Tag: quit tobacco

Doctors as Tobacco Users – What Made Them Start

Doctors are the intellects of the society. People look at them for guidance in all fields most importantly the health aspect of life. Advising is his profession and he sets example by his conduct and behaviour.

Lot of people when told to quit tobacco they give examples of doctors using tobacco. It is interesting to know the journey of a doctor from the time he enters the medical schools and how he gets into the trap of tobacco.

  1. Some of them come with the habit of tobacco to the campus – started in school
  2. Some were assigned rooms with a smoker/chewer
  3. Some where infected by their colleagues and “well-wishers” who unfortunately suggested them that the best way to Relieve the stress, perform well in the exams, stay awake to gobble up the books.
  4. Most Smokers in a medical college are ‘ullu’ (owl) of the campus, the old steam engine working throughout the night, throwing the polluted smoke and spit just anywhere in the room and campus.
  5. Some where forced into this during ragging and it catches up with them
  6. Some the ‘occasional’ ones enjoyed the ‘kash’ during the parties for the instant kick along with alcohol cajoled by the ‘friends’.
  7. ‘The family’ pressure due to fractured relationship pushing them into the company of party goes – alcohol and tobacco
  8. Impressing the girls – make belief impression show casing himself as a charismatic independent person. It’s a thought of doubt that any girls would ever get impressed because of tobacco use. Girls are smarter.
  9. Generally, the students who adopted to using tobacco did not have any second activity like sports or any hobbies to rely on the much-needed happy hormone the dopamine surge.
  10. Some start to give company to their seniors during the ward or emergency duties.

 

There are only two reactions when a person tries tobacco for the first time

  • Shit – I will never have it again
  • Wow- majha aagaya (enjoyed)

The very addictive nature of nicotine catches on.

Then the strong believe put by a tobacco user to the new user that one needs to “smoke/chew” to perform. However, the fact is that to perform an addict would require a constant dose of nicotine but an non-addict performs the better or same anyway.

Another biggest problem is the social acceptability and easy availability of tobacco in the medical campus.

Well I end by saying that “one is free to choose, but one is not free from the consequences of the choice”.

 

So “BE SMART DO NOT START” and for those who have started earlier you quit the better. Do not hesitate to take help of Certified Tobacco Cessation Specialist. Quitting Tobacco is easy but staying quit is difficult!  The specialist would give you support, medication, comorbidity management, follow up and continued motivation to prevent relapse during your journey.

Tobacco is a complex endemic disease. It is well recognised and now diagnostic methodology, specific medicines and counselling process are available to treat this disease. The book WIN OVER TOBACCO MADE EASY authored by Dr Pawan Gupta is a comprehensive guide for those willing to quit and also for doctors. It is moral responsibility of all doctors to take training to understand the intricacies of the disease and advice the patient in an evidence based method for tobacco quit to be successfully.

ICanCaRe Tobacco Wellness centre is coming up at various Hospital for helping tobacco patients in distress.

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

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)