Tag: 7D to quit tobacco

Control the Cravings – 7th D of 7D Intervention of Quitting Tobacco and Smoking – Drug

Too long use of tobacco in any form – smoking or chewing, disturbs us and has become a part of our life and the tobacco consumer tends to associate lot of their routine activities with it. The timing of tobacco consumption have been such that many of the daily activities coincide with it, and we tend to associate performance with it and the routine activities becomes reminder as a part of 3Rs of habit loop.

Going back, when we started tobacco, the need was to hide and have it. So the best places or timings were when you are alone or away from the family.

  • Washroom – the best hiding place, no one to disturb you
  • On way to school/office – you are alone and travelling
  • In the school/office – hiding places are ample and you have friends who are part.
  • After lunch – free time
  • Coming back home – from school/office
  • Post Dinner – going for a walk

Initially what started as experiment later becomes reason and need. We associate with believe that tobacco enhances these activities. The physical dependency takes over and soon becomes part of life routine drawing one into the slavery of tobacco and justifying our actions.

These withdrawal symptoms need to be noted and addressed, it may require behavioural intervention and many times need medicines.

  1. Dry Mouth – this is very common.
    • Water intake – One needs to be hydrated throughout the day(related reading – Controlling the Withdrawals –  first D – Drink plenty of water)
    • Glycerine rinse – water with glycerine gargles
    • Honey – a spoonful will help
    • Amla – put pieces in the mouth and crush
    • Vitamin C chewable tablets
    • Sugarless toffees/candies – vitamin C, Citrus or mint flavoured. It has to be sugarless as dry mouth is highly prone for dental caries
    • If the dryness persists – medicines are available in the market
  2. Throat Irritation – this is specially more in smokers. The menthol added to cigarettes anaesthetises the throat to stop irritation from the other harmful chemicals. When you stop smoking the healing process in the throat may cause a little irritation
    • Frequent water intake – warm water is preferable
    • Steam inhalation
    • Non Alcoholic gargles for initial few days
    • Honey
  3. Tingling sensation in oral cavity – this is more so in tobacco chewers, related to the long chemical assault of the buccal mucosa, making it white and parch like and dry mouth
    • Plenty of water
    • Curcumin (haldi) gargles, chewing gums
    • Aloe vera gargles, toothgel keep it in the mouth and rinse
    • Medicines – Folic acid, Vitamin C chewing tablets,
    • Aspirin Gargles – as per advice of the Specialists
    • Examination of Oral Cavity is a must to rule out any Premalignant conditions
  4.  Withdrawal Cough – This is part of healing process and needs top be addressed early on (related reading – Coughing on quitting tobacco- What to do). This lasts for few weeks and is a manifestation of healing process
    • Steam inhalation
    • Saline gargles
    • Ayurvedic Khada, licorice
    • Mucolytics cough expectorants
    • Acapella respiratory devices
  5. Constipation – one of the most important part of withdrawal symptoms (related reading – Managing Constipation – Withdrawal symptoms)
    1. Water intake as a routine. (Related Reading –
    2. Add fibres to your diet – fruits, vegetables etc
    3. Lemon water with honey in the morning
    4. Warm milk with haldi in the night before going to bed
    5. Ayurvedic Triphla can be quiet helpful
    6. Medicines – Isabgol, Lactulose, Rarely pegylated glycol may be required
    7. Medicines to increase motility of intestine may be given when absolutely required

6. Digestive/Gastric imbalance – there is been a tendency of many to smoke or chew tobacco after food associating it as digestive agent. There is no such enzyme or chemicals in tobacco which aids digestion. On the contrary it is a gastric irritant. Some of the abdominal symptoms associated with tobacco withdrawals like bloating, indigestion, hyperacidity etc may be taken care by both ayurvedic (home solutions) or allopathic

    • Water 2 glasses half an hour before food – keeps you hydrated avoids bloating and aids digestion
    • Clove, elaichi etc after food may have smoothening effect as an alternative to have something after food
    • Jeera water it has wonderful effect on your intestine
    • Ayurvedic Digestive preparation available in the market like panchnol etc
    • Allopathic medicines like Proton pump inhibitors, digestive enzymes, liver enzymes may be required and to be taken under guidance and prescription of specialists.

7. Anxiety – related to office/public activities. This has been reasons by many to smoke or chew before any major activity like going for a meeting, public talk, etc

    • Deep breathing exercise calms your nerves
    • Hold your hand close to your ears make it into a fist, take a deep breath and with a jerk and sudden exhalation throw away the tension. Repeat this three times. You would get magical relief and calmness
    • Some who have severe anxiety and palpitation may require anxiolytics (alprazolam) or beta blockers (propranolol) to be given for a very short period of time for the initial few days after symptom discussion when other things do not work.

8. Sleeplessness – This may trouble in the initial days and once accustomed to be nicotine free one tends to have sound sleep

    • Have an early dinner, a warm bath, mild exercise like walking, cycling or stretching.
    • No aerated drinks, tea or coffee after 6 pm
    • Avoid electronic gadgets which tends to keep your mind active and confused.
    • Deep Breathing Exercise before going to bed. Calms you down.
    • Sav aashan as in YOGA is wonderful to make you light and sleepy.
    • In unavoidable situations medicines may be prescribed

9. Vitamin, Mineral and Antioxidants Deficiency– Vitamin D, Folic Acid, Vitamin C many minerals like iron, calcium, magnesium, zinc, selenium etc. These may manifest in various ways like fatigue, tiredness, dry skin, abdominal discomfort, bony pain, muscle cramps and myalgia, general feeling of discomfort.

    • Most tobacco users would have deficiency. A laboratory tests would establish the grade of deficiencies. Testing for certain minerals like iron, calcium and magnesium may be indicative for other mineral deficiency, as testing for all may not be possible and costly.
    • Supplements of vitamins and minerals, with therapeutic treatment of laboratory guided deficiency would improve the general well being bringing back the liveliness and buoyancy of life.
    • Tobacco masquerades the deficiency, when the nicotine level in body depletes the person starts manifesting the symptoms, which may be a big deterrent for a person to quit.
    • This has to be taken care early on to make the transition smooth into the world free from slavery of tobacco.

Tobacco users justify the tobacco use with some of the above withdrawal symptoms. Following the first session, the client is asked to note the triggers which are addressed during the subsequent intervention sessions. The ICanCaRe Android APP records your triggers.

The ICanCaRe Tobacco Wellness Program incorporates all the above in the digitalised protocol based intervention program designed by Mr Rishabh Agrawal.

ICanCaRe team of Certified tobacco Cessation Specialists and Quit Coaches work with you to make your journey smooth, easy, interesting and achievable.

ICanCaRe Tobacco Wellness Centres with its India’s first digital protocol based assessment process guide intervention as per requirements.

Do visit the ICanCaRe Tobacco Wellness Centres or register online by visiting our page or call ICanCaRe quitline 011-43077695.

Control the Cravings – 1st D of 7D Intervention of Quitting Tobacco and Smoking – Drink Water

Drink Water for Hydration and Managing Cravings

Maintaining Hydration is one the most important aspect of Tobacco Cessation – both smoking and chewing. Water plays an immense role in controlling your cravings. When quitting tobacco there is an increase need for water intake.

When you have an urge, taking 2 glasses of water can magically relieve your cravings. (related – 7Ds of craving)

Physiology – how water helps in controlling cravings?

Tobacco withdrawal symptoms include thirst, dryness of mouth, light-headedness, anxiety, confusion, tiredness and fatigue and sometimes headache. These can be taken care with water and  Deep Breathing exercise.

The Nicotine receptors are present in the cardiovascular system. The nicotine in the body keeps the vascular system constricted and causes increase in heartrate. When you quit tobacco (smoking and chewing), decrease in nicotine the blood vessels dilate (comes to normal state) and heart rate normalizes. This leads to a relative decrease in blood volume and state of physiological dehydration. All the above withdrawal symptoms are signs of dehydration!. The action in such cases have been taking tobacco and going back to the constricted state. The better method is to replenish your body with water and maintain the blood volume and heart rate, part of your quit process.

Water take care of the following as part of the tobacco quit process:

  • Dryness of mouth – a sign water requirement and not smoking. The dryness is usually a trigger for tobacco. Avoid dryness with regular water intake
  • Cleansing of the body – water intake helps throwing away the accumulated toxins through urine and stool. It will take sometime before you start feeling fresh and energetic.
  • Managing cough – when the lungs are healing there is increase mucus secretion to clear the deposited tar and other particles. This requires proper hydration
  • Managing Constipation – water helps regulate bowel movements. Water binds to soluble fiber in the large intestine, this helps increase stool bulk, decrease transit time and make it easier to pass stools.
  • Helps in Digestion – Water helps in digestion and keeps the food moving controlling the bloating and gastric upset sometimes associated with tobacco withdrawals.
  • Weight management – taking water half hour before food, controls satiety, decrease appetite, improve digestion and boost metabolism. This controls the weight gain associated with tobacco withdrawal.

When should one drink water?

Keep yourself hydrated through out the day. This will keep cravings away. Discuss with your tobacco counsellors the triggers and time of cravings.  You would notice that there is a routine. The water intake should be target at those time. Your ICanCaRe tobacco cessation specialist would make a craving chart and recommend the timings of water intake accordingly

In the majority,  the cravings are in the morning, washroom time, before noon, post lunch, past evening and after dinner. In these situation I would suggest to start your day with Water at least two glasses, repeat two glasses in 1-2 hours. This will relieve your morning cravings and aid in bowel movements. A morning drink with antioxidant and nutrition both mineral and Vitamins would avoid fatigue and tiredness sometimes associated with tobacco withdrawal.

Half hour before food – lunch, evening tea and dinner. If you are hydrated enough it would avoid post meal cravings. Water helps in digestion, dilutes the spicy high salt content of the food, avoids bloating, maintains bowel movement. Mostly these are the associated reasons for smoking or chewing tobacco post meals.

Before bed time – Drinking water before going to bed, keeps you hydrated during the night you feel fresh when you get up in the morning. This avoids cravings during the night and also controls the early morning cravings. This facilitates bowel movement also.

What type of water for your body?

Everything that is fluid has water in it. 20% of our water requirement is by food we eat. Rest comes directly from all the fluids that include water, milk, juices, soft, drinks tea or coffee.

During the quit process it is generally recommended to avoid drinks which are reminders for your tobacco intake for eg if you were used to drink with tea, taking tea would again trigger tobacco use. Consciously you would have to replace with healthy nutritious drinks with antioxidants, anti-inflammatory and minerals like organic tea, juices, alkaline water, organic haldi drinks, lime honey water, Chaas etc. Do choose foods which are juicy and healthy. Avoid drinks which are less healthy with more sugar and calories or energy drinks which can have high caffeine.

Amount of Water recommended:

Generally, I recommend around 1 litre of water for 20 kg of body weight, to be taken at regular intervals through out the day. During the first week I would suggest a little more around 1.2-1.5 litres of water per 20 kg BW. For ladies it may be little less. You would notice the change in colour of your urine over the period. Your urine colour may be a good guide. Target is to have a urine which is light yellow to transparent. Please note if you are on Vitamin supplements it may alter the colour of the urine.

Carry water bottle with you

Always have water readily available to control the urge. Water is an essential part of your treatment plan. Do carry environment friendly water bottles (earthen, copper, steel) with you and water jugs should be available at all places at bedside, living room, office etc.

Drinking too much of water?

Drinking water is safe and one usually would not drink too much of water in one go as body would not allow it. There is a theoretical situation when a person drinks too much of water (3-5 litres) too quickly. This may cause water intoxication and sudden decrease in Sodium level in body (Hyponatraemia). This can be an medical emergency.

It is advisable to drink water on regular interval, 1-2 glasses at a time and fairly spaced through out the day.

ICanCaRe TOBACCO WELLNESS PROGRAM

Water is essential part of ICanCaRe Tobacco wellness program as a part of seven D intervention. The ICanCaRe tobacco cessation specialist would  chart your triggers and suggest the water intervention schedule. Along with water need may be also to supplement with minerals and vitamins to boost the immunity and take care of comorbid conditions and nutritional deficiencies associated with tobacco use.

ICanCaRe team of Certified tobacco Cessation Specialists and Quit Coaches work with you to make your journey smooth and easy.

ICanCaRe Tobacco Wellness Centres with its India’s first digital protocol based assessment process guide intervention as per requirements.

To quit visit us on ICanCaRe or call on 011-430-77695 with the most scientific, medically validated and most successful online cessation program (92% success rate).

References
Perrier, Erica T et al. “Urine colour change as an indicator of change in daily water intake: a quantitative analysis.” European journal of nutrition vol. 55,5 (2016): 1943-9. doi:10.1007/s00394-015-1010-2

ICanCaRe 7D Intervention to Quit Tobacco

7Ds of Quitting Tobacco

Ready to Quit tobacco? Tobacco Cessation is a bumpy ride for the users who want to quit tobacco. One needs to be well equipped and prepare themselves for the withdrawal symptoms, which is manageable if you do it with full consciousness as it makes the journey easy and interesting.

Withdrawal symptoms can be present in various ways – it can vary from mild to intense. It may be in the form of physical discomfort, that may look like an illness or it can be just feeling of depression, sadness and continuous thoughts and urges of tobacco. Tobacco has been your companion and has taken over your life for many years and now you need to break apart from this habit. Managing the discomforts that comes early on can make you win over tobacco for a life time. It is better to manage with a tailored plan to keep yourself on track.

The 7Ds of Tobacco Cessation

Most of the urges can be controlled by this ICanCaRe Seven Ds which I am going to describe. You can find more details on other blogs.

Understand these seven Ds and memorize them and respond to your cravings or urges in a healthy way. Believe me these Seven Ds are the mantras of tobacco Cessation.

The Seven Ds are

    1. Drink Water
    2. Deep Breathing Exercise
    3. Delay
    4. Distract
    5. Diet
    6. Discuss
    7. Drug

1.Drink Water

Proper hydration is most important during tobacco cessation.  Dryness of the mouth is a fairly common for all as part of withdrawal symptoms. During cravings just take 2 glasses of water/juice etc, surprisingly enough the cravings disappear. You feel at ease both physically and mentally. It also helps flush toxins from your body.

2.Deep Breathing Exercise

This quickly takes care of the stress, irritability and sleeplessness that comes with tobacco cessation both smoking and chewing. Follow the instruction given below:

  • Close your eyes, keep your back straight, palms to the front and deep breath.
  • Long inhale slowly fill your lungs with air, hold for 2 seconds.
  • Exhale slowly and completely, hold for 2 seconds.
  • Repeat this for 10 times. Be mindful of your breath. You will feel the calmness and relaxation.

Managing stress is the most critical thing to do during the quit journey. Mostly people use tobacco to relieve stress and sometimes quitting itself creates stress of its own. Stress causes strong urges to smoke or chew tobacco. DBE helps to destress on the spot and is a simple doable way to attain that.

3.Delay

Delay till the urges pass away. Cravings are difficult, but they usually pass fairly quickly.

Most urges last only for 3-5 minutes!

When you first quit, it may seem the craving is unending lasting for the full day, but the truth is that the urges are really short in duration. They are more during the initial few days of stopping tobacco, but with practice to learn to deal with them rather than tobacco, they will fade away.

4.Distract

Distract yourself! Think of anything but tobacco. You can do many things during these 5 minutes. But remember to avoid triggers do something different than what you did before. You can do yoga, exercise, cook, solve a puzzle etc. Distraction breaks the continuous thought process which would pull you back into tobacco. Controlling the mind and action to keep the thoughts at bay is important move ahead.

5.Discuss

Discuss with your buddy or with your quit coach. This will relieve you. Self-appreciate your resolve to quit, discuss and surely you can tide over the urges.

6.DIET

Indian tobacco use consists of chewing or smoking. There is tendency to have something in the mouth or in between the lips and fingers. Further there may be increase in appetite when one quits tobacco. Be careful to choose healthy alternatives – salad, peanuts, sprouts and so many. But please avoid fat and carbs, which would lead to increase in weight. As an alternate to chewing, I usually suggest roasted chia seeds.

7.Drug

In India tobacco use is associated with many of our routine. One of the most common is bowel movements. Some use tobacco for dental pain, some smoke to suppress cough. These have to be addressed and taken care either by some home remedies, maintaining hydration or it may require certain medications. Addressing these issues with understanding and scientific approach with reasoning will help control a majority of craving and withdrawal symptoms.

A good quit plan addresses both the short-term challenge of stopping use of tobacco and the long-term challenge of preventing relapse.

Planning for what you expect while quitting and re-planning as you move ahead in your journey will make you achieve your goals. The ICanCaRe Tobacco Wellness specialists and Quit Coach hand hold you during your journey, intervene and guide as required. The program is available online and you can connect with us through our app (https://app.icancare.in) or contact 011-430-77695 or visit https://www.icancare.in/quittobacco.

The above seven Ds are the mantras for smoking cessation. They help in most cases but need to be complemented by specific medicine, nicotine receptor agonist meant to control the withdrawal and reward phenomenon of tobacco. The bottom-line is that it is possible to quit and specialized help is available – earlier you quit better for you.