How to give up tobacco and focus on harm reduction?

Mr. Dhaval Gogate from Council for Harm Reduced Alternatives (CHRA) has shared some effective tips to give up tobacco. Read on to know more.
Health & Fitness,tobacco,harm reductionHow to give up tobacco and focus on harm reduction?

Tobacco use is predominant in India with an estimated 300 million Indians using some form of tobacco. That is more than the population of Pakistan and on its own will stand out as the fourth largest country by population in the world. Everyone knows how tobacco affects our health, with people getting hypertension, diabetes, COPD and fatal cancers over time. Quitting tobacco is the best way out; however, that is easier said than done. People start tobacco use for multiple reasons and varied factors can overlap to create a complex emotional state.

It is the nicotine in tobacco that is addictive, and nicotine by itself is not carcinogenic. It is the other chemicals in tobacco that cause the most harm. The consumption methods determine the damage caused to the body. Cigarettes and bidis which burn tobacco leaves are the most harmful, and while khaini is less harmful as there is no combustion, it is also deadly because of various carcinogenic substances mixed in it. Let us look at how we can give up tobacco use or reduce the harm caused to our bodies. Either quitting completely or moving to a safer alternative will remove or reduce the harm caused, respectively. 

Safer nicotine alternatives are the middle ground between abstinence and tobacco consumption and can be a viable option. Some people report an increase in their low-density lipoprotein (bad) cholesterol with nicotine use; and it is usually the body’s reaction to nicotine. Quitting completely will reduce bad cholesterol.

The top choice is abstinence or quitting completely. It takes a lot of willpower and determination to quit cold turkey and thus this is the least popular method. Smokers have used this method at least once and most of them have not been successful at quitting. Our routine, the places we visit and friends we hang out all trigger our consumption, and thus a lot of willpower is required for abstinence.

I know some people who quit during the coronavirus quarantine but are now back to smoking as they returned to their normal routine. Some people use nicotine gums or patches to satisfy their cravings. Many nicotine gums are available as over-the-counter medications in pharmacies and are guaranteed to reduce harm. You can also use snus, which is pasteurized tobacco, as an alternative since it is significantly less harmful than smoking and Indian forms of smokeless tobacco such as khaini, gutka, zarda, etc. 

Tobacco-free snus is a better alternative as it does not contain tobacco. This snus is made of cellulose fibres and nicotine and flavourings and is seen as a safer alternative to smoking. In October 2019, the US FDA approved Swedish snus as a modified risk tobacco product, meaning snus can be marketed as a safer alternative to smoking. 

A month prior, unfortunately, India banned electronic cigarettes. Electronic cigarettes or vaping devices are also a safer alternative to smoking; and many countries such as the United Kingdom, New Zealand and Canada incentivize vaping over smoking. E-cigs are available in pharmacies in the UK and Canada.

It will take some time for you to adjust to this new consumption method; and I would suggest you give a sincere effort for three weeks at least. Each method has advantages and disadvantages so choose any method that works for you. If one method does not work, move to a new method. Most importantly, keep an open mind and do not give in to temptation.

Increase your physical activity too during this phase. Exercise releases endorphins, the pleasure and reward hormone, which nicotine also does. It is this increased endorphin level that your body desires, and thus increasing your physical activity helps in reducing nicotine cravings.

Remember, there are people out there who have quit tobacco, and you can do it too. Keep a count of how many days you have been free from your tobacco habit, and reward yourself for every fortnight of being free from it. We can always make a better choice, and this is one choice you will love to make. Best of luck!

By Mr. Dhaval Gogate from Council for Harm Reduced Alternatives (CHRA). He is a tobacco harm reduction advocate and works on healthcare analytics that improves clinical quality outcomes.

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