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Al-Ahram Weekly 29 June - 5 July 2000 Issue No. 488 
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Published in Cairo by AL-AHRAM established in 1875 |
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Al-Ahram Weekly 29 June - 5 July 2000 Issue No. 488
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| Published in Cairo by AL-AHRAM established in 1875 |
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Egypt Region International Economy Opinion Culture Features Travel Living Sports Profile People Time Out Chronicles Cartoons Letters
Smoke where there's fire
By Akram Shaf'i*Two thousand million people throughout the world today consume tobacco in one form or another -- principally as cigarettes, but also through cigars, cigarillos, pipes, snuff, and shisha. The tobacco industry generates about $200 billion a year in revenues; the US tobacco industry alone has an economy as big as Austria or Turkey.
Tobacco consumption has a long history, going back to the ancient Egyptians and Greeks. Nowadays, 90 per cent of tobacco consumers get their fix from smoking cigarettes.
The dangers of smoking began to be identified in the 1950s, and are now generally well-known. Smoking has been linked to cancer, respiratory problems, heart problems, premature ageing, infertility and pregnancy complications. Approximately one out of every four smokers will die from smoking. In most of the world, laws have been passed to discourage people from this dangerous pastime, ranging from criminalising smoking in public places to banning tobacco advertising. Nevertheless, people not only continue to smoke, their ranks swell by the day.
Smoking cigarettes is as addictive as heroine or cocaine. It takes about seven seconds from the moment a smoker takes a puff for nicotine, the addictive ingredient, to pass down the throat to the lungs, then to the blood stream and, finally, to the brain, where receptors induce the sensations of relaxation, good humour, increased mental alertness and loss of appetite associated with smoking.
In addition to the physiological effects of nicotine addiction, there are the social and psychological factors: smokers grow accustomed to having a cigarette in their hand, and enjoy the different rituals associated with smoking. Sometimes these latter aspects are even more important, when addressing addiction, than the body's need to maintain nicotine in the blood at a constant level, which gives smokers their urge to light up on a regular basis. If nicotine levels drop too low, smokers experience withdrawal symptoms of irritability, nervousness, lack of concentration and even anger. Smokers' need for nicotine, whether social, psychological, physiological, or a combination of these, generally overrides any awareness that nicotine addiction is bad for your health.
Still, despite these difficulties, overcoming the urge to smoke is not impossible. Ultimately, it is a matter of willpower, which can be helped along with professional support. Quitting is a step-by-step process.
Regardless of the stern warning of the surgeon-general, and the writing on the packet if not on the wall, cigarettes will forever belong to the sensual world of perfumes and incense, to the times where glamour held sway and odalisque-like beauties addressed their manly companions in husky tones, nonchalantly waving their gem-studded cigarette holders before exhaling a scented cloud of smoke, which slowly wrapped itself around them, shrouding the scene in even more mystery. Gold-tipped and Turkish, rolled or ready-made, the cigarettes of the turn of the century spoke of boudoirs and feminine presence.
Later, when American manufacturers sought a more rugged image to market the less than mellow taste of their blends, sports-addicted thugs took over from the languid, rather decadent oriental beauties and the Marlboro man made a much noticed appearance, proudly riding up mountains and down valleys, a modern superman to be emulated but never conquered.
Loaded with symbolism, whether pertaining to the rituals of the Thousand and One Nights, rolled by Sherlock Holmes or travelling in the backpack of a fearless explorer tackling the mountains of the Tibet, cigarettes in their various packages, sizes and forms are an omnipresent, integral feature of every conceivable modern activity, endowing their lovers with a sense of worth and maturity often unattainable otherwise. Rather than encouraging smokers to quit cold turkey, shouldn't the detractors of the habit first think of providing a suitably character-boosting substitute?
First, you must identify your reasons for smoking and your reasons for quitting. Second, you must choose an appropriate time to quit, preferably taking time off your hectic and stressful lifestyle. You will appreciate a more relaxed environment during the first two weeks of quitting, which is the most difficult period. Step three: during this time, it is crucial that you receive medical support.
Alternatively, you can seek the help and counselling of a specialist from the start. This will increase your chances of success in quitting. Scientific progress in the past 10 years has enabled tobaccologists to understand the causes and mechanisms of nicotine addiction and to evaluate different methods of treatment. There are two main types of treatment: pharmacological and psychological.
Pharmacological treatment must be prescribed and monitored by a physician experienced in the field of nicotine addiction. It can take the form of nicotine patches or gum, which treat the addiction by maintaining the level of nicotine in the blood at a steady level, thereby minimising the withdrawal symptoms associated with quitting.
The second type of treatment deals with the psychological aspects of addiction, where these are acute. Again, an experienced professional may prescribe anxiolytics and/or anti-depressants, combined with either patches or gum. Treatment usually takes one to three months, with monthly medical follow-up sessions lasting about a year.
Whatever the method of treatment chosen by smokers in order to kick the habit, prevention still remains better than cure. The real challenge is getting across a convincing message to prevent young people from starting smoking in the first place.
* The writer is a physician specialised in the treatment of tobacco addiction.
