Tobacco cessation is essential to reduce the mortality and morbidity related to tobacco use. Studies have indicated that by 2050, if the focus is only on prevention of initiation and not cessation, the result will be an additional 160 million deaths among smokers.
Many smokers desire to quit, but only 30% try and only 3-5% actually succeed in quitting. Dr Shubha Maugdal, executive director, Cancer Patients Aid Association says, “As a part of our stated philosophy of Total Management of Cancer, we have initiated a Tobacco Cessation Centre to help those who wish to quit. The most important step in cessation is for the client to make the decision to quit.”
Dr Pankaj Chaturvedi, head and neck surgeon, Tata Memorial Hospitals says, “First and foremost the will power and determination to quit is needed and thereafter counselling helps in allowing them to stand by their decision.”
No two smokers or tobacco consumer’s reasons for taking up tobacco are the same. Hence, a singular approach cannot be used to help every tobacco user quit. It is extremely important to start from the root, and hence, behavioural therapy plays an important role.
Dr Maudgal says, “It is necessary to analyse why one has initiated tobacco use. Then his or her experience is probed and understood. The first stage of cessation requires counselling of the client to help them understand their physical and physiological needs for tobacco. Each client has a unique addiction and understanding the how, why, where of their habit and separating what is within their control and what requires medical intervention, helps the individual to gain control over their habit.”
A counsellor will provide the necessary psychological support required before quitting and during the process. The counsellor may also speak with the family members to help them understand the withdrawal symptoms and inform them on how to provide positive support.
Besides regular counselling sessions, it is important to explain to the smoker or tobacco chewer the dangers of smoking, the causal relationship with cancer, strategies used by tobacco industry for marketing in a scientific and non-threatening manner.
Dr Maudgal adds, “De-addiction sessions start by providing education on the deleterious effects of tobacco on health, benefits of quitting, motivation and introductory training on how to quit.” Subsequently, she says that a tailor made programme will be created depending on type of addiction, number of times and quantity of use and degree of personal commitment.
Mark Twain once famously said, “Quitting smoking is so easy. I have done it hundreds of time!” The chances of success are depressingly small and each failure leaves the individual further convinced that they cannot make it. To remain tobacco free is a daily struggle and at this stage it is useful to know that one is not alone.
Dr Maudgal says, “A support group of individuals who ha ve decided to take the step from one-on-one counselling to group mode should be created to reinforce the message and help those who have quit, to stay firm on their decision.”
Nicotine Anonymous is a fellowship of people who have been addicted to nicotine. Having found a way to live and grow without using nicotine, this program helps participants to share their experiences freely with all who wish to join. Nicotine is a subtle, yet powerful mind and mood altering substance. Many who have stopped using nicotine for years have found themselves overpowered by a compelling urge to return to it at any time. Therefore, it is useful to attend such regular meetings to avoid slipping back. The primary purpose of these meetings is to help others, and thus themselves, to a live free of nicotine.
Picture credit: BCCL