Dr Prakash C. Gupta, Director of Healis-Sekhsaria Institute of Public Health, has researched public health in India extensively over decades and shares with us his valuable opinions on tobacco use and cessation.
Scroll down to sign the pledge
The Age when it all begins
Even when it may be difficult to ascertain the age in which people start smoking, the mean age of initiating tobacco use in any form in India is determined at 17.8 years: 18 for males, 17.1 for females. For smoking, it is 17.9 (18.1 M, 14.7 F). For smokeless use, it is 17.9 yr (18.2 M, 17.1 F). These are mean ages, implying that 50% started under the mean age. (Source – GATS-India).
Factors Influencing Smoking
If one were to attempt at zeroing in on the factors that influence smoking, which is essentially a vast spectrum, the single largest factor would perhaps be environment. This is inclusive of the positive environment about tobacco use created by the tobacco industry through its advertisement and marketing, using all kinds of media: print, outdoor, point of sale, tv, films, internet etc, and promotional tactics like abundant vendors, incentives to vendors, low pricing, marketing of non-tobacco items (T-shirts, school bags, caps, stationary etc) with branding of tobacco products. It also includes tobacco use by parents, other family members, friends etc. Observing total strangers using tobacco also creates positive environment for use.
How to Counter Influence on Smoking
One of the best ways of countering would be to stop promotion of positive environment by tobacco control policies e.g. ban on tobacco advertisements, no smoking in public places etc. It would also help to create a negative environment e.g., No Smoking signs, warning labels on tobacco products, pro-health anti-tobacco messages in media etc.
The media campaigns and explicit pictorial displays on cigarette packets as well as smoking ban in most public places have certainly had a very positive effect globally. At one place, we can only observe combined effect of all policies. In India, recently released NFHS 4 (National Family Health Survey) results are showing a lower prevalence of tobacco use compared to NFHS 3 data.
Issues Related to Smoking
Even though the common perception is that Cancer is the most common outcome of smoking, in the West, many more people die due to heart diseases caused by smoking. The research in India has shown that very high number of persons die of tuberculosis due to smoking habits. The spectrum of diseases caused by tobacco is vast – it affects every part and every organ of the body. The disease burden on the family of the smoker is also considerable. We know that smoking causes early death among 50% of its users. Almost every smoker suffers from some or the other disease as a consequence of smoking.
Cessation
India is known to have one of the lowest rates of cessation globally. The single most barrier to cessation in India is the lack of public awareness of the disastrous effects of tobacco; and, among health professionals that they need to be actively engaged in cessation advice.
There are smokers who feel like great achievers after reducing from 20 cigarettes a day to 2-4 a day. But reduction as a step to complete cessation is one strategy – it is certainly not the most effective one. By itself, reduction itself offers little or no health benefit.
Quitting smoking is always a very difficult decision for hard core smokers. But some of the more effective methods of quitting may be taking a personal decision to quit, enlisting help of family members, friends, co-workers, setting a date for quitting and adhering to that. It is also important to remember in this respect that discomfort and cravings are temporary and would go away with time.
Cessation can also improve with a better enforcement of tobacco control policies. Of course, more awareness in general public and health professionals would help a great deal.
Smoking Kills. Quit Smoking - Find out why and how to quit Smoking
