:Tobacco cessation issues :A glimpse

Dr. Srabana Misra Bhagabaty: Assistant Professor cum In-Charge,

Department of preventive oncology, Dr. B. Borooah Cancer Institute

What is tobacco cessation

Tobacco cessation (colloquially quitting tobacco) is the process of discontinuing tobacco use

Why CESSATION is important

Demand SupplyTobaccoControl

Adding factors to the tobacco demand pool

TOBACCO DEMAND POOL

CESSATION IS ONE OF THE MOST IMPORTANT WEAPONS TO CUT DOWN THE DEMAND POOL(of the current tobacco users

FOR EFFECTIVE TOBACCO CONTROL

• Health benefits of tobacco cessation should be remembered.

TOBACCO CESSATION IMPROVES HEALTH

QUTTING TOBACCO LEADS US IN THE RIGHT PATH TOWARDS A HEALTHY AND LONG LIFE

IS TOBACCO CESSATION A CHALLENGE

YES

WHY

BECAUSE OF NICOTINE PRESENT IN TOBACCO

Nicotine is a potentparasympathomimeticalkaloid

Stimulates release of two chemicals

Nicotine reaches brain

Dopamine ‘Good’ feeling

Nicotine is highly addictive

with its

The Vicious Cycle of ADDICTION

A tobacco user

takes tobacco NoradrenalineAlertness & energy

NICOTINE ADDICTION• A psychoactive drug affecting mood and

performance

• Nicotine is:-

- 1000 times more potent than alcohol

- 10 – 100 times more potent than barbiturates

- 5 – 10 times more potent than cocaine or morphine

• Nicotine is a legalized drug more addictive than marijuana, cocaine, heroin, morphine and bhang

• Within 10 seconds reaches brain.

CESSATION SERVICE DELIVERY SYSTEM STILL NEEDS FURTHER UPGRADATION

• <Half of the current users in India visited any health care provider during last 12 months out of which only 46.3% of current smokers and 26.7% of current chewers got any advice to quit tobacco by any health care provider.

• North East these figures are even lower and only 24.7% current smokeless tobacco users and 41.6% current smokers got any advice to quit the tobacco habit by any health care provider

(Global Adult Tobacco Survey, 2010)

Motivation to quit needs to be geared up

India reports that only 38.4% of current tobacco users above 15

years of age made a quit attempt in the last 12 months. These

figures are much lesser in the North Eastern states

(Global Adult Tobacco Survey, 2010)

Tobacco cessation: is it at all possible

The answer is a BIG YES…many people have already done it.

85% of the tobacco users want to quit…. adding self confidence and determination to these “wants to quit” can make quitting a real success

Taking action towards tobacco

cessation

Hit the target : catch them young

Youth motivation not to take up the tobacco habit/ quit the habit : here role of a teacher, Institutional head, School Inspectors and education department is very important

Process of tobacco cessation

The main thing towards successful tobacco quitting is SELF DETERMINATION

Tobacco cessation has two ways

1. Expert help 2. Self help

The 5 A’sFor Patients Willing To Quit

• ASK about tobacco use.• ADVISE to quit.• ASSESS willingness to make a

quit attempt.• ASSIST in quit attempt.• ARRANGE for follow-up.

Expert help intervention type depends on

Use pattern and type, Stage of use, Level of addiction, Personality of the person, Type of motivation, Choice of quit method by the person and many other factors

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Expert help consists of

1. Counseling 2. Medication 3. Counseling + medication

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First-line pharmacotherapy

Nicotine Replacement Therapy

• Patch

• Gum

• Lozenge

• Inhaler

• Nasal spray

Bupropion (Zyban)

Non nicotine replacement

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Pharmacotherapy

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How an expert can help ?

Dealing with the withdrawal symptoms

Dealing with the medication side effects

Monitoring and follow up sessions

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Self help tipsQuitting following 4 Ds

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1. Delay: remember

that the worst

cravings last for

only a few minutes

and will become

even less frequent

the longer you

have quit.

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Deep breathe: this should help you relax and focus your mind on something else.

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Drink water: it is a good idea to drink plenty of fluids to help flush the nicotine and other toxins out of your system.

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Do something else: you could go for a walk, to the movies or visit a supportive friend. Try eating an apple or cleaning your teeth when you would normally have a cigarette. You could hold something else, such as a pen or beads, to replace the need to hold a cigarette, or chew some gum or eat or drink a healthy snack to have something other than a cigarette in your mouth.

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ASSAM

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MEGHALAYA

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MANIPUR

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NAGALAND

MIZORAM

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TRIPURA AND SIKKIM

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ASHA TRAINING

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NALBARI, DARRANG, BARPETA

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Cancer Screening

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HEALTH MELAS

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SCHOOLS AND COLLEGES

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Cotton Collegiate H.S School Control Cell : Dated 26.08.2014. Total participants: 250 KV Khanapara organized by State

Tobacco Control / Dated 25.082014. Total participants: 1500

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Community Awareness

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STREET PLAYS BY BBCI STAFF

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Signature Campaign for Tobacco Control

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WORKSHOPS AND ADVOCACIES

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Anti-Tobacco Pledge

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BBCI reaching out to Policy Makers

Governor of Assam & Nagaland Shri P B Acharya

on 20.06.15Health Minister of Assam Dr Nazrul Islam

on 23.06.15

Education Minister Sri Sarat Barkatoky

on 24.06.15

Former Chief Minister of Assam Sri P K Mahanta

on 16.06.2015DR.SRABANA

BBCI reaching out to Policy Makers

MP Sri R P Sharma on 02.05.15 MP Sri Kamakhya Prasad Tasa on 20.06.2015

Justice Sri B K Sarma on 29.05.2015 Editor – Purbanchal Prahari Sri G L Agarwala on 20.06.2015

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BBCI reaching out to Policy Makers

Former Governor of Meghalaya Sri R S Mooshahary

on 17.06.2015

Adviser (Health), NEC Dr. Bamin Tada

on 19.06.15

Former Chief Secretary, GoA Sri Haren Das

on 21.06.15

CM of Assam signing a anti-tobacco pledge

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Members of MUKTI working for TOBACCO control in AssamDR.SRABANA

BBCI Patient Welfare Group

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Workshop for Journalists

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RANI PHOTOGRAPHS

Volunteers : our strength

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SITE SEEING / Recreational programs: patient’s satisfaction

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Guru Stotram(Guru geeta):

Gurur Brahma Gurur Vishnu GurudevoMaheshwara –

Gurure[-I]va Param Brahma Tasmai Shrii-Gurave Namah ||1||

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Meaning:

The Guru is Brahma, the Guru is

Vishnu, the Guru Deva is Maheswara

(Shiva),

The Guru is Verily the Para-Brahman

(Supreme Brahma); Salutations to that

Guru.

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Dr. A.C.Kataki , Director BBCIDr.B.Borooah Cancer Institute

Department of Secondary Education, Assam

Assam State and DistrictTobacco Control Cell

Team members of Mukti

All the partners andDignified participants

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