Kicking butt is all about mind over matter

A recent AC Nielsen survey of Indian smoking habits reveals that while 85% of those polled believed smoking causes lung cancer and over 4/5th of adults believe second hand smoke causes serious illness among non-smokers, quitting still remains a challenge: nearly half of current smokers (47%) and smokeless tobacco users (46%) want to quit their tobacco use but a meagre 2% succeed.

Yet, the support structure needed by a smoker to kick the butt, freely available in the West in the form of Nicotine Replacement Therapy (NRT) products, psychological help and
community initiatives, have traditionally been difficult to locate in India.

Tapping into this market are products like Johnson and Johnson’s Nicorette, a sugar-free nicotine gum, the use of which, the company claims, doubles a smoker’s chances of quitting smoking successfully. Nicotine gum essentially provides therapeutic and ‘clean’ nicotine (minus harmful additives such as tar and carbon monoxide) slowly and in lesser quantities into the bloodstream than a cigarette, but also just enough to satisfy the cravings.

“Once the ex-smoker overcomes the psycho-social need to smoke, nicotine dependence is eliminated by successively reducing the dose of nicotine,” says Gautam Suri, General Marketing Manager, Consumer Division, Johnson & Johnson Ltd, India.

At the same time, adds Suri, “While the key enabler for quitting is will power, other factors such as family support, medical help or behavioural therapy can also help a person in quitting.”

Mind over body
Psychologists, cessation experts and counsellors are of the same view. “Once an individual has decided to quit, it’s important for him to seek support — whether it’s getting on medication or even counselling, because most often substance abuse of any kind is triggered by underlying anxiety or depression,” says Dr BR Madhukar, senior psychiatrist at St Martha’s Hospital.

Only in some cases can users overcome the habit through will power alone, says the doctor, recalling the case of a user who quit when a close friend and fellow smoker suffered a heart attack right in front of him.

It’s good news for Indian smokers that besides NRT products, emotional support is also more forthcoming today. Take the case of wellness centre Sampurnah, which uses an integrative medicine approach to treat chronic and lifestyle diseases. Sampurnah uses methods such as meditation, hypnotherapy and Emotional Freedom Technique (EFT) to help clients quit smoking.

“Through clinical hypnotherapy, the cause for the addiction is unearthed and then the therapist dwells deeper into identifying why the person is prone to addiction,” says Nilima Bhat, co-founder of Sampurnah. EFT is a combination of acupressure and psychology that falls under the ambit of Meridian Therapy and Energy Psychology, explains Bhat.

“Here, a therapist taps on acupressure points in the body to remove energy blockages. The technique relies on the fact that what the mind believes the body delivers.”

Talking also helps
Smoking cessation therapist and naturopath Suresh Shottam, who holds workshops for smokers, believes there is no point beating a smoker over the head with the fact that he or she must quit.

A former heavy smoker who was ‘cured’ by cognitive therapy as part of Allen Carr's trademarked EASYway To Stop Smoking (http://www.theeasywatostop smoking. com/), Shottam believes in the power of talk.

A typical therapy session with Shottam is an interactive session where smokers are encouraged to talk about their habit and challenge it themselves.

While the therapy is on, Shottam gives smokers five smoking breaks, and by the fifth break most admit that they don’t feel the itch to smoke any more. “But I insist that they do, as it is an important part of the process,” he says, adding that his therapy sessions have had a 90% success rate.

Psychological cues
While Shottam does not believe in nicotine replacement products and calls them “aids and gimmicks”, others such as cessation expert and epidemiologist Dr PC Gupta think otherwise. Dr Gupta, director of the Healis-Sekhsaria Institute of Public Health and a member of ACTIVE (Action for Cessation of Tobacco Initiative), believes the majority of smokers have a deep desire to quit.

“Nicotine is one of the most addictive substances known to mankind. It is more dangerous for being freely available,” says Gupta, and NRT products should be equally freely available, he feels.

“Along with using such products, one must also analyse one’s behaviour patterns and avoid situations that lead to smoking, such as drinking alcohol or coffee, which act as triggers. The first few weeks are the most important; once the psychological cues are gone, quitting becomes much easier,” adds Gupta.