Dear Doctor,

I understand that smoking is wrong for my health and society too has no kind words for 26-year-old girls who smoke. So I decided to quit, the problem is that it takes more than a decision. I have been smoking since I was in high school, (about 10 years) and developed an addiction. The last time I tried to quit, I only managed to be cigarette free for about two days.

Among the challenges I have is that at times when I am worked up or anxious, it is only a cigarette that can make me feel better.

I have tried advice in self-help books but they do not seem to work. I desperately need your advice.

Annette

Dear Annette

It seems you are hopelessly addicted to smoking. You yourself have stated that when worked up or anxious you feel like smoking, for example you feel relaxed after smoking.

Nicotine is the addictive substance present in tobacco which causes both physical and mental dependence. The smoke itself is harmful and contains more than 1000 chemicals which are detrimental to health. Tar present in the smoke causes permanent discoloration of lips, mouth, teeth and nails thus spoiling one’s looks. Smoking is implicated in causing lung cancer and other types of cancers, chronic bronchitis, abnormal sensations in legs and painful cramps, high blood pressure and heart problems. It also deprives the body of essential nutrients and vitamins.

To quit smoking, first, one needs to have a strong determination to do so. Professional counseling if sought is very helpful in this regard. A counselor explains the harmful effects of smoking and what the benefits of quitting smoking are. This itself serves as motivation for quitting.

If someone addicted to smoking stays without it for 24-48 hours or, so he/she develops withdrawal symptoms.

One may experience agitation, restlessness, trembling, and lack of sleep, among other things. Symptoms become so troublesome that one has to take up the cigarette again. Anxioyltic drugs, tranquilizers, anti-depressant drugs like Bupropion, etcetera, are used to help overcome these troublesome symptoms.

Nicotine replacement therapy (NRT) is used to help one give up smoking. This includes giving nicotine in very small amounts in other forms rather than a cigarette to smoke. Thus low dose nicotine satisfies the craving for it, whereas the risk of adverse effects produced in body is reduced. Inhalers, transdermal patches, sublingual tablets are some of the forms in which nicotine is used in NRT. Thus gradually a person reduces dose of nicotine consumed and may give it up eventually.

Keeping busy and not allowing the mind to be distracted towards tobacco, is also a good strategy to quit smoking. The moment an individual develops a craving for smoking, he/she can keep occupied with work, which can be reading, cleaning, sewing, anything for that matter.

Gradually as the time for smoking reduces, the desire vanishes too. Gradually with practice, there may no longer be any craving left for smoking. Eating something nutritious like peanuts when one has a desire to smoke is also useful. Avoid going in situations which may tempt you to smoke again or places where cigarettes are easily accessible like parties and pubs.

Drinking enough water is good for your health and it also aids in quitting smoking. Eating a healthy nutritious diet helps one to overcome this addiction and is useful in regaining health lost due to smoking. Regular physical exercise is also useful. Breathing exercises like yoga in particular help one to overcome the craving to smoke.

Giving up smoking is not impossible. One can adopt one or more of the necessary measures and shall surely be able to quit it.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.