Smokers most prone to relapse due to strong psychological dependence
As another World No Tobacco Day is observed on Thursday, the ‘land of beedi makers’ struggles to grapple with the containment, handling and the reduction of nicotine addiction.
While many believe there is a positive trend with the reduction of tobacco users, the number of people still in the nicotine net is still a concern.
Medically, the most apparent condition in chewing tobacco starts in the oral cavity, while for smokers it is the respiratory system that gets affected; and, with eating habits and sedentary behaviour increasing, cancers are increasingly being seen in young people, said Murali Mohan, a dental surgeon.
“Before, oral cancer was the fourth most common cancer among the elderly. Now, it is number one. And, due to a change in eating habits, oral cancer is steadily being seen among the youth,” he said.
While, chewing tobacco is less prevalent here than in other parts of the country, Sudhir Prabhu, Assistant Professor, Father Muller Medical College, said that culture of beedi consumption is equally dangerous. “There is a myth that beedis are natural, and not harmful. But, because they do not have filters, they are much more carcinogenic and lead to cancers at a faster rate than cigarettes,” he said.
With nicotine, carbon monoxide (from smoking cigarettes and beedis) and carcinogenic chemicals (in gutka) entering the body with every puff and satchel, Ramesh Holla, Assistant Professor, Kasturba Medical College, Mangalore, said the nearly 50 carcinogens in tobacco consumption can cause most types of cancers and nearly affect the whole body.
While smokers are seen commonplace on roads, in balconies and terraces, there are very few who end up in a de-addiction centre.
Hilda Rayappan, director of the Prajna Counselling Centre, said the number of tobacco addicts that have come to the centre are very few, putting the number at just 50 since the centre opened in 1987.
“People think a tobacco addiction is not a big thing to have,” she said, adding that nicotine addiction – especially here – does not get severe societal reproach, unlike other forms of addictions.
Nicotine de-addiction was difficult, she said, with no real treatment available. While alcoholism and drugs addictions have definite de-addiction steps, Ms. Rayappan said: “Nicotine withdrawal has not been studied much. Perhaps, it is because of lobbying. Nobody talks about it.”
Smokers are most prone to relapse due to the strong degree of psychological dependence.
“When a smoker stops, there is an intense urge to restart. As soon as the smoker quits, the body’s protective mechanism ensures there is coughing to cleanse the system. The smoker starts to believe that smoking again will stop the coughing and relapses. This is very common,” said Dr. Prabhu.
He believed the best to quit was on their own, with positive motivation, instead of using nicotine patches or chewing that only suppresses physical pain while the psychological urge continued.
There is a silver lining in the fight against tobacco. With numerous State-sponsored and private campaigns against tobacco, Ms. Rayappan believes the youth is far more hesitant taking up tobacco than the previous generation. “It has come down drastically when compared to a few decades ago. There is an educated community, and fear is strong,” she said.
Concurring with her Dr. Mohan said: “Awareness is being created and things cannot change overnight. But, the trend is in a positive direction.”
Whether it is in front of Cascia High School in Jeppu, or the Zilla Panchayat Higher Primary School (right next to the Pandeshwar station), Aloysius PU College, Besant College, or numerous other educational institutions in the city, it isn’t uncommon seeing shops selling cigarettes, gutka products in front of them.
The Cigarettes and Other Tobacco Products Act, 2004 (popularly called COTPA), which was approved four years ago, was supposed to control the advertising and availability of cigarettes near schools. However, most policemen do not seem to be aware of this. When asked, a senior policeman responded: “We have other duties like court, escort, crime, and bandobasts. Which policeman in the city has the time to implement all the laws… there are so many of them.”
This translates into pitiable figures in the implementation of the Act, and other Acts to curb tobacco consumption. This year, just 27 cases have been registered by the city police. Though the figure is low, it is an improvement over the 12 cases registered last year, and just 5 recorded in 2011.
Though denying a lack of awareness, Mangalore Police Commissioner Manish Kharbikar struggled to put a finger on the low number of cases. “It is insufficient. I will look into it, and discuss with my officers,” he said.