Saturday, March 12, 2011

Not a smoker? Too bad – smoking is still killing you!

I have just come back from the hospital where I attended a man with serious complications of a chronic disease. He was the 3rd person I saw today with similar complications from the same disease.
I am furious because none of these people needed to suffer. This disease is completely preventable.
The disease is tobacco addiction.
Perhaps you’re wondering what smoking-related disease urologists treat? You know that cigarettes cause heart disease and lung cancer, but those areas are far removed from urology territory. Give up? It’s bladder cancer – one of the top 10 types of cancer, and primarily caused by tobacco abuse.
The most serious bladder cancers are treated with major surgery: bladder removal and creation of a urinary stoma. It’s a long operation with significant complications. Many of those complications are related to other problems faced by smokers: heart and lung disease, poor wound healing, etc.
During the last month, I’ve had long conversations with 2 patients who were agonizing over their decision to undergo surgery for their bladder cancers. Both were long-time smokers and had severe lung disease. They knew that surgery would be risky, but were also facing certain death if the cancer spread. One man’s wife was in tears as we spoke on the phone.
The maddening thing is that the twin diseases they face never had to happen. They would be spared the physical and emotional suffering if they never smoked.
But, smoking affects non-smokers too. I don’t mean disease caused by second-hand smoke. I’m talking about the money and effort wasted treating largely preventable diseases. Cancer, heart and lung disease, and stroke burn up huge amounts of healthcare resources. That’s money from everyone’s taxes. It means longer wait lists as provider time is taken up managing chronic, tobacco-related disease.
None of this is news to you. We’re inundated with anti-smoking information from the time we’re in grade school. Yet, about 20% Canadians continue to smoke. This despite warning labels, funding for smoking cessation medications, and restrictions on smoking in public places.
These efforts aren’t enough. We’re all suffering the effects of smoking. Smokers suffer personally and dreadfully. Non-smokers pay the price through wasted healthcare resources.
I’m upset enough (and politically naïve enough) to demand a direct solution. And, I won’t direct this to “the system” or “the government”. I say this to the 4 people responsible for preventing smoking-related illness in Canada and Saskatchewan: Prime Minister Stephen Harper, federal Minister of Health Leona Aglukkaq, Premier Brad Wall and provincial Minister of Health Don McMorris.
Stop thinking about tobacco abuse as a personal choice to use a legal product. Tobacco is legal only if your government allows it to be. If you doubt that tobacco use is an addiction, visit my hospital in January when patients smoke outside, shivering in cotton gowns in -30C weather.
Warnings on cigarette packs and public smoking restrictions are not enough.
Choke this problem at its source: Make tobacco illegal in Canada. Wait a year before implementing the law. During that year, lavish free smoking cessation products and support on smokers.
There’s a long list of problems with this plan. We look to you – our leaders – to solve those problems.
Tobacco companies will fight you, literally for their survival. So what? They poison our neighbors. They profit on the back of your healthcare budget.
Save lives. Lead the world.
Put me out of a job. Please.

(April 19, 2011 - I received a response from Don McMorris, Sask Minister of Health.  He outlined Sask's initiatives to reduce smoking - no pharmacy sales, no smoking in cars with children,etc.  Thanks, Minister.)

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