Doctor shares 4 steps to quit tobacco smoking, and 6 warning signs that should not be ignored

Quitting tobacco for good requires significant effort and support, notes Dr Verma. He lists what helps, and the warning signs one should look out for.

There are very few people who are unaware of the ill effects of smoking tobacco in its many forms, yet its popularity remains unblemished. The warning text on movie screens fails to overshadow the swagger of the larger-than-life characters smoking away at their pleasure, and products themselves remain easily available at every corner shop in the country.

Speaking with HT Lifestyle ahead of World No Tobacco Day, observed on May 31, Dr Harish Kumar Verma, general physician and director of pulmonary medicine and critical care at ShardaCare Healthcity, stated that the diseases and deaths that result from tobacco are largely preventable. The issue is that it is not considered a public health emergency, but rather a personal failing.

Steps to quit tobacco products

The nicotine present in tobacco is a genuinely addictive substance that makes quitting extremely difficult, shared Dr Varma. “Willpower alone rarely works,” he noted. “Only about five per cent of unassisted quit attempts succeed long-term.”

This is not a character flaw of the person failing to quit; rather, it highlights the importance of effective support. This includes the following four steps.

1. Nicotine Replacement Therapy (NRT): Patches, gums, lozenges, and inhalers reduce withdrawal symptoms by delivering low, controlled doses of nicotine without the toxins in tobacco smoke. Widely available and safe for most adults.
2. Prescription medications: Varenicline and bupropion are proven to reduce cravings and withdrawal. Varenicline, in particular, more than doubles quit rates compared to placebo. These should be initiated under medical supervision.
3. Behavioural support: Counselling, either in person or via cessation helplines (India’s national quitline: 1800-112-356), significantly improves long-term success, especially when combined with medication.
4. Set a quit date and tell people: Social accountability matters. Remove tobacco products from your home and identify your triggers – stress, boredom, social situations – so you can plan ahead.

It is never too late to quit smoking, shares Dr Verma. (Pexel)

“The rewards of quitting are faster than most people expect,” highlighted Dr Verma. “The body starts repairing itself almost immediately. Within 20 minutes, heart rate normalises. Within 12 hours, carbon monoxide levels in the blood return to normal. After one year, the heart attack risk is halved. After ten years, lung cancer risk drops to roughly half that of a continuing smoker.”

The benefits accumulate regardless of how long or heavily someone has smoked; therefore, it is never too late to quit tobacco.

Warning signs that should not be ignored

The ill effects of tobacco go beyond cancers of the mouth, throat, lung and bladder. According to Dr Verma, tobacco also silently damages the heart and lungs, resulting in chronic obstructive pulmonary disease (COPD), heart attacks, and strokes. In India specifically, smokeless tobacco products like the different forms of chewing tobacco carry serious risks for mouth and throat cancers.

He went on to list the warning signs that should make tobacco users take note and get help at the earliest.

• A cough that has lasted more than three weeks, especially one that produces blood-streaked mucus
• Unexplained breathlessness during routine activity – climbing stairs, walking short distances
• A white or red patch inside the mouth, or a sore that does not heal within two weeks (a red flag for oral cancer)
• Difficulty swallowing or a persistent hoarse voice
• Unexplained weight loss of more than five kilograms without trying
• Chest pain or recurrent infections like pneumonia that keep returning