Tag: quit smoking

Be Careful Before Marrying of Your Daughter to A Tobacco User – Parent’s Responsibilities

Choose the Right Groom for Your Daughter – A Non-Smoker/Tobacco Consumer

Tobacco is commonly used in India. While choosing a groom, no one really bothers to ask about tobacco use. Tobacco use till now is still an acceptable social norm.

I have a question – “Would you marry your daughter to a person who is diseased or likely to have a disease?” 

  • “Arre Shadi ke baadh ladka tambaku chhod dega” (boy would quit tobacco after marriage) – why after marriage, let him quit for 6 months and then propose.
  • “Bahu tambaku chudwa degi” (daughter in law would make him quit tobacco) – 

Wow, the newlywed daughter-in-law is a demi-goddess and she is expected to do everything including tobacco cessation, that the mother, father, brother or sister could not do!

Why tobacco cessation after marriage? Why not before it?

If anyone in the family is taking tobacco, the entire family is ruined.

This reminds me of one of my patients – Rita(name changed) and Rohan(name changed). Rohan had cancer of the mouth, and he had come to see me along with Rita and her mother. Rita and Rohan were teachers in a primary school. They fell in love and got married in spite of Rohan’s tobacco use (which he promised to leave as soon as they got married). They started their married life without him being able to quit tobacco. Sadly he continued and developed cancer within one year. On one hand, Rita was pregnant and was planning of delivering their baby boy while on the other Rohan was diagnosed with oral cancer. His chemotherapy and surgeries coincided with the baby’s birth. Sadly, throughout the treatment, no family member of Rohan ever came to see me.

Well, friends, tobacco is a disease. By all means, the tobacco user would have some or the other complication due to tobacco use may it be a heart attack, respiratory problem, dental and oral problem, cancer stroke, etc. (200 listed diseases to count from). Tobacco is a disease and it has the highest addictive factor in the World. Had it been so easy to quit, people would have quit tobacco by now.

Tobacco as a disease needs treatment like any other chronic disease with intervention, medications, and follow-up.

LET YOUR DAUGHTER NOT SUFFER BECAUSE OF YOUR IGNORANCE! BE CAREFUL WHILE CHOOSING THE GROOM, DO ASK ABOUT THE TOBACCO HISTORY AND IF REQUIRED DO A COTININE TEST TO KNOW.

How to IDENTIFY A PERSON USING TOBACCO WITHOUT ASKING –  

There are tell-tale signs of tobacco use whether smoking or chewing. (Caution: the signs may not be confirmatory!)

  • Stains on teeth and /or lips
  • Bad foul smelly breaths
  • Constant coughing
  • Stains on nail beds, fingers
  • Foul smelly hair and cloths

Some behavioral aspects that one needs to notice:

  • Chewing gums – constant use
  • Frequently disappearing
  • Going for a walk avoiding you
  • Friend circle

Laboratory and Qualitative assessment

  • Laboratory tests are available for confirmation of tobacco use
  • Qualitative assessment of present health assessment

Help is available. Tobacco as a disease needs treatment. ICanCaRe Tobacco Wellness Centres and Tobacco Wellness program – Online are a call away. The ICanCaRe team of Certified tobacco Cessation Specialists and Quit Coaches work with you to make your journey smooth, easy, interesting, and achievable.

The ICanCaRe Tobacco Wellness Program incorporates an evidence protocol-based digitalized intervention program which is fully scientific, medically validated and has a 92% success rate.

ICanCaRe Tobacco Wellness Centres with 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 – 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.

Women Empowerment – Spouse’s Rights Towards Tobacco Use by Partner

There is evidently a very confusing  situation when a wife / spouse discovers that her counterpart is a tobacco user which she mentally does not accept as a habit in the normal go of life after marriage. In India, most of the marriages, whether arranged or loved, experience a lot of ambiguity about the habits and behaviors of their partners. In such cases the wife is entitled to exercise her rights and legal options to protect her body (health), person and self respect. Wife can take the redressal/ aids available and/ or counselling and treatment options so that her life becomes normal and humane.

Let’s take a look at the protections provided under the Fundamental rights that are enshrined in Part III (Articles 12 to 35) of the Constitution of India.

  1. Right to equality (Articles. 14-18): includes equality before the law, the prohibition of discrimination on grounds of religion, race, caste, gender or place of birth, equality of opportunity in matters of employment, the abolition of untouchability and abolition of titles.

Article 14, backs women and their rights in the country. It ensures women equality and equal protection of the laws. Article 15(3) empowers the state to take affirmative action in favour of a daughter-in-law:

  1. The Hindu Adoptions and Maintenance Act, 1956, entitles wives a basic right to reside in the matrimonial/ marital household.
  2. A married woman has the right to have a committed relationship: that is based on affirmative honesty in relationship and understanding.
  3. A wife has the legal authority to live with proper dignity and self-respect with her in-laws: hence a wife can not be treated with indifference and inhumane way or against her will to object perceivable harm to her body, property or repute/ emotion.

2. Right to Freedom (Articles. 19-22): includes freedom of speech and expression, assembly, association or union or cooperatives, movement, residence, and right to practice any profession or occupation.

3. Right to Constitutional Remedies (Articles. 32-35): is present for enforcement of fundamental rights.

When it is presumably found that the spouse or his family members defend the wrong action of tobacco abuse, the wife has the options to exercise her access to legal provisions that can be compounded as a recourse to the problem of correcting a tobacco user husband: 

as per  the Protection of Women from Domestic Violence Act (PWDVA), instituted in 2005, is a legislation aimed at protecting women from violence in domestic relationships.

  1. The definition of domestic violence is well written and wide-ranging and holistic. It covers, mental as well as physical abuse, and also threats to do the same. Any form of harassment, coercion, harm to health, safety, limb or well-being is covered. Additionally, there are specific definitions for the following:

Physical abuse: Defined as act or conduct that is of such a nature as to cause bodily pain, harm, or danger to life, limb or health or impair the health or development of the aggrieved person’.

The definition of “aggrieved person” includes any woman who is or has been in a domestic relationship with the respondent and who alleges to have been subjected to domestic violence by them. (See Section 2(a) of the PWDVA)

The definition of “respondent” includes any adult male who has been or is in a domestic relationship with the aggrieved woman, and against whom the woman has sought a relief or any male or female relative of the husband or male partner of a married woman or a woman in a relationship in the nature of marriage.

The definition of “domestic relationship” is any relationship 2 persons have lived together in a shared household and these people are:

  • related by consanguinity (blood relations)
  • related by marriage.
  • Though a relationship in the nature of marriage (which would include live-in relationships)
  • Through adoption
  • Are family members living in a joint family.

The definition of “child” is any person below the age of eighteen years, and also includes foster, adopted, or step child.

Further India is a leading member state with WHO FCTC (Framework Convention on Tobacco Control) and in our country, Children and wife is protected under the  Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act/ COTPA 2003, the Act that was enacted by the Parliament to give effect to the Resolution passed by the 39th World Health Assembly, urging the member states to implement measures to provide non-smokers protection from involuntary exposure to tobacco smoke.

The most effective way to address such cases is social counselling through family participation and adoption of all available protocol for psychological and physiological treatment of the patient.

ICanCaRe is the only organization in the world to have formulated 3600 approach for social and medical remediation of tobacco addiction, disease and cessation through medical, social and legal framework implementation under expert supervision and advice through online and personal consultancy and support.