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.

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. 
Marketing campaigns are shown in the movie theatres at the beginning of movies which depict the hazards of tobacco
Smoking is banned in most public areas, and warnings are on display.
Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
Schools and colleges do not have tobacco selling within 100 meters of the campus.
The price increase ensures that not everybody has easy access to cigarettes.
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. 

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

Smoking   Some Naked Facts!

Smoking kills > 420,000 people per year worldwide.
In India one million people die of smoking related diseases each year.
Tobacco use is the second leading cause of death world-over.
Smoking is more lethal than AIDS, Accidents, Homicides, Suicides, Fire, etc.
2700 substances have been identified in Cigarette smoke, most of them harmful including cyanide, benzene, formaldehyde, methanol, acetylene, ammonia, nitrogen oxide, carbon monoxide, etc.
Every cigarette takes 5.5 minutes of your life.
Smoking one packet a day for 10 years increases risk for Ischemic Heart Diseases by 300 % & risk for lung cancer by 500 %.
Passive smoking (breathing second hand smoke) is also harmful. Spending 2 hours in a smoky bar is equivalent to smoking 4 cigarettes. Living with a pack-a-day smoker is like smoking 3 cigarettes by yourself.

What are the Risks? 

Cancer: 85% of Lung Cancers and 28% of all cancer deaths are attributed to smoking. Smokers have higher rates of leukemia, kidney, stomach, bladder, and pancreas cancers. About 30% of cervical cancers have been attributed to both active and passive smoking.

Lungs: Smokers are generally at higher risk for nearly all major lung diseases like pneumonia, flu, COPD, bronchitis, emphysema, asthma, etc.

Brain: Smokers run almost two and a half times the risk of stroke as non-smokers and the risk for dementia is also higher in smokers.

Male Sexuality and Reproduction: Smoking decreases the amount of blood flowing into the penis, reduces sperm density, reduces sperm motility, and may lead to impotence & infertility

Female infertility, Pregnancy: Smoking increases the risk of female infertility, ectopic pregnancy, miscarriages, stillbirth, prematurity and low-birth weight, so also there is a risk of passing genetic mutations that increase cancer risks to unborn babies.

Children: Mothers exposed to smoke (active or passive) are more likely to have children with motor control problems, perception impairments, and attention disabilities. Exposure to smoke early on affect the lungs of infant as early as the first 2 to 10 weeks of life, it increases the risk for lower respiratory infections (asthma, bronchitis, and pneumonia) by 50% and worsens the condition of children who have existing asthma.
 
Spine & Bones: Smokers whose jobs involve lifting heavy objects are more likely to develop low back pain than non-smokers. They are at increased risk for developing osteoporosis and rheumatoid arthritis. Smokers are more prone to develop degenerative disorders and injuries in the spine, they have more trouble recovering from spinal surgery as smoking also impairs formation of new bone.

Why Quit?


Physical Benefits: They start as early as in few minutes.

Blood pressure and Pulse rate return to Normal in 20 minutes.
Levels of carbon monoxide and oxygen in the blood return to normal in 8 hours and chance of heart attack decreases in 24 hours.
Nerve endings start to regrow; ability to taste and smell increases within 48 hours.
Bronchial tubes relax; lung capacity increases by 72 hours.
In 2 to 12 weeks  time circulation improves and lung functions improve up to 30%.
In 1 to 9 months  time there is a decreased incidence of coughing, sinus infection, fatigue, and shortness of breath; cilia in lungs start re-growing, increasing the ability to handle mucus, clean the lungs, and reduce chance of infection.
Overall energy level increases.

Smoking - Facts, Risks & Why To Quit!

Smoking is a die hard habit and many people eventually die of the same. It remains one of the most common causes of cancer and lung diseases, which eventually lead to death. The irony is that almost all smokers know the harmful effects, but find it hard to quit. With a firm determination, there are people who quit, but then the relapse rate is quite high too.
Many believe that quitting requires a behavioural change. From peer pressure to a lifestyle habit, smoking is a social phenomenon. There are various methods to help quit smoking like quitting cold turkey and nicotine substitutes. Hypnosis is also gaining popularity as a method to help quit smoking. Research has shown an encouraging success rate in the range of 30 to 40% in cases where the desire and commitment to quit are high. This of course is with people who have strong will and are able to be hypnotized.
Hypnosis or hypnotherapy is a psychological technique used as supplemental therapy in a lot of cases, such as weight loss, depression, speech disorders, pain management, de-addiction; the list can be quite long.  It puts the person undergoing therapy into a deep sleep or trance, where they get in touch with themselves and find answers to a lot of questions. It is believed that while hypnosis puts a person to sleep, it also induces a higher level of cognition and a higher level of neurological activity. 
'During the actual session, the smoker is asked to imagine the numerous ill effects of smoking and the need to reduce its harmful effects on the body. This improves the willpower to quit smoking and reduces the desire. They are also advised of the benefits of quitting smoking, including longevity of life and better quality of life. The person is told that quitting smoking before 50 years of age gives a 50% chance of increasing the lifespan by 15 years. Now that is quite motivating for a lot of smokers to give up the habit.
It generally takes about 4 full sessions of hypnotherapy to reach a level where the patient is ready to kick the habits. Also, self hypnosis can be taught where the person can go into hypnosis on his own and enforce smoking cessation. There are even self hypnosis tapes that are available for aid.
However, a word of caution here, hypnosis is not for everybody as not everybody can be hypnotized easily and there has to be a strong belief that it will benefit, only then can smoking cessation be tried with hypnosis. It is still in the testing phase and is to be medically proven as a way to quit smoking.

Hypnotherapy In Smoking Cessation

The consumption of tobacco by humans began many years ago and has taken many forms ranging from rolled tobacco leaves and pipes to cigarettes. Smoking is a habit that is easy to start, but is difficult to quit. Smoking has both short term effects such as bad breath, tooth and gum loss, premature ageing and weakened immune system and long term effects that impair the respiratory system and cardiovascular system. 

Smoking can cause and worsen diseases like cancer of lungs, throat, mouth, kidneys and blood and other chronic obstructive pulmonary diseases. Smokers also have a higher risk of conditions such as dementia, cataract, pulmonary fibrosis, psoriasis, osteoporosis and optic neuropathy. Smoking can also affect fertility, cause erectile disorders and speed up the onset of menopause.

It is said that a smoker s life expectancy is 10 years less than that of a non-smoker. There are three main components of cigarette smoke that can harm the body.

Nicotine: Nicotine is what makes cigarettes addictive and make smoking a habit. In the beginning, it may stimulate the brain but in the long run, your body can begin to crave for nicotine. If this craving is not fulfilled, it can cause irritability, restlessness, headaches and shortened attention span.
Tar: Tar in cigarettes contains many harmful chemicals and is deposited in the lungs. From here it enters the blood vessels and is carried to other parts of the body. In many ways, tar is akin to a poison.
Carbon monoxide: Carbon monoxide affects the blood s capacity to transport oxygen from the heart to the rest of the body. In the case of pregnant women, carbon monoxide can also reduce the amount of oxygen available to the growing foetus and hence cause complications in pregnancy. Children born to smokers are also said to have an increased risk of suffering from congenital defects and conditions like asthma.
The good news is that quitting it is possible and its benefits can be experienced right away. Within the first 72 hours of quitting, the bronchial tubes begin to open up and breathing becomes easier. If you stop smoking before the age of 50, you can reduce your risk of dying from smoking related complications by 50%. The most important part of quitting nicotine is your own determination and willpower. Nicotine replacement therapy in the form of gums, patches, lozenges and inhalers can also help deal with nicotine withdrawal symptoms and make the process easier.

Smoking - A Slow Poison?

7 dangerous things that smoking does to your skin

Most people think that having a smoking habit adversely affects only the lungs and the heart. But apart from known links to lung cancer and heart disorders, smoking also causes skin damage. The intensity of damage is directly proportional to the number of cigarettes one smokes in a day and the number of years one has been smoking for.

Here are 7 of the horrible things that smoking does to your skin

1. Premature ageing: the process of skin ageing is accelerated by a smoking habit. The chemicals that are ingested through the smoke cause your skin to age much faster, making it look loose, dull and coarse, with uneven colouring. Most smokers have a muted orange or grey tinge to their complexions.

2. Wrinkles and lines: the nicotine from smoke constricts blood vessels in the outer layers of the skin, thereby cutting off the supply of oxygen and nutrients. This causes the skin to develop visible fine lines and wrinkles at a faster rate.

3. Scarring and pigmentation: since blood is not flowing properly to the outer layers of the skin, it is more susceptible to broken capillaries and veins, which can cause dark scarring and pigmentation on the face and other areas.

4. Darkening of the lips: constant exposure to heat from smoking causes stark darkening and pigmentation in the lips, which also become dry and coarse.

5. Delayed wound healing: the presence of nicotine, tar and other chemicals in the blood causes cuts and wounds on the skin to heal at a much slower pace with an increased risk of infection, blood clot formation and death of skin tissue.

6. Increased risk of skin disease: smoking makes the skin prone to various diseases and conditions like psoriasis, which happen as nicotine adversely affects the body's immune system.

7. High chances of skin cancer: skin cancer and oral cancer are the two lesser known variants of the diseases that can be caused by smoking. Skin cancer is far more common among smokers than among non-smokers.

The harmful effects of smoking on the skin are not entirely discernible until after 10 years of prolonged smoking. Fortunately, your skin starts to heal itself when you kick the habit.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: E-cigarettes : Good Or Bad?

7 Dangerous Changes that Smoking Causes to Your SKIN

Ready to Quit? Then Expect this!

Withdrawal Symptoms: Be aware that the withdrawal symptoms may begin as soon as four hours after the last cigarette, generally peak in intensity at three to five days, and disappear after two weeks. Withdrawal

Symptoms can be

Physical like Headache, tingling in the hands and feet, sweating, gastro-intestinal (cramps, nausea) and/or Mental like tension, craving, anxiety to withdrawal, feelings of dependency, temper tantrums, irritability, intense needs, , insomnia, mental confusion, strong emotional and mental responses like feelings of being an infant.

Plan to Quit:

Before you plan to quit, ask a few questions to yourself like,

Do I really want to stop smoking?
What is holding me back?
What are the Real problems/excuses?
Do I accept that there is no miracle cure?
  Be clear about your reason &amp; readiness to stop.
  Draw up an action plan.
  Set a date and stick to it.
  Plan what you will do instead of smoking.
  Give up completely.
  Don t allow even a quick puff.
  Make quitting number one priority.
  Particularly in the first crucial week.
  Plan it with your friends, agree to support each other and make a pact not to let each other down.
  Make sure all cigs are destroyed.
  Get rid of all smoking reminders.
  Stay away from people who smoke.
  Keep busy.
  Pamper yourself.
  Decide what you are going to do with the saved money and put it aside.
  Try to avoid danger areas.
  Find activities that focus the hands and mind but are not taxing or fattening: computer games, solitaire, sewing, crossword puzzles, etc.
  Set quitting goals on a day to day basis and reward yourself when they are met.
  Think repeatedly about the advantages of quitting.
  Do deep breathing exercises.

Intense Cravings:

When the cravings become uncontrollable, try these 5 D s
  Delay
  Deep breathing
  Decide
  Drink water
  Do something else

Pharmacological Agents:

Your physician can prescribe you one of the following treatment options to help you quit.

Nicotine replacement in the form of Nicotine patches, gums.
Medication like Bupropione hydrochloride (Zyban) and Verenicline,(Champix)
Always Remember: MOTIVATION IS THE ONLY KEY TO SUCCESS !

Quitting Smoking - Know Everything About It!

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