Tough love for smokers – Dr Edwin Okon

Submitted by the SVG Medical Association, in recognition of May as No Smoking Month

“One in five adults are smokers”; “50 per cent plus – more than half of young people have been exposed to second-hand smoke”; “one in six deaths in adults aged 35 and over can be adduced to smoking”. Everyone agrees on the harmful effects of smoking, including smokers. What is responsible for this? What alternatives are available for one seeking to cope with their reasons for smoking? What impressions do we as individuals and as a society have of a smoker? Do we as stakeholders in the society care about the effects of smoking?{{more}}

Smoking is an addiction, and addictions are uncontrolled habits that are learned in order to cope with stressors. Stressors vary from anxiety to emotional instability to peer pressure. Habits that are uncontrollable result from a mechanism of positive or negative reinforcement. Smoking is a negatively reinforced habit. Each one of us has a friend, family member or an acquaintance who has been seduced by the euphoria of smoking. But, have our efforts in awakening them to the darkness behind the pleasure been sufficient? The relationship between smoking and a myriad of health diseases cannot be understated and this information is as easy to assess as a cigarette.

Orderliness is the oil that facilitates a thriving society. For order to prevail, laws are made. Laws are created to provide legitimacy and justice to every member of the society. In a situation where an individual’s desire and quest to seek pleasure violates the safety of another, the law steps in. Smoking should be outlawed indoors – at work and home, and in public spaces as well. Besides, second-hand smoking – the exposure to cigarette smoke – has been proven to cause lung cancer, respiratory infections and aggravate asthma. In a society like ours, the problem is not with legislation, but with enforcement. Authorities saddled with the responsibility of enforcing the law carry out their job with leniency.

Furthermore, meta-analytic studies by the United States Public Health revealed counselling and medicines as the core components to successfully quitting. Counselling is very important, but the problems lie with too few qualified counsellors and the wrong group of people proclaiming themselves as counsellors. In the case of the former, young school leavers should be tailored and encouraged with incentives to study and educate themselves in the field of counselling, while in the latter, qualified counsellors ought to establish a body that is delegated with the responsibility of informing the public of qualified counsellors.

Medicines can help in the form of nicotine gums, patches, nasal spray, inhalers and newer medications, such as Bupropion – a drug used to help with smoking cessation. In a health care setting like ours, where service is next to free, government can assist in procuring medicines to aid addicts interested in quitting; however, the cost of these medications should be totally borne by the individuals and not subsidized. The No Smoking initiative from the World Health Organization has encouraged the application of VAT rates and higher import duties on cigarettes to ensure that this revenue assist in covering the cost for health care provided to smokers. In a number of countries, this initiative has been proven to reduce the number of smokers.

Finally, while we continue to work on ways to improve our society and eliminate smoking, I believe it is possible to achieve significant results. Humans fight to survive, and survival is what drives us to seek out means of coping with stressors. Smokers should be encouraged to develop coping mechanisms to quit smoking.