Tobacco causes cancer is a message that even smokers know even if sometimes they don't pay heed to it. But what most tobacco users don't know is the damage it does to their heart. Doctors too agree that most patients, particularly the younger ones, who undergo a bypass do not realise that they landed on the operation table because of tobacco use. "Earlier we often associated heart trouble with affluence and lifestyle choices associated with urban living. But a lot of my patients in the 30 to 35 age group are from rural areas and a substantial number of them are having heart trouble because of use of tobacco," said Dr Atul Maslekar, Cardiac Surgeon with Narayana Multispeciality Hospital. "It is often our belief that those who live in villages have better health because they breathe fresh air, have more exercise and eat better food. But the patients coming to us tell a different story and most of them including women are tobacco users," sadi Dr Maslekar. He admits that almost all the patients if questioned would know about cancer and tobacco. "The 'tobacco causes cancer campaign' has worked well and people know about it even if they don't pay heed to the warning. But the havoc that tobacco plays on your heart is something most people are unaware of,"said Dr Maslekar. A study done on smokers and smokeless tobacco users in Gujarat have found a correlation between tobacco use and Coronary Artery Disease (CAD). The 2013 study titled - Smoking, smokeless tobacco consumption & Coronary Artery Disease published in the National Journal of Community Medicine found that tobacco, in any form (smoked or chewed) is a major risk factor of CAD. The study was done by Dr Rohit Ram and Dr Atul Trivedi, the community medicine specialist, found a strong statistical association between smoking and CAD with smokers having a 2.96 times higher chance of developing CAD than non-smokers. The study was carried out in Civil Hospital Ahmedabad Interestingly, the study also found that most of the subjects smoked beedis. Dr Maslekar too said that most of his patients smoked beedis. "That is unfiltered tobacco and it is dangerous," said Dr Maslekar. The study also found that the higher the duration of smoking the more the risk of developing CAD. It found there was a 2.03 times chance of developing CVD among cases who smoked up to 10 biddies per day and this shot up to 4.82 times among those who smoked more than 10 biddies per day. HOW THE PUFF HITS? Tobacco consumption in any form either smoking or chewing is an independent risk factor for CAD. It increases the risk of cardiovascular disease by damaging the endothelium lining of blood vessels It also leads to thickening of blood It increases cholesterol plaques and LDL-cholesterol (bad) and lowers the HDL-cholesterol (good). Source: Smoking, smokeless tobacco consumption & CAD

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