Wherever you travel in India, be it metro cities like Mumbai or Delhi, or the rural areas, one thing is common – a large part of the population is addicted to tobacco.

India is the second-largest consumer of tobacco. Over 300 million people in the country use tobacco regularly – either smoking cigarettes, beedies or chewing it raw in the form of khaini or gutka.

While the government tries to curb the consumption by employing several measures, including mass media campaigns and banning advertising of tobacco products, it remains a significant public health issue.  Lately, e-cigarettes (or vape pens) are also witnessing a massive demand amongst Indian consumers. Chewing tobacco has been part of rural lifestyles since ages.

The Global Adult Tobacco Survey 2 (GATS e2) 2016-2017 indicates that 232. 4 million adults in India use tobacco. These include chewing tobacco (khaini), beedi (cheroot) and gutka (tobacco mixture).

Indian government’s survey reveals alarming incidence of tobacco addiction – one in every ten adult smokes tobacco – 11.9% in rural and 8.3% in urban areas. Second-hand smoke is increasingly becoming a severe cause of concern in India.

Tobacco usage in India is an age-old practice; it can be traced back to 2000 BC and has become part of the cultural fabric of the country. It’s only recently that some anti-smoking campaigns are striving to bring down the consumption, but the scenario continues to be rather bleak. A large number of users do not realize the full impact of the habit on themselves.

Health hazards of tobacco consumption

Regular consumption of tobacco products can cause a variety of severe health issues. These include, but are not limited to, multiple types of cancer, cardiovascular diseases (CVD), chronic lung diseases, stroke, diabetes, tuberculosis (TB), infertility, blindness, erectile dysfunction – the list is endless. A recent survey conducted by the Tata Memorial Centre (TMC) indicated that nearly 10 lakh Indians die each year from tobacco-related diseases.

What is tobacco addiction?

Tobacco addiction is caused by a dependency on nicotine, a highly addictive chemical which is present in cigarettes, beedis, khaini, gutka and any other tobacco products. When you first start using tobacco, you may experience slight physical discomforts such as dizziness, nausea, or headaches. Some individuals like this ‘buzz’ and want to repeat it. However, as you begin to use tobacco regularly, these effects fade away, and your brain starts secreting the feel-good chemical called dopamine whenever you consume tobacco. The temporary pleasure generated by nicotine is the main reason for tobacco addiction.

When the pleasurable sensation wears off, the mind craves for another shot at nicotine. So, the deadly cycle of addiction continues.

The pleasurable ‘buzz’ created by nicotine is the body’s reaction to tobacco; however, in time, the consumers connect this sensation to their daily and social activities. So psychologically, they find it extremely difficult to quit in fear of breaking their routine.   Like other addicts, tobacco users then fabricate denial about their nicotine addiction.

How bad is tobacco addiction?

While most people may not consider tobacco as a drug, nicotine generates similar neurobiological effects as substances like cocaine, heroin and methamphetamine. However, since tobacco consumption has always been part of social culture, nicotine addicts do not realize the seriousness of their addiction. They continue their harmful habit because of denial, ignorance and social acceptance.

Increasing tobacco addiction in public spaces

Even a decade ago, a woman smoking in India was quite a rare sight, especially in urban areas. With changing societal norms and more financial independence of women, the number of female smokers has significantly increased.  A recent survey by Assocham Social Development Foundation among 2,000 women found that smoking among women in cities like Bangalore, Delhi, Kolkata, Mumbai, Hyderabad, Jaipur, Lucknow, Chennai, Ahmedabad and Pune, is rising sharply.  Moreover, hookahs and e-cigarettes have also become a trend among urban youth. Despite government-mandated restrictions on tobacco advertising, and messaging on the packaging, easy access to tobacco products is mainly responsible for increasing tobacco addiction

When should you seek treatment?

Most people don’t even accept that they have a problem with tobacco addiction until it gets too late. If you have made more than one unsuccessful attempt to quit smoking means you do have a problem. Or if your spouse or family member is objecting to your habit, it is an indication that it is an issue that needs to be addressed. Another sign of tobacco addiction is nicotine withdrawal symptoms. These may include craving, anxiety, irritability, restlessness, anger, increased appetite, constipation and sleep disturbance. If you experience these symptoms when not smoking, it is time to seek professional support. Do not depend too much on ‘will power’ – the power of addiction is much stronger!

Methods of treatment

Tobacco addiction can be treated successfully with the use of medication and counselling. The individual should be motivated and willing to stick to the advice of a doctor and therapist.

Nicotine Replacement Therapy (NRT) is a common method and easily accessible to anyone. Nicotine patches, chewing gum and lozenges help you gradually wean off the cravings. This method usually takes eight weeks. There is medication also available for curbing nicotine craving, available on prescription of a doctor.

Sometimes it is observed that tobacco users are struggling with mental health problems such as depression, anxiety, stress or issues related to childhood. In such cases, it is essential to address these underlying issues while treating someone with tobacco addiction. In such cases, behavioural treatments, including talk-therapy and group counselling sessions, can prove to be very useful for long-term resolution of tobacco addiction.

The Hope Nicotine Cessation Program

Hope Trust, a leader in addiction treatment since 2002, has a nicotine cessation program that is safe, scientific and confidential. The program consists of five sessions (physical or online) and includes an interaction with a psychiatrist to explore the option of NRT. By enrolling in the program, individuals have the support of world-class therapists who guide the individual through every step on the path of recovery.

The online option is especially useful for those who are reluctant to visit a therapist due to the stigma attached to addiction and is accessible to all from any part of the world. Call +91 90008 50001 or Email info@hopetrustindia.com for details.

While the government is doing what they can, we as individuals need to encourage our loved ones to quit tobacco and lead a healthier, more fulfilling life.