Break the smoking habit!

The World Health Organization estimates that smoke related-diseases kill one in ten adults globally, and by 2030, if current trends prevail, smoking will kill one in six people. Health, Body and Mind interviews Dr Yousuf Kamal in this regard

By Our Correspondent

For most smokers, quitting smoking is a daunting task. But for seriously motivated quitters, quitting may be a little tough initially, but is quite doable. To successfully quit smoking, smokers have to have the motivation and the drive to not go back to smoking after going through a relapse.

Health, Body and Mind interviewed Dr Yousuf Kamal, Consultant Physician, AKU and Medilink who spoke about various aspects of cigarette smoking. The following are excerpts from the interview.

H,B&M: Is smoking merely a habit or is it an addiction?

Dr YK: Smoking is an addiction. In the beginning it is a habit but gradually this habit becomes an addiction, reason being its pleasurable effects which slowly increase smokersí dependency on cigarette.

H,B&M: Does smoking have any real health benefits?

Dr YK: Well, if there are any, I am sure they are so miniscule that the benefits can not outnumber the dangers associated with smoking. I categorically say that smoking is not beneficial but is indeed, injurious to health.

H,B&M: Is quitting smoking as easy as it sounds? What kind of emotional or physical problems does one experience when one gives up smoking?

Dr YK: No, it is not so easy. In fact, no addiction or old habit is easy to break. If doctors give proper counselling to smokers, their counselling could help them gradually reduce their reliance on cigarette and finally quit.

Initially, when smokers try to quit smoking, they have strong bouts of craving for a smoke and feel uneasy and restless as a result of suppressing the craving; some do not have a bowel motion while others complain of uneasiness and lack of concentration. These problems occur as a result of the fixity that certain body organs develop on cigarette smoke.

H,B&M: What are some of the most common diseases associated with cigarette smoking?

Dr YK: The 44,000 chemicals present in cigarette smoke could cause a number of diseases, most common of which are the diseases of the heart, lung and brain. Long-time smokers run the risk of suffering from Chronic Bronchitis, COPD (Chronic Obstructive Pulmonary Disease), coronary heart disease and hypertension.

H,B&M: What are the benefits of quitting smoking?

Dr YK: There are manifold benefits of quitting smoking. Quitting helps smokers reverse changes in different organs of the body, improve lung function and lung capacity, lessen respiratory problems and reduce chances of coronary hear diseases. Smoking often becomes the cause of prolonged coughing; quitting smoking could help people get rid of persistent cough.

H,B&M: Is physical and psychological dependency on cigarettes a medical condition, requiring counselling or treatment?

Dr YK: As I said before, smoking is an addiction, which affects the hippocampal region of the brain. There are receptors in the brain which become dependent on nicotine (an addictive chemical in cigarette), and when the nicotine levels reduce, the person gets the craving to smoke to feed nicotine to the brain. This dependency on cigarette requires both counselling and treatment.

H,B&M: Why do smokers often fail their attempts at quitting despite their wish to quit?

Dr YK: There are many reasons why smokers can not successfully quit smoking. The absence of anti-smoking clinics in Pakistan, lack of follow-up by the social support system, lackluster interest of physicians in forcing smokers to stay quit and weak will power of smokers are some common factors that contribute to smokersí failure to quit.

In my opinion, the primary driving force could be the physician. They should conduct PFTs (Pulmonary function test) of smokers to show them tangible results of smoking on their lungs and tell them how well their lungs could work if they quit.

H,B&M: Tobacco control policies laws exist but are not enforced in Pakistan. What steps would you recommend to the government for effective implementation of these laws?

Dr YK: It is true that government earns plenty of revenue from tobacco companies. A responsible government, should, however, think not of immediate gains but the cost of disease burden on the nation.

Being a developing nation, we can ill-afford the economic burden of diseases associated with cigarette smoking. Government should recognise the disease burden and educate people about the health risks of smoking. The government should stop tobacco advertisements, and also ban smoking in public places, which they have done to a large extent. Government should also consider increasing excise duty on tobacco products to make them more expensive for a large majority.

H,B&M: What are the responsibilities of healthcare professionals in reducing smoking prevalence in Pakistan?

Dr YK: First of all, health professionals should create awareness amongst people about the hazards of smoking; then comes proper counselling of patients and their families and recommendation of medical treatment to overcome the addiction.

H,B&M: How far, in your opinion, do socio economic pressures contribute towards smokersí failure to quit? How can a smoker fight off these challenges in his/her quitting journey?

Dr YK: There is no denying the fact that social economic pressures exist. Smoking is viewed as a means of escape from the problems of life. People are inclined to take an easy route to release tension and stress through smoking rather than using other useful means. Smokers should understand that cigarette smoking is not a necessity; it is a useless luxury that adds to their financial burden. They should seek other forms of relaxation, such as recreational activities, sports etc. Also, smokers should exercise their will power and avoid surroundings where they are more tempted to smoke.

H,B&M: What kind of medical support is available for motivated quitters in Pakistan?

Dr YK: Until a few months back, the only option one had was an anti-anxiety drug (Zyban) which controlled the craving and replacement of nicotine through gradually reducing the need by using nicotine chewing gum or nicotine patches. Now there is another powerful anti-smoking drug (Chantix) which acts directly on the brain receptors affected by Nicotine, ìdisplaces nicotine but does not produce the same pleasurable effects of smokeî and therefore addiction is reduced.

H,B&M: What advice would you give to smokers who have smoked for the most part of their life and think that quitting at an older age will not benefit them?

Dr YK: I will say that quality of life is more important than quantity. Smokers should seriously think about quitting smoking, regardless of their age. They should look at their PFT, lung function test and ECG to see how seriously they need to quit smoking. The best part is that most of these changes can be reversed and quality of life could improve.