Debunking Myths About Smoking And Cardiovascular Disease – Dr Yap Jun Fai, Prof Dr Moy Foong Ming & Dr Lim Yin Cheng

The best way to ensure optimum cardiovascular health is to avoid using tobacco products in any form or to stop smoking. 

According to the first Global Adult Tobacco Survey performed in 2011, the majority (92.2 per cent) of Malaysian adults knew that smoking could cause serious illnesses such as cardiovascular disease (heart attack or stroke). More than 10 years later, the overall prevalence of Malaysian smokers has shown a promising decline from 22.8 per cent in 2015 to 21.3 per cent in 2019.

However, key findings from the latest National Health and Morbidity Survey 2022 have revealed a worrying rising trend of vaping (or smoking e-cigarettes) among secondary school students. In this context, a dramatic shift in teen smoking behaviour was noted, where the national prevalence of vaping and e-cigarette use among students escalated from 9.8 per cent in 2017 to 14.9 per cent in 2022.

Realising the importance of raising health awareness among the public (especially adolescents), here are a few common myths and facts regarding smoking with its effects on cardiovascular disease:

Myth 1: If you have smoked for many years, your risk of having a heart attack cannot be reduced.

Fact 1: No. Regardless of your age, your smoking history, or the number of cigarettes smoked in the past, you can still gain many cardiovascular benefits gradually as you quit smoking. For example, harmful substances like nicotine or carbon monoxide levels in your blood will drop to almost zero after several days of quitting smoking.

Within a year of no smoking, your risk of a heart attack will be reduced by nearly 50 per cent. After more than 15 years of abstinence, your risk of a heart attack (as a former smoker) will decrease further to become close to that of someone who does not smoke.

Myth 2: Vaping is a safer alternative to the use of traditional tobacco cigarettes.

Fact 2: No. Daily vaping habit is associated with a 70 per cent higher chance of having a heart attack, as compared to people who have never vaped. In general, vaping impacts negatively on the cardiovascular system by increasing oxidative stress and damaging body cell DNA.

Certain vaping products also contain a type of chemical substance called vitamin E acetate which is strongly linked to the occurrence of a new respiratory illness called E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI). In view of the many harmful health effects, vaping should not be viewed as an entirely safe replacement for traditional tobacco smoking.

Myth 3: Thirdhand smoke is not harmful.

Fact 3: No. Thirdhand smoke (persistent residue from tobacco smoke which adheres to indoor environment surfaces like furniture, clothing, cushions, carpets, or other housing materials) can be as harmful as secondhand smoke. Thirdhand smoke contains residual tobacco pollutants which can be re-emitted into the air and react with other environmental compounds to produce more dangerous pollutants.

Potential mid to long-term health consequences exist when human beings touch the contaminated surfaces and subsequently put their hands into mouth. Inhalation of the gases that thirdhand smoke may release or dermal absorption are other possible routes of exposure.

For instance, infants or toddlers who spend longer indoor time are particularly vulnerable to thirdhand smoke, as they tend to crawl and put non-food items into their mouths. Animal studies have proven that maldevelopment of the brain, cardiovascular disease, or even cancer formation is possible after prolonged exposure of thirdhand smoke.6,7

In line with World No Tobacco Day on May 31, 2023, we must acknowledge that there is no safe level of exposure to tobacco smoke. Indeed, the best way to ensure optimum cardiovascular health is to avoid using tobacco products in any form or to stop smoking. 

Dr Yap Jun Fai, Prof Dr Moy Foong Ming and Dr Lim Yin Cheng are affiliated with the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya and the Department of Public Health, University Malaya Medical Centre. 

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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