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MUSC student takes on cause of World No Tobacco Day, observed May 31

 News Center | May 29, 2014

global healthMUSC medical student Rahoul Ahuja lets a Costa Rican girl pretend to listen to his heart during a recent medical trip.
Photo Provided 

Over the past few years, I’ve had the opportunity to volunteer alongside health care professionals in developing countries, work with global health experts at the World Health Organization (WHO) and Centers for Disease Control (CDC) and conduct research in Argentina. Through these experiences, I’ve not only cultivated a passion for global health but also have found that international traveling is very humbling and really broadens your perspective.


In 2010, I traveled to Costa Rica to work with doctors to provide health care in rural communities with high disease burdens. As an aspiring physician, I was surprised to see that contrary to popular belief, infectious diseases were not the leading cause of death in the developing world; rather, chronic, non-communicable diseases like heart disease and cancer imposed the highest burden of morbidity and mortality.

As weeks passed, I found myself captivated not just by the causes of NCDs, such as tobacco use, an unhealthy diet and lack of physical activity,  but also by what was at the root of these causes -- the social and structural determinants of health. Indeed, the conditions in which people live and work are the primary drivers of disease worldwide. My myriad experiences inspired me to learn more about the social, legal and ethical issues surrounding global health and led me to intern at WHO headquarters in Geneva, Switzerland in 2011.

Working with the WHO’s Noncommunicable Diseases and Mental Health program was the most humbling and enriching experience of my life so far. Among my fellow interns were physicians from India and Egypt as well as graduate students from every continent worldwide. As the only American in my area, I came to see how working with people of different backgrounds is critical to tackling global health problems.

But while working at the WHO, one particular health issue caught my eye: The global burden of tobacco use. While I knew tobacco use was certainly harmful, I didn’t know it was the number one preventable cause of death worldwide, responsible for six million of the 56 million deaths that occur every year globally (with nearly 500,000 in the U.S. every year). Since tobacco use kills up to half of its long-term users, it imposes not just debilitating health burdens but also enormous economic costs on countries worldwide.

While at the WHO, I also learned how implementation of strong tobacco control policies — just simply passing and enforcing them — has far-reaching potential to avert preventable deaths. In China for instance, where 49 percent of all males smoke, a 50 percent tobacco tax increase would prevent 20 million deaths by 2050. The Centers for Disease Prevention and Control’s recent anti-smoking ads helped approximately 100,000 people quit smoking, preventing nearly 50,000 premature deaths.

Smoking cessation doesn’t necessarily require massive amounts of funding to solve, but it does require strong support from the public and policy makers. To create sustainable global health progress (and address NCDs), it is key to reduce the population prevalence of tobacco use.

Ahuja loved working at the World Health Organization in Geneva, Switzerland. 

After my experiences at the WHO, I also had the opportunity to conduct research at the CDC’s Global Tobacco Control Branch in 2012, as well as research in Buenos Aires, Argentina where I examined how indirect tobacco advertising in entertainment media may affect youth smoking rates in developing countries. I’ve also had the great pleasure of working with researchers like Jim F. Thrasher, Ph.D., MA, MS, associate professor in the Department of Health Promotion, Education, and Behavior in the Arnold School of Public Health at the University of South Carolina, as well as K. Michael Cummings, Ph.D., MPH, a professor in the Department of Psychiatry & Behavioral Sciences and researcher with the Hollings Cancer Center’s Cancer Prevention and Control program. Cummings is a global leader in tobacco control who is helping incorporate smoking cessation services into the MUSC Hospital system.

In South Carolina, a third of all cancer deaths are linked to tobacco use, and since tobacco use kills nearly one-half of its long-term users, this work will go a long way towards preventing premature deaths. All the work we do —from members of the health care team to global health researchers — can make a real difference in people’s lives. Ensuring that a critical issue like tobacco use is not neglected, whether on the United Nation’s global agenda or in health care clinics, it is vital to improving the well-being of those in our communities and populations globally.

 Ahuja found one of the best parts of global health is how it broadens perspectives and informs how best to prevent premature deaths. Here, he visits the Matterhorn.

I’ve learned some important lessons from my experiences abroad as well as here in MUSC’s classrooms. There are some things that are going to happen, no matter what you do. But then there are other things sitting on the fence that could go either way. Success is not guaranteed, but if you really make a focused effort you can succeed. These on-the-fence issues are priorities or winnable battles. Tobacco control is a winnable battle; hundreds of countries have already made tremendous progress in implementing the WHO’s recommendations on tobacco control.

Still, there is plenty of work to be done. One billion people are expected to die this century from tobacco use unless urgent action is taken. These numbers resonate with me not only as an aspiring global health advocate but also as a medical student where seeing the real human toll of tobacco use in the clinics humanizes the statistics and gives me a greater sense of urgency.

I hope to use my medical training here at MUSC to develop my skillset as an aspiring physician-scientist in order to lay the groundwork for internationally collaborative efforts to tackle these issues. There will be numerous challenges along the road, no doubt. But if we work hard together and make a concerted effort, we will reach the right solutions.

Editor's Note: Inside Track is a periodic column by MUSC faculty and staff about the intersection of health matters and our lives. Rahoul Ahuja is a second-year medical student at the Medical University of South Carolina.



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