The World Health Organisation today marks World No Tobacco Day with the theme ‘Tobacco breaks hearts, choose health, not tobacco’.

Smoking is associated with around seven million global deaths per year and is an independent, major risk factor for myocardial infarction, stroke, heart failure and low quality of life. According to statistics, tobacco is responsible for more than one in 10 deaths caused by cardiovascular disease.

In spite of being only the second country in Europe to introduce smoking bans, tobacco use in Malta remains prevalent. It is estimated that 360 persons die every year in Malta from diseases caused by smoking.  

According to the European Health Interview Survey 2014, 20.1 per cent of the Maltese population smoke on a daily basis. According to the Health Behaviour in Schoolchildren Survey 2014, 12 per cent of 15-year-old boys and 11 per cent of 15-year-old girls smoke.

Within 10 to 15 years [of quitting], the risk of heart disease is equal to that of a person who never smoked

The latter statistic is “even more alarming”, says Robert Xuereb, president of the Malta Cardiac Society and chairman of the Department of Cardiology at Mater Dei Hospital.

Despite the public being familiar with the impact that tobacco causes on health, it may be rarely thought of as being one of the main causes for cardiovascular disease (CVD).

But “tobacco use is a major risk factor for heart attacks. In fact, it increases the risk of a heart attack by two to four times,” comments Dr Xuereb.

Smoking damages blood vessels and thickens blood. It increases blood rate and blood pressure and replaces oxygen, making it an important risk factor in the development of coronary disease, stroke and peripheral vascular disease. Furthermore, it is the second most prevalent cause of CVD after hypertension.

“However, not all is gloom and doom for smokers,” remarks Dr Xuereb.

If one decides to quit smoking, “within 24 hours, the chance of a heart attack starts to reduce”.

“Within five years, the risk of a heart attack is decreased by half that of a smoker. Within 10 to 15 years, the risk of heart disease is equal to that of a person who never smoked.”

Smoking cessation support services are widely available in Malta.

He refers to the “recent admirable and brave initiative” taken by the Mater Dei Hospital administration to restrict sugary food items on offer at the hospital and says that this should be closely followed by an equally visionary project to turn Mater Dei into a smoke-free hospital.

Dr Xuereb adds that Malta should follow Finland’s example, which is set to eradicate smoking by the year 2040, and aim to become a smoke-free country. 

Looking ahead

On September 29, the World Heart Federation will be celebrating World Heart Day with the objective of raising awareness about the importance of good cardiovascular health. One of their key messages is around the immediate and long-term health benefits brought about by quitting smoking:

• Within just 20 minutes, heart rate and blood pressure drops;

• Twelve hours after stopping smoking, the carbon monoxide levels in blood drops and returns to normal levels;

• Between two and 12 weeks, circulation will have improved and pulmonary function increased;

• Over the first nine months, coughing and breathlessness diminishes;

• One year after quitting smoking, the risk of contracting a coronary disease is approximately half that of a smoker;

• Between five and 15 years after quitting smoking, the risk of suffering from a cerebrovascular accident drops to that of a non-smoker;

• Fifteen years after having quit smoking, the risk of suffering from a coronary disease equates to that of a non-smoker.

According to World Heart Federation president David Wood: “Tobacco consumption constitutes the main avoidable risk for cardiovascular health. Because of this, it is our duty to help our patients with heart disease to quit smoking, and for those patients at high risk of having a heart attack or stroke to help them quit as well. By doing so, we can help all our patients to reduce their risk but, even more importantly, we need to raise awareness and educate the public about the impact tobacco on our hearts and, crucially, the importance of children and young people never starting.”


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