Smoking. It all begins with a positive attitude towards tobacco, based on the experience of peers and role models. At the end of the road, though, there is only the smoker’s acute awareness - the awareness that quitting is not easy. And so begins the journey where winning is about quitting. Tobacco needs a “ceremonial burial” and you must never quit quitting, writes Dr Praveen Kumar Chintapanti.
A good level of awareness on the harmful effects of tobacco consumption and the legislative measures to curb the menace not withstanding, India and much of the developing nations continue to record an unfortunate increase in tobacco consumption. As per current usage trends, we are hazarding a scenario where about 30 per cent to 40 per cent of the 2.3 billion young people will be smoking tobacco in early adulthood. The various forms by which tobacco is consumed are: Smoking (cigarette, beedi, cigar), chewing (khaini, ghutka, pan masala, zarda, tobacco toothpaste) and inhalation (snuff).
Stark Facts
Youth aged between 15 and 26 years are the most vulnerable for tobacco use.
Tobacco kills about 40,00,000 people every year.
Every day, about 2,500 deaths in India are attributable to tobacco use.
Tobacco users are likely to die 15 years younger than non-users.
Almost 70 per cent of tobacco users think of quitting tobacco use, but only 30 per cent try to quit every year and only 3 per cent to 5 percent succeed in the process.
The Ills You Hazard
Tobacco smoking and chewing can affect every organ in the body.
There is a clear connection between heart attacks, lung cancers, oral cancers, low-birth weight babies, sudden infant deaths and tobacco use.
Secondary smoking affects the members of the family and others around the smokers. Secondary smoking can cause sudden deaths amongst children; lung disease and also increase the risk of cancer and heart disease.
There are around 4,000 harmful chemicals in tobacco when smoked. Some are: a) Nicotine which is the main addictive substance is an insecticide b) DDT is a pesticide c) Cresol is used in industrial plastics d) Pyrene is found in coal tar e) Carbon monoxide is toxic
Succumbing To Addiction
Nicotine is the active ingredient that causes the dependence or addiction. The users go through different stages before they get addicted to tobacco.
Initially they might develop a positive attitude towards tobacco based on the experience of their peers, role models etc.
They then go on to try some and graduate to regular use.
Regular use leads to dependence.The whole process takes about three years on an average and individual cases may vary. When a person addicted to tobacco does not get it, he or she might experience the following withdrawal symptoms. a) Feeling unhappy b) Lack of sleep c) Getting upset or angry very easily d) Loosing focus e) Becoming agitated and restless f) Increased appetite
Preparing To Kick The Habit
With support and help, the number of people exiting addiction to tobacco can increase and the risk of relapse can be reduced. Preparation is the most
important step.
Understand your attitude towards tobacco.Judge as to why you smoke or chew tobacco.
Make a list of reasons as to why you smoke. (It is likely to read as follows: to relax; to feel good; for a break from work; it’s a habit; it’s a craving; I enjoy smoking.)
Make another list i.e., of the reasons why you want to quit. (It may read as follows: my family wants me to; I want to improve my health; I can be a better role model; I will live longer; my food will taste better; and so on.)
Once you decide to quit, set a date to quit. Inform people around you that you are quitting from such and such a date. Tell your friends who smoke to stop offering you any cigarettes, from your set date and after.
When the day arrives, give tobacco a ceremonial burial. Go through a ritual of discarding all your addiction related products – lighters and cigarettes included. Take a sacred vow, if that helps.
Get started in the period between your decision to quit and the actual date of quitting itself. Buy the cigarette brand that you dislike the most. Change the use of the hand by which you normally hold a cigarette: use the other hand.
Question yourself every time you use tobacco; ask yourself if it is necessary to have it.
Learn relaxation techniques.
Try to get good amount of sleep.
Try not increase your tobacco intake, just because you have set a date to quit.
The Quitting Process
Managing your first 48 hours is crucial and it is no easy walk. Your body starts to heal as soon as you quit; the repair process starts within 24 hours. Food will taste better, you will inhale better and your lung carbon monoxide levels decrease. Within a few weeks the lungs start producing more cilia, reducing the risk of lung infections. The risk of lung cancer, which was higher, decreases within a year. Do not forget to consider the money you save and improvements you spot in your social grace.
You Have Many Options
There are several ways to quit smoking. People consider tapering off by 10 per cent to 20 per cent every day. This technique might not work as effectively as cold turkeying. Cold turkey is the method of stopping tobacco use completely on a set day.
For help, you may choose from the following:
Nicotine Replacement Therapy: a) Nicotine gum – available as 4mg gum in India b) Nicotine patch – available in three strengths and as 24 hour and 16 hour patches c) Smoke free cigarettes
There are certain medicines that help people quit tobacco and also remain tobacco free. Buproprion (an antidepressant available as varenicline and selegiline) is known to work well.
All these medications may be taken under medical guidance only. Your doctor will first assess if your medical history okays the prescription of these drugs.
Dealing With Craving And Withdrawal
Craving is an intense desire to have tobacco. It can occur in bouts of 30- 90 seconds each. During the early period of cessation they can occur more frequently with greater intensity. There could be a “rapid fire” of craving. Cravings are the worst on the first three days and can persist for a month or longer in some. Deal with craving with 4 Ds:
Delay- Delay the desire to yield to the craving. Postpone the action
Distract- Distract yourself from tobacco to something more interesting. Divert your attention till the craving subsides.
Deep Breathing- Works very well. Find a calm place and take deep and slow breaths. Inhale to the count of four slowly and exhale to the count of six. Breathe with your abdomen i.e. your abdomen should expand every time you inhale.
Drink Water- Drink water every time you crave. Besides providing distraction, it also combats craving effectively.
Along with craving, people who quit tobacco can experience withdrawal symptoms.
You will be irritated. It is best dealt by taking a walk. Taking breaks during work and avoiding potential conflicts.
You may suffer insomnia or sleeplessness. Try some hot chocolate with milk. Take it mild, a couple of hours before going to bed. Avoid stressful discussions at bedtime.
You may tend to eat more. Increase in appetite can be a temporary phenomenon, but the habit can get carried further leading to weight gain.
Be aware of it and manage your diet and exercise efficiently.
Preventing Relapse
Preventing relapse is the most important phase of tobacco cessation. You may feel confident and think that one cigarette will not cause harm. It is a slippery path and you can relapse to previous levels very quickly. Be aware of the pitfalls.
Avoid situations that might drive you to smoke.
Avoid going to the pub or drinking if it is associated with smoking.
Avoid smokers if you can, especially during the first four weeks and later be on the guard for six months to avoid the temptation to try one.
Take up a hobby to fill the void. People seem to enjoy spending time with family more effectively once they quit smoking.
Take up a sport. This will engage you and give you the necessary exercise.
Do not forget to reward yourself. Take one day at a time. Be proud of your achievement. Try to buy yourself a present for your achievement.
Have a little box where you can actually put the money you were spending on smoking to see how well you are doing, by seeing the money grow.
Should for any reason you lapse, i.e. consume a cigarette or use any form of tobacco, do not think of it to be the end of the world and resume your old habit. Lapses should reinforce your determination to fight your nicotine addiction. Start all over again.
DO NOT QUIT QUITTING.