In most European countries, smokers have become a dying breed – in more ways than one. Pushed to the margins of public space following extensive indoor smoking bans, they huddle together outside restaurants and office buildings in miserable weather and puff on their cigarettes as if each one were a resolution to exist until the bitter end. Every so often, one of them feels too tired for revolution, and bites the cold turkey.
The new UAE anti-smoking laws came into effect on December 21, making it illegal to smoke in enclosed public spaces (except in designated smoking areas) and sell cigarettes to minors. As in Europe, the government, health authorities and doctors are hoping it will encourage even more people to quit. Yet while the powers that be can enforce laws and slap graphic labels on packages, the only person that can persuade a smoker to give up for good is themselves. We’ll merit that it’s not an easy (or even appealing) feat for some, which is why specialist advice is always welcome.
Step forward Dr Saul Shiffman, a research professor at the University of Pittsburgh, who recently visited the Middle East for a series of lectures for healthcare professionals about smoking cessation with therapeutic nicotine. His first statement may come as news to some: nicotine is not evil. It is addictive, but has virtually no harmful effects.The harmful ingredients in cigarettes are the tar, carbon monoxide and poison gases that are produced by incomplete combustion when you burn nicotine to smoke it.
‘Think about it this way,’ says Dr Shiffman. ‘Forget that there’s such a thing as cigarette smoking. If someone had a barrel full of leaves and was burning it and then stuck their head in to breathe, you’d think they were doing something stupid. It’s obvious that it’s harmful.’
What if the smoke is filtered, such as in shisha? Is that a safer option?
It’s not. People think because it’s put through water, it’s safe. I just think of it as giving you ‘wet poison’. It doesn’t really filter out the poisons, and because of the charcoal in the bowl of shisha, it actually gives you much more carbon monoxide. Someone who is smoking shisha takes in three times as much carbon monoxide as someone smoking a cigarette.
Can you talk us through nicotine replacement therapy (NRT), which helps people quit?
The most popular way for people to get nicotine therapeutically is a patch, which puts nicotine into your body at a very slow and steady rate, but you can’t control how much you get or when you get it.
What’s the alternative? We’ve heard about NiQuitin lozenges, which are now available here…
The advantage of the lozenges is that you have some control over how much you take and when you take it. We’ve shown that the lozenges are effective at reducing cravings very quickly when people get into a situation where they’re tempted to smoke.
How effective are alternative therapies?
I’ll give you the quantitative scientific facts: hypnosis has been tested repeatedly and has been found to have no effect. Acupuncture has been tested repeatedly and has been found to have no effect. But when you’re going to a psychiatrist for sessions, it depends. The kind of counselling that’s been shown to be effective for quitting smoking is not about thinking about your relationship with your mother, it’s a very practical set of procedures on how to minimise the craving you feel, how to deal with it when it comes on, and how to get through it. It’s really like a ‘how-to’ manual and a coach.
For clinics, counselling and smoking cessation advice, visit Al Ittihad Health Centre Jumeirah (04 3421 005)
Tips to help you quit
• You need to change your behaviour to deal with the problems of the addiction.
• Don’t just jump into quitting – it’s important to have a plan. Think about when you’re going to find it difficult, such as places or situations in which you’d usually smoke.
• Use NRT medication such as NiQuitin on a schedule (as recommended), and also when you have cravings.
• Both counselling and NRT are effective in themselves, but you’ll get the best results if you do both.
• Enlist the help of friends and family – they can encourage and get you through the hard times.