SMOKING: CULPRIT OF ALL EVIL

Of all major factors that lead to the development of non-communicable diseases (Diabetes Mellitus, Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Bronchial Asthma, etc.), smoking is the most common and poses significant danger to the health of most people. The danger are not only for those who are active smokers, but also those who are exposed to second-hand smoke. (Cuevas, 2007, Public Health Nursing in the Philippines)

As relation to reproductive health, this article tackles about SMOKING AS A RISK FACTOR OF CANCER.

There are different types of cancer, it is not a single disease. Cancer develops when cell in part of the body begin to grow out of control. Normal body cells grow, divide, and die in orderly fashion. Cancer cells, however, continue to outgrow and divide even when there is no need to do so. Instead of dying they outlive normal cells and continue to form new abnormal cells. Cancer cells often travel to other parts of the body where they begin to grow and replace normal tissue also know as metastasis.

Most of different types of cancer is associated with lifestyle specifically SMOKING. Types of cancer that smoking or tobacco use is a significant risk factor are LUNG CANCER, ORAL CANCER , LARYNGEAL CANCER, BLADDER CANCER, RENAL CANCER, ESOPHAGEAL CANCER and even CERVICAL CANCER.

This disease may alter the sexual pattern of some couples that may lead to unsatisfying sex. Unsatisfying sex with their partner may result to infidelity, the partner may look for other people that can satisfy their needs. Therefore as responsible citizens we should promote healthy lifestyle to prevent this from occurring. Health is not only the responsibility of the health care team, but it is the responsibility of every person --- every Filipino.

In health promotion and disease prevention each individual should first be knowledgeable or informed about such cases. Here are facts about Cigarette smoke/tobacco:
HARMFUL SUBSTANCES

• TAR- the particulate matter left when water and nicotine are removed from cigarette smoke, contains hydrocarbons and other carcinogenic substances. Tar is deposited in lung passages, paralyzes the cleaning mechanisms (cilia) and damages the air sacs (alveoli).
• NICOTINE- also a particulate, causes release of epinephrine and norepinephrine, resulting in arrhythmias , increased heart rate, blood pressure, cardiac output, stroke volume, contractility, oxygen consumption, and coronary blood flow. It is also an addicting substance
• CARBON MONOXIDE- reduces oxygen carrying capacity of the blood causing hypoxia, because it competes with oxygen and has greater affinity for hemoglobin.

Tobacco contains more than 4000 chemicals, 43 of which have been proven to be carcinogenic (agent capable of causing cancer). Some of these toxic chemicals and gases include the following:

ACETONE - used in nail polish
ACETIC ACID - used in vinegar
AMMONIA - used in food and toilet cleaners
ARSENIC - used to make rat poison
BUTANE - used in cigarette lighter fluid
CADMIUM - used in rechargeable batteries
CARBON MONOXIDE - found in exhaust fumes
FORMALDEHYDE - used to preserve dead bodies
HEXAMINE - used in lighter fluid
HYDROGEN CYANIDE - used in gas chambers
METHANE - used like gasoline
NAPHTHALENE - used to make moth balls
NICOTINE - used in insecticide
NITROBENZENE - used as gasoline additive
NITROUS OXIDE - used as disinfectant
DDT/DIELDRIN -used in insecticide
ETHANOL - alcohol
STEARIC ACID - used in candle wax
TOULENE -used as industrial solvent
VINYL CHLORIDE - used to make PVC pipe

(PUBLIC HEALTH NURSING IN THE PHILIPPINES, CUEVAS, ET. AL.,2007)

SMOKING IS CULPRIT OF ALL EVIL, WHAT EVER REASON YOU HAVE, EVEN YOU DENY OR HIDE IT, STILL, IT WILL FIND YOU, WORST IS, IT WILL KILL YOU!

PHILIPPINE REPRODUCTIVE HEALTH

NOTE: This is not specific to the reproductive health BILL, it talks about the REPRODUCTIVE HEALTH IN THE PHILIPPINES including its ELEMENTS.

The Philippine is one of the signatory country to the International Conference Plan of Action of Reproductive Health in Cairo in 1994. To support the effective implementation of the program, the Department of Health issued AO 1-A s.1998 establishing the Philippine Reproductive Health which define the RH service package consisting of 10 elements that include Family Planning. In order to strengthen reproductive health AO 43, s.1999 was issued adopting reproductive health policy to integrate RH service in all health facilities as part of the basic package of health services and thus ensuring a more efficient and effective referral system from primary to tertiary, public and private facilities.
In 2004, harmonization and integration if the various approaches and different efforts in relation to women's health and reproductive health, it came up with integrated Reproductive Health and Women's Health Framework with an overall goal of achieving "BETTER QUALITY LIFE AMONG FILIPINOS".
It's main objectives are:

• Reducing Maternal Mortality Rate
• Reducing Child Mortality
• Halting and reversing spread of HIV/AIDS
• Increasing access to Reproductive Health Information and Services

There are 10 ELEMENTS very crucial on reproductive Health. These are:

      1. FAMILY PLANNING

Family Planning (FP) is the foremost interventions in attaining RH. It allows couples to freely decide on the number and proper spacing of births. It is one of the 10 elements selected as a response to the needs of men and women of reproductive age. The horizontal approach to the RH program ensures that the client is given health care and services in a holistic manner thus making the patient a client centered taking into consideration on particular needs.

      2. MATERNAL AND CHILD HEALTH AND NUTRITION

Family Planning is one of the pillars of the Safe Motherhood program. The goal attaining the optimum maternal and child health and nutrition can be achieved through the use of safe and effective family planning methods. Proper birth spacing of three to five years will give the mother ample time to regain her health and to render proper care to her newborn and other older children. The risk of pregnancy can be avoided. Thus, maternal, neonatal and infant morbidity and mortality can be reduced.

      3. PREVENTION AND MANAGEMENT OF REPRODUCTIVE TRACT INFECTIONS (RTIs)INCLUDING SEXUALLY TRANSMITTED INFECTIONS (STIs) AND HIV/AIDS

FP is the central focus to prevent reproductive tract infections especially on sexually transmitted disease and HIV/AIDS. Risk assessment of RTIs is part of determining the client's eligibility for FP methods. Clients who are at risk contracting STIs may need dual protection through the use of FP methods such as condom, aside from being an effective means preventing the spread of STIs. Education of people prevent RTIs and reduce the incidence of secondary infertility due to blocked fallopian tube.

      4. ADOLESCENT REPRODUCTIVE HEALTH (ARH)

Fertility awareness, human sexuality and counseling are basic services which help promote responsible sexuality among adolescents. These are very critical among the young adult to understand reproductive health.

      5. PREVENTION AND MANAGEMENT OF ABORTION AND ITS COMPLICATIONS

The major causes of maternal deaths are complications from unsafe abortion as consequences as unplanned pregnancy. Preventing unwanted pregnancy through FP reduces maternal deaths. Proper management of complications includes medical treatment and FP counseling and services.

      6. PREVENTION AND MANAGEMENT OF BREAST AND REPRODUCTIVE TRACT CANCERS AND OTHER GYNECOLOGICAL CONDITIONS

Breast and other reproductive tract cancers and major concerns in public health. The provision of FP services provide an opportunity for screening and detection of breast and reproductive tract cancers. Moreover, combined oral contraceptives are proven to reduce the risk of ovarian and endometrial cancers. Routine cancer screening  offer clients opportunity to choose various FP methods when further diagnostic work ups have to be undertaken to establish diagnosis.
     
      7-8. EDUCATION AND COUNSELING ON SEXUALITY AND SEXUAL HEALTH, MEN'S REPRODUCTIVE HEALTH (MRH) AND INVOLVEMENT

Sexuality Education is a basic component of FP. FP counseling and providing correct information on sexuality will help reduce unwanted pregnancies.

      9. VIOLENCE AGAINST WOMEN AND CHILDREN

Domestic violence mostly occur in women and children. It is recognized now as important social and public health issues. One of the most common forms is sexual violence. This provides an opportunity to discuss and promote family planning.

      10. PREVENTION AND MANAGEMENT OF INFERTILITY AND SEXUAL DYSFUNCTION





Source: PUBLIC HEALTH NURSING IN THE PHILIPPINES, CUEVAS, ET.AL, 2007