May 2006

R: Dear audience, May 31st is the day dedicated to the fight against smoking worldwide. Why we have to fight against it is what The Romanian Cancer Society and our tireless friend, Marlene Fărcaş, non-smoker, together with her guests, will talk about during the debate we proposed tonight. I wouldn’t want to make a very long presentation of the guests as they want to be just symbols. Good evening, Marlene!

MF: Good evening, Rada, thank you for your invitation. Good evening, dear audience. Today, our invitation is addressed not only to our regular public, but also to all children and young people, as smoking is a dangerous temptation, being the number one cause in the occurrence of lung cancer.

R: This is not only a show for young people; it is a sincere talk with our conscience. We want to face the idea with what we know and what we do. This is not only a show for children and young people, but even adults have something to learn from it. Good evening to our guests. Be honest, do you youngsters smoke?

L: No.
T: I am not a smoker either.

R: Whether you tried or not, Doctor, please tell us why nowadays 50% of the world population pleads against smoking?

Dr: I would like to start by saying “Good evening”. My name is Doina Todea and I am a Reader at the University of Medicine and Pharmacy of Cluj. About 95% of lung cancers are due to smoking. Many people start smoking out of curiosity. Children tend to imitate their parents and they do what they see in their families. Numerous smokers develop lung cancer, and extremely few cases can be saved. Lung cancer is an aggressive form of cancer with rapid evolution, which starts with the fast and uncontrollable multiplication of certain cells in the lung. Of course we also have to consider other factors that cause this cancer – there are genetic factors, pollution, professional exposure such as asbestos and radon; diet shouldn’t to be neglected either. The symptoms of this type of cancer – breathing problems – do not manifest in the incipient phase of the illness. In the advanced phase, cells spread through the lymphatic system, sometimes reaching the other lung. The metastasis – the spreading to other organs such as the liver or brain – is rapid and the feeling of choking dominates the last days.

MF: I interrupt you because in our home care programs I’ve seen cases of persons suffering from lung cancer and I would like to mention that this sufferance is terrible, not only for the patient, but also for the ones around him / her, because one is helpless in front of the illness. I do not want to scare young people; I just want them to be aware of the ill-fated relation between smoking – active or passive – and lung cancer. It’s a pity to destroy our health for this ephemeral pleasure which is smoking.

R: What do you think, Lavinia? Why is it so important to quit smoking?

L: My name is Lavinia Vaida. I am a second year student at the Faculty of Psychology, “Babes-Bolyai” University of Cluj. I have never smoked. Knowing the injurious effects of smoking, I stopped this desire from the beginning. Every year, millions of people die because of smoking all over the world. The number is equivalent to the number of passengers dying from the everyday crash of 22 planes. In Romania there are 30,000 persons dying every year because of smoking. All start by smoking 1 or 2 cigarettes out of curiosity, but after that they do not quit. There are several methods to quit smoking. But the best one is the spontaneous one, not the gradual method over time. Do you have a meat-mincing machine at home? Introduce your last pack of cigarettes to it, mince them and never touch them again!

R: Yes, but there are counterexamples which say that old man X smoked his entire life and did not get sick. Maybe I won’t either.

T: My name is Tudor Ciogmărean and I am a 12th grade student at “Emil Racoviţă” High School. In my opinion it is risky to venture into this “maybe” world. Smoking is a cause of illness and death. With one cigarette one inhales in the human body 40 toxic substances, different hydrocarbons that destroy various organs: the lungs, the heart and the blood circulation. The most dangerous substance is the nicotine which creates tobacco dependence. We are not well enough informed. In mass-media, the number of deaths caused by smoking is not presented.

L: And if we take a look at the statistics, many smokers say they will quit smoking, but they don’t. They start smoking when they are 18 and die at 45 – 54.

T: In Hiroshima or Nagasaki millions of people have died and we have a commemoration day. In the Holocaust, tens of millions of people have died and we have several memorialsi. Tobacco kills ten times more people and we hush it up.

Dr: Tudor is a very nice boy and what he is saying is very important. Bronchopulmonary cancer and smoking are directly related to one another. Tobacco contains over 4000 substances, many of them carcinogenic, but what is more important is the risk inferred by tobacco on cancer and its further development. The risk grows if we start smoking at an early age; it also grows if the cigarette consumption is great, it depends on the type of cigarettes we smoke, the ones without filter being more harmful. The period of our life in which we smoke is also important. And not only for the smokers, but also for the ones who live around them, knowing that passive smoking is just as harmful as active smoking. It has now extended to women as well. Of course we want the woman to have equal rights with the man in positive areas, but this is a negative one. The percentage of women smoking is increasing and it has secondary effects as smoking leads to an early aging, a worsening of the complexion, a pale withered color, the skin changes its color, the nails and the toes turn yellow, they have that unpleasant smell, and many others. Let’s also remember that the woman gives birth and smokers’ children are usually smaller at birth, have a smaller weight and are more sensitive than the ones born by non-smoking women.

MF: Doctor, you have made us conscious of the dangers of smoking. But it is known that very often we act first and only after that we think, we meditate on our acts. It is important to discuss about this aspect of our impulsivity, especially when one is 10 – 20 years old. Why do youngsters start smoking? Smoking definitely goes with the intense inner unrest. I wonder what the parents’ reaction is when their children refuse to give them a kiss because they smell like tobacco. What is the girlfriend’s reaction when she sees the loved one with pale skin, unhealthy complexion, breathing like a railway engine, with a charming smile and brown teeth, with his hair, skin, and clothes smelling unpleasantly? Is it worth it?

R: Now is the time to meet Rodica. You had been a confirmed smoker for years. How did you quit smoking?

Ro: Rodica Elena Uioreanu – volunteer at the Romanian Cancer Society. I came to the society as a smoker. Marlene tried to convince me not to smoke, but I managed to quit only later. I’ve had this vice for many years, I’ve done my best and God helped me when, together with my husband, a convinced smoker too, we became the patients of this Doctor. The truth is that I have always considered the cigarette as being my friend, a friend that never argues with me, it listens to you, doesn’t protest, but I have realized in time that the cigarette is a great enemy. Anyway, I have tried to keep the children away from the smoke, and as a result I have healthy children and grandchildren.

R: Your children don’t smoke?

Ro: Definitely my grandchildren don’t smoke.

R: Doctor, we have here a former patient who proudly says she has quit smoking. But what does the actual disease really suppose? What treatment does the improvement of health need? Which are the financial efforts that have to be done for the so-called free treatment of cancer? Who supports the costs of this free treatment?

Dr: If I have to start with the beginning, I must say that this bronchopulmonary cancer is incapacitating in its evolution. The consequences are disastrous and they often lead to the patient’s death. First, I would like to say that there are two types of lung cancer: Small cell lung cancer and the one without these cells. They are very different when looked at through the microscope (watched during the proliferation – cell growth and different spreading), As well as in what the treatment is concerned. Non-small cell lung cancer is more frequent, owing 75% of the cases. Cells grow and spread slower. Small cell lung cancer is more rare, but it develops really fast in most cases and it metastasizes in other organs, the diagnosis being usually tardive. Small cell lung cancer is directly associated to smoking. The prognosis of a patient diagnosed with lung cancer depends on several factors: establishing the type of cancer mentioned above, the lung cancer stage when given the diagnosis, the person’s age and general health condition. Lung cancer treatment combines the following therapeutic options: surgery to remove the tumor, radiotherapy (X-ray flux untens therapy or others), chemotherapy (medicine which destroy carcinogenic cells). Only the first stages can be cured by treatment. A smoker diagnosed with lung cancer can increase the treatment efficiency by quitting smoking even if the long-term prognosis is not significantly improved. But, I repeat, the best thing to do is to prevent the disease by quitting smoking.

R: Obviously, we have to think seriously to quit smoking.

T: I have asked many friends why they’ve started smoking. All of them told me that it is the pressure of the group they are part of. The essence is that you want to be noticed because you feel like an outcast. Smoking attracts the ones around you. At parties, everyone wants to be in the center of attention. And because in the center there are the most interesting ones, often smokers, you start smoking. At the beginning, you smoke at parties, you don’t inhale the smoke, but you continue to do it. It’s a pity to destroy our health. Smoking is not a criterion of social growth.

R: Maybe it’s rather mimicry than the pressure of the group.

L: The way to get noticed is not the mediocre way, but the one of exploiting the talents you have. If you can sing, then sing, make jokes, and show your intelligence, your ambition……..

R: But maybe you are mediocre; what do you do?

MF: Youth is extraordinary through the youth itself. Each one has his/her qualities hidden by the specific age. But you should trust yourself and your hidden talents. Young people want to stand up, but they hide away because of their timidity. Be timid at that age. You can stay on a bench, silent, watching the world around you; there are so many things for you to learn; you can meditate on how to gain self-confidence. Basically, you can be part of the other 50% who are non-smokers. You can be part of a silent group, of dreaming of good things…. Everything can be done without cigarettes.

R: Back to the physical complex of the non-smoker who is rejected by the group.

L: Yes, I have colleagues who started smoking in order to be accepted by the group. It is not quite a rejection, it is rather ignoring, and you are not invited where you want: cabins, parties. Even if you are there, you are not in the center of attention. Smokers are the most popular ones. It is said that if tobacco hurt, it would be the most painful illness. We avoid accidents, other diseases, but we don’t avoid the destructive impact of the cigarette that we inhale every 5 minutes.

R: Still, smoking brings certain pleasure due to its amphetamines. Opinions are divided. Smoking diminishes stress and there can also be other advantages.

Dr: Yes, we’ve talked about the negative effects of smoking. As a doctor, of course I struggle to fight smoking, but I must admit there also is a positive part of smoking. Although it is hard to say what it is. I have found in the literature much data concerning smoking. I have statistics from America that justify smoking. It has been noticed that smoking gives you energy, strength; you have the pleasure of taking a cigarette in your hand, of making it. Some people relate it to the morning coffee that can’t be drunk without a cigarette. I don’t understand as I am a non-smoker and I still drink my coffee with pleasure. Students often say: “I’ll go and relax 5 minutes in a cigarette break”. They can’t quit smoking.

R: And still, in order to diminish stress before an exam, we smoke a pack of cigarettes.

MF: Stress is not counteracted with a cigarette, but with will, more or less will, but which needs to be improved. It is a quality that we can guide towards the ones around us. We smoke and we think about my stress which requires a cigarette, my inner feelings that require a cigarette, and my ego that needs a cigarette and always me, then the others. Let’s think about the others first and give them a little bit of our time.

R: Extravagance is a way to defy death, because you are ephemeral. Let’s look at these things from another point of view. Smoking is first of all incriminated for the occurrence of lung cancer. Let’s see the specialist’s point of view.

Dr: From the specialist’s point of view who knows that tobacco is harmful, I worked on the relation between tobacco and bronchopulmonary cancer. But we also have to refer to other diseases of the respiratory apparatus, bronchitis, emphysema, infections, and pneumonia, plus the extremely important effects on the cardiovascular apparatus, the arterial hypertension, the CVA (cerebral vascular accident or stroke). There are also different types of cancer related to smoking. The cancer of the entire digestive apparatus, lip cancer, specific ulcerations, persistency and malignancy, cancer of the oral cavity, liver cancer, pancreas cancer, bladder cancer, kidney cancer and other forms. There isn’t only the relation between tobacco and bronchopulmonary cancer, but also the connection with other pathologies that appear in the entire human body. We must understand them because when we start smoking we have to consider also its consequences.

R: Has the Cancer Society developed a campaign against smoking?

MF: Yes, we have a partnership with the School Inspectorate, the Center for Health Enhancement and the Association of Medical Students. May 31st is the international day against smoking, and one day before that we organize a special action of street drawing made by children who want to show their talents. We invite all people interested in participating in this action, which is a meditation occasion, from 10 a.m. to 1 p.m. For the child, smoking has a psychological aspect. He draws and it often reflects his desire that his parent stops smoking. Maybe he draws them as an image of a head surrounded by a dense cloud of smoke and next to it another head with a gas mask.

R: Today’s show…

MF: Dear Rada, before the end of this show I would like us to listen to Tudor’s message. This morning I had an extremely interesting talk with him.

T: Health comes first. You may not be ill now, but think about the future. There are 1000 reasons for you not to smoke; I would tell my friends: I don’t want to see you in 10 years’ time the patients in IO. I don’t want to see you bribing nurses to tell you how much you have left to live. I don’t want to see you pale, with a cadaverous color in your cheeks. I don’t want to see you dying when you’re 35. It’s sad to bury your friends at such an early age.

Ro: At the end of the show, please allow me to say something too. You can quit smoking. The morning coffee may be drunk without smoking a cigarette, it is even better without it. The sooner you quit, the better it is.

R: The purpose of today’s show was not to convince you to quit smoking, but to make you ask yourself some questions. Today, we’ve met young people who maintained their points of view. We can see once again that age is not important, but in time we become more wise and that can be noticed.