Despite the known fact that smoking is injurious to health, India has 12% of smokers in the world, approximately 120 million. We can find advertisements on cigarette packs, tobacco sachets, boards, hoardings, and even before the movie starts in cinema for awareness.
People tend to neglect because the short term effects only include bad breath, decreased appetite, dizziness, nausea, and fatigue. These signs are easily ignored, smokers appreciate the feeling of relaxation, mild euphoria and it initially stimulates the central nervous system (CNS), and later on, the neural activity decreases. Tobacco causes cancer but 28.1% of mortality happens because of Ischemic Heart Disease (IHD), Cerebrovascular accidents (CVA), lower respiratory tract infection (LRTI) and most common the most prevalent is a chronic obstructive pulmonary disease (COPD). All these conditions cause disability and have the highest mortality in death due to tobacco.
The cigarette smoke contains nicotine which triggers an immune response in the mucosal lining of respiratory tracts and local inflammation of lining occurs. Because of repetitive and long-term response to smoking, it gradually damages the epithelium and the respiratory airways get narrowed. Toxins like carbon monoxide (CO) and Nitrogenous oxides adversely affect the oxygen-carrying capacity of the blood. Nicotine with carbon monoxide hardens the arteries. The heart has to work faster and the blood pressure rise, leading to other heart-related problems and risks of coronary artery disease, heart enlargement (cardiomegaly).
Water-pipe (Hookah) smoking is trending among young Indians; they believe that hookah smoking has less risk of damage than smoking tobacco. Water-pipe smokers use moist and flavored tobacco. This contains the same kind of toxins and smoking water-pipe and cigarette has no distinguish effects. Smoke accompanies carcinogenic tar which coats then the lungs from inside. The surface area for oxygenation gets lined with tar, leading to reduces perfusion. As a long term effect, the lungs lose their compliance. This means the soft lungs losses their elastic property to expand and recoil during breathing. A smoker is always prone to cancer of throat, trachea, and lung parenchyma. There are increased chances of stroke, heart attack, and other systemic diseases.
People suffering from COPD, chronic heart diseases are prone to a heart attack or other cardiac problems. They face difficulty in activities of daily living; they are mostly tired and get easily breathless. More serious presentations involve supplementary oxygen for comfortable sleep. This bounds the patients with their bed or isolates them from society because of their inability to move outside. This grows depressed mental state and loss of self-esteem. Such patients lose their wish to live with this kind of life and mostly depend on medications for their well-being.
Various researches have proven that cardio-respiratory physiotherapy is very effective in improving the quality of life and inducing functional independence.
By correcting the pattern of breathing has significantly improved ventilation and reduced respiratory muscle fatigue. Diaphragmatic facilitation improves the oxygenation and respiratory volumes. Arterial blood gas analysis (ABG) reports the improvement of oxygen saturation in arterial blood after breathing exercises. Aerobic exercises improve the ventilation and oxygenation, this helps in improving tolerance to physical exercise and delay fatigue. Various techniques like active cycles of breathing techniques, postural or autogenic drainage, and chest clapping have a significant effect in clearing off the airways and helped the patient to lead a more independent and stress-free life.
Pankaj MPT 3rd Sem Cardiopulmonary Faculty of Physiotherapy
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