA
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Newsletter | December 2017
CONSTITUENT
CARCINOGEN (CA), RESPIRATORY TOXICANT (RT), CARDIOVASCULAR TOXICANT (CT), REPRODUCTIVE OR DEVELOPMENTAL TOXICANT (RDT), ADDICTIVE (AD)
CONSTITUENT
CARCINOGEN (CA), RESPIRATORY TOXICANT (RT), CARDIOVASCULAR TOXICANT (CT), REPRODUCTIVE OR DEVELOPMENTAL TOXICANT (RDT), ADDICTIVE (AD)
Glu-P-2 (2-Aminodipyrido[1,2-a:3', 2'-d]imidazole)
N-NITROSOPIPERIDINE (NPIP)
CA
CA
N-NITROSOPYRROLIDINE (NPYR)
CA
HYDRAZINE
CA, RT
N-NITROSOSARCOSINE (NSAR)
CA
HYDROGEN CYANIDE
RT, CT
NORNICOTINE
AD
Indeno[1,2,3-cd]pyrene
CA
PHENOL
RT, CT
IQ (2-Amino-3methylimidazo[4,5-f]quinoline)
CA
CA
ISOPRENE
CA
PhIP (2-Amino-1-methyl-6phenylimidazo[4,5-b]pyridine)
LEAD
CA, CT, RDT
POLONIUM-210
CA
MeA-α-C (2-Amino-3methyl)-9H-pyrido[2,3-b]indole)
CA
PROPIONALDEHYDE
RT, CT
MERCURY
CA, RDT
PROPYLENE OXIDE
CA, RT
METHYL ETHYL KETONE
RT
QUINOLINE
CA
5-METHYLCHRYSENE
CA
SELENIUM
RT
4-(Methylnitrosamino)-1-(3-pyridyl)1-butanone (NNK)
CA
STYRENE
CA
NAPHTHALENE
CA, RT
O-TOLUIDINE
CA
NICKEL
CA, RT
NICOTINE
RDT, AD
NITROBENZENE
CA, RT, RDT
NITROMETHANE
CA
2-NITROPROPANE
CA
N-NITROSODIETHANOLAMINE (NDELA)
CA
N-NITROSODIETHYLAMINE
CA
N-NITROSODIMETHYLAMINE (NDMA)
CA
N-NITROSOMETHYLETHYLAMINE
CA
N-NITROSOMORPHOLINE (NMOR)
CA
N-NITROSONORNICOTINE (NNN)
CA
Newsletter from University Hospital Sharjah
TOLUENE
RT, RDT
Trp-P-1 (3-Amino-1,4-dimethyl5H-pyrido[4,3-b]indole)
CA
Trp-P-2 (1-Methyl-3-amino5H-pyrido[4,3-b]indole )
CA
URANIUM-235
CA, RT
URANIUM-238
CA, RT
VINYL ACETATE
CA, RT
VINYL CHLORIDE
CA
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HEALTH RISKS FROM SMOKING Tobacco use causes nearly 6 million deaths per year worldwide. It is predicted that tobacco use will cause more than 8 million deaths annually by 2030. And for every person who dies because of smoking, at least 30 people live with a serious smoking-related illness according to the CDC. Thus any form of tobacco is harmful and lethal not only to the ďŹ rst hand smoker but also to the people around him/her.
RISKS OF SMOKING SMOKING CAN DAMAGE EVERY PART OF YOUR BODY
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SECOND HAND SMOKE The combination of smoke from cigarette and the smoke breath out by a smoker is called second hand smoker. People who are exposed to secondhand smoke occur mostly in homes and workplaces according to CDC. Among other places are restaurants, bars, and casinos—as well as in cars and other vehicles. Like the first hand smokers, second hand smokers are not free from the health risks of cigarette smoke. Health conditions such as heart diseases, lung cancer and stroke are linked to second hand smoke.
HOW TO PROTECT YOURSELF AND YOUR FAMILY FROM SECOND HAND SMOKE?
Quit smoking.
Not allowing anyone to smoke anywhere in or near your home.
Not allowing anyone to smoke in your car, even with the windows down.
Making sure your children’s day care center and schools are tobacco-free
Seeking out restaurants and other places that do not allow smoking.
Teaching your children to stay away from secondhand smoke.
Being a good role model by not smoking or using any other type of tobacco.
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THE SILENT KILLER All are familiar from second hand smoke but not with the silent killer “third hand smoke”. This is a term used to describe the remaining pollution from tobacco smoke that stays in rooms long after smoking stops and remains on our clothes after we leave a smoky place. It may seem merely like an offensive smell, but it is also indicative of the presence of tobacco toxins.
HOW CAN I QUIT SMOKING? Smoking cessation requires dedication and commitment. It is important that the person is ready to begin this healthy change. These are 4 simple tips for users to become a tobacco-free individual. 1. Get Ready - Set a date to begin quitting smoking. 2. Get Medicine - Visit and book an appointment in a Smoking Cessation Clinic. 3. Get Help - You can find a support group that would motivate you to quit smoking. 4. Stay Quit - You can and should quit for good. There is a recent survey done in the country by Ministry of Health and Prevention that 20% of the people who went to smoking cessation clinics ended up quitting the bad habit. The point is if others can, why can’t you?
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Newsletter | December 2017
HOW TO STAY SMOKE FREE?
Giving up smoking is tough. It’s a process that takes time. There are ways you can take to help you stay smoke free, both now and long term.
RECOGNIZE YOUR TRIGGERS Triggers are the things that make you want to smoke. Certain people, places, things, and circumstances can give an urge to smoke, even years after quitting. Knowing your triggers can help you be ready and fight off cravings. FIGHT CRAVINGS Beating cravings can be easier if you have a plan. Prepare by making a list of things you can try when you have the urge to smoke. Take a walk, practice deep breathing, or do whatever works for you to get past cravings. Keep your list handy. It is difficult to stay smoke free when cravings hit. But the longer you go without smoking, the more these urges will fade. STAY POSITIVE Having a positive outlook in life will help you overcome any obstacles. Thinking positively and looking at the health benefits of quitting smoking will give you the enthusiasm to stay smoke free. CELEBRATE YOUR SUCCESS Staying smoke free is a big achievement. Treat yourself regularly. Perhaps, you can use the extra money you used to buy cigarettes with something special for yourself. GET SUPPORT Friends and family play a vital role in smoking cessation. Ask for help and support. You can also check for support groups in your area. It is good to have a support system.
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Newsletter | December 2017
THE BENEFITS OF TIMELINE
Find out how fast you'll notice the benefits of stopping smoking After 20 minutes - Pulse rate and blood pressure returns to normal, instantly reducing risk of heart
attack, and the body temperature of hands and feet increase, improving circulation. After 8 hours - Nicotine and carbon monoxide levels in blood reduce by more than half and oxygen
levels return to normal. After 48 hours - Carbon monoxide will be eliminated from the body. Lungs start to clear out mucus
and other smoking debris. There is no nicotine in the body and ability to taste and smell is improved. After 72 hours - Breathing becomes easier. Bronchial tubes begin to relax and energy levels increase.
After 2-12 weeks - Your circulation improves.
After 3-9 months - Coughs, wheezing and breathing problems improve as lung function increases
by up to 10%.
After 1 year - Risk of heart disease is about half compared with a person who is still smoking.
After 10 years - Risk of lung cancer falls to half that of a smoker.
After 15 years - Risk of heart attack falls to the same as someone who has never smoked.
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BE A HERO FOR OTHERS
QUIT SMOKING
RESOURCES: 1. 2. 3. 4. 5.
https://www.khaleejtimes.com/nation/general/smoking-kills-27-people-in-uae-each-week http://www.who.int/mediacentre/factsheets/fs339/en/ https://www.cdc.gov/tobacco/index.htm https://www.nhs.uk/smokefree/why-quit/what-happens-when-you-quit https://www.ahrq.gov/professionals/clinicians-providers/guide-
lines-recommendations/tobacco/index.html 6. http://www.no-smoke.org/learnmore.php?id=671 7. https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer.html 8. https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm20035927.htm 9. Jasmine Al Kuttab (2017, November, 15) 15% of smokers in UAE are teens under 18. Khaleej Times
Don’t Forget To Check December Edition of
ARISE Nursing Newsletter December Edition of ARISE Nursing Newsletter raises awareness on HIV AIDS. As a part of creating more awareness on World AIDS Day, this issue focuses on various facts to understand the cause. Also, it provides guidance to organisation and nurses for handling such critical situations.
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Newsletter | December 2017
SCOPE OF SERVICES AT UHS MEDICAL SERVICES
SURGICAL SERVICES
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Evoked Potential Test
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(BAEP)
Emergency Medicine
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Neonatology Nephrology Neurology Pediatrics Psychiatry Pulmonology Rheumatology MEDICAL DIAGNOSTICS IMAGING (MDI) 128 Channel CT Scan with Coronary and Cardiac Facility
PATHOLOGY & LABORATORY MEDICINE
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Mammography and Guided Breast Intervention
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Tympanometry
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