As smokers rise, so does the anti-smoking mart

-Every year approximately 1 million Indians are likely to die from smoking related complications — New England Journal of Medicine.
-India is home to about 12% of the world’s smokers — The World Heath Organisation

If these estimates are shocking, then they have also indirectly provided an impetus for introducing products designed to assist smokers quit the habit.

Prescription and usage of products like nicotine patches, nicotine chewing gums, nasal sprays, tablets, etc that aid in smoking cessation are gathering momentum.

Manufacturers like Sun Pharmaceuticals, Cipla, Pfizer, GSK, Elder Pharmaceuticals are looking to tap this Rs 720 crore market.

Adithya Bhat, managing director of business consulting firm Protiviti Consulting, said affordability issues and the tobacco industry lobby could hamper growth of smoking cessation products.

“To make these products affordable, manufacturers should get certain incentives from the government. At the same time, there are chances of the tobacco industry coming out with various means to attract more customers, which would hamper growth of anti-smoking products,” he said.

Avdhesh Bansal, senior consultant, respiratory medicine, Indraprastha Apollo Hospital, New Delhi, said these products are only supportive items.

“The tablets like varenicline and buproprion are effective in 40-50% of users, while the patches are effective in about 20-30% of users. Most importantly, the user has to have a strong desire to quit smoking, otherwise none of the products will work.”

Experts say the nicotine patches and gums are usually given after testing the nicotine dependency levels of the smoker.

“If dependency is minimum, there is no need for such products. For people with mild to moderate nicotine dependency, nicotine chewing gums are given, while for those with moderate to severe nicotine dependency, chewing gums along with anti-depressants are prescribed,” said Padma Sundaram, head of department and consultant pulmonologist, Manipal Hospital, Bangalore.

However, experts say, despite the positives of anti-smoking agents, their side effects are not worth ignoring.

Drugs like varenicline and buproprion currently carry black box warning in the US (strongest type of warning for medicines) over their side effects like depressions, and suicidal tendencies.

Bansal said the use of nicotine patches and chewing gums, which work on the mechanism of replacing nicotine in cigarettes, can cause nicotine addiction.

By using the nicotine patches or gums, people tend to give up smoking, but become addicted to nicotine, said Shyam Aggarwal, senior oncologist, Sir Ganga Ram Hospital, New Delhi.

“Nicotine is expensive. So, after getting addicted to nicotine as a result of using the patches or gums, some users can’t afford it, and hence go back to smoking. So there are times when these anti-smoking products lead to a vicious circle.”