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M. P. Ravindra Nathan

The joys of smoking will almost always be followed by agonies of ill health. Winston Churchill, who smoked cigars all his life, may have escaped, but Walt Disney didn’t; he died of cancer. If you are a heavy smoker, always remember that you are precariously balanced on life’s precipice.

Dr William Castelli, the great cardiovascular researcher and the past director of the most acclaimed Framingham Heart Study, said during a recent conversation: “If we could eliminate cigarette smoking in America, it will cut down half of the cancers.” Lung, throat, stomach, bladder and many other cancers are included. It is that dramatic! And

And yet tobacco companies led by Phillip Morris USA, the leading manufacturer of most brands such as Marlboro, Virginia Slims, etc., say, “Our core business is manufacturing and marketing the best quality tobacco products to adults who use them,” giving the impression that you will be OK if you use their brands. The company steadfastly denied that its products were addictive or harmful, even under oath during a congressional hearing in 1994. It took intense pressure from scientists and an outcry from the public before they would finally relent and post this message on their Web site “Philip Morris USA agrees with the overwhelming medical and scientific consensus that cigarette smoking is addictive. It can be very difficult to quit smoking, but this should not deter smokers who want to quit from trying to do so.”

Why do people smoke? Teenagers light up one to be ‘cool’ like the rest of the gang, out of peer pressure. They are often influenced by the ads on the big billboards and magazines; the classic image is that of a sportsman or a rugged cowboy smoking a Marlboro Menthol, exuding perfect health. In the box office hit “What Women Want,” the handsome Mel Gibson acting as the quintessential male macho, smokes a cigarette in almost every scene. If parents are smokers, children can easily get their hands on cigarettes. For adults, it may be more of a stress buster. But for nearly everybody, it is an addiction; once you get hooked on to the powerful nicotine, it is not easy to stop.

“Have you ever smoked?” asked one of my cardiac patients who suffer from heart disease and had undergone multiple coronary angioplasties.

“No, not to speak of, may be an occasional pipe when I was braving the cold in England, years ago,” I answered.

“Then you don’t know how hard it is to quit,” he said with a sigh. “I have tried everything, even hypnotism.”

“Well, Ron,” I tried to reason with him. “The past is past, it is your life and you have to keep on trying your best.”

“I know, I know,” he said with a sense of resignation in his voice, recognizing the uphill battle ahead.

Purchasing cigarettes at cheaper prices has become easy. Just log on to ‘’ and you will see their message: “We are the No. 1 resource for discount tobacco and cheap cigarettes on the net! Marlboro Reds, Marlboro Medium, Marlboro Lights, Marlboro Menthol, we have all styles and flavors at low prices.” The popular brand Camel costs $26.99 for a carton of 10 packs from the Internet, but $29.99 from your local gas station. You will still need to shell out about $1,000 a year to support one pack a day habit, and voluntarily buy ill health!

Other forms of tobacco smoking such as ‘cigar smoking’ isn’t any safer as the cigar smokers passionately believe. “There's no safe level of tobacco usage - including cigar smoking, tobacco chewing etc,” say the experts. The risk from any type of tobacco use depends primarily on the intensity and frequency of exposure. In addition, one has to worry about secondhand smoke (SHS) or ‘environmental tobacco smoke,’ also. The scientific consensus that SHS increases cardiovascular disease risk by 30 percent is based on solid epidemiological and biological evidence. Yet, the tobacco industry has strongly contested this evidence, obviously to preserve its own ‘corporate viability.’

Benefits of quitting smoking: Do you know that smoking is the single most preventable cause of death? Many chronic smokers think, “Why quit now? The damage is already done. Let me enjoy this some more.” Not true. No matter where you are in the continuum of smoking, quitting is always followed by improvement of your health. Here is a case in point. Earl H., 89, was recently admitted to our hospital with a broken arm when he fell down in his house. He is not taking any medications and appeared to be in good health. When asked what he owed his good health to, he said, “The only reason I am alive today, doc, is I quit smoking 20 years ago.” And I agreed.

Smoking cessation has immediate health benefits for people of all ages. Reducing the risk of dying prematurely is the most important benefit. The risk of lung and other cancers will decline proportionate to the years you have stopped the habit. Once you have reached the 15-year mark, your risk is down to nearly the same as a non-smoker. Same with coronary heart disease; there is a substantial reduction of risk within two years and after 15 years, the risk is the same as that of a non-smoker.

So, what is the take home message? “To remain healthy and vigorous, to feel good about yourself, to age gracefully, and to stay alive. These are some mighty powerful reasons to take the journey to a smoke-free life!” says Garland Y. DeNelsky, Ph.D., in his book “Stop Smoking Now” (Cleveland Clinic Press 2007), a must reading for everybody.

(This series will conclude in the next issue)

Cardiologist Dr. M. P. Ravindra Nathan, director of Hernando Heart Clinic in Brooksville, lives in Brooksville.



Here are three 20- to 30-minute leg exercises. There exercises give full leg workout in 20 minutes. Start with the assisted squat. Then move on to lunges. Finish the leg workout with a set of steps.

Assisted squat: Quads, Glutes and Hamstrings

For beginners: Take a position by standing in front of door with feet wider than shoulders and hold onto a towel wrapped around the doorknob. Using towel for stability, bend knees and keeping weight on the heels, lower butt until it's parallel to floor (or as low as you can). Keep abs in and make sure you can see your toes.

Level 1: As you progress, let go the help of towel and perform the squat holding hands straight.

Level 2: After 2 weeks of regular exercise, increase the resistance by holding weight and perform squat.

* Start with two sets of 10 repetitions. After two weeks, you should be able to do two sets of 12 repetitions. As you progress, every two weeks you want you increase repetitions and weight.

Lunge: Helps your Glutes, Hamstrings and Hips

Beginners: Take a giant step forward with right leg and lower into lunge position and keeping abs in, knee behind toe and knees at 90 degree angles. Keep your hand on your waist for balance. Push through the front heel to raise back up and repeat all reps on right leg then switch to other leg.

Level 1: After 2 weeks of simple lunges, you should have constant balance while performing the entire set of lunges. Now, hold equal amount of light weight in both hands and perform lunges.

Level 2: After 2 weeks of regular exercise, increase the weight by 2.5 to 5 pounds in each hand.

* Start with two sets of 10 repetitions. After two weeks, you should be able to do two sets of 12 repetitions. As you progress every two weeks, you want to increase repetitions and weight. You may keep the same repetitions but increase entire set every three to four weeks.

Steps: Helps your Quads, Glutes and Hamstrings

Beginners: Stand next to a flat bench or wooden chair. Step up onto the bench or chair with one foot and then bring up the other foot so that you end up standing on the bench with both feet. To return to the floor, carefully step backward off of the bench with the same foot you started with. Repeat the movement with the opposite foot first and alternate as you go on.

Level 1: As you progress over two weeks, raise the height of the bench or chair. If that is not possible at home, add resistance to your steps by holding weight in each hand.

Level 2: As you get used to number of repetitions and light weight, increase your weight by 2.5 to 5 pounds and raise the repetitions by one full set.

Start the steps with three sets of 10 repetitions. After two weeks, you should be able to do three sets of 15 repetitions with weight. As you progress, increase the weight and number of repetitions. Regular 20- to 30-minute leg workout will give beneficiary results in 4 to 8 weeks.

Achut Mashruwala of Fitness Guru Inc. can be reached at (813) 857-5103 or e-mail

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