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QUIT SMOKING – A LITTLE DETERMINATION AND SOME HELP

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History of Smoking

Tobacco was introduced in India by the Portuguese about 400 years ago and the British brought forth the commercial production of cigarettes in India 200 years ago. Since then the habit has been growing far and wide and it has been estimated that about 16.6% of the world’s smoking population is comprised by Indians. It has also been estimated that about 65% of all men and 33% of all women in India use some form of tobacco 1

Smoking of tobacco is practised in the form of cigarettes, cigars, beedi (hand-rolled, filter-less tobacco cigarette) or hookahs (traditional water pipe). Smoking affects the health of the individual regardless of the type 1

Health Hazards

Worldwide, smoking tobacco has been identified as a preventable but leading cause of illnesses and death. Approximately half of all the cancers in men and about one-fourth of all the cancers in women are related to the use of tobacco. Each year, about 8.3 million cases of heart disorders and lung diseases are reported due to the use of tobacco. Though these figures are alarming, the consumption of tobacco has been increasing at about 2-3% every year and it has been projected that by the year 2020, 13% of deaths will be due to smoking tobacco 1. Hence stop smoking now to be out of that 13%.

Some of the ill effects of smoking include:

  • Formation of blood clots in the major blood vessels of the brain
  • Cancer of the lung, mouth, throat and other numerous organs
  • Heart disorders
  • Diminished ability to taste and smell
  • High blood pressure
  • Respiratory disorders including asthma
  • Problems during pregnancy
  • Diseases affecting the teeth and gums 2

There is strong evidence that smoking negatively impacts virtually all facets of fertility. Studies have illustrated that when a pregnant woman smokes, the future fertility of the foetus (male or female) is also put in jeopardy. Men’s smoking can be associated with minor reductions in sperm count/morphology. There is also evidence that smoking induces DNA damage in sperm 3

Why Is It Harmful? 

Tobacco contains mainly an addictive substance known as nicotine. This along with 19 other recognised cancer causing chemicals results in various illnesses and death worldwide. It also contains about more than 400 chemicals in addition among which carbon monoxide, acetone, cyanide, ammonia and methane are few of the major ones related to the numerous disturbances in the normal functioning of the body 2.

Addiction

Although nicotine has several stimulating effects initially, it results in development of tolerance wherein the individual requires higher doses to attain the same stimulation that he used to attain with 1 cigarette initially. Ultimately it results in the individual becoming dependent on nicotine the unavailability of which may result in irritation, anxiety, sleeplessness, decreased concentration and craving for smoking 4

Smoking is both harmful to the one who smokes as well as to the one who inhales it passively. Individuals who are exposed constantly to the tobacco smoke are at increased risk of developing lung and heart disorders. Infants and children are more prone to develop asthma, infections of the throat and decreased functioning of the lungs. Pregnant mothers who smoke are at risk of delivering their babies prematurely and also put their unborn child to the risk of death in the womb 2

Advantages of Quitting

Numerous advantages have been identified with the cessation of smoking. These advantages depend on the duration since quitting and complete cessation of smoking for the progressive life. The risk of death in all categories related to smoking is lowered and the risk of developing cancer is almost reduced by 75% when compared to regular smokers. The lung functions also begin to improve as the habit is stopped completely.

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Some of the interesting facts about what happens after quitting are given below.

20 minutes after quitting – the blood pressure and heart rate return to normal.

8 hours after quitting - the levels of carbon monoxide in the body begin to drop and the level of oxygen increases reaching the normally required levels.

1 day after quitting – the risk of developing a sudden heart attack is decreased.

2 days after quitting - the normal senses of smell and taste begin to return.

2 weeks to 3 months after quitting – the blood circulation improves and day to day activities can be performed with more ease as the lung function increases.

1 year after quitting – the risk of developing heart disorders are reduced by half of that compared to those who still smoke.

5 years after quitting – the risk of developing lung cancer and subsequent death decreases by nearly 50% 4

HOW TO QUIT?

Self determination is the key to successful quitting of the smoking habit. A strong desire to quit which is aided by appropriate support from family and friends can help one to overcome the habit completely. It has been noted that most of the smokers give up smoking on their own 5. So all set to quit? Here are some tips that can help in giving up smoking.

Simple Steps

Set a quit date:This is the first step towards quitting smoking. Set a date and be firm with that date. During the period before quitting some preliminary preparations are considered to be helpful in making your decision stronger.

Meet your physician: to know more about the harmful effects of smoking and the advantages of quitting

Tell your friends and relatives: about your decision and ask them to encourage you in that aspect by not smoking in front of you or leave cigarettes around you

Make a list: of the timings or events during the day or night when you feel like smoking regularly and plan for alternative activities that you can do when the urge of smoking is the most. For e.g., if you smoke while having tea, switch to drinking coffee at that times; go for a stroll when you feel stressed; remove all things associated with smoking such as lighters, ashtrays from your room or car; take a different route to work if you tend to smoke on the way to your workplace. If you smoke when you have a drink, then avoid drinking for at least a period of three months; instead drink a lot of water and other non-alcoholic drinks. 

Start reducing: the number of cigarettes smoked everyday and also the strength of the cigarette. Throw all the cigarettes just before your quit date and clean out everything that smells of smoke such as clothes, curtains and other stuff.

D day: quit smoking completely. Avoid taking the usual routes to your workplace and have breakfast, lunch or dinner at a different place if you have the habit of smoking during these times. Think of the advantages of quitting. Drink plenty of water and fruit juices. Mark in your dairy or calendar the number of days you have succeeded in quitting. As the number of days increases your health and confidence increases.

DON’T GIVE UP IF YOU FAIL TO QUIT AFTER SETTING THE DATE.

Many individuals require 2-3 attempts before quitting completely. Try and analyse where you went wrong and plan for corrective measures during the next attempt. Also enrol yourself in some self help groups that work towards this cause. Try exercising, taking a walk and avoid stressful situations 6

Still Not Able To Quit ?

Some individuals tend to develop dependence to nicotine over a period of time of chronic smoking. The advice of a doctor is considered necessary in such cases. The doctors usually analyse the severity of dependence based on some questionnaires. Certain medications and medicated substances are available to help individuals quit smoking.

The doctors usually advise nicotine containing patches, chewing gums, lozenges, inhalers or nasal sprays to aid in this process. The doctors may also advise certain medications that belong to the group of bupropion, nortriptyline, clonidine or rimonabant either as a single tablet or in combination with other tablets or with nicotine replacements. These tablets are contraindicated under various circumstances and hence consulting a doctor is of utmost importance before consuming these. Most individuals who are unable to quit in case of nicotine dependence have been noted to have succeeded in complete cessation after these therapies 7, 8

Alternative therapies such as hypnotherapy, acupuncture, behaviour counselling and self support groups have also been found to have an additive effect on the mode of quitting undertaken 4, 8, 9

REFERENCE:

1.Shimkhada R, Peabody JW. Tobacco control in India. Bull of the WHO 2003;81:48-52.

2.Metz CN. Metabolism and biochemical effects of nicotine for primary care providers. Med Clin North Am. 2004; 88(6): 1399-1413.

3.Klonoff-Cohen H. Female and male lifestyle habits and IVF: what is known and unknown. Hum Reprod Update. 2005 Mar-Apr; 11(2):179-203.

4.Balbani APS, Montovani JC. Methods for smoking cessation and treatment of nicotine dependence. Rev Bras Otorrinolaringol. 2005; 71(6): 820-6.

5.Lancaster T, Stead LF. Self-help interventions for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD001118. DOI: 10.1002/14651858.CD001118.pub2.

6.MedlinePlus. Smoking - tips on how to quit. [homepage on Internet]. Bethesda, MD: U.S. National Library of Medicine; [updated 2007 Oct 10; cited 2008 Feb 04]. Available from: http://www.nlm.nih.gov/medlineplus/ency/article/001992.htm 

7.Henningfield JE, Fant RV, Buchhalter AR, Stitzer ML. Pharmacotherapy for Nicotine Dependence. CA Cancer J Clin. 2005; 55:281-299.

8.Okuyemi KS, Nollen NL, Ahluwalia JS. Interventions to Facilitate Smoking Cessation. Am Fam Physician 2006;74(2):262-71, 276.

9.Marlow SP, Stoller JK. Smoking Cessation. Respir Care 2003;48(12):1238 –1254.