: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 Supply
Tobacco
Control
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 potent
parasympathomimetic
alkaloid
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 Noradrenaline
Alertness & 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’s
For 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 DR.SRABANA
Expert help
consists of
1. Counseling
2. Medication
3. Counseling + medication
DR.SRABANA
First-line pharmacotherapy
Nicotine Replacement Therapy
• Patch
• Gum
• Lozenge
• Inhaler
• Nasal spray
Bupropion (Zyban)
Non nicotine replacement
DR.SRABANA
Pharmacotherapy
DR.SRABANA
How an expert can help ?
Dealing with the withdrawal symptoms
Dealing with the medication side effects
Monitoring and follow up sessions
DR.SRABANA
Self help tips
Quitting following 4 Ds
DR.SRABANA
1. Delay: remember
that the worst
cravings last for
only a few minutes
and will become
even less frequent
the longer you
have quit.
DR.SRABANA
Deep breathe: this should help
you relax and focus your mind on
something else.
DR.SRABANA
Drink water: it is
a good idea to
drink plenty of
fluids to help
flush the nicotine
and other toxins
out of your
system.
DR.SRABANA
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.
DR.SRABANA
ASSAM
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MEGHALAYA
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MANIPUR
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NAGALAND
MIZORAM
DR.SRABANA
TRIPURA AND SIKKIM
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ASHA TRAINING
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NALBARI, DARRANG, BARPETA
DR.SRABANA
Cancer Screening
DR.SRABANA
HEALTH MELAS
DR.SRABANA
SCHOOLS AND COLLEGES
DR.SRABANA
CottonCollegiateH.SSchoolControlCell:
Dated26.08.2014.Totalparticipants:250 KV Khanapara organized by State
Tobacco Control / Dated 25.082014.
Total participants: 1500
DR.SRABANA
DR.SRABANA
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Community Awareness
DR.SRABANA
STREET PLAYS BY BBCI STAFF
DR.SRABANA
Signature Campaign for Tobacco Control
DR.SRABANA
WORKSHOPS AND ADVOCACIES
DR.SRABANA
Anti-Tobacco Pledge
DR.SRABANA
BBCI reaching out to Policy Makers
Governor of Assam & Nagaland Shri P B Acharya
on 20.06.15
Health 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 16.06.2015
DR.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 LAgarwala on 20.06.2015
DR.SRABANA
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
DR.SRABANA
Members of MUKTI working for TOBACCO control in Assam
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BBCI Patient Welfare Group
DR.SRABANA
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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
DR.SRABANA
Guru Stotram
(Guru geeta):
Gurur Brahma Gurur Vishnu Gurudevo
Maheshwara –
Gurure[-I]va Param Brahma Tasmai Shrii-
Gurave Namah ||1||
DR.SRABANA
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.
DR.SRABANA
Dr. A.C.Kataki , Director BBCI
Dr.B.Borooah Cancer Institute
Department of Secondary
Education, Assam
Assam State and
DistrictTobacco Control Cell
Team members of Mukti
All the partners and
Dignified participants
DR.SRABANA
DR.SRABANA

Tobacco Cessation issues