Did you know... 1 KNOW WHAT YOU DO… Tobacco is addictive. Tobacco contains nicotine, a substance that is addictive and can make it very hard, but not impossible, to quit. Cigarettes, beedis, cigars, chuttas, dhumti, pipe, hooklis, and hookah are the smoking forms of tobacco. Smokeless forms of tobacco include chewing paan (betel quid) with zarda (tobacco), guthka, pan masala, manipuri tobacco, mawa, khaini, kaddi pudi, chewing tobacco leaves, mishri, gul, and ingestion of tobacco water or use as snuff.

Effects of Tobacco on the body: The chemistry: Nicotine in tobacco is a very powerful substance that affects mood, focus and thinking. In seven seconds, a puff of nicotine begins to calm a smoker’s brain. With one nicotine hit for each puff or chew the brain gets used to hundreds of nicotine ‘hits’ each day. The behavioural psychology: The smell of a beedi or a cigarette or a cup of coffee automatically produces a strong urge to smoke. Similarly the sight of strings of pan masala in a pan shop or extreme tiredness after work or getting bored may urge a person to chew. A lot of smoking is done automatically, without thinking about it. Similarly for chewers, a spicy meal or hungry stomach may be the stimulus to chew. Smokers often feel they need a cigarette to feel right or to think clearly, when a chewer misses a packet, he/she feels lost and irritated. People with a history of depression, schizophrenia, attention deficit disorder and other conditions may have a harder time stopping tobacco use. The social factors: Smoking is a social ritual for many people, shared with family, friends or co-workers. When other people light up, it is often natural for the smoker to join them. 2 Did you know... Did you know... 3

For chewers, it is even lesser of a social taboo to be seen chewing. There are also no limitations as chewing does not emit any smoke!

TOBACCO KILLS – A PAINFUL DEATH Tobacco is the second major cause of death in the world. It is currently responsible for the death of one in ten adults worldwide (about 5 million deaths each year). If current smoking patterns continue, it will cause some 10 Cigarette smoking or Gutkha chewing would have been million deaths each year by 2020. Half a part of your life for sometime, have you really cared to know the people that smoke today about 650 what is in a cigarette that you smoke or in a packet of gutkha million people will eventually be killed or pan masala that you chew… by tobacco. • One Cigarette and One Beedi contains 4000 chemicals. Even though it may take years to kill, tobacco use most often does not kill suddenly……….long use brings with it • One packet of Pan Paraag, Guthka, Khaini, Hans contains pain and suffering 3000 chemicals. “….tobacco is the only legally available consumer product • Nicotine is the addictive agent that makes a person a which kills people when it is entirely used as intended.”- slave of tobacco. The Oxford Medical Companion, 1994” • 40 % of cancers detected in India are because of tobacco “If younger adults turn away from smoking, the industry use. will decline, just as a population which does not give birth will eventually dwindle,”- RJ Reynolds researcher, 1984 • One Cigarette and one Beedi reduces 6 minutes of your There are currently about 240 million tobacco users aged life span. 15 years and above in India • One packet of Pan Paraag, Khaini, Gutkha, Hans causes Smoking currently causes about 700,000 deaths per year a wide spectrum of oral mucosal lesions/conditions, in India most commonly leucoplakia which is seen as a white plaque and periodontal disease. The risk of dying is 40% - 80 % higher in a tobacco user compared to a non user • “An hour a day in a room with a smoker is nearly a hundred times more likely to cause lung cancer in a Quit if you don’t want cancer, stroke, heart attack, sexual non- smoker than 20 years spent in a building dysfunction… and many more…. containing asbestos.“- Sir Richard Doll, 1985. 4 Did you know... Did you know... 5

• Tobacco kills more men in developing countries than • Women smoking in their in industrialised countries, and it is likely that deaths reproductive age are at higher risk among women will soon be the same. of having miscarriage, low birth rate babies, still births or have babies with infections of the middle ear, coughing and wheezing. • Women smoking after their reproductive age are at higher risk of low bone density and coronary artery disease. • Causes problems to family, friends and co-workers from the smoke of the cigarettes – exposing them to For those two minutes of satisfaction… your long time gains… the same dangers. This is called second hand smoking. • Increased risk of cancer in mouth, throat, maxilla, lungs oesophagus, stomach, urinary bladder. • Sexual impotence in men, miscarriage and infertility in women. • An aged skin, stained teeth, bad odour, mouth ulceration, Is it worthwhile to QUIT? difficulty in swallowing. Yes yes yes yes yes yes !!!!!!!!!!!!!!!!!!!! • Effect on every organ in the body from head to toe, Quit if you are young especially on the brain, lungs and heart. Quit if you are old • Heart attacks, chronic cough and lung disease, Quit if you are a man worsened treatment resistant diabetes mellitus, hyper Quit if you are a woman tension and reduced physical stamina. Quit if you have a health problem Quit if you don’t…and avoid being at risk for any health problem. 6 Did you know... Did you know... 7 What difference will quitting make After 1 year: • Your risk of heart disease will be about half of what it After 20 minutes: would have been if you continued to smoke. • Blood pressure levels and pulse rate becomes normal. After 5 years: • Body temperature of hands and • Your risk of stroke will be substantially reduced; within feet increases to normal. 5 to 15 years after quitting, it becomes about the same as a non-smoker’s. After 8 hours: After 10 years: • Carbon monoxide in your body drops. • Your risk of dying from lung cancer will be about half • Oxygen level in your blood increases to normal. of what it would have been if you had continued to smoke. After 2 days: • Your risk of cancer of the mouth, throat, oesophagus, • Sense of smell and taste will improve. You will enjoy bladder, kidney, and pancreas will also decrease. your food more. • Your risk of heart attack begins to decrease. Within 15 years: • Your risk of dying from a heart attack is equal to a After 3 – 4 days: person who never smoked. • Bronchial tubes relax and your lung capacity will have increased, making breathing easier. Other benefits of quitting After 2 weeks: Reducing your chances of premature death and illness are important, but they aren’t the only benefits of quitting smoking. • Blood flow improves; nicotine has passed from your body. • You’ll be in control – cigarettes, beedis or gutkha and pan masala Within 2 weeks to 3 months: will no longer control you or your • Circulation will improve, making walking and running lifestyle. Your self-image and self- easier; lung functioning increases up to 30%. confidence will improve. You’ll feel proud of your ability to overcome Within 6 to 9 months: something so challenging. • You’ll experience less coughing, sinus congestion, • You will have more energy to do tiredness and shortness of breath. the things you love. 8 Did you know... Did you know... 9 WHY SHOULD YOU QUIT: the other stuff STEPS FOR QUITTING • Your smoking will no longer be a bad influence on younger children (including your brothers and sisters, Statutory Warning: Don’t use tobacco…now…or in the sons and daughters). future • Think of the money you will save by not buying tobacco, lighters, ashtrays, matches and so on. If you smoke or chew it’s never too late to quit. Kicking the habit early will also help curtail • You will look and feel younger. Smokers are more likely the addiction. to wrinkle at an earlier age and have deeper wrinkles. • Your clothes may last longer (no chance of accidentally burning a hole). • Pick a stop date. Choose a date 1 to 2 weeks away so you can get ready to quit. If possible, choose a time • Quitting reduces bad breath. when things in your life will change. Or just pick a time when you don’t expect any extra stress at school, • No more yellow teeth or fingers. work or home. For example, quit after final exams or a • Regardless of your sport or activity, your performance, project assignment, not during them. endurance and ability to play the game will improve • Make a list of the reasons why you want to quit. Keep after you quit. the list on hand so you can look at it when you have a • No need to worry about which restaurant you go to or nicotine craving. whether you can smoke in a particular place. • Keep track of where, when and why you smoke. You • No more looks of disapproval or feelings of guilt. may want to make notes for a week or so to know ahead of time when and why you will crave for tobacco. Plan • No more nagging from people asking when you’re what you’ll do instead of using tobacco. You may also going to quit. want to plan what you’ll say to people who pressure you to smoke or chew. • Throw away all of your tobacco. Clean out your room if you have smoked there or left a tobacco packet lying around. Throw away your ashtrays, lighters, empty packets, anything that you connect with your tobacco habit. • Tell your friends that you’re quitting. Ask them not to pressure you. Find other things to do with them besides using tobacco. 10 Did you know... Did you know... 11 • When your stop date arrives, STOP. Plan little rewards Puzzle Your Way to the Facts- Second Hand for yourself for each tobacco-free day, week or month. Smoking For example, buy yourself a new shirt or ask a friend to see a movie with you. Fill in the blanks using the tobacco vocabulary and then complete the crossword puzzle. Things to do instead of smoking or chewing cancer respiratory asthma exposed • Chew sugarless gum. hours circulatory die toxic • Call a friend. DOWN • Chew sunflower seeds, ground pudina leaves, 1 There is a link between second-hand smoke and lung (___). cardamom, cloves, tulsi leaves, a chocolate or a toffee. 2 Second-hand smoke contains some (___) chemicals. • Go to a movie or another place where you can’t smoke. 4 Even if an expectant mother is only (___) to smoke-filled • Take a walk or work out. rooms she will have a baby who is more likely to have health problems. • Remind yourself why you want to quit. 5 There is a link between second-hand smoke and heart • Develop a healthy lifestyle. disease, (___) , middle ear infections, and a range of other diseases.

If you can’t do it by yourself……… ACROSS It’s understandable…because tobacco 1 Second-hand smoke can have a bad effect on the body’s is so addictive! (___) systems. You can get help through counselling 3 Second-hand smoke can also have a bad effect on the body’s and medication. (___) systems. 6 Second-hand smoke can stay in a room for (___), even if a Medications that help you quit include nicotine replacement, window is open. bupropion and others. 7 Researchers say over 500 non-smoking Indian (___) each year from the effects of second-hand smoke. 12 Did you know... Did you know... 13 Yeh he hai right choice baby…….. 12 No cigarette or gutkha is worth your health or the health of the people around you. The Tobacco Cessation Centre (TCC) a WHO and Ministry of Health, Govt. of India 3 4 5 initiative, runs at the De-addiction Out Patient Department (OPD) of NIMHANS, Bangalore every Monday and Saturday from 9 am to 1 pm, is the right CHOICE towards a smoke free life. 6

Call us at 080-26995311 / 26995312 or email us at [email protected] for further details. 7

Choose Life…Not Death.....

Note: This has been compiled from various sources for the benefit of the general public. Compiled by: Deepa Krishnan Mathews Sebastian DID YOU KNOW... Maneesh Dhingra Amit Zutshi Vivek Benegal Pratima Murthy

the facts and myths of smoking and chewing tobacco

Tobacco Cessation Centre National Institute of Mental Health and Neuro Sciences BANGALORE for the Tobacco Cessation Centre, NIMHANS, Bangalore, 2007