Smoking and addiction
Tobacco is a plant that has leaves which are cured or dried to make a number of products that people consume by smoking or chewing. This includes cigarettes, cigars, cigarillos, pipes, flavoured tobacco in water pipes (hookahs or shishas), chewing tobacco and snuff. Nicotine is a very addictive substance found in all tobacco products. In addition to lung cancer, smoking tobacco products is linked to a variety of different health problems, including heart disease, lung disease and other forms of cancer [1].
There is a clear link between smoking tobacco products and cancer. Tobacco smoke contains over 4,000 chemicals, more than 70 of which cause cancer. It is estimated in Canada that smoking is responsible for more than 30 per cent of all cancer deaths and related to 85 per cent of all lung cancer cases. Second-hand smoke is also very harmful, as non-smokers can be exposed to the same harmful chemicals as smokers—there is no exposure to second-hand smoke is safe [2].
According to the Ontario Tobacco Research Unit, addiction is the number one predictor of difficulty quitting. The same findings show that on average smokers will attempt to quit at least once each year. On average, it takes a smoker an average of thirty times to quit successfully, but if you keep trying your chances improve drastically. Over a two year period, the chances can improve from 9 per cent at the start to 92 per cent after two years [3].
Smoking and the social determinants of health
Our health is shaped by a wide variety of factors, employment, income, working conditions, health and social services, education, food and housing, among other factors. And contrary to the idea that Canadians have personal control over a lot of these factors, they are often decided by larger social, economic and political forces [4].
Social Determinants of Health: The Canadian Facts considers there to be fourteen social determinants of health: income and income distribution; education; unemployment and job security; employment and working conditions; early childhood development; food insecurity; housing; social exclusion; social safety network; health services; aboriginal status; gender; race; disability [5].
And research consistently shows that lung cancer risk is linked to socio-economic status (SES) or your level of income and level of education [6]. In a review of 45 nationally representative surveys carried out in Canada between 1951 and 2011, one study found that despite the overall decline in rates smoking across all education levels, the absolute differences in rates of smoking between certain education levels had increased [7].
As an example, among women who had only completed a secondary education, the prevalence of smoking decreased from 40.0 per cent in 1950 to 32.6 per cent in 2011, whereas women with a university level education decreased from 44.7 per cent in 1950 to an estimated prevalence of 7.7 per cent in 2011. And while men showed declines across all educational groups, there was a varied response in the rate of decline, with a less significant decline among those who had not completed secondary education [8]. In 1950, the smoking prevalence was 63.9 per cent among men with less than secondary education, compared to 54.3 per cent among university-educated men. By 2011, the corresponding prevalence was 42.5 per cent among those with less than secondary education and a striking 12.6 per cent among those who had completed university [9].
The same study analysed the socio-economic gradients associated with starting and stopping smoking from 1999 to 2011. Those with lower levels of education reported higher levels of starting smoking. Furthermore, quitting smoking was found to be higher amongst the highest education groups in both women and men over the twelve year period [10]. This could also be attributed to other social determinants as well, such as the influence your social network or lack of access to quitting resources.
The purpose of sharing this information is to combat the idea that persons are the only ones responsible for their personal health. Social and economic forces play large parts in our health and while individuals can quit on their own, responsibility still lies with our institutions and governing agencies to employ effective, evidence-based public health policies that address the needs of all populations.
Tobacco use in Canada: Patterns and trends – 2015 edition
Quitting smoking
Quitting smoking is no easy feat, but as the biggest risk factor for lung cancer, it is one of the best things you can do for your lung health. The risk of lung cancer is much less in people who quit than smokers who do not. Furthermore, as the number of years smoke-free increase, the risk of cancer decreases: five years after quitting smoking, the risk of lung cancer is 30-60 per cent lower [11]. The earlier you quit the better, those who quit in their 30s may avoid most of the risk associated with tobacco use, but even smokers who quit after age 50 reduce their risk of dying early. Unsurprisingly, getting sick is one of the factors that trigger attempts to quit smoking [12].
While it is a challenge to quit smoking, quit aids, perscription medications, individual counselling and programming exist to help people quit [13]. Nicotine Replacement Therapy (NRT) is a popular methods to help people quit. It is a treatment that supplies low doses of nicotine with the goal of cutting down on the cravings and easing the symptoms of nicotine withdrawal. NRT supplements come in many forms: gum, inhalers, lozenges, nasal spray and skin patches. When coupled with a counselling program, the more likely you are to quit [14].
Other methods such as self-help, quit contests and counselling are very popular and are often blended with different methods. 83 per cent of pharmacotherapy users (prescription medication) have also tried self-help and/or counselling [15].
The Canadian Cancer Society has a number of resources, including booklets for people who want to quit smoking, people who don’t want to quit smoking and for supporting someone quit smoking. The Smokers’ Helpline is a free, confidential service that can help you develop a quit program and give you tips to deal with cravings, withdrawal symptoms and refer you to support services within your community. All of the aforementioned and more can be found below:
Canadian cancer society – Smoking and tobacco resources
The lung association – quitnow.ca
Radon
Radon is a colourless, odourless, tasteless radioactive gas found naturally in the environment. It is released when uranium breaks down in the rocks and soil. Once released, radon breaks down into elements that attach to dust and other substances in the air we breathe. We can be exposed to radon by indoor air when it seeps into the home and builds up in enclosed places, particularly ones that are poorly ventilated. Workplace exposure can occur from the air in uranium and other underground mines that do not have proper ventilation systems in place.
The International Agency for Research on Cancer classifies radon as a known cause of cancer. Exposure to radon gas increases your risk of lung cancer. This depends on the level and length of exposure and if you’re a smoker –if you smoke you’re at higher risk for developing lung cancer. Health Canada estimates that about 16 per cent of lung cancer deaths are caused by radon exposure in the home. In Canada, it’s estimated that about 3000 lung cancer deaths are related to radon each year.
A 2014 survey commissioned by the Canadian Cancer Society showed that 96 per cent of Canadians had not tested their homes for radon gas. A 2012 Health Canada report indicating that 6.9 per cent of Canadians are living in homes with radon levels above the current Canadian guidelines of 200 Becquerels per cubic metre (Bq/m3).
The table below from the 2012 Health Canada report shows the population-weighted percentage of Canadians living in homes with radon concentrations below 200 Bq/m3, between 200 and 600 Bq/m3, above 600 Bq/m3 and above 200 Bq/m3 for each province and territory.
[16] Information taken from the Canadian Cancer Society
[17] Table 3
How to test for radon
To test your home for radon, you can purchase a test kit at your local hardware store, or online from several organizations working in radon. You can also hire a professional to perform a test for you. Find out more about how to test for radon in your home.
Reducing your radon exposure
If the indoor radon level is more than 200 Bq/m3, it needs to be to be reduced. While it isn’t possible to reduce indoor radon levels to the same level as outdoors, radon levels in most homes can be reduced to around 75 Bq/m3 or less. The age of your home is not a good indicator of how high indoor radon levels could be but you need to test to know for sure.
If radon levels are high, a certified radon professional can reduce the radon level in your home. Steps that may be taken to reduce radon levels include:
- Installing an active soil depressurization system (also known as sub-slab depressurization system). This reduces the concentration of radon in the soil, especially next to your home’s foundation. Active soil depressurization is the most common and usually the best way to reduce radon levels in your home.
- Sealing cracks and holes in basement floors and walls (including joints between the wall and the floor), and openings in the basement for utility connections (for example, openings for water, sewer, electrical, natural gas and fuel oil).
- Covering sump pumps and drains (without interfering with how they work).
- Increasing air circulation by regularly opening windows or by installing a mechanical ventilation system that helps make sure there is a balanced flow of indoor or outdoor air.
[18] Information taken from the Canadian Cancer Society
References
[1] “Smoking and Cancer.” Canadian Cancer Society. Canadian Cancer Society, 2016. Web. 22 Mar. 2016.
[2] ibid.
[3] Quitting Smoking in Ontario. Digital image. The Ontario Tobacco Research Unit. Ontario Tobacco Research Unit, Nov. 2013. Web. 22 Mar. 2016.
[4] Mikkonen, Juha, and Dennis Raphael. “Social Determinants of Health: The Canadian Facts.” The Canadian Facts. www.thecanadianfacts.org, 2010. Web. 22 Mar. 2016.
[5] ibid.
[6] ibid.
[7] Corsi, Daniel J., Michael H. Boyle, Scott A. Lear, Clara A. Chow, Koon K. Teo, and S. V. Subramanian. “Trends in Smoking in Canada from 1950 to 2011: Progression of the Tobacco Epidemic According to Socioeconomic Status and Geography.” Cancer Causes & Control 25th ser. 25.1 (2014): 45-47. Springer. Web. 22 Mar. 2016.
[8] ibid.
[9] ibid.
[10] ibid.
[11] “Lung Cancer.” Lung Cancer Canada. Lung Cancer Canada, 22 Sept. 2011. Web. 23 Mar. 2016.
[12] OncoLink Team. “Former Smokers and Cancer Risk.” OncoLink. Abramson Cancer Center of the University of Pennsylvania, 23 Mar. 2012. Web. 23 Mar. 2016.
[13] Quitting Smoking in Ontario. Digital image. The Ontario Tobacco Research Unit. Ontario Tobacco Research Unit, Nov. 2013. Web. 23 Mar. 2016.
[14] “Nicotine Replacement Therapy.” MedlinePlus. U.S. National Library of Medicine, 2 Aug. 2015. Web. 23 Mar. 2016.
[15] Quitting Smoking in Ontario. Digital image. The Ontario Tobacco Research Unit. Ontario Tobacco Research Unit, Nov. 2013. Web. 23 Mar. 2016.
[16] “Radon.” Canadian Cancer Society. Canadian Cancer Society, 2016. Web. 23 Mar. 2016.
[17] Health Canada. Table 3. Digital image. Cross-Canada Survey of Radon Concentrations in Homes. Health Canada, Mar. 2012. Web. 23 Mar. 2016.
[18] “Radon.” Canadian Cancer Society. Canadian Cancer Society, 2016. Web. 23 Mar. 2016.