Breaking smoking’s ferocious grip

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It’s a safe bet that virtually everyone in Canada knows smoking is bad for your health. Many years of anti-smoking campaigns, and widespread prevention programs in schools, the workplace and in the community, have driven the message home that smoking is deadly.

In Ontario alone, smokers account for a half million days of acute hospital care annually. Thirty-five Ontarians die each day from tobacco-related illness, tallying 13,000 premature and avoidable deaths each year. Fully one-half of all smokers will die from smoking-related diseases, including cancer, cardiovascular disease and lung disease.

Yet despite the high level of awareness, about one in five Ontarians – 2.1 million people – still smoke. In Hamilton, the percentage is even greater, reflecting the health disparities in our community and the fact that tobacco use is higher among populations with lower income and fewer social support networks.

These stark disparities were highlighted in the Code Red series published The Hamilton Spectator last summer.

The ongoing debate on how society should respond to this devastating health problem is fraught with emotion: frustration among smokers, their families and their doctors, and even anger and blame by many who see smoking as a life-style choice and who resent the high cost to the province’s healthcare system — estimated at $6.1 billion annually — and the burden this imposes on every taxpayer.

[This article is a repost from Dr. Tytus' opinion piece in the Hamilton Spectator]

But smoking is not a lifestyle choice. It is one of the most powerful of addictions. In my medical practice, I see patients who struggle with their tobacco habit every day. Most began smoking before the age of 18 and, despite their desperate efforts to quit, will relapse several times throughout their lives. This is precisely why the medical community now considers smoking as an addiction and chronic disease with a pediatric onset, not a lifestyle choice or habit.

So how do we tackle an addiction that stubbornly defies the efforts of government policymakers, healthcare professionals, parents, teachers, concerned family members and smokers themselves to conquer it?

A key step is to place far more emphasis on smoking cessation strategies than has been done in the past. About one million Ontarians tried unsuccessfully to quit in the past year alone. Despite the fact that today’s cessation medications — such as nicotine patches and prescription drugs — can more than double the chance of success for someone trying to quit, many low-income Ontarians, and many who live Hamilton, can’t afford the cost of medication.

This inequity adds insult to injury. If you live below the poverty line, you are more likely to smoke and less likely to afford the very treatment that could cure you of your addiction.

Based on the numbers, providing cessation medication free of charge by adding it to the provincial drug plan is a smart and socially enlightened policy option. If those one million Ontario smokers who tried to quit last year had actually succeeded, there would be half as many smokers in the province today. Acute care hospital stays among smokers would be cut in half, along with the death rate, the financial impact on our health system, the huge loss in productivity from sick days, and so on.

Adding smoking-cessation medications to the Ontario Drug Benefit Plan would cost the provincial treasury between $7 million and $12 million annually. The savings in terms of saved lives and reduced healthcare costs would be about $21million to $36 million. This conservative estimate is based on the Ontario Medical Association’s calculation that, for every dollar spent on smoking cessation, there is almost a three-dollar return.

This represents a substantial net benefit for the Ontario taxpayer and a boon for the provincial economy.

Cessation medication is not a panacea. However, it is an essential element of a comprehensive anti-smoking strategy that includes prevention programs, counselling and support, and tough tobacco control measures.

National Non-Smoking Week is the perfect time to get in touch with your local MPP and tell them that you support free smoking cessation medication.

Let’s make this week Ontario’s — and Hamilton’s — time to quit.

Posted on January 19, 2011 in Articles and Tips

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Visit my Canadian doctor friend's websites:
Dr. Arya Sharma (Obesity Expert) and Dr. Stuart Weprin, ObGyn Dayton Ohio