Marjolein Smidt - Smokers are victims too
Marjolein Smidt, professor of surgical oncology at MUMC+, is perplexed by how easily people can access tobacco products. “Imagine someone marketing an apple today with a warning label saying that it will give you cancer later in life; no one would buy that apple, and a quick ban would follow.” With this analogy, Marjolein questions why tobacco products are still legal: “It’s undeniable that smoking kills, but despite ongoing efforts to reduce smoking, tobacco products and vapes remain legal to purchase.” And a small group reaps all the profits, while society pays for the damage. “As a business model, this one does stand out.”
The rippling effect of tobacco on health
Marjolein specialises in breast cancer and sees the effects of smoking on her own patients. “If a patient who smokes requires surgery, there is a higher risk of wound complications. Reconstructive surgery becomes more difficult because smoking constricts blood vessels, making it harder for tissue to heal. Smoking can also increase the risk of complications from radiotherapy and may contribute to the development of secondary cancers. Smoking is also associated with poorer survival outcomes. The entire treatment process becomes more complicated.”
Marjolein is well aware of the growing pressure on healthcare services and the resulting need for more healthcare professionals. “We are facing a shrinking labour market in the years to come. To keep healthcare accessible for all, we need to continue working on preventing unhealthy behaviour. And quitting smoking or never starting is one of the greatest health gains we can make.” These interventions may focus on individual smokers, but according to Marjolein, they are not to blame. “Big Tobacco is.”
Young people aren’t to blame
The adolescent brain is still developing and is more vulnerable to addiction. “Add social influences such as peer pressure, and it becomes increasingly difficult to blame a young person for starting to smoke in the first place or to describe it as a free choice.” What’s even worse is the so-called alternative to smoking promoted by the tobacco industry: vaping. “Some vapes contain very high levels of nicotine, making them particularly addictive. Some children can’t make it through the night because of their nicotine dependence.”
If you are not being patronised by the government or healthcare professionals, you are being patronised and exploited by Big Tobacco
Don’t patronise me
Patients who smoke, often feel patronised when a healthcare professional starts talking about cessation of smoking. “But make no mistake, if you are not being patronised by the government or healthcare professionals, you are being patronised and exploited by Big Tobacco."
Call to health students
Even on our smoke-free campus, some people continue to smoke or vape. What would Marjolein say to health students and professionals who smoke? “I understand why you started smoking or continue to do so. But as a future or current healthcare professional, you also have a role in promoting health, and there is help to quit smoking. Imagine what you could do with the money you could save over the years instead of handing it over to a small group of industrialists. And for the non-smokers: Think about taking part in the lesson programme: Vapen Jouw keuze. They need you!
Text: Ruben Beeckman