Thursday, 05 December 2019

India’s battle against tobacco addiction

30 May 2019 | Views | By Dr Gowri Kulkarni

Every year, on 31 May, the World Health Organization (WHO) and global partners celebrate World No Tobacco Day

Be it Mumbai, Bangalore or Delhi; all metro cities in India have one thing in common – a large part of their population are regular smokers. Despite the government coming up with a slew of measures and regulations, tobacco addiction remains a pressing health issue in the country. After all, India is the second largest consumer of tobacco in the world, with over 300 million people actively using tobacco products that range from premium cigarettes to locally-made beedis. E-cigarettes (also known as vape pens) and electronic nicotine delivery systems (ENDS) are also witnessing a huge demand among Indian consumers. Apart from that, the practice of chewing tobacco has been prevalent in rural areas since ages.

According to the Global Adult Tobacco Survey 2 (GATS 2) 2016-2017, 232. 4 million adults in India use tobacco daily in some form. The most commonly used tobacco product in the country is khaini, followed by beedi and gutkha respectively. The survey by the Ministry of Health and Family Welfare further reveals that every tenth adult in India smokes tobacco—11.9% in rural areas and 8.3% in urban areas. In addition to this, second-hand smoke is steadily becoming a serious cause of concern in India. Well, the findings are shocking, to say the least.

India’s battle with tobacco addiction has been a long one as its usage in the country dates back to 2000 BC. While the recent anti-smoking campaigns have managed to bring down the number of tobacco users to an extent, the scenario still appears rather bleak. To make matters worse, a majority of these users don’t realize the severity of the danger they are exposing themselves to by consuming tobacco. Regular use of tobacco products can cause multiple types of cancer, cardiovascular diseases (CVD), chronic lung diseases, stroke, diabetes, tuberculosis (TB), infertility, blindness – the list is endless. In fact, a recent survey conducted by the experts of Tata Memorial Centre (TMC) said that as many as 10 lakh Indians die each year from tobacco-related diseases. The dire situation calls for the need for building awareness among Indians about the harmful effects of tobacco addiction.

What is tobacco addiction?

Tobacco addiction is caused by a dependency on Nicotine, a chemical which is present in cigarettes, hookah, beedis and any other tobacco product. When you first start using tobacco, you may experience slight physical discomfort such as dizziness, nausea, or headaches. However, as you become a regular user of tobacco, these effects fade away and your brain starts secreting adrenaline and the feel-good hormone called dopamine on consumption. The temporary pleasure generated by nicotine is the main reason behind the rising cases of tobacco addiction.

However, most fail to realize that the buzz experienced from using tobacco is the body’s reaction to nicotine, which leads to the disruption of the natural hormonal balance.  When it comes to smokers, they often end up connecting their smoking habits with their daily and social activities. As a result, they find it impossible to quit smoking in the fear of breaking their usual routine or pattern. Unfortunately, in many cases, tobacco users are either unaware or in denial about their nicotine addiction.  

How bad is tobacco addiction?

While most people do not consider tobacco as a drug, the nicotine present in it generates similar neurobiological effects as illegal substances like cocaine, heroin and methamphetamine. However, since tobacco consumption has been a part of the social culture for so long, users do not realize the grievousness of their addiction. Due to their ignorance, they continue with their tobacco usage without any worry.

Increasing tobacco addiction in urban spaces

Even a decade ago, a woman smoking in India was quite a rare sight. However, with more women now being financially independent, the number of female smokers in our country has gone up alarmingly in the last few years. As per a recent survey by Assocham Social Development Foundation among 2,000 women, smoking among women from cities like Bangalore, Delhi-NCR (National Capital Region), Kolkata, Mumbai, Hyderabad, Jaipur, Lucknow, Chennai, Ahmedabad and Pune, is on the rise. Besides women, smoking cigarettes or hookah has also become a trend among urban teenagers. In fact, the tobacco addiction of young adults living in metro cities has contributed to the increasing popularity of e-cigarettes. Easy access to tobacco products is the main factor behind the growing cases of tobacco addiction in urban areas.

Health hazards caused by tobacco addiction

As mentioned earlier, tobacco addiction can prove extremely costly for consumers. From lung cancer to mouth cancer, tobacco usage has been associated with nearly every type of cancer. However, tobacco use is directly associated with lung cancer most prominently. According to statistics published on cancerindia.org, 87% of males and 85% of females in India with lung cancer have a history of active tobacco smoking.

Other than that, tobacco use can increase the chances of developing type-2 diabetes, heart diseases, erectile dysfunction, ectopic pregnancy and vision loss. Although it's a fact unknown to many, regular tobacco users are more likely to experience strokes as compared to their counterparts. It has also been established in various studies that the life expectancy of a smoker and a non-smoker differ by as many as 10 years.

When should you seek treatment?

Most people don’t even acknowledge their tobacco addiction until it gets too late. You should seek medical consultation if you have made more than one unsuccessful attempt to quit smoking. Another sign of tobacco addiction is nicotine withdrawal symptoms which include strong craving, anxiety, bouts of depression, irritability, restlessness, anger, increased appetite, constipation and diarrhoea. Once you have started experiencing these effects, it’s advisable to look for treatment.

Methods of treatment

Tobacco addiction can be successfully treated with the use of medication and counselling. However, a strong addiction may need multiple attempts and long-term treatment to achieve desired results. Enlisted below are the few popular options that can help you get rid of your tobacco addiction.

Nicotine patch: Owing to its easy availability, a nicotine patch is the most commonly used product to battle tobacco addiction. Once you stick it to your arm, the patch delivers a little amount of nicotine into your bloodstream through your skin. This helps your body gradually wean off the nicotine. Ideally, you should wear the patch for at least eight weeks or longer depending on the intensity of your addiction.

Nicotine gum: Nicotine gum is another over-the-counter product that works effectively to bring down your cravings. It can especially help addicts who require the oral fixation of smoking or chewing. Similar to the nicotine patch, nicotine gum also releases low levels of nicotine in your body to manage the withdrawal symptoms. However, you should not chew over 25 nicotine gums a day. You would do well if you consult a doctor for the same.

Medication: In some cases, doctors recommend the use of medication for tobacco cessation. There are certain drugs which help in curbing the body’s nicotine cravings. Anti-depressants also come in handy in the treatment of tobacco addiction. Along with medication, doctors suggest addicts to embrace a better lifestyle by eating healthy and exercising regularly.

Behavioural treatment: It’s often seen that tobacco users are struggling with mental health problems such as depression, anxiety, high levels of stress etc. Hence, the importance of addressing these underlying issues while treating someone with tobacco addiction can’t be underlined enough. In such cases, behavioural treatments including talk-therapy, group counselling sessions and even hypnotherapy can prove to be successful.

How effective is online consultation?

Just like any other addiction, getting rid of tobacco addiction can seem challenging at first. Tobacco addicts need a lot of hand-holding through their entire recovery journey. However, they might feel reluctant to go to a doctor due to the social stigma attached to addiction problems. This is where online doctor consultation apps come in. With the use of these platforms, you can get access to world-class doctors who will guide you at every step through texts, phone calls and video calls as you strive to reach your goal. And, all these with just the touch of a button.

Tobacco addiction is a grave issue faced by lakhs of Indians, which requires urgent attention from the government. Other than placing stricter laws, tobacco demoralization strategies should be implemented at workplaces and in social settings to discourage the habit of smoking. On a personal front, we should make relentless efforts to ensure our friends and families are not falling in the trap of tobacco addiction.

 

Dr Gowri Kulkarni, Head of Medical Operations, DocsApp

 

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