On the World Anti Tobacco day (May 31, 2011), the media will be full of advice to the smokers from medical and other professionals. However, they adopt anintimidatoryapproach rather than anempatheticapproach. The former usually consists of creating a fear about reduction in age by about 10 years, getting cancerous diseases, loss of appetite and a gradual reduction in skill or efficiency in dealing with complex tasks.

The effectiveness of this approach is questionable as Oxford University researcher Brian Earp recently found out: ‘No smoking' signs have an ironic effect on smokers driving them to light up their cigarettes! This is a reaction to the advice which does not at all take into account the apparent advantages of smoking!

For example, nowadays people areNOTgenerally interested in continuing to live to a ripe old age! Most of them say: “I want to finish my duties to my family and kick the bucket as early as possible, say, around 60 years of age.” This is because unlike in the last generation, old people have very little voice in the affairs of nuclear families and find it difficult to adjust to the ways and demands of the younger generations.

Regarding the possibility of cancers, people are used nowadays to live with diabetes, blood pressure, arthritis, etc, so much so that cancer is another item added to the list of illnesses! If they are cured of it, O.K.; if not, to die around 60 (the age when many cancer deaths occur) is O.K. too!

Appetite loss? If may be seen as an advantage by the poor workers! They are less troubled by hunger after smoking their ‘beedies'!

What about the decrease in efficiency while dealing with complex tasks? Most of the people have only simple tasks to perform to which they have become habituated! So that is not a problem to be worried about!

Hence the need for anempatheticapproach which takes into account the biochemical mechanism of addiction to tobacco, withdrawal problems as well as the apparent advantages as perceived by the addicts.

The biochemical mechanism:as soon as the tobacco smoke is inhaled, within seconds nicotine goes into blood and to the brain. Its structure is similar to acetylcholine (a neurotransmitter) and so it fits on the surface of neurons (like a duplicate key). When 1.5 mg of nicotine accumulates, it triggers the secretion of adrenalin (which normally happens when one has to run or jump into quick action). Because of the consequent stimulation and blood flow to the brain, the smoker feels very energetic and clear-headed.

But after 30 minutes, the nicotine is ingested, and its concentration falls down. The energy falls down too. That jolts the smoker and tenses him up. He lights up the second cigarette. To avoid overstimulation now, cortisol (a stress regulator) and Beta endorphin (a pain-reliever) are released and a relaxed feeling grows in the smoker.

After about 60 minutes, more nicotine receptors are created in the brain in anticipation of the need to accommodate more nicotine molecules to come! (It is like bulging of the stomach due to over-eating: If normal eating is done, the extra space in the stomach gives a feeling of being half-empty and one is tempted to eat more).

The consequence is a similar feeling of a kind of emptiness in the smoker. So he lights up another cigarette! He feels normal now, i.e., when nicotine floods his neurons; and abnormal when it does not! He seems to perform better when smoking than when he is not! Actually, haemoglobin molecules are bound up by smoke-by-products and so only less oxygen is taken up by the blood leading to less energy to perform complex tasks!

It is a confidence trick by nicotine that it appears to do good in the beginning but at greater and greater cost to the health and economy of the smoker. And the withdrawal effects can be very trying.

In theempatheticapproach, therefore, we must empathise with the smoker and bring out (through films, video, etc., shown to groups of students and others) this cheating mechanism of nicotine's action. Then complement it with the exhibition of various health hazards of smoking and stop with that! No advice must be given!

Further, the psychological advantages of smoking for particular individual must be probed by psychologists:

A person, especially a student with inferiority complex (due to comparisons with peer group), may take to smoking to feel like a hero who in films tosses up a cigarette and catches it in his mouth! So the cigarette is vicariously making him a hero! In such cases, the cause of the complex must be unearthed and overcome suitably.

Perhaps, the smoker is psychologically boosting his ego by imitating the model in some such advertisement! Perhaps, he is frustrated in his office or family life and trying to ventilate his feelings through smoking, pooh-poohing his boss, father and father-in-law through blowing smoke in their faces in imagination! Such possibilities must be explored and their illusory nature must be exposed and more healthy alternatives must be pointed out to face their problems or their problem-makers.

He must also be taught to cope with nicotine withdrawal effects for at least one month. This approach may be slow but will bring about steady and sure results.

(The writer's email is: opvidyakar@gmail.com)

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