SUDBURY - Northern Ontarians must shed their complacency about higher than average rates of smoking – and the heart, lung and other diseases that result from unhealthy lifestyles, says an international expert on heart health and smoking cessation.
Dr. Andrew Pipe, chair of the board of the Heart and Stroke Foundation of Canada, doesn’t mean to sound arrogant, but says it’s time northerners dropped the victim mentality and accepted there is much that can be done to prevent complications from heart and vascular diseases.
Pipe lives in Ottawa, but spent three years as a family physician in Levack-Onaping at the start of his career, so he has an understanding of the North. He has fond memories of living here, but says “people in Northern Ontario have got to stop the kind of, ‘Oh, we’re in the North, what the hell? It’s all going to happen anyway,’ ” attitude and take charge of their health.
“Northern lungs and northern hearts and northern brains are every bit as important as brains, hearts and lungs in any other part of the province,” said Pipe, who speaks in Sudbury today. “It’s time we ensured, particularly in areas where there are high rates of cardiovascular disease such as the North, that we are as robust and rigorous in delivering programs of prevention ... because the need is so abundantly clear.”
Pipe will be keynote speaker at the first annual cardiovascular and cerebrovascular symposium in Sudbury, presented by the medicine program at Health Sciences North on May 3. He will speak on the topic “Cardiac Rehabilitation: The Priority of Secondary Prevention.”
He will address the fundamental importance of the integration of cardiovascular rehabilitation programs in the treatment of anyone diagnosed with cardiovascular disease. Such rehab programs are often considered “a nice afterthought,” said Pipe, when in fact their presence – or lack thereof – is an indication of whether proper care is being delivered.
The absence of cardio rehab programs is, in his view, indicative of sub-standard care, “and nobody wants to be delivering sub-standard care,” said Pipe in a telephone interview from Ottawa.
Cardiac rehabilitation programs advocate having anyone diagnosed with cardiac disease have a specially designed exercise program in a regular, safe and appropriate manner. Exercise confers “tremendous, tremendous advantage in terms of overall cardiovascular health for the future,” Pipe said.
“It ensures that ... nothing is slipping through cracks, that people are having all particular risk factors addressed.”
The issues underlying heart problems must be addressed, he said, and can range from mental illness to other related health problems, and the identification of previously unknown conditions or the presence of diabetes. Having diabetes and cardiovascular vascular disease at the same time is particularly dangerous, as is the impact of smoking.
Quitting smoking is the single most important thing anyone with cardiovascular disease can do, he added. But Pipe said it is not as simple as blaming smokers for being weak-willed or stubborn, but rather putting programs in place that increase people’s chances of quitting.
“The most addictive drug ... can be nicotine, so this idea that if smokers were just better informed, better motivated, nicer people, got their ducks in a row, they should all be able to stop smoking” is just wrong. “It flies in the face of everything we know about nicotine.”
Pipe was instrumental in developing the Ottawa Model for Smoking Cessation at the University of Ottawa Heart Institute. He travels the country and the world speaking about it. In all, 47,000 Canadians die every year as a result of tobacco use. That infuriates Pipe.
“If 47,000 Canadians died as a result of airplane crashes, do you think we would be adopting the same kind of, ‘Well, you know, gee whiz, people are gonna smoke’ ” attitude?”
Pipe lays some of the blame on health care institutions and even medical schools that are stressing the importance of quitting smoking on cardiac health. He said he is surprised he has never been contacted by the Northern Ontario School of Medicine until recently to speak about smoking cessation, despite high smoking statistics in the North.
The biggest villain in tobacco use is the tobacco industry, said Pipe. It has been given “unfettered access to sell a lethal and highly addictive product, and our governments have stood by and done nothing.”
In the North, there is an issue with cheap cigarettes being sold on First Nations, he said. Other provinces have addressed the issue “in a much more forthright and insightful way than has been the case in Ontario.”
Pipe said he is not familiar with what cardiac rehabilitation programs are available in Sudbury and the North. But he said every person with a cardiovascular diagnosis should be referred to such a program. Those programs should have in place processes that facilitate prompt, rapid entry for individuals and offer programs to deal with obstacles such as distance or address special concerns of groups such as women.
There should be systematic programs in place in every clinical setting to identify and offer assistance with smoking cessation to every person who enters a health care setting, he said.
Pipe has harsh words for the Government of Ontario, which is cutting funding to health promotion programs and to public health.
At a time when so much cardiovascular disease can be prevented, to cut budgets for health promotion and public health disease prevention “is absolutely, indescribably stupid,” he said.
“I’m just horrified to ... hear the kind of comments that are now emerging as to approaches that might be taken.”
Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists.
- Sudbury.com/Laurentian Media