Stub out that ciggie!

May 30, 2013, 07:30 IST | Dr Pankaj Chaturvedi

On the eve of World No Tobacco Day, eminent surgeon Dr Pankaj Chaturvedi explains what one can do to kick some butt and when doing so, kick it in style

We have a law against advertising tobacco products, so tobacco companies take to surrogate advertising. These companies diversify into other luxury goods and publish advertisements for these products - such as soaps, shampoos - in prominent newspapers.

Even one puff of a cigarette can prove carcinogenic. Pic/Satyajit Desai

These advertisements carry the logo of the tobacco company. One company has even branched out into school stationery so even my 10-year-old daughter now knows about the tobacco company. This is upsetting, because one effective way to ensure that someone does not become a tobacco addict is to start educating them when they are children. De-normalising tobacco for children and making them allergic to it can stop the spread of tobacco consumption.

Why quit
One has to quit tobacco totally. Reducing the number of cigarettes smoked per day or changing to a ‘safer’ alternative won’t work. Each puff contains enough carcinogenic material to cause damage at the genetic level.

Sulaiman Merchant performs during the Cancer Patient Aid Association musical evening on May 26, 2013. Pic/AFP

Tobacco and the smoke from cigarettes do not simply stain the teeth or tongue - they cause genetic mutation. It takes 10 years after someone quits tobacco totally for the genetic damage to reverse and become normal. Till that time, the person is at a high risk of developing tobacco-related disease.

Only 10 years after they quit, will their risk level reach that of a person who has never used tobacco. This genetic mutation can be transmitted to the foetus through its parents. Women who smoke also have a higher chance of delivering stillborn babies. Not only that, but when parents use tobacco, it legitimizes the habit for children, as parents are the role models for children.

Teenagers sign a pledge to quit smoking. Pic/Atul Kamble

Relapse rate
It is very tough to quit tobacco. Despite so much information, tobacco is consumer gold because it is addictive. I have found that across all socio economic strata, users find it very tough to quit. They have tried all the methods available on the market. What is needed is will power. All (deaddiction) drugs have side effects, and they can be given only temporarily. A relapse can happen even after six years of quitting. We have cancer patients who have survived the disease and then gone back to smoking all over again.

Studies have shown that if you try to make someone quit it in a controlled manner, with a lot of counselling, advocacy, etc, 10 per cent of the population is able to quit. If you add medicines to that, it improves the chances of quitting from 10 to 20 per cent. Even this is not permanent, they reverse to smoking or using tobacco. Without such help, only 2 per cent are able to quit. What is most important is denormalising tobacco for children. Only then can we end the tobacco menace in society.

Tips for quitting tobacco
>> Quit cold turkey. It is a myth that one can quit by slowly reducing the tobacco consumption. You have to stop consumption totally. In the long run it’s the easiest and most effective technique of quitting tobacco. Quit tobacco one day at a time. Do not concern yourself with next year, next month, next week or even tomorrow. Concentrate on not taking tobacco from the time you wake up until you go to sleep.

>> Work on developing the attitude that you are doing yourself a favour by not consuming tobacco. Do not dwell on the idea that you are depriving yourself of something like tobacco in your life. Be proud that you are tobacco free and you have taken the first step in breaking the cycle.

>> Be aware that many routine situations will trigger the urge for a single use of tobacco. Situations which will trigger a response include: drinking coffee or alcohol, sitting in a bar, social events with smoking friends, card games, and the end of meals. Try to maintain your normal routine while quitting. If any event seems too tough, leave it and go back to it later. Do not feel you must give up any activity forever. Everything you did as a tobacco user, you will learn to do at least as well, and maybe better, as an ex-tobacco user.

>> Make a list of all the reasons you want to quit tobacco. Keep this list with you, preferably where you used to carry your tobacco. When you lose your motive and feel an intense urge to smoke, think of the list and its benefits. Drink plenty of fruit juice for the first three days. It will help flush the nicotine out of your system.

>> To avoid weight gain (occurring after you quit tobacco), eat vegetables and fruit instead of candies and pastries. Celery and carrots can be used safely as short-term substitutes for cigarettes.

>> If you are concerned about weight gain, do some moderate form of regular exercise. If you have not been exercising regularly, consult your physician for a practical exercise programme which is safe for you.

>> If you encounter a crisis, (for example, a flat tyre, flood, family illness) while quitting, remember, tobacco is not the solution. Tobacco will just complicate the original situation while creating another crisis, a relapse into nicotine addiction.

>> Consider yourself “tobacco free”. One single puff of a cigarette and you can become hooked again. No matter how long you have been off tobacco, don’t think you can safely consume it just one time!

>> Don’t debate with yourself how much you want it. Ask yourself how you feel about going back to your old level of consumption.

>> Save the money you usually spend on buying tobacco and buy yourself something you really want after a week or a month. Save for a year and you can treat yourself to a vacation. Practise deep breathing exercises when you have a craving. Tell people around you that you have quit tobacco. A strong support system will help you stay tobacco free.

Dr Pankaj Chaturvedi is Professor and Head and Neck surgeon at Tata Memorial Hospital, Mumbai.

Tough task
Convincing someone to quit tobacco is difficult not only at the individual level but also at the social level. Said Dr Zahra Merchant, project head, tobacco cessation programme, Salaam Bombay Foundation, “People know tobacco is harmful, but it is not considered a taboo, such as alcohol and drugs. It doesn’t have a negative connotation. It is socially acceptable. Hence, it is tough to convince people to come forward to seek help, and to also convince them that it is possible for them to quit the habit with professional counselling.

Even if you take the decision to quit, it is tough to do so on your own. Getting counselling increases the success rate. However, counselling sessions have to take place at specific intervals of time for effectiveness. It is the same principle as taking medicines at regular intervals to cure a cold or bring down a fever. Sadly, society doesn’t think that tobacco addiction is a crucial problem, so it is very difficult to arrange follow up sessions.” She added that nicotine is more addictive than drugs.

“The brain has a nicotine memory, which means that someone who has quit smoking, can relapse at any point of time. Such a memory is there in case of drugs too, but it is stronger with nicotine. The addiction is physical, psychological and behavioural. So those who have quit smoking, have to keep their hands busy, as withdrawal symptoms are high.” 

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