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Smoking is a major health hazard. There is now an exhaustive body of evidence - including hundreds of epidemiological, experimental, pathological and clinical studies - to demonstrate that smoking increases the smoker’s risk of illness and death from a wide variety of diseases. It would be fair to describe cigarette smoking as “the chief preventable cause of death in our society.” 120 million smokers - almost 10 per cent of the world's smokers - live in India. What is even more alarming is that, while smoking is declining in many Western countries, its prevalence is on the rise in India. A recent study published in the New England Journal of Medicine estimates that, during the decade beginning 2010, smoking will cause about 930,000 adult deaths in India annually; of the dead, about 70 per cent will be between the ages of 30 and 69 years.

Health problems caused by smoking

Smoking harms nearly every organ of the body and diminishes a person’s overall health. Smoking is a leading cause of cancer and of death from cancer. It causes cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach and cervix, as well as acute myeloid leukemia.

Smoking also causes heart disease, stroke, lung disease (chronic bronchitis and emphysema), hip fractures and cataracts. Smokers are at higher risk of developing tuberculosis, pneumonia and other airway infections. A pregnant smoker is at higher risk of having her baby born too early and with an abnormally low weight. A woman who smokes during or after pregnancy increases her infant’s risk of death from Sudden Infant Death Syndrome (SIDS).

Millions of Indians have health problems caused by smoking. Beedi and cigarette smoking, and exposure to tobacco smoke, cause around 850,000 premature deaths each year in India alone. Of these premature deaths, about 35 percent are from tuberculosis, 10 percent from other lung diseases, 30 percent from cancer and 25 percent from heart disease and stroke.

Regardless of their age, smokers can substantially reduce their risk of disease, including cancer, by quitting.

Immediate benefits of quitting smoking

The immediate health benefits of quitting smoking are substantial. Heart rate and blood pressure, which were abnormally high while smoking, begin to return to normal. Within a few hours, the level of carbon monoxide in the blood begins to decline. (Carbon monoxide, a colorless, odorless gas found in cigarette smoke, reduces the blood’s ability to carry oxygen.) Within a few weeks, people who quit smoking have improved circulation, don’t produce as much phlegm and don’t cough or wheeze as often. Within several months of quitting, people can expect significant improvements in lung function.

Long-term benefits of quitting smoking

Quitting smoking reduces the risk of cancer and other diseases, such as heart disease and lung disease, caused by smoking. People who quit smoking, regardless of their age, are less likely than those who continue to smoke to die from smoking-related illness. Studies have shown that quitting at about age 30 reduces the chance of dying from smoking-related diseases by more than 90 percent. People who quit at about age 50 reduce their risk of dying prematurely by 50 percent compared with those who continue to smoke.

Does quitting smoking lower the risk of cancer?

Quitting smoking substantially reduces the risk of developing and dying from cancer, and this benefit increases the longer a person remains smoke free. However, even after many years of not smoking, the risk of lung cancer in former smokers remains higher than in people who have never smoked. The risk of premature death and the chance of developing cancer due to cigarettes depend on the number of years of smoking, the number of cigarettes smoked per day, the age at which smoking began, and the presence or absence of illness at the time of quitting.

Why is quitting so hard?

Many ex-smokers say quitting was the hardest thing they ever did. Do you feel hooked? You’re probably addicted to nicotine. Nicotine is in all tobacco products. It makes you feel calm and satisfied. At the same time, you feel more alert and focused. The more you smoke, the more nicotine you need to feel good. Soon, you don’t feel “normal” without nicotine. It takes time to break free from nicotine addiction.

Quitting is also hard because smoking is a big part of your life. You enjoy holding cigarettes and puffing on them. You may smoke when you are stressed, bored or angry. After months and years of lighting up, smoking becomes part of your daily routine. You may light up without even thinking about it.

Smoking goes with other things, too. You may light up when you feel a certain way or do certain things. For example:

  • Drinking coffee, beer or hard liquor
  • Talking on the phone
  • Driving
  • Being with other smokers
You may even feel uncomfortable not smoking at times or in places where you usually have a cigarette. These times and places are called “triggers.” That’s because they trigger, or turn on, cigarette cravings. Breaking these habits is the hardest part of quitting for some smokers.

Treating the addiction...

When you quit smoking, you may feel strange at first. You may feel dull, tense and not yourself. These are signs that your body is getting used to life without nicotine. It usually lasts only a few weeks.

Many people just can’t handle how they feel after they quit. They start smoking again to feel better. Most people slip up in the first two weeks after quitting. This is when feelings of withdrawal are strongest. There are treatments that can help with feelings of withdrawal: these include nicotine replacement therapy (nicotine gum) and bupropion.

Nicotine gum

Nicotine gum is available over the counter in 2- and 4-mg strengths. When a person chews nicotine gum and then places the chewed product between the cheek and gum tissue, nicotine is released into the bloodstream through the lining of the mouth. To keep a steady amount of nicotine in the body, a new piece of gum can be chewed every 1 or 2 hours. The gum releases nicotine more effectively when coffee, juice, and other acidic beverages are not consumed at the same time.

Bupropion

Bupropion, a prescription medicine available in India, was approved by the USFDA in 1997 to treat nicotine addiction. This drug helps reduce both the nicotine withdrawal symptoms and the urge to smoke. Research has shown that bupropion, under medical supervision, can help double smokers’ chances of quitting for good.

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