Category: Quitting Tobacco

How to help others quit tobacco. Behavioral 7D intervention to help quit tobacco. Articles to help specialists intervention.

Areca Nut (Betel Nut, Guwaha, Supari) – Agents of Oral Cancers

Introduction:

The use of betel nut in various forms is rampant in India. It is being glamorized by the industry and sold in various forms. Rich and poor, male or female, all age groups are consuming it, almost 30% of the population in both rural and urban India consume it freely across all ages and socio-economic sections of the community. That’s why Oral cancer is very prevalent in India and stands at 30% of all cancer cases reported. Betel nut is one of the significant contributors to this. The market size of areca nut is around 100 billion rupees and it is being sold in India in various forms and advertised as mouth fresheners under various names Rajshree, gutkha, mukhwash, tulsi, rajnigandha, etc. Unfortunately, the young generation is being lured into using this harmful product. It is time we create awareness about the dangers of supari.

Areca (Betel) nut is a seed of the fruit of Areca Palm.  It is a stimulant drug.

The betel nut is used in various ways – fresh, dried, boiled, baked, roasted, or cured.

Betel nut consumption is rampant in the northern and eastern zones of the country. A common way of consuming betel nut is by using it as paan betel quids i.e. betel leaf, slaked lime, and betel nut with any other additives like cloves, elaichi, etc. Nowadays it is available in varieties in the market as part of paan masalas.

In many parts of India and Southeast Asia, it is part of social practice/customs, religious practices, and cultural rituals.

Effects of betel nuts:

It is carcinogenic and used with tobacco it causes cancer of the oral cavity, oropharynx, and esophagus. Betel nut affects almost all organs of the body including the brain, heart, lungs, gastrointestinal tract and reproductive organs, and also the endocrine system.

It is a stimulant drug. Like all drugs, there is no safe limit and one needs to be careful. The effect of the drug may vary according to size, weight, and health of the individual and also on the amount consumed. The variety of betel nut also matters.

As a stimulant the person may experience the following:

  • Mild euphoria and feeling of wellbeing
  • Alertness
  • Increased heart rate
  • Increased blood pressure
  • Sweating
  • Redness on the face and feeling warm
  • Tremors
  • Dizziness
  • Upset stomach, diarrhoea, vomiting
  • Psychosis

Long term effects:

  • Oral cavity and dental –
    • Discoloration of teeth and gums
    • Oral ulcers and gum diseases
    • Submucous fibrosis
    • Oral Cancers
  • Heart diseases – myocardial infarction, cardiac arrhythmias
  • Pulmonary – asthma
  • Gastrointestinal system – Stomach ulcers, hepatotoxicity
  • Reproductive system – infertility, harmful effect on the fetus when being used during pregnancy.
  • Endocrine system – diabetes, hyperlipidemia, hypothyroidism, prostate hyperplasia, central obesity
  • Aggravate immune system- suppressed T-cell activity
  • Cancers – oral cavity, oropharynx, esophagus, liver, biliary tract, and uterus.
  • dependency

Pathology and metabolism

Betel nuts contain 4 main alkaloids – Arecholine, arecaidine, guvacoline, and guvacine

The main alkaloid Arecholine has a systemic effect as well as it is a carcinogen. A number of nitrosamines are formed in the oral cavity mainly methylnitrosaminoproprionitrile which is most carcinogenic in the oral cavity causing cancers and submucous fibrosis.

The betel nut is being glamorized by the industry as mouth fresheners sold as Paan Masalas and fresheners. It is a harmful substance and needs to be banned.

The patient is referred to the Tobacco Cessation Intervention specialist to treat the patient for the smoking and chewing tobacco including betel nut, paan masala, gutkha, khaini, etc. One can Call 011-43077695 or visit www.icancare.in/quittobacco for assistance.

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is the author of the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convenor for Certified Course in Tobacco Cessation under the Gujarat University)

References:

Garg A, Chaturvedi P, Gupta PC. A review of the systemic adverse effects of areca nut or betel nut. Indian J Med Paediatr Oncol. 2014;35(1):3-9. doi:10.4103/0971-5851.133702

ABCD of ICanCaRe Tobacco Cessation Intervention Program

Quitting Tobacco has been a challenge. Most do not plan to fail, but fail to plan! Planning and preparation is the most important step to being successful.

Any successful tobacco Cessation program has to incorporate these 4 things which I put as ABCD of the ICanCaRe Tobacco Cessation program. And this is the success mantra for achieving 100% success for our patients.

ABCD of our Cessation, how we will help you in this quitting journey.

  1. A – for ACTIVE MOTIVATION and FOLLOW UP in which quit coaches will give you follow-up calls to check your progress on this quit journey of yours. Keep you constantly motivated with encouraging words making your journey pleasant and happy.
  2. B – BEHAVIORAL INTERVENTION takes the form of advice, discussion, encouragement, and other activities designed to help quit attempts succeed. In this, we will give you the detail about 7D of coping with the urge of Tobacco. We will also explain to you to abstain from common trigger points and manage withdrawals.
  3. C – COMORBID CONDITIONS, to ensure those suffering from comorbidities of tobacco are appropriately recognized and treated to prevent Cancer, Cardiovascular, malnutrition and immunity deficiencies, and other chronic diseases.
  4. D – DRUGS OR MEDICATION which can be divided into Nicotine Replacement Therapy, non-nicotine medications, and supportive medications that have anti-craving effects. Certain other supplements as per the requirement would be added for the purpose.

An ICanCaRe-certified tobacco cessation specialist follows the ABCD Of tobacco cessation for a 100% quit rate.

Book your appointment today to start a healthy tobacco/smoke-free life with the best in class tobacco/smoking cessation experts at www.icancare.in/quittobacco or call 011-430-77695 for help. Download the ICanCaRe e-cessation app for quitting smoking and tobacco at https://app.icancare.in. 

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is the author of the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convenor for the Certified Course in Tobacco Cessation at Gujarat University)

What You Need for Successfully Quitting Tobacco Chew and Smoking – COMMITMENT (COMMIT TO QUIT)

Yes, this is the only thing that I need from you for a 100% quit rate. Full Commitment and I assure you my and my team’s full commitment to handhold you through your journey. Make your journey a pleasurable and happy one. Happy while actively quitting and happy ever after.

The preparation needs careful planning and would need modulation as we go on. We would need all the inputs from you to help you cope up with the different situations that would arise.

  • Will power – The willpower to quit is needed. The willpower would not be the same for everyone. The Will Power Index helps me understand your requirement for the type of intervention.
  • Motivation – Motivation will vex and vane. Some days you may be high and other days your motivation would dwindle. Our team would be there to support you and keep you motivated. Please feel free to discuss.
  • Slips – It may happen. It gives an opportunity to understand weaknesses and learn how to handle those weak points. Discussing the reason for the slip and finding out a solution to handle it next time makes you stronger and committed to staying quit
  • Friends – Two types – 1. encouraging talking positively about your commitment to quitting. 2. Discouraging – making fun of you for your decision to quit. They are generally the ones who themselves are diseased, better avoid them now and forever. No need to argue with them they are not worth your time.
  • Nagging – It may have negative effects but let us think positively about the person nagging. The fact is that the other person is so frustrated over the period of time. Your positive approach would convert these negative factors to positive ones and give you the respect that you deserve. The only people you need around you are the positive people.

Remember: WITH EVIDENCE BASED APPROACH it is easy to SUCCESSFULLY QUIT TOBACCO. You need to take the first step and give us your commitment to quit, leave the rest to us. ICanCaRe Team will make this quit journey smooth and easy for you.

Once we have your commitment, we would help you through the withdrawals, the cravings, and various situations that would arise during the journey, but finally, you would win and that is assured. Just need to follow the ABCD of Tobacco Cessation. 

All the best and wish you a clean green healthy and lively life ahead. Visit www.icancare.in/quittobacco or call 011-430-77695 to get professional assistance to quit the tobacco/smoking addiction. Download the ICanCaRe APP.