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The problem of nicotine dependence among Indian adolescents

The problem of nicotine dependence among Indian adolescents

Many teenagers pick up smoking without a thought and find it hard to quit. But the benefits of quitting can be experienced within hours of giving up the habit
Representational Illustration| Shutterstock

No matter what age a person is, smoking is dangerous to health but can be hard to give up. Countries across the world have tried to deter smoking, through a range of measures, from imposing an outright ban on doing so in public and private spaces to other punitive measures designed to deter.  

Tobacco companies in India are now promoting alternative products like so-called herbal cigarettes and paan masala. Their flashy marketing campaigns project the consumers as cool, independent and attractive individuals – images that target many teenagers. As a result, many adolescents buckle under peer pressure and get addicted to cigarettes.  

 A college student spoke to Happiest Health about how he took to smoking during the initial year of college. “When I first shifted to another city for higher education, I met friends who smoked in their PGs, flats and hostels. We went to many resto-pubs where ashtrays [full of] cigarette butts were lying around. It made it appear as if it was cool to smoke.” 

Cigarettes contain more than 200 chemicals out of which at least 60 are known to cause cancer. The smoke carries nicotine from the mouth and through the respiratory tract to the lungs where it is absorbed and then diffused in the blood. Tobacco products when chewed disintegrate skin cells in the oral cavity exposing minute blood capillaries. Nicotine gets absorbed in the mouth via the exposed capillaries and into blood. 

Prolonged consumption of tobacco in any form increases the risks of cancer. Nicotine helps in releasing adrenaline and dopamine, hormones which cause high blood pressure, an increased heart rate and rapid breathing.    

Prolonged consumption of tobacco makes its users susceptible to cardiovascular ailments, lung diseases and tuberculosis besides an increased risk of stroke. A large number of smokers, among them teenagers, find it appealing to consume tobacco in alternative forms such as e-cigarettes and hookahs. Smokeless alternatives like gutka and paan masala are readily available with vendors.  

Why do adolescents smoke?

At least 40% percent of smokers first smoked between the ages 12 and 16, while the average individual began smoking regularly at the age of 18, according to a global adult tobacco survey of 2015. 

Addiction is largely influenced by social groups – friends, peers or relatives – who persuaded them to start smoking. Regardless of statutory warnings and law enforcements, it was found that the prevalence of tobacco use in schools ranged between 6.9 percent and 22 percent. 

Dr Jayant Mahadevan, assistant professor of psychiatry at the National Institute of Mental Health and Neurosciences, Bengaluru, lists some of the causes for smoking among adolescents: experimentation, curiosity, peer pressure and stress. “Adverse experiences in childhood, abusive past, parental negligence and lack of adult supervision are some of the root causes and general factors leading to consumption of tobacco in various different forms.” 

According to the teenage smoker we spoke with, “I started smoking at the age of 17. I eventually got into the habit mainly because my friends started smoking around the same time.” 

Stress and anxiety add to nicotine dependence. He said, “I easily smoke three to four cigarettes every day. Shops selling them are located not far from where I live. I spend about Rs 60-70 a day.”  

While discussing the ill-effects of tobacco consumption, it is also important to assess and stem the rampant “vaping culture” that is gaining momentum in the country.   

Many adolescents fail at quitting smoking despite trying to, even after understanding its risks. This is because a person trying to quit nicotine addiction experiences symptoms of withdrawal such as coughing, restlessness and difficulty in concentrating.  

 “The initial state of withdrawal is marked by disturbance as nicotine is a fairly addictive toxin. At least 30-40 percent teenagers get addicted to and develop a nicotine dependence at an early age,” says Dr Mahadevan, who is also a consultant for de-addiction psychology and clinical assessment at NIMHANS. 

However, once a person comes out of the addiction to smoking, they can experience improved health, positive mood and an elevated quality of life. Here are the bonus points of giving up tobacco, according to the American Cancer Society: 

  • Oxygen levels return to normal after eight hours of quitting; reduced risk of heart attack and improvement in lung functioning are apparent within three days. 
  • In the following months, respiratory issues subside and heart-related ailments even out. In five successive years, the risk of stroke is largely reduced and the possibility of lung cancer is halved. 
  • After 15 years, the risk of heart disease is similar to someone who never once smoked.

Many specialists help in tobacco de-addiction. Familiarisation with medication and counselling helps in nicotine replacement. General practitioners and even dentists have helped in overcoming nicotine dependence. Prohibitions, early knowledge, overall community development and preventive measures can prevent consumption of tobacco among adolescents. 

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