Tobacco use, says the World Health Organization, "is a major risk factor for many chronic diseases, including cancer, lung disease, cardiovascular disease and stroke."
The international organisation further adds that tobacco use is one of the major causes of death and disease in India and accounts for nearly 1.35 million deaths every year. It refers to India as the "second largest consumer and producer of tobacco."
Dr Samir Parikh, Chairperson, Fortis National Mental Health Program, Fortis Healthcare spoke to THE WEEK on the significance of de-addiction in India.
Q/ What have been your observations in terms of tobacco de-addiction in India, at present?
A/ My observations regarding tobacco de-addiction in India at present reveal several significant challenges. Tobacco addiction is often not recognized as a medical illness that requires treatment by mental health professionals.
Instead, many people view it as a habit, sometimes driven by social influences within their network, where tobacco use is socially acceptable, even though there is a clear correlation between tobacco use and severe health issues, such as cancer.
In my experience, tobacco addiction is not widely seen as an addictive disorder or a treatable illness. There is a significant gap in healthcare providers’ discussions about addiction treatment programs, particularly in the context of tobacco detox.
Q/ How has the situation evolved in the past five years?
A/ In my observation, to recognize that tobacco addiction is an illness and that one needs to see a mental health professional is not commonly accepted. If I were to make a comparison, more patients who want help to deal with their alcohol usage seek treatment than those with tobacco addiction.
One of the reasons for this is that the alcohol intoxication factor, its withdrawal symptoms, and the impairment in functionality are often easier to notice. When people experience these issues, they are more likely to seek help.
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In contrast, with tobacco, these factors are less apparent, and as a result, fewer people seek intervention. The worrying part is that not many people come forward for intervention until they start experiencing physical effects.
Many only visit a physician, dental surgeon, or oncologist before reaching out for help when they notice physical symptoms. This trend has remained consistent over the past five years. If I compare the number of people who come to me for tobacco cessation to those seeking help for alcohol or other substances like opioids, the latter far outweighs the former, this is an area of concern.
Q/ Do you see the eagerness to enrol into addiction mechanisms among the youth in recent times?
A/ When it comes to enrollment in addiction treatment programs, there’s often a lack of significant participation from those affected. If you look at the broader healthcare landscape, you'll realize that many healthcare providers don't emphasize addiction treatment programs across the board. In fact, if you explore social media, you’ll find more discussion about behavioural addiction and digital detox than about tobacco detox, which reflects the harsh reality of our times.
Q/ Is there a specific case among the ones you've come across in your practice that you want to share?
A/ One such case that comes to mind is that of an individual who exhibited significant anxiety, depressive symptoms, sleep impairment, and even experienced panic situations. The trigger which made them reach out to us was a cancer scare they experienced.
Medications were prescribed for treatment, and it took about three to three and a half months to reach a tobacco-free phase. The medical intervention we designed for him primarily involved medications, therapy with a psychologist, and some family-related tasks.
Deploying a behavioural modality to exercise control with the help of a psychologist, along with addressing other parameters, was crucial in treating this individual. Now, almost 8 to 10 months later, this individual is tobacco-free and has noticed a significant improvement in their quality of life. Social relationships have also improved.
Q/ Please share statistics on the age and gender of those coming to you for de-addiction services for tobacco consumption...
A/ Today's youth are exposed to various influences that subtly promote tobacco use. Thus, de-addiction education has to start at the middle school and high school level and arm them with the right skills to resist peer pressure, understand the myths surrounding substance use & build resilience against social influences.
