When something is going wrong in your body, there will be signs. They may be subtle, but they are visible in close observation. If you are a smoker, you may be worried about the smell of smoke emanating from your mouth or clothes. However, there are other signs that tell whether you smoke or not and these signs are difficult to get rid of!

Smoking is the harmful act of inhaling tobacco infused smoke and is a common activity all over the world. According to the Center of Disease Control and Prevention (CDC), over 480,000 deaths happen each year due to smoking or smoke inhalation. The organization explained that smoking causes harm to nearly all organs and quitting lowers the risk of early death and other smoking related diseases.

Like many other substances, there are clear tell-tale signs when someone is smoking. This is especially important for finding lung problems like Chronic obstructive pulmonary disease (COPD), which is a lung disease that makes it hard to breathe, sooner so people can get help.

Why Does Smoking Affect Your Physical Appearance?

Action on Smoking and Health (ASH) explains that tobacco smoke has more than 7,000 harmful chemicals like nicotine, carbon monoxide, and various metals like arsenic, cadmium, and lead, quickly reach your lungs and then travel through your blood to all your organs, including your skin. Smoking damages your skin's ability to heal because it increases an enzyme metalloproteinase (MMPs) that breaks down collagen. Collagen is what keeps your skin smooth and elastic. As you lose collagen, your skin sags. Squinting from the smoke and puckering your mouth when smoking also cause wrinkles around your eyes and mouth.

Smoking also reduces blood flow to your skin, which means it gets less oxygen and nutrients. All these things together lead to what doctors call a "smoker's face." Quitting smoking can help prevent or slow down these skin problems."

Visible Signs Of Smoking

Here are some visible signs of smoking in people, according to 2013, Lung India

Fingers and Nails

When people smoke, the tar and other chemicals in the smoke stick to their fingers and nails. This repeated contact causes a yellow stain that's hard to wash off. It's a very common sign that someone regularly handles cigarettes or biris.

Moustaches

Especially in older people with white moustaches, smoking causes a yellowing effect. This is most noticeable in the center of the moustache, where the smoke from the nose directly hits the hair. The consistent exposure to smoke colors the hair over time.

Lips

Heavy smokers often have a bluish-black tint to their lips. This discoloration happens because the chemicals in tobacco smoke affect the blood flow and the color of the skin on the lips. The constant exposure changes the lip's natural color.

Teeth

Smoking causes teeth to stain both inside and out. The outside of the teeth turns yellow from the tar, while the inside develops a brownish-black stain. This happens because the smoke seeps into the enamel and discolors the teeth over time.

Premature Wrinkling

Smoking makes the skin age faster. This leads to wrinkles like "crow's feet" around the eyes and "cobblestone wrinkles" on the neck. This happens because smoking reduces blood flow, limiting oxygen to the skin, and damages collagen, which keeps skin elastic.

Nodular Elastosis

This condition, also known as "Favre–Racouchot syndrome," causes blackheads and wrinkles, especially around the eyes and temples. It is made worse by both sun exposure and heavy smoking. The skin becomes discolored with visible nodules and wrinkles.

Facial Wrinkling and COPD

A study published in Thorax 2006 found a connection between wrinkles on the face and COPD, a lung disease. It's thought that smoking affects both the skin and lungs through similar processes. If doctors notice signs like "crow's feet" on a smoker's face, they might recommend tests for COPD. This early detection can help people get treatment sooner and improve their lung health.

In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.

This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.

While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.

The Challenge of Low Health Literacy in India

The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.

Several factors explain this reality:

• Low literacy levels: A significant proportion of the population cannot read or interpret basic medical instructions, leading to mismanagement of conditions.

• Poverty and affordability: For millions living on less than INR 100 a day, awareness alone is not enough when healthy choices remain unaffordable.

• Gender and cultural barriers: Women often have lower access to information and autonomy in health decisions, particularly around reproductive and maternal health.

• Distrust in healthcare systems: Overcrowded facilities and inconsistent care erode confidence, driving many to informal or unverified sources.

Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.

Blockbuster drug Ozempic, known for treating type 2 diabetes and obesity, has a surprising side effect. A new study published in The Lancet Psychiatry showed that the GLP-1 receptor agonists might prevent worsening of depression and anxiety.

People with diabetes or obesity are generally more likely than the general population to suffer from depression and anxiety. It is because both diabetes and obesity increase the risk of mental ill-health, and vice versa.

The findings showed that people with diabetes using semaglutide had a substantial decrease in hospitalizations and sick leave due to mental illness, including less worsening of depression, anxiety, and self-harm.

“Our findings suggest that GLP-1 drugs, particularly semaglutide, might contribute to better mental health in people with diabetes and obesity, but since this was an observational study, controlled clinical trials are needed to confirm the results,” said Jari Tiihonen, specialist physician and professor at the Centre for Psychiatry Research, Karolinska Institutet.

What Did The Study Find?

The research, led by an international team from Griffith University, the Karolinska Institutet, and the University of Eastern Finland, tracked Swedish national registers between 2009 and 2022.

It included 95,490 people, of which GLP-1 receptor agonists were used by 22,480 individuals during the follow-up period.

Semaglutide was associated with a decreased risk of worsening

• depression
• anxiety
• substance use disorder
• self-harm.

Patients using semaglutide experienced a 42 percent lower risk of hospitalization for mental health issues during periods of use, compared to periods when they were not taking the drug.

More specifically, the risk reduction was 44 per cent for sickness absence or hospital care due to depression, 38 per cent for anxiety disorders, and 47 per cent for substance use.

Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying

The team also found some benefits with Liraglutide. The drug was associated with an 18 per cent lower risk of sickness absence and hospital care due to psychiatric reasons.

How Does Semaglutide Work?

Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.

They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

Read More: Can Semaglutide Help Fight Cancer In The Brain?

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and the body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.

In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.

The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.

However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.

Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".

"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.

What Is ICU? Who Needs Critical Care?

The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.

They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.

Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.

Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:

• a serious accident
• a serious short-term condition
• a serious infection
• a major surgery.

"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.

ICU Admissions: What India’s Guidelines Say

India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:

• ICU admissions must be based on the severity of organ failure and the necessity for organ support or in anticipation of a potential deterioration in the patient's medical condition.
• Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives.
• ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival.
• Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.
• Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.
• Blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status among other parameters should be monitored in a patient awaiting an ICU bed

1. patients with altered level of consciousness,
2. hemodynamic instability,
3. need for respiratory support,
4. patients with acute illness requiring intensive monitoring
5. organ support or any medical condition or disease with anticipation of deterioration.

Guidelines For ICU Discharge Criteria In India

The guidelines stress the importance of physiological parameters returning to near-normal or baseline status.

Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors.

Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.