Take your breath away

Hollywood actor Russell Crowe decided to end his 36 year-old deadly affair with cigarettes last week. Active! checks in with the experts to find out why quitting is the best decision of his life, and yours if you happen to be a smoker, plus yoga asanas to help you quit

Hollywood actor Russell Crowe went cold turkey last week. After 36 years of smoking more than 40 cigarettes a day, the 46 year-old decided that the time had come for him to kick the habit. Incentive came in the form of his six-year-old son Charlie, who "sneaked up" on Crowe while he was smoking in his office.

The actor, who took home an Oscar in 2001 for his nuanced portrayal of John Forbes Nash in A Beautiful Mind, felt that he had reached a point where "my body was telling me I had to stop". An indication that could easily save his life, according to experts.

Says Dr Vijay Surase, senior interventional cardiologist, Jupiter Hospital, "Cigarettes contain almost 4,000 different types of chemicals and almost 30 carcinogens. Previously, it was believed that smoking causes cancer of the lungs and of the oral cavity, but researchers have now found a direct link between smoking and heart disease."

Smoking causes heart attacks, according to Dr Surase. It is an established risk factor along with diabetes, hypertension, high lipid or fat levels, hereditary-genetic factors and lack of exercise. Smokers have a four-fold risk of developing a heart attack as compared to non-smokers, adds Dr Surase.

Smokers also have higher levels of vaso-constrictor chemicals, which cause spasms or constrictions of blood vessels. This causes more viscosity (thickening of blood) and blood develops the property of stickiness.

"Over a period of time, smokers develop aggressive deposits of fat or cholesterol inside the linings of the blood vessels, causing the internal lining to become hard and develop cracks.
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The heaps of fat or blocks which are non-obstructive (plaque) might rupture and develop aggressive clot formation at the site, also known as thrombosis. Clot formation leads to hampering of blood flow and stoppage of nutrition to the tissues," explains Dr Surase.

Lock & stock these smoking comments
(I was) smoking 40 on an easy day, but on a day when I'd be up at 4 am and working till midnight, it was 60-plus and it just got to the point where my body was telling me I had to stop. - Hollywood actor Russell Crowe

But it (smoking) slowly kills you, and people stop only when they are advised by the doctor. Everyone should quit before reaching that stage.
Bollywood actor Salman Khan in an interview in 2009

Smoking is an extremely addictive poison; equivalent to smoking heroine or being on morphine. - Dr Zarir Udwadia, chest physician, Hinduja Hospital.

Not-so-Smoking-hot stats
If current trends continue, tobacco use will kill 10 million people each year by 2030, according to forecasts made by the World Health Organization (WHO).
Of the more than 5 million people who die each year from tobacco use, approximately 1.5 million are women.
80% of smokers now live in less developed countries.u00a0
WHO forecasts the 21st century's death rate from smoking to be 10 times the 20th century's rate.

Smoking on the rise
According to a study by the National Institute of Public Finance and Centre for Global Health Research published in April this year, the number of smokers in the age group of 20 to 24 years increased from 13% to 25% from 1999 to 2006 in India.

The study goes on to add that male cigarette smokers around the age of 30 are likely to lose up to 10 years of their life.

Apart from the hazardous effects of smoking on the cardiovascular system, it also impacts the respiratory organs. "There's a strong link between smoking and tuberculosis," states Dr Udwadia. A report by Dr Udwadia and Dr Lancelot Mark Pinto pegs India as the bearers of a fifth of the world's tuberculosis (TB) burden.

Smoking Impacts Fertility
The ill effects of smoking don't end there. Smoking adversely impacts fertility in both men and women.
"Smoking reduces sperm count and sperm motility in men. It is as detrimental to fertility as alcohol," says Dr CN Purandare, past president, Federation of Obstetric and Gynaecological Societies of India (FOGSI).
Adds Dr Hasmukh Ravat, Cardiologist, Fortis Hospital, Mulund, "Smoking during pregnancy can lead to congenital anomalies, still birth or low-birth weight babies."

The news gets worse for women smokers who use oral contraceptives. "They are 20 times more susceptible to heart attacks, stroke and peripheral vascular disease. The effects of smoking on pre-menopausal women is greater than on men in the same age group, as women have relatively smaller blood vessels. Blood vessels get constricted due to smoking, and the hazardous effects are intensified in women," explains Dr Surase.

Passive smoking also has its share of health complications with cases of passive smokers developing lung cancer, throat cancer, chronic asthma and chronic bronchitis.

Never too late to quit

"Those in the age group of 30 to 50 who quit smoking can have their longevity prolonged by six to nine years. While those who quit smoking between 50 to 70 years can have their life expectancy increased by two to four years," says Dr Surase quoting from a study done by the American Heart Association in 2004.
A sentiment echoed by Dr Udwadia who says, "Smoking is the most preventable cause of death." It's never too late to quit.

Does smoking on film promote the habit?

Not according to a US-based study done in 2005 and published in the journal of the American College of Chest Physicians, which found that 35% of villains smoked as compared to only 20% of heroes, assuming of course that everyone aspires to be a hero. The study examined almost 450 hit US films made since 1990.u00a0 Here's our pick of the meanest onscreen smokers:

101 Dalmatians (1996)
Glen Close's deliciously wicked take on Cruella de Vil, the character based on Dodie Smith's 1956 novel by the same name, had us wanting to stub her out for her evil intentions, which involved the skinning of adorable dalmation puppies for their fur.

Dreamgirls (2006)
Despite his talent, James 'Thunder' Early had a tough time keeping his star rising. The hard-talking, hard-smoking musician falls from grace and into drugs when fate deals him a rough hand in this American musical directed by Bill Condon.

Dev D (2009)
The main protagonist of this film raised debauchery to an art. Spoilt, callous, and self-destructive, we had next to no sympathy for Anurag Kashyap's take on the jilted lover based on Sarat Chandra Chattopadhyay's classic.

Yoga Asanas to quit smoking

Yoga expert Shameem Akhtar on how yoga helps detoxify a smoker's system:
The process of de-addiction and de-toxification happen simultaneously with yoga. It also promotes a strong sense of discipline that helps the mind to "talk" back to cravings and helps you move away from the temptation.Interestingly, smokers who have used yoga to drop the habit will tell you that nicotine tastes odd in the mouth after a year of yoga. So it also prevents relapse, a huge problem with those who struggle with dropping the habit.

Upavista Konasana (Spread-legged wide angle pose)
Sit up straight, back erect, shoulders relaxed. Spread legs as widely as you can comfortably. Again adjust back to see that it has not slumped. Place hands on thighs, palms facing up. Shut eyes. Stay in this pose for a few seconds initially. Keep increasing duration of pose as comfort levels increase, up to one minute or so.

Why this works: Servicing the pelvic region improves blood circulation to the entire uro-genital system which is biologically involved with hormones and neurochemicals that affect our moods and orientation, whether it involves drive or craving.

Anulom vilom (Alternative nostril breathing)
Do a modified form without any retention. Sit in a cross-legged position, or even in a chair. Keep left hand in chin mudra (index finger touches thumb), and right hand in Vishnu mudra, with index and middle fingers bent, using the remaining fingers to shut and open the nostrils. Inhale and exhale twice, deeply. Then closing the right nostril, inhale from left to a count of two. Then shut the left nostril, to exhale from the right to a count of four. Inhale from the right to a count of two, and exhale from the left to a count of four. This is one round. Do up to nine rounds. After a few weeks, you may double the ratio to four-count inhalations and eight-count exhalations. Then a few weeks later to the actual ratio of four counts for inhalation, 16 counts for retention, and eight count exhalation.

Why this works: Improves brain bi-lateralisation, which means both your brain hemispheres are engaged equally, the emotional and logical sides to our personality are bothu00a0 involved in problem-solving or decision-making. We tend to favour just one which makes us lop-sided while dealing with life situations. This is also a powerful practice in impulse control.

Apanasana (Downward flowing energy pose)
Lie on your back. Fold both legs at knees, placing knees close to hips as shown. Place one hand on the stomach, other alongside body. Shut eyes. Focus on the stomach's up and down movement as it keeps pace with the breath. This pose also makes long meditation easy. You may start by counting your breath, both inhalation and exhalation as one count. Start from hundred and count back to zero. This will need about five minutes. You may increase the count to three hundred later (takes 15 minutes) to further boost your de-addiction programme.

Why this works: This is a powerful awareness meditation, which helps in impulse and addiction control. It also restores the body's homeostasis or ability to physiologically regulate its inner state in response to changes in the external environment, naturally. This is important to heal the harmful effects of nicotine. It is a mood uplifting practice that creates self-control and bliss which helps control addictive tendencies.

Confessions of a chain smoker who successfully kicked the addiction

DAY 18
"I used to comfort myself as a smoker, with the thought that the incidence of bowel cancer amongst smokers is much lower than among non-smokers. I figured that if a cancer was on offer then a lung cancer might be preferable. After, all you have two lungs and you might get away with the removal of one. But bowel cancer?"

DAY 19
"I did manage to go eight months without a fag. So I can do it. I have done it before and there is no reason why I shouldn't go just as long again, or even longer. I have promised myself that I shall smoke again when I am 90. If it shortens your life then chances are mine has already been shortened, so I shouldn't lose too much.

This way I can look forward to smoking again one day... Hey, it's whatever gets you through this process.
My biggest worry is the old: 'I'll put on three stone if I give up'. How fat shall I get? Answer: not much fatter than I am now. I have resolved:
> No sweets to counteract the loss of nicotine
> No nibbling on biscuits between meals
> Cut out all puddings after meals

I have also been looking at advice online to see what I'm supposed to be doing. Skipping breakfast is a bad idea apparently as it just makes you hungry. Better to eat a low fat breakfast instead. Also nibble on fruit, eat low-fat yoghurt, low fat muesli bars, toast with savoury spread such as Marmite.

Apparently people put on weight because they feel hungry, need to keep up some sort of oral satisfaction (I chew pens), eat more because food tastes better, replace the end of the meal fag with another helping of pudding (guilty). I did also read that smoking actually cuts down the rate at which food is absorbed in the gut so giving up means we actually digest more even while eating the same amount. This could be as much as 30%. Therefore to maintain our weight when we stop smoking we actually need to cut down the amount we eat, otherwise we pile on the pounds."

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