World No Tobacco Day

World No Tobacco Day

31^st May is World No Tobacco Day. World No Tobacco Day is important as cigarette smoking is the leading preventable cause of mortality and is estimated to cause nearly six million deaths worldwide annually. Heart disease, lung cancer and chronic obstructive lung disease (COPD) are the three major causes of smoking related mortality.

Smoking cessation leads to reduced risk of mortality and death by reducing the risk of heart attack, sudden cardiac death and stroke; lung infections, lung cancer and COPD; diabetes mellitus, osteoporosis and hip fracture; reproductive disorders such as spontaneous abortion, ectopic pregnancy and low birth weight in pregnancy, premature menopause, erectile dysfunction and subfertility in both men and women; peptic ulcer disease and Helicobacter pylori infection; periodontal disease including gingivitis and periodontitis; and lastly, delay wound healing and pulmonary complications post-operatively.

Smoking cessation frequently leads to nicotine withdrawal symptoms, which includes increased appetite and thus, weight gain, depressive symptoms, anxiety, insomnia, irritability, restlessness and difficulty concentrating. It is important that these factors are addressed in order for smokers to know what to expect and how to respond if these happen. Nicotine replacement therapy, bupropion and varenicline are smoking cessation medications that help to relieve the symptoms of nicotine withdrawal.

Since tobacco use is both a learned behaviour and physical addiction to nicotine, the combination of pharmacotherapy and behavioural counselling are important in smoking cessation to acquire higher quit rates. Behavioural counselling addresses weight gain by including dietary and physical activity interventions; and depression. Medications for smoking cessation are nicotine replacement therapy such as nicotine gum, nicotine lozenges, nicotine inhaler, nicotine nasal spray, transdermal nicotine patch; and non-nicotine therapy including bupropion and varenicline (Champix) whereas non medication therapies are hypnosis, acupuncture, behavioural therapy and motivational therapies.

Varenicline (Champix) is effective in smoking cessation by reducing symptoms of nicotine withdrawal and reducing the rewarding aspects of cigarette smoking. Research conducted showed that varenicline helps in continuous abstinence at six months or longer and preoperative treatment with varenicline improved the abstinence rate at 12 months. Varenicline is superior in smoking cessation compared to bupropion and other nicotine replacement therapy.

To stop smoking, start with START.

          S = Set a quit date.

T = Tell family, friends and co-workers that you plan to quit.

A = Anticipate and plan for the challenges you will face while quitting.

R = Remove cigarettes and other tobacco products from you home, car, and work.

T = Talk to your doctor about getting help to quit.

          Tips for managing cigarette cravings are replace that moment after a meal with fruit or dessert, try non-alcoholic drinks or snacking on nuts and chips, let your social circles know your decision to quit, stay active by keep yourself distracted and occupied, keep your hands, fingers and mind busy by squeeze balls and reading or listening to music, find an oral substitute such as mints, carrot or celery sticks and sunflower seeds; drink plenty of water helps minimize withdrawal symptoms and cravings pass faster. In additional, keep a craving journal to monitor your daily progress in what that trigger your cravings. Get support from others, manage changes in mood, which usually gets better in 1 or 2 weeks; and eat healthy diet and staying active to help maintain your current weight.