World No Tobacco Day - Making An Effort To Control Tobacco Usage!

When man first started using tobacco, he probably did not know that it would grow to be an epidemic that could cause multiple health issues. Be it smoking or chewing, tobacco has severe negative effects on health. Take any of the current lifestyle diseases from diabetes to obesity, the common risk factor is tobacco abuse. In addition, depending on the form of tobacco used, specific organs are affected. For instance, chewing tobacco leads to oral cancer while smoking causes lung cancer.

The statistics around tobacco abuse are extremely startling and can be read below:

• A total of about 90 trillion rupees are spent on various tobacco products.
• About 1.4 trillion is spent on healthcare-related to conditions caused by tobacco abuse.
• India has about 120 million tobacco users.
• More than 7 million people die every year due to tobacco usage.
• The Government has levied a GST of 28% on cigarettes, making them unaffordable, which is one of the ways to promote quitting.
• For those who want to quit but are not able to, there is a quit-line setup, which is toll-free, 1800-11-2356 and is accessible from 8 a.m. to 8 p.m.

Tobacco is a menace in all the strata of society. The lower economic classes are adversely affected both due to lack of knowledge and healthcare facilities. Therefore, the government uses the World No Tobacco Day (WNTD) that is observed by all members of the World Health Organization as an opportunity to drive this awareness.

This is celebrated on May 31st every year. Some measures that are taken to promote 'say no to tobacco' campaign are listed below.

1. In 1975, the Cigarettes (Regulation of Production, Supply, and Distribution) Act was introduced, which made it mandatory for cigarette packs to have a warning stating “Smoking Kills” or “Smoking is injurious to health.”
2. Marketing campaigns are shown in the movie theatres at the beginning of movies which depict the hazards of tobacco
3. Smoking is banned in most public areas, and warnings are on display.
4. Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
5. Schools and colleges do not have tobacco selling within 100 meters of the campus.
6. The price increase ensures that not everybody has easy access to cigarettes.
7. Celebrities promote quitting tobacco and smoking by talking about their personal stories.

How can a healthcare professional help you?

A healthcare professional plays a vital role in a smokers life, as it the healthcare professional that can increase the odds of quitting with guidance, medication, and support. 

What should a healthcare professional do?

• Identify people who smoke 
• Motivate them to quit or think about quitting
• Refer a person who smokes for treatment and support
• Support ongoing abstinence

What is the right smoking cessation strategy?

• Ask: Every smoker to visit a healthcare professional
• Advice: Urge the smoker to leave smoking
• Assess: Assess whether the person is willing to quit in 30 days
• Assist: Plan and help Rx Quit
• Arrange: Arrange a follow-up through phone or SMS or in-person

What is that people who smoke need help with?

• First and  the foremost challenge are the withdrawal symptoms 
• Urge to smoke and borderline depression with a possibility of relapse
• People who have high pre-abstinence nicotine intake

How to get over the initial withdrawal discomfort?

• Behavioural support is of proven efficacy
  • Can be delivered in different formats
    • Face-to-face
    • Telephone
    • Internet
• Nicotine replacement therapy and nortriptyline are of proven efficacy

Facts On Nicotine Replacement Therapy (NRT)

• There are no real contradictions related to NRT
• No drug interactions 
• Side effects, if there are any are localized e.g.
  • Taste of oral products
  • Hiccups with the mouth spray 
  • Skin irritation with patch 

Treatment for quitting Nicotine  - Medications: Medicines which are useful adjuncts in the determined but unsuccessful quitters are Varenicline and Bupropion. 

Though smoking out in the open has reduced, there are miles to cover when it comes to eradication of tobacco.