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Smoking: A slow euthanasia

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Smoking, often called a form of slow euthanasia, continues to claim millions of lives worldwide. In Pakistan, smoking remains a severe health risk with staggering consequences. Recent statistics show that approximately 20 million Pakistanis smoke, contributing to a global epidemic responsible for over 8 million deaths each year. With an expected increase in smoking-related deaths, it is critical that communities, healthcare professionals, and policymakers collaborate to curb this deadly habit.

The disease burden and predicted mortality: The health burden of smoking is severe, as smokers face heightened risks for chronic conditions like lung cancer, heart disease, chronic obstructive pulmonary disease (COPD), and several other cancers. The burden extends beyond mortality, as thousands of smoking-related illnesses every year place tremendous pressure on the healthcare system. Alarmingly, smoking prevalence is also rising among youth and individuals with severe mental health illnesses. The World Health Organization reports that individuals with mental health disorders are 70% more likely to smoke than the general population, with rates significantly higher among those with schizophrenia, bipolar disorder, and severe anxiety or depression. This further worsens their physical and mental health.

In Pakistan, 19.1% of adults aged 15 and older use tobacco in some form, with 31.8% of men and 5.8% of women participating in tobacco use. Among these, 12.4% of adults smoke, 7.7% use smokeless tobacco, and 3% use waterpipes such as hookah or shisha. For youth aged 13-15, 10.7% use tobacco products, with 7.2% smoking and 5.3% using smokeless tobacco; nearly 40% of those who’ve smoked began before age 10.

Secondhand smoke exposure remains widespread, affecting 72.5% of indoor workers and 86% of adults in restaurants, with 37.8% of youth exposed in public and 21% at home. The health toll of tobacco is severe, causing over 163,600 deaths annually in Pakistan, with 31,000 from secondhand smoke. Tobacco-related deaths account for 10.9% of all deaths, leading to high mortality rates from lung cancer, COPD, ischemic heart disease, diabetes, and stroke.

Behavioral Cognition Therapy (CBT) is a valuable tool for smoking cessation, complementing medication by addressing the thought patterns fueling addiction. It helps individuals, especially those with mental health challenges, identify triggers, reduce cravings, and adopt healthier coping mechanisms. CBT equips patients to manage stress and impulses, significantly improving long-term recovery.

Community engagement: A vital role in reducing smoking community engagement is essential in addressing the smoking epidemic. Involving local leaders, healthcare providers, and community members creates a supportive environment that empowers individuals to quit. Community-level educational campaigns, support groups, and cessation programs promote awareness of the risks of smoking and the benefits of quitting.

Through community involvement, education, and evidence-based therapies like CBT, we can work together to reduce smoking rates, support those with mental health challenges, and ultimately decrease the smoking-related disease burden in Pakistan.

—The writer is contributing columnist, based in Rawalpindi. ([email protected])

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