Clearing the Smoke Around Tobacco Cessation

Arzoo Dutta

Tobacco use is the leading preventable cause of death worldwide. Tobacco may be smoked (in the form of cigarettes, beedis), chewed (as gutka, khaini, etc), and inhaled as snuff. Cigarettes and other forms of tobacco are addictive because of the presence of nicotine. It is worth mentioning that nicotine blood levels achieved by smokeless tobacco use are similar to those from cigarettesmoking.

Nicotine, the chemical that makes addicts out of tobacco users, is a stimulant with properties similar to those of cocaine and amphetamines. It provides the pick-me-up feeling that tobaccousers feel. It increases the heart rate, blood pressure, and respiratory rate, and makes theuser feel more alert. Unfortunately, these effects wear off after twenty minutes or so, and thetobacco user is left craving for another smoke. When a person abstains, the craving rates become abnormally high, causing withdrawal symptoms like feeling tense and irritable, trouble in concentrating, sleep disturbance, headaches, digestive upset etc. The role of nicotine in the compulsive use of tobacco products is now known to be equivalent or more to the role of cocaine, ethanol and morphine.

To unwrap and tackle addiction, it is important to understand the various stages of development of addiction itself. The initiation and development of tobacco use among children and adolescents progressesin stages. The first stage always consists of forming attitudes and beliefs about Tobacco through a peer circle. This is often followed by the first cigarette, or trying it once to fit in or adhere to status quo. It is at this point where experimenting with Tobacco starts becoming cool and going against the grain, especially among the local youth. As nicotine starts affecting one’s behavior, and leads to an effect where it creates an urge for its repeated usage. It is at this stage when one is treading towards becoming an Addict to Tobacco. This process generally takes between 3 months to 3 years depending on individuals.

Tobacco cessation (also known as quitting) is the process of discontinuing tobacco. Around 55.4% of current smokers are planning or thinking of quitting smoking and 49.6% of current smokeless tobacco users are planning or thinking of quitting smokeless tobacco use. Tobacco cessation significantly reduces the risk of dying from tobacco-related diseases such as coronary heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer. These different stages of behavior can be largely divided into three stages: Behavioral strategies for cessation, withdrawal triggers & post-quitting conduct.

Most users who try to quit do so without assistance, wherein only 3%- 6% of quitting attempts without assistance are successful. Behavioral counseling and medications each increase the rate of successfully quitting, and a combination of behavioral counseling with medication is more effective than each intervention alone. The National Tobacco Control Programme& Assam Cancer Care Foundation have collaborated on tobacco cessation activities pan- Assam where we are looking beyond awareness, to combine these two. However, the power to choose a life without Tobacco resides in the individual. Thereby, I would try to address the intricacies related to cessation and small behavioral changes that a smoker can imbibe towards quitting.

Many different strategies can be used for cessation, including abruptly quitting without assistance - cutting down the quantity, behavioral counseling, and medications. Apart from that, there are other behavioral methods, like changing to a non-preferred brand, buy less cigarette/ sachet at a time rather than piling the stock, keeping a record of the amount and frequency of tobacco used, increasing your water intake, decreasing the number of puffs when smoking, leave large stubs, don’t inhale deeply.

Withdrawal

In nicotine-dependent users, quitting can lead to withdrawal which begins within a few hours of the last tobacco use, and may manifest as nicotine cravings, anxiety, irritability, depressed mood, insomnia, irritability, frustration, or anger, Difficulty in concentrating, Restlessness, Decreased heart rate, Increased appetite or weight gain.

Professional cessation support methods generally attempt to address nicotine withdrawal symptoms to help the client break free of nicotine addiction. On days when one has an extraordinary craving to take tobacco, there are certain ways of dealing with triggers. Trying alternatives (chewing gum, toffee,peppermint), taking small sips of water, deep breathing can significantly calm an individual. Further, substituting stimulants associated with tobacco i.e. tea can be replaced by milk or juice also helps.

Doing something else when you feel the urge to smoke/ chew tobacco. This will help youkeep your mind off tobacco.Delay the act, count till 100 and think of pleasant situations and thoughts. Remove ashtrays or lighters from your house or workplace.

Once You Quit

The last endeavor is one’s deportment after quitting. Thecrucial task is learning to say no to tobacco offers from others. It includes not taking even one puff and remaining in smoke free areas by avoiding company of smokers and chewers. A lot of people have been able to get help by making a group of people who have quit tobacco. Often, trying alternative ways to deal with stress like – relaxation, deep breathing, listening to music, exercises, taking a walk, talkingto someone over telephone etc physically allows us to resist sudden urges. One must remember there can be some withdrawal symptoms when you quitlike headache, irritability, lack of concentration etc.But these are temporary and disappear within a few days. Lastly, even if you fail in your attempt, don’t get disheartened. It is a paramount to try again andseek help from those who have quit tobacco, combined with professional help and medical advice. One is never too late to choose one’s life over one’s habitual fixation.

Also Read: Director Abdul Basit Declared Naharlagun Mini Secretariat as ‘No Tobacco Zone’