Article written jointly by Phuong Vu and Brian Luong. Phuong Vu is a staff pharmacist at Walgreens Pharmacy in Sacramento, California. He plans on becoming involved in a medical mission to Vietnam in the near future.
“Mind if I smoke?” asks Khôi to his girlfriend, who sits on the other side of the table in a Saigon cafe.
Smoking condition in Vietnam is a serious public health problem if not being addressed seriously. For every hour we spend on OneVietnam Network, there are 5 tobacco related deaths in Vietnam. Do you think Neil’s 10,000 deaths per year on the road is bad? Now, quadruple that number will give you a total estimated 40,000 caused by smoking, and this will increase to about 70,000 by 2033 if we don’t take an effective measure. Some experts even believe this figure could be much under-reported due to deaths outside of hospitals.
Khôi used to sit by Daddy after dinner watching him smoked. “Con h?n Cha là nhà có phúc.” Young Khôi would proudly imitate his every move, picked up his left over bud and started to put it in his mouth. Khôi was 4.
About half of 86 million adult males use tobacco in Vietnam. This makes the country one of the highest in the world (other countries are China, Malaysia and Laos). Young Vietnamese school boys start to pick up the habit of smoking from as early as 13 years of age. Up to half of all smokers will die prematurely from tobacco related diseases that include cancers, heart disease, stroke, birth defect, infertility, impotence (Yes gentlemen, how cool is that?), and many more. Ha Noi School of Public Health estimates the costs from cancer, circulatory, and respiratory diseases resulting from smoking is more than 75 million USD per year.
Now at the age of 21, Khôi already smokes an average of 1 and 1/2 packs a day. Today, however, being deeply sad about his father’s diagnosis of oral cancer, Khôi’s almost on his last cigarettes of the second pack. He needs a night out, so Khôi calls his girlfriend.
Although there are only 2 percents of the Vietnamese female population who smoke, second-hand smoking by these women also shares the same health risks mentioned above. A survey conducted by the Hanoi Medial University in 2005 shows that 2/3 of Vietnamese women and more than 60 percents of school children aged 13-15 years old are regularly exposed to second-hand tobacco smoke at home and in public places. Worldwide, of the more than 600,000 deaths caused every year by second-hand smoke, 64 percents occur in women.
Fortunately, there are already efforts by the Ministry of Health, World Health Organization (WHO) and World Lung Foundation (WLF) to raise awareness. In December 2004, Vietnam ratified the WHO Framework Convention on Tobacco Control. It has banned all forms of advertising, increased taxes on cigarettes and last year added larger warning labels to packaging. From December 2009 to January 2010, the “Cigarettes are Eating You Alive” campaign was launched and spread through television, posters and the press. Beginning January 1st, 2010, smoking would be prohibited in all public spaces. In May, 2010, results from the survey of the “Cigarettes are Eating You Alive” revealed that 77 percents of Vietnamese people who had seen anti-smoking materials oppose being exposed to second-hand smoke in public places.
If we all wish Vietnam to be a better place in the future, then smoking is one problem must not be ignored.
“Mind if I smoke?” asks Khôi to his girlfriend, who sits on the other side of the table.
“Yes, Khôi. Please don’t!”
Oral Cancer
It is no surprise that smoking can cause numerous diseases. The insult begins in the mouth where smoke, heat, and carcinogenic products interact directly with oral tissues. As the ad above points out, ‘Tobacco causes mouth disease’.
In particular, oral cancer can be one of the scariest and most debilitating of diseases linked to smoking. The Oral Cancer Foundation reports that close to 36,000 Americans will be diagnosed with oral or pharyngeal cancer this year in addition to causing 8,000 deaths. More startling is that of the 36,000 diagnosed, only half will be alive in 5 years. Surprised?
We’re not there yet.
The death rate for oral cancer is higher than cancers which we hear more often about – cervical cancer, Hodgkin’s lymphoma, or malignant melanoma (skin cancer). Yet the puzzling thing is that oral cancer is … treatable.
Consider this: “The death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development.”
If smoking can lead to oral cancer, and oral cancer is treatable, what can we do to lower the death rate? For starters, quitting is the most absolute best way to extend one’s life and prevent the onslaught of cancer formation. Although it may take several decades of smoking for the accumulative damage to develop into cancer, tobacco use in all its forms is at the top of the list of risk factors in individuals over 50. Statistics show that at least 75% of those diangosed at 50 and older are tabacco users. New data are developing but have yet to be released. The situation worsens when tobacco use is paired with heavy alcohol use, leading to a synergistic effect that increases the risk of cancer development by 15 times.
Oral cancer is treatable if caught early. To illustrate this point, imagine the oral mucosa as a multilayered cake that is rotting away from top to bottom. The cake perhaps can be salvaged early on by removing the top layer that has rotted. However, over time the cake will rot throughout rendering it unsalvagable. Oral cancer is often discovered too late when the cancer has penetrated throughout the layers of the mucosa, enabling the cancer to metastasize or break free into the blood stream where it can spread to other locations. When this event has occured, the outcome of treatment is very poor.
Patients often miss early signs because oral cancer can present without pain or symptoms (or symptoms that are not readily recognizable). It is extremely important to receive annual check ups by your dentist. Make sure that when you come in for your 6 month recall or cleaning, you are also receiving your oral cancer screening.
Resources and references
WHO Viet Nam (http://www.wpro.who.int/vietnam)
VINACOSH (http://www.vinacosh.gov.vn/)
WORLD LUNG FOUNDATION (http://www.worldlungfoundation.org/)
Oralcancerfoundation.org
Great article Phuong & Brian! Do you think posting the cost of treating smoking-related disease will deter people from smoking? I’d love to have some statistics about the cost.. I’m sure it’s enormous!
From the WHO website. Although the stats could use an update, it gives an idea how a pack of cigarettes’ cost varies from country to country and its relative cost to basic food items. Now multiply the cost of each pack times how many packs a smoker smokes a day times 7 days a week, times 52 weeks a year… With the money saved, you could go on a nice vacation, buy a new computer, save for a new motorcycle or car. Heck, you could even start saving for a new lung or two, or how about a healthy life? What do they cost anyway?
http://www.who.int/tobacco/en/atlas14.pdf
The success rate for lung transplants is very low. Best bet is to just quit. The lungs do heal/recover.
The best way to combat smoking in Vietnam is probably NOT through general health warnings but specific target messaging.
Smoking is dangerous to your health…
Sure it is, but everyone knows this.
Smoking in Vietnam is mainly a male problem. So hit them where it hurts.
Smoking causes IMPOTENCE.
That is a message to strike fear in mens hearts and combat the macho imagery of the tobacco ads.
All tobacco companies in Vietnam are joint-venture or wholly-owned by the government. They have a vested interested in not having warning pictures and increasing tax. Would take a lot of lobbying and advocacy i feel…