The Tobacco Epidemic

Tobacco use kills around 6 million people each year, according to the World Health Organization – which is set to rise to 7.5 million people in 2020. World No Tobacco Day is celebrated every year on the May 31st. This year, the campaign aims to highlight the impact of smoking on lung health and act as a prompt for both individuals and policy-makers to take action. Sir Richard Doll and Sir Austin Bradford-Hill were British epidemiologists, who first provided the world with evidence that smoking was linked to lung cancer and many other conditions in the 1950’s. Yet, over 60 years later, smoking still holds millions in a chokehold grip.

Now well-recognised as being damaging to the lungs, the detrimental effects of smoking are widely known. Smoking has been proven to cause chronic lung diseases, such as Chronic Obstructive Pulmonary Disease (COPD) and can exacerbate pre-existing lung conditions such as asthma. Second-hand smoke can impact those around the smoker, with children being particularly vulnerable to chest infections such as pneumonia as a result.

Even the developing foetus inside the womb can be affected. Labelling it as the ‘tobacco epidemic’, the WHO set up the Framework Convention on Tobacco Control (WHO FCTC); the Treaty was adopted by the United Nations and includes 168 Signatories.

There are large-scale plans to combat smoking in the global arena, but what is being done in Myanmar?

Myanmar joined the WHO FCTC in 2005 and Tobacco Control Laws have been modified accordingly, yet over 65,000 people die from tobacco-related illnesses each year in Myanmar, according to the Tobacco Atlas. In Myanmar it is still legal to smoke in pubs and bars, indoor offices and on public transport. Further changes to the laws on tobacco, with added taxation, is likely to make the most significant difference in reducing the incidence of smoking. A packet of cigarettes will set one back by only K1000, compared to the average cost of £10.40 in the UK (approximately K20,100). Escalating the price of a packet of cigarettes and making smoking a habit that is simply not sustainable will considerably lower the incidence of smoking-related diseases in Myanmar.

Smoking has been prohibited in a number of places in Myanmar, including some buildings and offices, according Chapter IV of the Control of Smoking and Consumption of Tobacco Product Law (2006). Although restaurants and bars are still off the hock, some have tried to ban smoking by hanging no smoking signs. Paradoxically, ashtrays can still be found on tables and cigarettes for sell at the counter, indicating that there is still a long way to go to challenge the norm.

If you are still reading this article then perhaps either you are interested in quitting or have a loved one that continues to smoke. In support of World No Tobacco Day here are a few helpful tips to ramp up your efforts to stop smoking;

Think about why you want to stop

This is incredibly important – what does smoking mean for you and why is it that you want to stop. Write a list down and look at it again when you are going through a more challenging period.

Set a stop date

Plan in advance and tell people about it as this means you are now committed to it. Planning an attempt to quit and thinking about how you will manage cravings means you are much more likely to be successful.

Recruit your followers

Tell family and friends; you will need their encouragement and support. When life throws a stressor your way, instead of reaching for a cigarette, reach for the phone. If you can find another to quit at the same together, you can support each other.

Go digital

In an era where so many have smartphones, there is an app for everything. There are many apps available to motivate you and guide you through the journey.

Know yourself and the triggers

Understanding where the obstacles lie will allow you to come up with a plan to tackle them. Perhaps there are certain situations where you would always smoke and would be more tempted than others. How will you manage that? Either avoid those scenarios completely or have a plan to cope with the temptation that will inevitably be there.

Find a substitute

Nicotine replacement therapy can be a very helpful adjunct to stopping smoking and significantly increases the likelihood of a successful attempt. A smoking cessation service can provide a lot of useful advice and support strategies in addition to guiding you as to which nicotine replacement therapy would be the best match. There are a variety of different forms, such as gum, lozenges, patches, inhalers and nose sprays. If you prefer something simpler, perhaps just using a carrot stick, matchstick or toothpick can help manage the craving and act as a substitute for a cigarette.

Consider prescription medication

There are tablets available that do not contain nicotine, but help with cravings (champix and zyban). Used in combination with nicotine replacement therapy, these can double the chances of a successful quit attempt.

Get outside

Evidence has shown that exercise can help ward off cravings. As well as being good for mental health, keeping active will help you manage the symptoms as well as your waist line.

Be positive

Smoking is a powerful addiction and it is not easy to stop. So reward yourself along the way. Perhaps consider the money you have saved from not smoking and put it towards something else that you want.

Keep trying

Many aren’t successful on their first attempt so don’t be too hard on yourself, smoking is a powerful addiction.Keep going, the more you try, the more likely you are to succeed.

The effect on the economy is huge, but the price the individual pays is greater. Don’t let smoking keep a hold on you. Stopping smoking is the single best thing you can do to impact positively on your health.

Dr Bethany Moos is a doctor from Oxford in the UK and is currently based in Yangon as an Improving Global Health Fellow.

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