Smoking causes lung cancer and respiratory disease like Chronic Obstructive Pulmonary Disease (COPD), and chewing tobacco leads to oral cancer. These are two main disease caused by smoking. As per WHO, in Bhutan, tobacco kills an estimated 221 people each year which is around 5.7 percent of all deaths.
A former medical superintendent, Dr Gosar Pemba, of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) said some people smoke their entire life and they don’t get cancer, while there are some people who smoke for a few years and develop tobacco related diseases.
Cancer is usually multi-bacterial infection caused by many factors such as taking tobacco products. Smoking is the number one risk factor for lung cancer. People who smoke are 15 to 30 percent are more likely to get lung cancer than people who do not smoke. The more cigarettes they smoke each day, the more the risks increase. People who quit smoking can cut down on their risk of getting lung cancer.
Tobacco, which contains an addictive chemical called nicotine, is the leading cause of preventable non-communicable disease, deaths and disability affecting people in the most productive years of their lives. Tobacco kills more than 8 million people globally every year, of which more than 7 million of these deaths are from direct tobacco use, and around 1.2 million are due to second-hand smoke.
As per the Global Youth Tobacco Survey (13-15 year students) conducted in 2020, despite strong laws, tobacco use remains high in Bhutan, and the youth start using tobacco at a very young age. Susceptibility of youth to tobacco use continues to remain a serious concern in Bhutan. Findings from these surveys reveal that more than one out of five students (22.2 percent) currently use tobacco products (2019). The prevalence of current cigarette smoking was 14.7 percent and 12.5 percent students currently consume smokeless tobacco products.
Credible international research found that smoking can cause cancer and then block your body from fighting it. Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill the cancer cells. When this happens, cancer cells keep growing without being stopped.
Doctors have known, for years, that smoking causes most lung cancers. When nearly 9 out of 10 lung cancers deaths are caused by smoking cigarettes or secondhand smoke exposure. In fact, smokers have a greater risk for lung cancer today than they did in decade ago, even though they smoke fewer cigarettes. One reason may be changes in how cigarettes are made and what chemicals they contain.
Smoking can cause cancer almost anywhere in your body. Quitting smoking lowers the risk for 12 types of cancer: cancers of the lung, larynx, oral cavity and pharynx, esophagus, pancreas, bladder, stomach, colon and rectum, liver, cervix, kidney, and acute myeloid leukemia.
Within 5-10 years of quitting, your chance of getting cancer of the mouth, throat, or voice box drops by half. Within 10 years of quitting, your chance of getting cancer of the bladder, esophagus, or kidney decreases. Within 10-15 years after you quit smoking, your risk of lung cancer drops by half, and within 20 years after you quit smoking, your risk of getting cancer of the mouth, throat, voice box, or pancreas drops close to that of someone who does not smoke. Also, the risk of cervical cancer drops by about half.
Meanwhile, as per the population-based cancer registry of Bhutan 2014-2018, the age adjusted incidence rate per 1000,000 populations is 64 and 89.9 for male and female, respectively. The cumulative risk of getting cancer among females is 1 in 9 (11%) and among males is 1 in 11 (9%). The top five cancers in males are stomach, oesophagus, liver, lung and rectum cancers, whereas cervix uteri, stomach, breast, thyroid and ovary cancers are the five leading cancers in females.
Around 62 percent of cancer cases were referred out of country for treatment and confirmation of diagnosis.