Tobacco continues to be an important source of direct and derived diseases. Dr. Xavier Fàbregas Pedrell, a medical expert in addictions, explained in an interview how smoking is another pandemic, the rebound of this addiction during confinement and, especially, in new smokers. He also explained how the process to quit smoking should be.
Tobacco has been a public health problem for many years but it has been somewhat pushed into the background by other news, even though it is still one of the most important health problems. In addition, quitting smoking may be the most important possibility to collaborate with our own health because it is evident that the person who quits smoking reduces the incidence of many respiratory and oncological diseases that are directly related to tobacco smoke.
The stress and anxiety of confinement have not helped smoking.
Stress and anxiety during confinement have not helped smoking, but it should be noted that there is a false belief that smoking reduces anxiety and stress, when what it does is to reduce the anxiety itself by having nicotine in the blood. But there is no scientific evidence that smoking helps to be less nervous but what it does is that, if you are more nervous because what you lack is the nicotine base, if you smoke it reduces that anxiety.
With the pandemic, some conflicts have become evident, for example, people who were at home without balconies and with little ventilation, who have realized that they are more annoying when they smoke than when they are in the street. And this may be one of the things that have highlighted the problem of smoking, and that perhaps was not so evident before. But there is still a false belief that it helps us get through the nervous moment.
Has being cooped up at home been detrimental to smoking addiction?
It is still too early to talk about figures, but it is always said “it is a bad time to quit smoking”, but it will always be so because the hardest thing is to take the first step, which is motivation. Curiously, we make a great effort to get used to tobacco (let’s remember that the first cigarette we smoke is never pleasant) and we do it for a series of psychological motivations to feel bigger and more transgressive, which causes us to quickly get hooked, as tobacco has many addictive substances.
From this point on, smoking is something that is done to avoid this unpleasant fact of the lack of nicotine, not so much because it is really a pleasure. However, there is a whole sort of mythologizing about smoking, even with Hollywood movies and actors from years ago or the fact of relating to others, including when quitting smoking something as insignificant as the difficulty of what to do with your hands when quitting.
What is the state of tobacco addiction today, especially in young people who start smoking?
There was a time when the incidence of smoking was greatly reduced in these early smokers, but now we are once again seeing an upturn in young people starting to smoke, despite the fact that we thought that this message had already been received by the population. It is probably now more women than men who smoke more in the youth group.
In terms of numbers, there has probably been a 20% increase in the number of people who have taken up smoking. And this new incidence may have to do with a series of campaigns that have been carried out, as well as with new ways of smoking. For example, we have very much associated rolling tobacco as something rebellious, something you can do yourself and go “against the industry”, when in fact it is the industry itself that provides the tobacco, the rolling papers and the filter. And, above all, something very recent that we all remember: vapers. There was a time when there was a store on every corner, but they appeared and disappeared fast. It was a fever that lasted about a year but it was a way to get young people hooked, because it was a device that had a modern look, with a whole variety of flavors, where nicotine was vaped with “things” that seemed to make this first step of starting to smoke easier, by making it less unpleasant. This had to be curtailed because we realized that it was a way for people who had never smoked before to start smoking.
Now there are devices that say they just heat up the tobacco and are less harmful but, in reality, the message is once again being sold that doing that is less bad, and it’s the wrong message.
Is it easy to quit smoking? The first step: wanting to quit
Wanting to quit smoking is the key factor. Every person who wants to quit smoking must take the step of convincing themselves why we quit smoking. Without this reflection it is probably not even worth trying because the person will be continually playing inside his head with a series of contradictory reasons to his desire to quit smoking, and it will be a losing battle.
Therefore, the first thing to consider is why a person stops smoking, what motivation guides him. There are health reasons, economic reasons… and the fact is that what a person spends on tobacco can be invested in many beneficial things. And there is also a slightly more revolutionary idea of why we smoke, why we accept that, in some way, they influence us, adding more than 600 substances to tobacco. This is proven after the European Commission put pressure on the tobacco industries and got them to publish the list of added products that make tobacco more addictive.
In general, there are many reasons to quit smoking, but the most difficult is not to relapse.
Does science and/or medicine currently have medication to curb tobacco addiction?
There is a very useful drug, varenecline. It makes the process of quitting smoking (getting over the “monkey”) easier, and about 50% of people who try it stop smoking. The person takes it while still smoking and makes these cigarettes less pleasant. Therefore, by the time the person quits, they quit more easily because they are giving up a habit that is no longer as rewarding and enjoyable. This is used to curb consumption, and the key is not to start again. The problem is the person who explains to you that he has quit smoking, that he is going to the gym and does not choke, that his clothes do not smell of tobacco and that food tastes much better, but after a month you see him again with a cigarette because he has not been able to stop the moment of memory associated with many social circumstances.
Tobacco is one of the substances, like alcohol or gasoline, with more direct taxes. Therefore, there is a contradiction because it has been shown that the cost of tobacco (including associated diseases and health costs), is higher than the benefit that is achieved at the level of taxes. In addition, there is a problem in anti-smoking campaigns, which should foresee that the harm, although evident at the medical level, is not immediately perceived by the patient. When a person sees the slogan on the tobacco package that says “tobacco kills”, he does not see it, because he smokes and sees that it does not happen.