Anti Tobacco Day - Begin your journey now.

Ever seen a loved one smoking and had this strong urge to stop them? Or your head swam with thoughts and worry when you saw your child use fancy vaping devices? Or been telling yourself that this new year resolution is to quit for the past three years, yet going back to it as soon as there’s ‘trouble’?

Smoking is an acquired habit and has quick psychological and bio-chemical benefits - it helps people to feel good quickly. It becomes a part of your everyday, making its way into your routine casually, giving you a way to cope with uncomfortable emotions like stress and boredom. What has to happen to change this is to break the automatic habit that links wanting to smoke to everyday routines - after meals, after waking up, while on the phone, while taking a break from work - to find another way of getting the same benefits of smoking.

Apart from affecting the lungs, tobacco smoking and other allied products can also be responsible for kidney cancers, diabetes, nasal cavity and oral issues, heart diseases, dementia, reduced fertility, fatal death, TB to name a few. While this is something people are definitely aware of, sometimes just the extent of it goes unnoticed.

Lets understand a bit more -

How does addiction come about?

There is a certain way that the brain responds to the nicotine present in tobacco. When a person inhales smoke through a cigarette or a cigar or any vaping device, nicotine reaches the brain in a few seconds. It improves the mood, focus and concentration, reduces stress and anger, relaxes the muscles tension and diminishes appetite. These are all pleasant feelings that make the person enjoy this behaviour. However it doesn’t last too long - regular doses of nicotine lead to changes in the brain. These lead to ‘nicotine withdrawal symptoms’ when the supply of nicotine decreases. So, during the act of smoking, the symptoms reduce temporarily, but are back at play soon enough causing it to become a vicious cycle and reinforcing the habit of smoking. This cycle is how most people become nicotine dependent.

Apart from the biological aspect, social and psychological factors also have a part to play. Peer circle, curiosity, parental attitude towards smoking, financial status, and other factors that cause stress make it likely for people to get into the habit of smoking.

Smoking and Anxiety :

The usual feeling is that smoking reduces anxiety. However, research has shown that instead of helping people to truly relax and be stress-free, it can increase anxiety and tension. The immediate sense of relaxation that is felt during the act of smoking is temporary, and it is quickly over ruled by the stress caused by nicotine withdrawal. In fact, studies have shown that teens who smoked are more likely to develop generalised anxiety as adults, and even cause episodes of panic. It is the factors that lead people to smoke in the first place, that need attention, especially if it is done as a way of coping with some stressor.

Smoking and Depression :

Statistics in the UK show that the rate of tobacco usage in adults having depression is twice s much as adults without depression. These people face a more intense withdrawal when they are not using nicotine, making it very hard to give up.

Dopamine is a chemical in the brain associated with positive feelings and mood. In persons with depression, the dopamine levels are found to be quite low. Nicotine stimulates the release of dopamine in the brain, and hence these people choose to smoke as a way of temporarily increasing the dopamine supply and feeling feelings of happiness. The cycle doesn’t just end here - the more you smoke, the more your brain learns to reduce its own supply of dopamine production - prompting people to smoke more.

The relation between depression and smoking is deep and complex, and studies as ambiguous about which leads to the other,

Smoking is also a tool for people having psychosis (schizophrenia and bi-polar disorder) to manage some symptoms associated with their illness and aid in temporary unease caused as side-effects to medicines.

The short term pleasant feelings that smoking provides are completely out weighed by the ill effects of smoking on physical and mental health.

Smoking Cessation :

Cessation plans, family support and the right time to try are all crucial in having a sustainable quitting experience. The change can only come about through introspection on your relation with smoking - how it affects you, what can be the benefits of giving up like fresher breath, better physical health etc., how it affects your loved ones etc. Writing it all down can serve as a reminder on days when quitting seems impossible.

Somethings to ensure before you begin your journey towards quitting :

- Finding alternate coping methods for stress

Getting support from family and friends

Avoid the triggers that link to smoking for you

Understadning and mentally preparing yourself early on for withdrawal symptoms

Therapy and group counselling support

Therapies that can be used :

The 5A method is the most sought after plan for tobacco cessation, along with which these alternative therapy models can be used.

Cognitive Behaviour Therapy -

If smoking or tobacco is used to cope with feelings of anxiety or depression, CBT treatments may be quite effective, as the treatment can be holistic and draw attention to the root cause of the mental problem. In fact, if the symptoms of anxiety or depression reduce, it may be less likely that the person will look for solace in tobacco. CBT can help in

identification of triggers that lead to tobacco use

relapse prevention techniques like relaxation methods, breathing

The right coping strategies to avoid smoking as a way to deal with stress

Motivational interviewing -

This is a completely patient focussed technique that urges people to explore and resolve the confusion that accompanies behaviour change through reflection and introspection. By making people see the difference between their current behaviour and values/goals, they can be motivated to sustain their abstinence from tobacco use.

Mindfulness training -

This method teaches people to increase awareness of the physical sensations they are experiencing, and practice detachment from them. This can alleviate the capacity to tolerate negative and unpleasant emotions.

In this article, we have tried to touch upon several factors related to tobacco use, especially through smoking. While the topic remains of huge concern, with a lot of literature, we hope that you have gained some insight into the cycle of smoking and its effects. This year on World Anti Tobacco Day, we urge you to wake up to the tobacco lobby by the big guns in the industry - look carefully at how they use enticing flavours to capture the youth market, attractive designs like USB’s for vaping devices, unproven claims of being “less harmful” or “better than” without scientific backing so the youth is easily swerved, influencers doing endorsements, creative and accessible product placements so the youth is definitely seeing it again and again.

This year, the WHO encourages people, especially the youth, to look beyond these gimmicks and learn to value their own physical and mental health.

Reach out to us, or any of these to help your family friends or yourself.

Some helplines in Pune :

1. Muktangan Rehabilitation Center- 02-26697605

2. Samyak Mental Health Care and De-addiction Center, Pune - 9823161661

3. Nityanand Rehabilitation Center, Pune- 020-24364424

4. Chaitanya De-addiction Center- 8087050441

5. Astha De-addiction, Pimpri Chinchwad, 9822191510

6. Nirman Psychiatric Nursing Rehabilitation and De-addiction, Lohagaon, Pune- 9096806320

7. Toll-free Helpline for Alcohol and Drug- Addiction- 1800 11 0031

- Urvi Chordia

Psychologist, Vidula Psychological Consultancy