Prof. Dzulkifli Abdul Razak
The Sun, June 27,1995
THERE IS NO ONE ANTIDOTE WHICH can be used to neutralise the thousands of toxic chemicals like those found in a cigarette. This is a fact that must be duly recognised by all. However, there is one quality that can help you kick the habit - WILLPOWER.
Willpower is also a multicomponent concoction that has a multi-pronged action against cigarette poisons. Each of the components in willpower not only provide an effective antidotal remedy in itself, but together they can combine to provide a fool-proof cure. In fact, it has been proven to work time and again if diligently instituted.
How it works:
W - willingness to take positive and affirmative actions to quit smoking
I - inculcating new smoke free habits
L - learning how to cope without using tobacco
L - love and live a healthy lifestyle without tobacco
P - positive attitude in facing difficulties while attempting to quit
0 - orienting all efforts towards success in quitting smoking
W - well versed with the actions to be taken in order to quit
E - exercise and eat a balance meal in the course of quitting
R - resolute, not to begin smoking again
(c)PRN 1995
With the willpower to quit smoking, quitting is easy and success is guaranteed all the time. It costs nothing and is readily accessible to all smokers anytime and anywhere.
To date, there are no drugs that can be used to convincingly counteract the effects of cigarette smoking, although a number have been tried with limited success.
Notwithstanding this, there are also supporting programmes that could assist smokers to quit. These include the 10 steps that were discussed previously (Healthtrack, June 13). In addition to this is another approach using what is called 'Nicotine Replacement Therapy (NRT).' It involves the use of nicotine in the form of chewing gums or patches as a substitute to cigarette smoking. One of the barriers to giving up smoking successfully in the past has been the physiological or mental dependence to nicotine of the smoker.
For such people, quitting the habit would cause them to experience a number of withdrawal symptoms. Often, such a 'cold turkey' approach deters many from even attempting to quit. Therefore, in principle, the use of NRT is to allow each individual smoker to cope with the adverse effects of quitting smoking, eventually leading to the cessation of smoking.
In other words, through NRT the use of cigarette is being substituted by other means to supply nicotine to the body. In this way the effort to quit smoking can be slowly managed, especially in coping up with some of the barriers experience by the smoker - oral, manipulative, social or mental (see Healthtrack, June 13).
Over a period of time the use of NRT can also be tapered down so that the dependence on nicotine can be totally eliminated. While many smokers can give up the habit by willpower alone, others need assistance, especially those who are addicted to nicotine.
There are many types of nicotine substitutes that are available in the market. They are the nicotine-laced chewing gums (Nicorette) or patches containing nicotine which are called Transdermal System or TDS (Nicotinel).
The former has been shown to be useful to those who need to keep their mouth busy, apart from relieving the desire to smoke. As for the latter, it comes in various strength depending on one's smoking habit. Unlike the chewing gum, the TDS must be applied to the skin so that the nicotine contained in it can be slowly released into the circulatory system, thus sustaining a level of nicotine in the body. NRT is smokeless and the effects of 'passive smoking' can be totally eliminated. However before choosing which type of NRT to go for, it is important to decide which one would suit the needs of the smoker.
There are a number precautions that must be taken so that the best effect is achieved. Those interested can call the National Poison Centre at 04-6572924 during office hours for advice.
In general, users of NRT will still have to deal with the manipulative, oral or even social barriers that a smoker has. NRT is normally aimed at relieving the crave for nicotine. It is only a complement to willpower.
Having said this, many studies have indicated that NRT alone is not sufficient to ensure success in any smoking cessation programme. It should be supplemented with a counseling programme that can assist in some of the behavioral adjustments required of the smoker.
One study reported that factors associated with higher success rates for quitting smoking using TDS and counseling therapy are:
- being male
- more than 40 years old
- having a spouse or partner
- concerned about weight gain
- being highly motivated
Although there was a slight trend towards improved rates of quitting with higher levels of education, fear of other problems like smoke-related diseases, excessive use of alcohol or nicotine withdrawal symptoms were not significant predictors of success.
Other support programmes that can be helpful is an organised group meeting similar to Alcoholic Anonymous. Through such support programmes, ex-smokers can get together to share their experience as well as explore new ones in their efforts to quit smoking.
Generally, such gatherings can enhance one's willpower to quit. As such, undergoing group dynamics alone without the use of NRT can also be considered. On the other hand, hypnosis, acupuncture and even other alternative medicines have also been used, although it is not sure how effective they are.
Another important programme that could help is stress management. Through such a programme, smokers can get in touch with their emotions, especially in matters that could influence them to resume smoking again.
Such programme can include aerobics and other forms of exercise that could help in dissipating tension and stress.
A good eating programme is also important because most people, especially ladies, are not willing to quit smoking for fear of putting on excessive weight. Some have the tendency to overeat, not only because the taste buds are more sensitive, but also because they need to keep their mouths and hands busy!
As such, any smoking cessation programme should also be complemented with information about how to eat a balanced meals and avoid gaining unnecessary weight.
In conclusion, whilst there is no one antidote that could be effectively used against smoking, there are plenty of supporting programmes that could be mobilised to assist anyone who wants to quit.
The keyword however is still willpower.
