Kick the butt now. It’s never too late to quit smoking | columns | Hindustan Times
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Kick the butt now. It’s never too late to quit smoking

In India, tobacco causes 100,000 deaths each year, leading to 1 in 20 deaths in women and 1 in five deaths in men.

columns Updated: Dec 18, 2017 12:51 IST
Sanchita Sharma
Studies show that people who began smoking as young adults but stopped before age 40 avoid more than 90% of the health risks of those who continue over the next few decades.
Studies show that people who began smoking as young adults but stopped before age 40 avoid more than 90% of the health risks of those who continue over the next few decades.

Tobacco is the only legal consumer product that, when used as intended, kills half of its long-term users.

With countries around the world adopting a slew of initiatives – raising taxes, announcing bans, enforcing smoke-free public spaces, graphic warnings labels and plain packaging – to lower tobacco use, the US Food and Drug Administration (FDA) on Friday announced a new roadmap for tobacco and nicotine regulation, to tackle its ‘devastating addiction crisis’ and better protect children.

Moving beyond warning labels and smoke-free spaces, the US FDA will lower nicotine in cigarettes to ‘non-addictive’ levels.

The FDA also delayed its regulation of additional tobacco products, such as e-cigarettes and flavoured vaping liquids, because it said it needs more time to set a comprehensive framework for regulation.

Both actions are aimed at striking an “appropriate balance” between regulation and the development of innovative tobacco products that are less dangerous than cigarettes, which delivers nicotine through smoke particles, which is the most damaging kind of delivery mechanism for the substance.

A typical cigarette contains between 0.5 gm and 1 gm of tobacco and, on average, 10 mg of nicotine, which, when smoked, reaches the brain within 7 seconds of inhalation. A typical smoker absorbs 1 mg to 2 mg of nicotine, with nicotine’s elimination half-life – the level in the blood halves after you stop smoking – being two to three hours.

Bidis, widely believed to be safer, are actually even more deadly than cigarettes. Nicotine concentrations in the tobacco of bidis (21.2 mg / gm) are significantly higher than the concentrations in manufactured filtered (16.3 mg / gm) and unfiltered cigarettes (13.5 mg / gm).

A typical smoker absorbs 1 mg to 2 mg of nicotine, with nicotine’s elimination half-life – the level in the blood halves after you stop smoking – being two to three hours.

Legal addiction

Tobacco use killed 6.4 million people worldwide in 2015, accounting for 11.4% of global deaths, reported The Lancet. It’s the second biggest cause of early death and chronic disease, show data from 195 countries.

Smoking also kills those who don’t smoke: exposure to secondhand smoke kills 890,000 non-smokers each year, estimates the World Health Organisation.

More than half of the smoking-related deaths (52.2%) in 2015 took place in just four countries -- China, India, the US and Russia. Based on population growth trends and current smoking patterns, annual tobacco-attributable deaths are expected to cross 10 million worldwide in a few decades, with most deaths occurring in low- and middle-income countries.

In India, tobacco causes 100,000 deaths each year, leading to 1 in 20 deaths in women and 1 in five deaths in men. The loss to economy from tobacco-related disease and premature death in India was a staggering Rs 104,500 crore in 2011.

Raising taxes, using pictorial warnings on products and banning advertising, smoking in public spaces and sale to minors helps lower tobacco use by reducing the number of young people starting to smoke and increasing the number of smokers who quit.

These measures have helped India reduce tobacco use by 6% in 7 years. Tobacco consumption in India fell from 34.6% in 2009-10 to 28.6% in 2016-17, with 810,000 fewer people using tobacco, show data from the Global Adult Tobacco Survey, 2017. The fall was the sharpest in young people aged 15 to 24, with tobacco use in this segment falling by 33%, from 18.4% in 2010 to 12.4% in 2017. Young people on average are also lighting up later, with the average age of regular tobacco use rising from 17.9 years to 18.9 years.

Quitting tobacco

Apart from cessation aides such as patches, gum and counselling, e-cigarettes – which deliver nicotine without the other health-damaging substances added to cigarettes – are also being considered as tools to help smokers quit.

A study in the BMJ this week adds to evidence that e-cigarettes help smokers quit their addiction.

The severity of withdrawal symptoms vary between people and genders – physiologically, women have a tougher time quitting – and depend on the number of cigarettes smoked and the duration of the addiction, but symptoms remain the same.

Most people experience cravings, irritability, frustration, anger, anxiety, depression, difficulty concentrating, restlessness and increased appetite, which may cause weight gain. Withdrawal peaks between 24 and 48 hours after cessation, decreasing gradually over the next few weeks.

But the benefits are huge. Those who have smoked since early adulthood but stop at ages 30, 40, or 50 gain about 10, 9, and 6 years of life expectancy respectively.

People who began smoking as young adults but stopped before age 40 avoid more than 90% of the health risks of those who continue over the next few decades. And those who stop at 50 avoid more than half the health risks.

So you see, it’s never too late to stop.