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Quitting smoking is as important as wearing a mask

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World ‘No Tobacco Day’ falls tomorrow on the theme ‘Commit to Quit’

by Randima Attygalle

Chemicals found in nail polish, rat poison, battery acid, car exhaust fumes, paints, rubber cement and gasoline are just a handful of what you will find in a single cigarette. A lighted cigarette create more than 7,000 chemicals and nearly 70 of them are known to cause cancer; and many are toxic. While many of these chemicals found in consumer products carry warning package labels (eg. rat poison), there is no such warning about toxins in tobacco smoke, points out the American Lung Association.

While cigarette smoking is the most common form of tobacco use worldwide, all forms of tobacco including water pipe tobacco, smokeless tobacco products, cigars, pipe tobacco, bidis and kreteks (used in Indonesia) are all harmful. ‘The tobacco epidemic’, according to the WHO, is one of the biggest public health threats the world has ever faced, killing more than eight million people a year around the world. More than seven million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to tobacco smoke. ‘Over 80% of the 1.3 billion tobacco users worldwide live in low and middle-income countries, where the burden of tobacco-related illness and death is heaviest. Tobacco use contributes to poverty by diverting household spending from basic needs such as food and shelter to tobacco,’ notes the WHO.

Cigarette smoke reduces the amount of oxygen carried to tissues and even in case of COVID patients, oxygen saturation (percentage of oxygenated hemoglobin returning to the right side of the heart) levels are low. Consultant Respiratory Physician and Senior Lecturer from the Department of Anatomy, Faculty of Medicine, University of Colombo, Dr. Yamuna Rajapakse points out that several studies have now confirmed that oxygen saturation is less in patients who smoke compared to non-smokers. “Smokers function in a low oxygen saturation environment, hence they are at greater risk than non-smokers during COVID lung involvement.”

Smoking causes thrombosis or blood clot formation. This could lead to stroke, heart disease and peripheral vascular disease. COVID too causes thrombotic effects and smoking may increase this risk she explains. Tobacco smoking is a significant risk factor for both viral and bacterial infections of the respiratory system. Smokers are five times as likely to develop influenza and twice as likely to have pneumonia. This, as many reputed medical journals including the British Medical Journal (BMJ) confirms, is an important factor worsening the impact of COVID-19. ‘There is evidence from case series that smoking is associated with more severe disease, a greater risk of intensive care need and excess mortality in people with COVID-19 admitted to hospital,’ notes the BMJ.

Smokers have more phlegm in their system and experience bouts of what is commonly known as the ‘smoker’s cough’. “Tobacco smoke burns the protective mechanism we have in our lungs which acts as a buffer against dust, viral and bacterial particles entering the respiratory system,” says the physician. She adds that smokers are more likely to develop pneumonia and this risk is aggravated in COVID patients who smoke.” Dr. Rajapakse also remarks that while the majority of COVID patients are asymptomatic, smokers show more COVID symptoms as research findings from China and UK also confirm.

New tobacco trends such as shisha smoking (smoking tobacco through a water bowl via a hose or tube) has also become an added problem notes Dr. Rajapakse who also warns that sharing of cigarettes and shisha tubes could increase the transmission of COVID and other respiratory infections.

Lung cancer which is the leading cause of cancer death the world over with smoking long established as a major cause, is now being diagnosed in a younger adult population. “Today we see advanced lung cancers in those in their 30s and 40s. Although genetic predominance is also present in lung cancer, a sizable percentage is attributed to second-hand or passive smoking (involuntary inhalation of other people’s smoke). Victims include women exposed to a smoking spouse.” Pregnancy is the worst time one could be around smoke, says the physician who warns that babies born to mothers exposed to passive smoking have lower lung reserves. Low birth weight is also common among such babies. Third-hand smoke where residual nicotine and other chemicals are left on indoor surfaces, clothing etc. is also bad for people who are exposed to them.

Entailing symptoms similar to asthma with wheezing and coughing, Chronic Obstructive Pulmonary Disease (COPD) is another serious smoke-induced condition. A non-reversible condition, COPD does not respond very well to inhalers, explains Dr. Rajapakse. Smokers with a specific enzyme deficiency can end up with COPD prematurely, she warns. Besides noncommunicable diseases such as high blood pressure, heart disease and stroke, smokers are also at a higher risk of having intermittent claudication and vascular ulcers leading to amputation of limbs, she says.

Despite tobacco smoking being established as a real risk factor for COVID-19, seriously compromising immunity and structural functioning of the respiratory system, there is very little discourse on it, observes the Consultant Psychiatrist from the National Hospital of Sri Lanka and the Director, Centre for Combating Tobacco, Dr. Mahesh Rajasuriya.

“Not smoking is as important as wearing a mask, yet the tobacco industry has been careful in downplaying this,” says the Psychiatrist who adds that apart from developing very serious complications, tobacco smoking also directly violate COVID control measures. “Smokers are compelled to remove their masks to smoke and even if they are smoking outdoors, there is a tendency for them to interact with a few more people in a small enclosure inhaling and exhaling each other’s breath more sharply. Here the risk of contracting COVID is enormous. Secondly our health care system is already exhausted with COVID patients and if a smoker suffers a heart attack, a stroke or gets pneumonia to which they are more susceptible, it will add to the burden.”

While hardly anyone “pledges to smoke to the grave”, most smokers wish to quit at sometime but several factors prevent them from doing so, says Dr. Rajasuriya. “These can be broadly classified into demand and supply factors. While the former makes smokers want to smoke again, the latter keep the environment conducive to smoking such as making cigarettes cheaper and more accessible.” Although the price of a cigarette should be more than what it is now in the Sri Lankan market compared to other consumer goods, it has on the contrary become more affordable, driving those from lower socioeconomic levels and youngsters who are still dependent to become addicted, says Dr Rajasuriya. “The tax increases on cigarettes too has been fraudulent with less money going to government coffers and larger proportions to the tobacco industry.”

The non-availability of a local license system as in the case of many countries including several in the region such India and the Maldives, makes cigarettes freely available, he points out. The absence of a law banning single stick sales adds fuel to fire during the pandemic he says. “Added to the physical touch when selling single sticks, the smoker does not see the pictorial health warnings on cigarette packs.”

A large majority of smokers quit without any psychological help says the psychiatrist who observes that the tobacco industry has created a myth that quitting is an uphill task and only those with extraordinary willpower can do so. “It is imperative to see through this myth first if you want to quit smoking,” he reflects. Certain stereotypes ingrained in the brain such as the need for physical pharmaceutical support for quitting often discourages a smoker wanting to quit the habit. “Another myth which needs to be debunked is that cigarettes need to be replaced with another chemical to help one to quit.”

The benefits of quitting tobacco are almost immediate, confirms the WHO. ‘After just 20 minutes of quitting smoking, your heart rate drops. Within 12 hours, the carbon monoxide level in your blood drops to normal. Within two to 12 weeks, your circulation improves and lung function increases. Within one to nine months coughing and shortness of breath decreases. Within five to 15 years, your stroke risk is reduced to that of a non-smoker. Within 10 years, your lung cancer death rate is about half that of a smoker. Within 15 years, your risk of heart disease is that of a non-smoker.

While some can navigate the transitional phase after quitting, many experience ‘withdrawal symptoms’ such as irritation, anxiety for which medication may be required. Getting rid of not merely cigarettes but all smoking associated paraphernalia including lighters and ashtrays is vital when preparing to quit says Dr. Rajasuriya. The comprehensive course designed by the Centre for Combating Tobacco, Help Quit sponsored by the WHO country office helps those who aspire to quit smoking and other support personnel including doctors, nurses, psychotherapists, counselors etc. to assist others to quit.

“The image about smoking is negative today, although the tobacco industry is trying hard to project otherwise. In this exercise, social media is now heavily used to induce the smoking habit and also to target a locally untapped market of young girls and women. Hence it is important for the public to see the true picture and not be deceived by the tobacco industry’s marketing strategy,” concludes Dr. Rajasuriya.



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Acid test emerges for US-EU ties

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European Commission President Ursula von der Leyen

European Commission President Ursula von der Leyen addressing the World Economic Forum in Davos, Switzerland on Tuesday put forward the EU’s viewpoint on current questions in international politics with a clarity, coherence and eloquence that was noteworthy. Essentially, she aimed to leave no one in doubt that a ‘new form of European independence’ had emerged and that European solidarity was at a peak.

These comments emerge against the backdrop of speculation in some international quarters that the Post-World War Two global political and economic order is unraveling. For example, if there was a general tacit presumption that US- Western European ties in particular were more or less rock-solid, that proposition apparently could no longer be taken for granted.

For instance, while US President Donald Trump is on record that he would bring Greenland under US administrative control even by using force against any opposition, if necessary, the EU Commission President was forthright that the EU stood for Greenland’s continued sovereignty and independence.

In fact at the time of writing, small military contingents from France, Germany, Sweden, Norway and the Netherlands are reportedly already in Greenland’s capital of Nook for what are described as limited reconnaissance operations. Such moves acquire added importance in view of a further comment by von der Leyen to the effect that the EU would be acting ‘in full solidarity with Greenland and Denmark’; the latter being the current governing entity of Greenland.

It is also of note that the EU Commission President went on to say that the ‘EU has an unwavering commitment to UK’s independence.’ The immediate backdrop to this observation was a UK decision to hand over administrative control over the strategically important Indian Ocean island of Diego Garcia to Mauritius in the face of opposition by the Trump administration. That is, European unity in the face of present controversial moves by the US with regard to Greenland and other matters of contention is an unshakable ‘given’.

It is probably the fact that some prominent EU members, who also hold membership of NATO, are firmly behind the EU in its current stand-offs with the US that is prompting the view that the Post-World War Two order is beginning to unravel. This is, however, a matter for the future. It will be in the interests of the contending quarters concerned and probably the world to ensure that the present tensions do not degenerate into an armed confrontation which would have implications for world peace.

However, it is quite some time since the Post-World War Two order began to face challenges. Observers need to take their minds back to the Balkan crisis and the subsequent US invasions of Afghanistan and Iraq in the immediate Post-Cold War years, for example, to trace the basic historic contours of how the challenges emerged. In the above developments the seeds of global ‘disorder’ were sown.

Such ‘disorder’ was further aggravated by the Russian invasion of Ukraine four years ago. Now it may seem that the world is reaping the proverbial whirlwind. It is relevant to also note that the EU Commission President was on record as pledging to extend material and financial support to Ukraine in its travails.

Currently, the international law and order situation is such that sections of the world cannot be faulted for seeing the Post World War Two international order as relentlessly unraveling, as it were. It will be in the interests of all concerned for negotiated solutions to be found to these global tangles. In fact von der Leyen has committed the EU to finding diplomatic solutions to the issues at hand, including the US-inspired tariff-related squabbles.

Given the apparent helplessness of the UN system, a pre-World War Two situation seems to be unfolding, with those states wielding the most armed might trying to mould international power relations in their favour. In the lead-up to the Second World War, the Hitlerian regime in Germany invaded unopposed one Eastern European country after another as the League of Nations stood idly by. World War Two was the result of the Allied Powers finally jerking themselves out of their complacency and taking on Germany and its allies in a full-blown world war.

However, unlike in the late thirties of the last century, the seeming number one aggressor, which is the US this time around, is not going unchallenged. The EU which has within its fold the foremost of Western democracies has done well to indicate to the US that its power games in Europe are not going unmonitored and unchecked. If the US’ designs to take control of Greenland and Denmark, for instance, are not defeated the world could very well be having on its hands, sooner rather than later, a pre-World War Two type situation.

Ironically, it is the ‘World’s Mightiest Democracy’ which is today allowing itself to be seen as the prime aggressor in the present round of global tensions. In the current confrontations, democratic opinion the world over is obliged to back the EU, since it has emerged as the principal opponent of the US, which is allowing itself to be seen as a fascist power.

Hopefully sane counsel would prevail among the chief antagonists in the present standoff growing, once again, out of uncontainable territorial ambitions. The EU is obliged to lead from the front in resolving the current crisis by diplomatic means since a region-wide armed conflict, for instance, could lead to unbearable ill-consequences for the world.

It does not follow that the UN has no role to play currently. Given the existing power realities within the UN Security Council, the UN cannot be faulted for coming to be seen as helpless in the face of the present tensions. However, it will need to continue with and build on its worldwide development activities since the global South in particular needs them very badly.

The UN needs to strive in the latter directions more than ever before since multi-billionaires are now in the seats of power in the principle state of the global North, the US. As the charity Oxfam has pointed out, such financially all-powerful persons and allied institutions are multiplying virtually incalculably. It follows from these realities that the poor of the world would suffer continuous neglect. The UN would need to redouble its efforts to help these needy sections before widespread poverty leads to hemispheric discontent.

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Features

Brighten up your skin …

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Hi! This week I’ve come up with tips to brighten up your skin.

* Turmeric and Yoghurt Face Pack:

You will need 01 teaspoon of turmeric powder and 02 tablespoons of fresh yoghurt.

Mix the turmeric and yoghurt into a smooth paste and apply evenly on clean skin. Leave it for 15–20 minutes and then rinse with lukewarm water

Benefits:

Reduces pigmentation, brightens dull skin and fights acne-causing bacteria.

* Lemon and Honey Glow Pack:

Mix 01teaspoon lemon juice and 01 tablespoon honey and apply it gently to the face. Leave for 10–15 minutes and then wash off with cool water.

Benefits:

Lightens dark spots, improves skin tone and deeply moisturises. By the way, use only 01–02 times a week and avoid sun exposure after use.

* Aloe Vera Gel Treatment:

All you need is fresh aloe vera gel which you can extract from an aloe leaf. Apply a thin layer, before bedtime, leave it overnight, and then wash face in the morning.

Benefits:

Repairs damaged skin, lightens pigmentation and adds natural glow.

* Rice Flour and Milk Scrub:

You will need 01 tablespoon rice flour and 02 tablespoons fresh milk.

Mix the rice flour and milk into a thick paste and then massage gently in circular motions. Leave for 10 minutes and then rinse with water.

Benefits:

Removes dead skin cells, improves complexion, and smoothens skin.

* Tomato Pulp Mask:

Apply the tomato pulp directly, leave for 15 minutes, and then rinse with cool water

Benefits:

Controls excess oil, reduces tan, and brightens skin naturally.

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Features

Shooting for the stars …

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That’s precisely what 25-year-old Hansana Balasuriya has in mind – shooting for the stars – when she was selected to represent Sri Lanka on the international stage at Miss Intercontinental 2025, in Sahl Hasheesh, Egypt.

The grand finale is next Thursday, 29th January, and Hansana is all geared up to make her presence felt in a big way.

Her journey is a testament to her fearless spirit and multifaceted talents … yes, her life is a whirlwind of passion, purpose, and pageantry.

Raised in a family of water babies (Director of The Deep End and Glory Swim Shop), Hansana’s love affair with swimming began in childhood and then she branched out to master the “art of 8 limbs” as a Muay Thai fighter, nailed Karate and Kickboxing (3-time black belt holder), and even threw herself into athletics (literally!), especially throwing events, and netball, as well.

A proud Bishop’s College alumna, Hansana’s leadership skills also shone bright as Senior Choir Leader.

She earned a BA (Hons) in Business Administration from Esoft Metropolitan University, and then the world became her playground.

Before long, modelling and pageantry also came into her scene.

She says she took to part-time modelling, as a hobby, and that led to pageants, grabbing 2nd Runner-up titles at Miss Nature Queen and Miss World Sri Lanka 2025.

When she’s not ruling the stage, or pool, Hansana’s belting tunes with Soul Sounds, Sri Lanka’s largest female ensemble.

What’s more, her artistry extends to drawing, and she loves hitting the open road for long drives, she says.

This water warrior is also on a mission – as Founder of Wave of Safety,

Hansana happens to be the youngest Executive Committee Member of the Sri Lanka Aquatic Sports Union (SLASU) and, as founder of Wave of Safety, she’s spreading water safety awareness and saving lives.

Today is Hansana’s ninth day in Egypt and the itinerary for today, says National Director for Sri Lanka, Brian Kerkoven, is ‘Jeep Safari and Sunset at the Desert.’

And … the all-important day at Miss Intercontinental 2025 is next Thursday, 29th January.

Well, good luck to Hansana.

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