There are nearly 12 crore smokers in India. Around 10 lakh deaths per year in India are attributed to smoking related diseases. In India, smoking is 10 times more in males than females. 24 percent children below 16 years of age have used tobacco in some forms.

 Important risk factors for smoking initiation are:

1. Friends who smoke
2. Parents who smoke
3. Other risk factors are lower socioeconomic status, lack of education, sensation-seeking, rebelliousness, receptivity to tobacco ads, film exposure

Benefits of quitting Tobacco Smoking of any form are reduced rate of heart attacks, reduced mortality in COPD, reduced incidence of lung cancer, improved mental health and reduced anxiety and depression, improved quality of life and survival.

Indian studies show that 70 percent of smokers want to quit, but a meagre 2 percent succeed. Social reasons, insufficient policy support, lack of alternative therapies, lack of briefing by clinicians at primary level may be the reason.

How to quit smoking

Smoking tobacco is both a physical addiction and a psychological habit. The nicotine from cigarettes provides a temporary and addictive high. Eliminating nicotine causes the body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, many smoke as a way of coping with stress, depression, anxiety, or even boredom.

For many people, an important aspect of giving up smoking is to find alternate ways to handle these difficult feelings without turning to cigarettes. Even when cigarettes are no longer a part of life, the unpleasant experiences that prompted smoking in the past will remain. So it’s important to think of different ways to deal with stressful situations and the daily irritations.

Tips for avoiding cigarette craving:

Alcohol: Many people smoke when they drink. Try switching to non-alcoholic drinks or drink only in places where smoking is prohibited. Alternatively, try snacks, chewing gums.

Other smokers: When friends, family, and co-workers smoke, it can be doubly difficult to give up or avoid relapse. Talk about your decision to quit so people do not tempt you to smoke.

End of a meal: For some smokers, ending a meal with a cigarette becomes habit. Try replacing with something else, such as fruit, healthy dessert, chocolate.

Reward yourself: Whenever you triumph over a craving, give yourself a reward to keep yourself motivated.

Coping with cigarette craving:

Find an oral substitute like mints, carrot or celery sticks, gum.

Keep your mind busy by reading a book, listen to music,do a crossword or Sudoku puzzle, or play an online game.

Drink water – Slowly drink a large glass of water. It helps the craving pass, and helps in  hydration.

Get active – Go for a walk, do some jumping jacks or push ups, try yoga stretches, or run around the block.

Go to places where smoking is prohibited – Step into a public building, store, mall, coffee shop, or movie theatre, religious place.

Common nicotine withdrawal symptoms include:

Cigarette cravings

1. Irritability, frustration, or anger
2. Anxiety or nervousness
3. Difficulty concentrating
4. Restlessness
5. Increased appetite
6. Headaches, Insomnia
7. Tremors
8. Increased coughing
9. Fatigue
10. Constipation or upset stomach
11. Depressio

  Medication and therapy to help you quit

There are many different methods that have successfully helped people to kick the smoking habit. While you may be successful with the first method you try, more likely you’ll have to try a number of different methods or a combination of treatments to find the ones that work best for you as decided by Clinician.

Smoking cessation medications can ease withdrawal symptoms and reduce cravings. Two types of therapies are available.

1. Nicotine replacement therapy. Nicotine replacement therapy involves “replacing” cigarettes with other nicotine substitutes, which relieve some of the withdrawal symptoms by delivering small and steady doses of nicotine into your body without the tars and poisonous gases found in cigarettes and helps to focus on breaking psychological addiction.
2. Non-nicotine medication. These medications help you stop smoking by reducing cravings and withdrawal symptoms without the use of nicotine.
3. Alternative therapies. There are several measures that can be adopted to stop smoking. These include hypnosis, acupuncture, behavioural and motivational therapy.

What is e-cigarette?

It eliminates the tar and toxic gases found in cigarette smoke, so is less dangerous than smoking conventional cigarettes. However, there are some concerns with e-cigarettes:

• The liquid used in e-cigarettes contains nicotine which has many negative health effects, including high blood pressure and diabetes.
• The nicotine from e-liquid is especially dangerous to the developing brains of children and teens.
• E-liquids may contain flavoring agents that can cause chronic lung disease.
• Some vaporizers can generate significant amounts of toxins such as formaldehyde.

(Writer Dr Latha Sharma is consultant pulmonologist, KIMS Hospitals, Secunderabad. Views expressed are a personal opinion.)

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