Tag: quit smoking

Dilemma of a Doctor – Advise to Quit or Not?

Dilemma of a doctor – A 44 year old tobacco chewer with advance stage of cancer – should he be asked to quit tobacco???

Author – Dr. Monalee Prasad, BDS(2007), PGD in Aesthetic Dentistry (2009),TII -IDA(2020) ,OCTC (2021), CTCS (2021).

This is a case of a 44 year-old male patient suffering from Stage IV recurrent oral cancer with extensive neck and systemic metastasis. He was being treated somewhere in Uttarakhand. He attended OPD for treatment. He has been a chronic chewer and smoker for years and he continues to do so even after being diagnosed with advanced cancer with a short life expectancy. Besides the palliative treatment, the big question is about his tobacco – Should we ask him to quit? Or should we not ask him to quit?

How should we plan his treatment with regards to tobacco cessation?

The case was put for discussion during the tutorial for Certified Tobacco Cessation Specialists were – different difficult cases that we come across in Tobacco Cessation practice and their treatment are planned. It was a mixed opinion with more suggesting  that the patient should be told to quit tobacco.

The same question was put in the group who are actively working for tobacco control and the majority said that the above patient needs to quit so that the treatment will be helpful and the organs will respond better to treatment.

Now opinion from group of oncologists was seeked, unanimously they said there is no need for him to quit tobacco.

The argument put forth by was that with Stage IV cancer there is no hope of his long survival and it will not be of much help at this juncture to force him to quit. Also the handling of withdrawal symptoms is more difficult in this case along with the Palliative care that has to be provided. It will not improve the quality of life of this already dying patient.

Hence, it wouldn’t matter whether we advise him to quit or not. It would be his wish.

Also, in case we are able to convince him to quit; there are two case scenarios which were discussed and how we can use it as a positive messaging for the next generation.

One scenario is where he is able to quit completely and then the message that can be conveyed through him that even though he suffered from taking tobacco and has reached the last stage of his life, he could quit his habit with the help of our esteemed doctors. And if he can do it, anyone at any stage can do it and the sooner one quits, the better it is for health.

Second case scenario is when he is unable to quit despite all the efforts by the doctors and himself and he continues to smoke till his last breath. The message that we can pass on in this situation is that Tobacco is a deadly disease and really addictive one. Message is clear for the youngsters and family members – never to start such a habit and quit as early as possible. BE SMART DO NOT START and if you have then please QUIT.

So, an important learning was shared via this case by Dr. Pawan as to how to choose the messaging we need to convey to the society at large and always choose the treatment keeping the patient’s overall benefit in mind.

Medical treatment is available to quit tobacco and treatment from the cessation specialists should be seeked.

Do share your thoughts on this in the comments below? What would be your choice of treatment?

Quitting Tobacco Strategy and Capacity Building – ICanCaRe Protocol

Quitting Tobacco Strategy and Capacity Building – ICanCaRe Protocol

Quitting tobacco is frustrating. And for a healthcare professional it is a challenge! Every day whatever discipline one is practicing, tobacco users, do visit your clinic. Most of the symptoms the patient has are also related to tobacco use – smoking, chewing, or vaping. The outcome of treatment is compromised if the person continues to use tobacco, thus losing trust with the patient.

It is also seen that a doctor who addresses the issue of tobacco with the patient and goes the extra mile in guiding the person to quit tobacco gains instant recognition from the patient and family. By doing this the doctor does gain directly and indirectly better value in society and definitely more clientele.

268 million people in India use tobacco in some form. The numbers are increasing every day. WHO reports that 70% of educated people who have taken tobacco for a substantial time wish to quit tobacco. They try it unsuccessfully by themselves and frustrated look for support from medical professionals. Medical professionals need to be skilled in tobacco cessation.

I am an Oncosurgeon, practicing for 27 years now.  70 % of my patient are tobacco addicts, as is the case with all other medical professionals, except a few branches. My initial intervention was restricted to just asking the person to quit tobacco. Beyond that I did not know, referring to the psychiatry department was not agreeable, and more importantly, the low quit rate was not acceptable. So, my journey into tobacco cessation began with a deeper understanding of the psychosocial and physical patterns of tobacco addiction and coming up with a successful ICanCaRe intervention model. ICanCaRe launched a comprehensive tobacco control program as SAVE the Youth Campaign.

QUITTING TOBACCO – is now easy

Tobacco addiction is multifactorial. The skill lies in assessing each of the components and balancing the issue with the patient. The intervention is individualized and is not a copycat prescription for all. The most important roadblock for every patient is the “Fear of Failure”. ICanCaRe incorporated all the components into digital format http://app.icancare.in and made it simple, scalable, and saleable. The balance lies in managing withdrawals, cravings, suffering, societal pressure, and managing medical issues. This intervention process is simplified as “ABCD of Tobacco CESSATION” which is Active Motivation, Behavioural intervention, Co-morbidity management, and Drugs and medications like Nicotine-Acetylcholine receptor agonists and supplements.

ICanCaRe E-pharmacy for tobacco medications is available to ensure timely doorstep delivery of the medications to ensure compliance. And more recently multilingual virtual clinics have been introduced to help guide remote patients. Quit tobacco is now just a call away – 011-43077695.

The ICanCaRe standardized protocol for cessation has been designed, piloted, and implemented to help individuals quit any form of tobacco and smoking with ease. This protocol is tailored to suit the individuals’ needs and habits so that adapting to the tobacco-free routine is easy and simple. More details are available at www.icancare.in/quittobacco. 

Quitting tobacco is now available, feasible, and effective!

CAPACITY BUILDING – ICanCaRe Academy

Capacity building is the absolute need of the hour so that the HCPs are readily available across every corner of the country to offer help for a cessation to their patients. Every hospital needs to establish a dedicated cessation center with a dedicated team to offer assistance in quitting and oral examination.

ICanCaRe Academy – introduced the Certified Tobacco Cessation courses accredited with GUJARAT UNIVERSITY to train doctors and health care workers across India. Lots of trained skilled HCP and Tobacco cessation clinics are needed across India. Tobacco MARSHALs in society are trained influencers who motivate people to SAVE the youth. www.icancare.in/academy

The pillar of success for the program lies in visibly, available skilled and networked Health Care Professionals following a reproducible digitalized intervention for a successful outcome.

At ICanCaRe we are committed to SAVE the youth by sensitization, assisting them to quit, Volunteer Training, and Enforcing tobacco control.

ICanCaRe is here to stay with its innovative 360-degree intervention for tobacco cessation.

Collaboration and synergizing together are the way ahead to putting an end to this pandemic. ICanCaRe is open for collaborations with institutions, hospitals, pharmaceutical companies, and tech-based institutions to amplify cessation across the country.

Join the ICanCaRe community to #SAVEtheyouth www.facebook.com/groups/icancare.

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He authored 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. He launched the #SAVEtheyouth campaign and Tobacco MARSHALs in the community)

 

REACH OUT FOR TOBACCO CESSATION

St. John’s Hospital, Bengaluru Inaugurates Tobacco Cessation Centre

St. John’s Hospital, Bengaluru Inaugurates Tobacco Cessation Centre

ICanCaRe Academy congratulates Dr. Pradeep Johnson for starting of Tobacco Cessation center at St. John’s Hospital, Bengaluru.

Dr. Pradeep a senior Psychiatrist inspired by ICanCaRe SAVE the youth campaign skilled up a CERTIFIED TOBACCO CESSATION SPECIALIST course accredited by Gujarat University conducted by ICanCaRe in November 2020.

Tobacco Cessation centers are essential to assist people desirous of quitting tobacco and are needed in every place. Starting of a TCC at St. Johns is an important milestone and the beginning of the acceptability of large hospitals that such a center is required for a holistic treatment of patients.

ICanCaRe as part of SAVE the youth campaign capacity building trains doctors as CTCS and hand holds them to establish TCC centers powered by the ICanCaRe digital APP for a standardized intervention protocol for reproducible results across all centers.

Team ICanCaRe

www.icancare.in/academy

011-43077695

Dr. Pawan Gupta M.Ch. Cancer Surgeon

Convenor – Tobacco Cessation Certified Courses accredited by Gujarat University