Ram Singh was 14, when he took first puff of a bidi; with that puff a demon called nicotine entered his airways for the first time, along with troop of few thousand toxic substances, including 60 cancer causing ones. They were to toil on all of his organs, annihilating them slowly. Nicotine took control of his brain by making him happy and elevating his mood, so much so that he wanted nicotine to wander in his blood all the time, his day started and ended with smoking.

After 30years, hard work of the devils started showing result; first organ to wilt was the lungs, when Ram Singh developed cough with shortness of breath. At this time hecame to us for consultation, detailed examination and investigations suggested severe obstruction of his airways.He was still smoking, in past whenever he tried to quit he became depressed, anxious, irritable, restless, lost concentration, developed headaches and constipation.

We started the treatment and asked him to do breathing exercises, reduce consumption of tea, drink more of lemon and plain water, and consume healthy meals on time. We also offered him nicotine chewing gums (nicotine without toxic substances). On next follow up his condition improved, but was still smoking, he promised to quit completely but unfortunately for reasons known to him only, he never came back.

One day when I reached emergency to attend an emergency call, I saw Ram Singh struggling for breath, his response was sluggish and he looked delirious. His tongue and nails were blue due to the lack of oxygen. He was in respiratory failure, with enormously high carbon dioxide levels and blood counts. His BP was low and x-ray chest showed the ominous “pneumonia”.

We had no options but to put him on ventilator, we counseled his family about his grave situation. During counseling we came to know, after a month his daughter was getting married. His son asked us to do the best possible. We shifted him to ICU, connected him to ventilator, started drugs to lift his BP along with antibiotics for pneumonia. Fortunately his BP got stabilized, his fever started declining, his blood counts slipped down after few days. But he remained on ventilator as he was too weak to sustain the respiration. On 7th day, he was off ventilator, and on 14th day he was discharged.

His family spent a substantial amount on his treatment; the major chunk came from savings for his daughter’s marriage. He was lucky to survive, but many in his condition don’t.

Smoking has got devastating effect on our bodies. It causes lung cancer, COPD (Ram Singh’s disease), and increases risk of heart attack and stroke. It causes cancer of mouth, food pipe, throat, voice box, urinary bladder, pancreas, liver, kidney, cervix, stomach and intestines. Smoking makes one look old; it irritates skin, encourages wrinkles.Teeth and nails become yellow. It can make men impotent and infertile, women carries risk of infertility and miscarriage. The babies born to smoking mothers are of low birth weight and may have impaired lung function.

Benefits of quitting are enormous, if one quits before age of 35, he will miss out on 90 percent of the health risks associated with smoking. If one quits before 50, he can still halve the risk of dying in the next 15 years. No matter whatone’s age is, health will benefit if one stops smoking. Just 20 minutes after last cigarette, heart rate goes down. Twelve hours later, the blood carbon monoxide levels drops to normal. Lung function, risk of infection, cough, breathlessness and circulation improves within months.After one year, the risk of heart disease drops by half. After5 years of quitting, risk of stroke decreases immensely.

The best way to prevent nicotine dependence is not to smoke at all. Let us fight this demon and make the society smoke free, so that our coming generations can enjoy better health.

Dr. Puneet Tyagi

Director Medical Services

Department of Pulmonary Medicine and Critical Care

Velmed Hospitals


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