By Dr. Prashant Saxena,
HOD (Pulmonology & Sleep Medicine) & Principal Consultant (Critical Care Medicine),
Max Super Specialty Hospital, Saket
As many as 2,500 persons die every day due to tobacco-related diseases in India. Tobacco use can lead to nicotine dependence and other serious health problems. Tobacco/nicotine dependence is a condition that often requires repeated treatments, but there are helpful treatments and resources for quitting. An Indian Council of Medical Research (ICMR) report says that use of tobacco accounts for about 30% of all cancers in men and women in India. Cancer of mouth is most common among men followed by lung cancer. Tobacco related cancer accounts for 42% of the male deaths and 18.3% of female cancer deaths.
Portrayal of cigarette smoking in popular culture has been a leading cause in creating perceptions and associations of a ssoker as edgy and cool, especially among the youth. However, advertising, especially for e-cigarretes and the associated myths around its relative harmlessness, when compared to regular cigarette has propagated misconceptions. E-cigarettes typically deliver nicotine, which at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.
Tobacco smoke contains a deadly mix of more than 7,000 chemicals; hundreds are harmful, and about 70 can cause cancer. Smoking increases the risk for serious health problems, diseases, and death.
The following treatments have proven to be effective for smokers who want help to quit:
* Brief help by a doctor (such as when a doctor takes 10 minutes or less to give a patient advice and assistance about quitting): t is essential that clinicians and health care delivery systems consistently identify and document tobacco use status and treat every tobacco user in a health care setting. Multiple brief help sessions can lead to better frequency of treatment.
* Individual, group, or telephone counseling: Telephone quitline counseling is effective with diverse populations and has broad reach. Therefore, both clinicians and health care delivery systems should ensure patient access to quitlines and promote quitline use
* Behavioral therapies (such as training in problem solving)
* Treatments with more person-to-person contact and more intensity (such as more or longer counseling sessions)
* Programs to deliver treatments using mobile phones
Counseling and medication have hown good results when used by themselves for treating tobacco dependence. The combination of counseling and medication, however, is more effective than either alone. Thus, clinicians should encourage all individuals making a quit attempt to use both counseling and medication. Numerous effective medications are available for tobacco dependence, and clinicians should encourage their use by all patients attempting to quit smoking—except when medically contraindicated or with specific populations for which there is insufficient evidence of effectiveness. These include a range of nicotine replacement products like:
* Over-the-counter (nicotine patch [which is also available by prescription], gum, lozenge)
* Prescription (nicotine patch, inhaler, nasal spray)
* Prescription non-nicotine medications: bupropion SR (Zyban),varenicline tartrate (Chantix)
Qutting smoking is possible even though it can be overwhelming. It’s not only about breaking a powerful physical dependence on an incredibly addictive substance, but also about significantly changing one’s lifestyle and habits. People who stop smoking often start again because of a range of withdrawal symptoms, stress, and weight gain. These include - feeling irritable, angry, or anxious, having trouble thinking, feeling hungrier than usual and huge craving for tobacco products. Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. And, quitting is undeniably the single most important step that smokers can take to improve the length and quality of their lives. Although the health benefits are greater for people who stop at earlier ages, no one is ever too old to quit.