Wendel Abel - I AM WHAT I THINK THE DECISION to address the issue of cigarette smoking was influenced by a discussion I had with someone this week. A number of questions were raised that has prompted me to write on the matter. Before you read this article, test your knowledge, answer a few questions and see how aware you are!
The number of young people who smoke cigarettes in Jamaica is less than 10%? Yes/No Is cigarette smoking harmful to the body? Yes/No Is cigarette smoking a major cause of lung cancer? Yes/No Can someone become addicted to cigarettes? Yes/No Can cigarette addiction be treated? Yes/No Major concerns are raised about the level of smoking in developing countries and among the youth. A study funded by the Planning Institute of Jamaica in 1997, revealed that 27% of students between the age of 11 and 21 admitted to "ever used" cigarettes. Research has shown that young people with lower self-esteem are more likely to use tobacco. In addition, a number of other factors contribute to cigarette smoking among the youth, peer pressure, the need to identify, stress and experimentation are only a few.
Peter started smoking at age 16, he commented, " I find smoking sexy, fashionable and macho it allows me to be identified with the crowd and people I see in movies, videos and on TV." Many young persons continue to smoke even though they are aware of the harmful effects but they believe they will be able to escape the harmful effects by quitting before they set in. "I know that smoking is dangerous says 21 years old Maria, " who works in an investment firm, "but I am still young and I will be able to quit in time." " Wrong!" says Psychologist Dr. Kai Morgan, "smoking leads to addiction. The sooner one quits the better, years of smoking cement the habit. It then becomes difficult and problematic to stop."
Nicotine is one of the active ingredients in cigarettes, when it enters the body it is absorbed into the blood stream and travels to the brain where it activates the brain reward centre or the pleasure zone. When this reward centre is stimulated the individual gets pleasurable feelings. Food, water and sex will also stimulate this pleasure zone and other drugs will also stimulate the pleasure zone. In order to repeat these pleasurable feelings individuals will repeatedly use drugs. This is the basis of addiction.
Withdrawal symptoms may occur when an individuals stops smoking cigarettes, these include feelings of depression, sleeping problems, irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, increased appetite and weight. Lenworth, a smoker of twenty years commented, "these withdrawal symptoms can be very distressing. Every time I try to quit smoking, I get them and it is these withdrawal symptoms that make it difficult for persons like myself to stop smoking."
At the age of 45 and after 25 years of smoking my cousin George started to lose weight and had severe shortness of breath. The difficult task was mine to break the news to him in 1987. He had developed lung cancer. He died eighteen months later. A report by the Ministry of Health stated that smoking has been identified as the single most important risk factor for lung cancer; the majority of lung cancer death (90%) is due to smoking. Lung cancer is the second commonest cancer among men in Jamaica. Smoking patterns among men in Jamaica contributes to the high incidence of lung cancer. Cigarette smoking is the single largest preventable factor contributing to the burden of disease, disability and death in Jamaica.
SMOKING RELATED DISORDERS
Apart from lung cancer smoking may cause:
Coronary Heart Disease
Cerebrovascular Disease
Chronic Obstructive Lung Disease
Cancers: lip, oral cavity, pharynx, larynx, esophagus, pancreas, bladder and kidney.
SMOKING - RELATED DISORDERS IN INFANTS
Tobacco smoking is associated with a number of outcomes in newly born infants these include:
Growth impairment
Low birth weight
Small for gestational age
Respiratory problems
Respiratory tract infection
Acute and chronic bronchitis and pneumonia
HOW TO QUIT SMOKING
1.Recognize that you have an addiction - this is the first step in the recovery process.
2.Identify factors that trigger your urge to smoke and work on them
3.Engage in physical exercise as this will promote a general sense of well being, it provides structure to your life and helps in weight loss (many persons tend to eat more and put on weight when they stop smoking)
4.Become a part of a support group e.g. Narcotic Anonymous, Codependency Anonymous, Grief Support Group and the Depression Support Group these exist in Jamaica.
4.Substitution methods include nicotine patch and chewing gums
5.Discuss with your doctor the possible use of medication e.g. buproprion, which is now available in Jamaica.
Having read this article, how did you perform on the test?
Dr. Wendel Abel, consultant psychiatrist; senior lecturer, University of the West Indies
