Quitting Tobacco!

Our present and future generations must be urgently protected from the devastating consequences of tobacco consumption and exposure to tobacco. It hurts deep inside to witness the perils of ‘Tobacco’ and produces a quick alarm to control this menace before it is too late. The world celebrates ‘No Tobacco’ day on 31st May that stimulates awareness and enhances political attention and public action. But it has to turn a routine practice and action oriented to completely get rid of this menace. Who exactly was the first one to smoke tobacco has been lost to history. Some researchers theorize that tobacco was first cultivated thousands of years ago in the Americas, around the regions that have become known as Mexico and Brazil. The populations grew the plant for medicinal and ceremonial purposes.In 1531 tobacco is believed to be cultivated for the first time in Europe. By 1600 tobacco use had spread across Europe and England. By the 1700s smoking had become more popular practice and a tobacco industry had developed as a promising industry. Cigarette making machines were developed in the latter half of the 1800s. Mass production at an economical rates and the use of cigarette advertising allowed tobacco companies to expand their markets during this period. India too has a long history of smoking. While dhumpana (drinking smoke), has been in practice for quite some time, tobacco was introduced to India only around 1600.Modern pipes with stems of different length and chillums were used as a tool to inhale smoke. As a progression cigarette smoking later was adopted as a popular smoking practice. But it was during 1920s, the first medical reports linking smoking to lung cancer appeared on the scene. In 1950s and 1960s major researches confirmed that tobacco caused a range of serious diseases.In the twentieth century, smoking became less popular due to a rapid increase in knowledge of the health effects of both active and passive smoking.People also became aware of the tobacco industry’s efforts to mislead the public about the health effects of smoking and to manipulate public policy for the short-term interests of the industry. The first successful litigations against tobacco companies over smoking-related illness took place in the latter part of the 20th Century.

“Tobacco kills up to half of its users. This menace kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke. Around 80% of the world’s 1.1 billion smokers live in low- and middle-income countries. In some countries, children from poor households are frequently employed in tobacco farming to provide family income. These children are especially vulnerable to “green tobacco sickness”, which is caused by the nicotine that is absorbed through the skin from the handling of wet tobacco leaves” (A report by World Health Organization). Being a smoker has not only self-containing consequences. Second hand smoke inhaled by the by standers is equally harmful. Smoking has an alarming impact on others directly and indirectly. Smokers victimize the non-smokers through forced passive smoking leading to serious diseases. Many researches although without high facts, consider passive smoking more harmful than active smoking. If so, whom we should blame- the production companies, the Govt. bodies, the smokers or the victim of his own fault?

Smoking is enormously destructive to our health. There’s no safe way to smoke. Replacing cigarette with pipes or hookah etc. is never by any means a safe alternative and won’t help avoid the health risks associated with tobacco products. Cigarettes contain many ingredients and on burning, generate more than 4,000 chemicals, and likely cause cancer according to the American Lung Association. Cigars and tobacco used in pipes and hookahs also contain many of the same ingredients. According to popular cancer institutes’, cigars have a higher level of carcinogens, toxins, and tar than cigarettes. There is also a myth that the water absorbs the toxins from the smoke rendering it safe for the smoker. On the contrary, the smoke that emerges from the water bowl has several toxicants known to cause lung cancer, heart diseases and other diseases. In fact, a hookah smoking session may expose the smoker to more smoke than over a longer period of time than cigarette thus increasing the hazards by many folds. Hookah is also mostly used by groups, with the same mouthpiece passed from person to person, which may not even be cleaned properly. It thus risks the transmission of infectious diseases like tuberculosis, lung infections, several viral infections, stomach ulcers etc. Some sweetened and flavored nontobacco products are also used for smoking.

However although they do not contain tobacco but the smoke from both preparations contain carbon monoxide and other toxic agents known to increase the risks for smoking-related cancers, heart disease, and lung disease. The concept of e-cigarettes also came to the forefront but never without any challenges and ethical considerations. A Californian health chief recently claimed that e-cigs are a “community health threat”. Any teenager who uses an e-cig faces a risk of harming their BRAIN development. E-cigarettes contain nicotine and other harmful chemicals, and the nicotine in them is as addictive as the nicotine in cigarettes. Smoking produces disastrous effect on nervous system, respiratory system, cardiovascular system, skin, hair and nails, Digestive, sexuality and reproductive system etc.

Smoking leads to a bigger hole in our finances. One study reported that a 30-year-old who smokes five cigarettes a day would lose over Rs 1 crore due to the habit by the time he is 60.The biggest drain on the wallet is the price of cigarettes. Cigarettes are priced around Rs 10-15, but it assumed a price of Rs 12 per stick. If a person smokes five cigarettes a day, he spends Rs 60 daily — or Rs 1,800 a month. However, this is not a static cost. Cigarette prices have risen by an average 20% every year in the past four years, and will keep rising every year as taxes on tobacco products go up. The study assumed a more conservative rise of 8% in cigarette prices per year. Calculated over a period of 30 years, the smoker will spend Rs 24.47 lakh on cigarettes. Now comes the interesting part. If the money spent on cigarettes was instead invested every month to earn 9% returns a year, it would grow to Rs 69.23 lakh in 30 years. The next big cost is the higher medical expenses that smokers incur due to poor health and it is assumed that a smoker will spend an average of Rs 400 a month on medical expenses which will keep rising over the years as Medical inflation is very high compared to consumer inflation. Prices of drugs, doctor’s consultation charges and diagnostic charges are rising at nearly 15%. Assuming a 12% rise in these costs per year, a smoker will spend Rs 11.59 lakh over a 30-year period. If this money was invested to earn 9% returns, it would grow to Rs 26.70 lakh in 30 years (A report by Economic Times Wealth). Irrespective of the form and means of smoking, it is proving fatal and has disruptive consequences for the society.

Many studies have found that few people understand the specific health risks of tobacco use. A 2009 survey in China found that only 38% of smokers knew that smoking causes heart disease and only 27% knew that it causes stroke.

Proper counseling initiatives and medication can do wonders for smokers to quit tobacco and lead a better life.

Hard-hitting anti-tobacco advertisements and graphic pack warnings reduce the number of participants who begin smoking and increase the number of smokers who quit. Researchers have found that after the implementation of pictorial package warnings in Brazil, Canada, Singapore and Thailand, pictorial warnings have significantly increased awareness of the harms of tobacco use. Bans on tobacco advertising, promotion and sponsorship have also significantly reduced tobacco consumption. India is not an exception. In India, legislations and the awareness campaigns against the tobacco menace have been the routine now. In 2008 the Ministry of Health and Family Welfare notified the Prohibition of Smoking in Public Places Rules, 2008 by which smoking in public places was prohibited. Indian Govt. mandated the companies to keep 85 percent warnings on the packs including the text and graphics. Increasing taxes and fines are also utilized as a good measure to control the consumption.

Our action plans are not enough towards the complete end of tobacco. It requires more honest and perseverant efforts from many agencies involved. It may be more right to say that every member and every section of our society has a huge role to protect our generations. Tobacco use by parents, teachers and friends is associated with adolescents’ tobacco habits. Parental and family smoking to a higher extent can result in children picking up smoking. The Student Health Survey 2009 conducted by the Health Promotion Board (HPB) showed that 50% of youth smokers had at least one parent who smoked. Families must establish homes as smoke-free places. Do not smoke, if possible, or at least provide an anti-smoking education. Parents can take a parenting skills course to learn how to provide an anti-smoking and refusal skills education at home. Mass media especially social media campaigns are the need of the time now. Such initiatives can highly reduce tobacco consumption by influencing people to protect non-smokers and convincing youths to stop using tobacco consumption. Moreover school and college programmes are often one of the first approaches to control tobacco addiction. Teachers who are smokers themselves have a lot to be blamed. Not only such teachers are their own health destructors but are guilty in providing the wrong lessons. Disciplining students is a necessary step and possible when teachers and parents are non-smokers and supportive of the anti tobacco programmes. High emphasis must be laid on helping to teach the smoker how to quit and then how to stay off. It is also high time to engage teachers, youth workers and counselors in promoting a tobacco-free lifestyle among the young. To quit tobacco is not an easy task as tobacco dependence is a resultant of behavioural, cognitive and physiological phenomena. It is true that very few tobacco users can successfully quit the habit in their first attempt. But the evidence is strong that it can be done. It is our slogan, smoking must be totally banned, as it had made our lives pained. Really Tobacco has played a tough game. So let us pledge to finish its name

(The author is Assistant Professor, ITM University Gwalior. Feedback at: [email protected])