SMOKING: Gateway To Drugs

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Cigarette and other tobacco products are one of the largest public health problems due to its effects on human body and its association with a variety of chronic and other dangerous diseases. Most smokers start smoking in their youth when growth has not been yet completed and they are more susceptible to the harmful components of tobacco and responsible for more than six million deaths annually worldwide with leading causes of death as cancer with lung cancer being the most common, besides of ischemic heart disease, chronic obstructive pulmonary disease (COPD) and stroke. In Jammu and Kashmir, particularly in Kashmir valley, around 83% of smokers begin smoking before the age of 18, in the age group of 13-15 years, with a good ratio of college girls.

Cigarette smoking in childhood and adolescence leads to short and long-term health problems, besides smoking among young has been shown to increase the risk for both on counter drugs and street drugs, as well as the risk to be engaged in fighting and other risky behaviors which are now-a-days very much visible around colleges, schools and coaching centers. The number of children and adolescents those initiate smoking annually making the existing smoking epidemic figures worse in Kashmir valley; according to the Global Tobacco Survey 2016-17 , one in five, or 20.8%, of J&K’s people smoke, against the national average of 10.7%. The state ranks the sixth highest among Indian states by smoking habits, behind Meghalaya, Tripura, Arunachal Pradesh, Manipur and Mizoram in ascending order. The reason why an adolescent begins smoking varies and differs by gender and educational level. The exact age of beginning smoking also varies and is not the same in all populations.

The risk of smoking initiation can be higher due to family and social causes in order to participate more easily in social groups; due to boredom or stress during their stay in college; also, due to social beliefs that promote smoking as evident in the gatherings of faith healers in the rural as well as urban areas of Kashmir valley. At the same instance for students whose parents smoke is easier to start smoking. If an adolescent’s parent smokes, the adolescent himself also may become a smoker. However, if an adolescent’s parent has in the past quit smoking, himself won’t start smoking so easily. In our society, the adolescents who know that both their parents would be opposed to smoking would not initiate smoking; also, parents themselves with their acts can prevent their children from initiating smoking. Teenagers that face problems in their social or family life are more likely to initiate smoking. There is a true connection between anxiety, depression and smoking. People suffering from anxiety and depression have many possibilities of smoking initiation after suffering some stressful events. Moreover, smokers with depression and anxiety can easily become addicted to other substance abuse. Smoker college students have shown much more depressing symptoms than the non-smokers. In addition, adolescents who show depression signs and are regular or non-regular smokers have a higher chance of addiction in nicotine. Acceptance from friends and the other gender plays a significant role in smoking initiation in childhood and adolescence. A parent, brother, close  relative or a friend who smoke will affect a child or an adolescent in his smoking initiation. As the young boy grows it will be more affected in initiating smoking by his close friends than his parents’ smoking habits. 

Smoking initiation in children and adolescents is also influenced by the promotion of smoking products in cinema movies. Despite the existence of limitations on smoking products in cinema movies, the placement of smoking products in movies still exists and affects children and adolescents. Many movie stars smoke in popular movies and the star is often linked with a cigarette brand. Negative results of smoking are also never shown in the movies and young men see only a positive aspect of smoking. As a result, favorable conditions for smoking initiation are created   a young man smoking is presented as more masculine, so young people are intrigued to start smoking. An aspect of how the internet can influence young people to initiate smoking has not been studied much. The influence of internet on smoking initiation is mostly seen through internet advertisements, e-mails and special web sites. There, children and adolescents can find cheap markets that sell cigarettes online.  School or college is a place where a great number of young smokers exist on date. For this reason, school is an ideal place where smoking prevention and cessation programs could be practiced; children can be informed about the harmful habit of smoking in order to prevent them from initiating and proper smoking cessation protocols could be promoted. In the same direction, teachers could also assist by taking proper training with special programs in order to convince students to abstain from smoking. However, the success of these anti-smoking programs that are based on schools is questioned. These school programs in order to be more successful should be combined with anti-smoking initiatives based on the community and the society. Programs can be more effective if they are focused on specific student subgroups; aiming to each gender separately and assessing the educational direction. Low educational level is associated with a higher risk of smoking initiation in children and adolescents. For this reason, health care specialists who are dealing with anti-smoking programs should give greater concern to this population group. In our modern era, when use of tobacco products and Drugs are increasing, when the risks to the adolescent brain are becoming increasingly apparent, every parent should become familiar with these six steps:

  1. Learn the major risk factors for tobacco/ drug use among children.
  2. Learn about smoking /drug use consequences and make clear statements that you disapprove of drug use.
  3. Be involved in your child’s life,
  4. Know your child’s friends.
  5. Minimize a child’s stress at home.
  6. Learn the signs of a child’s Smoking/drug use and how to respond.

Role of parents, particularly mother, is more important, a game changer, in the current scenario. Every mother shall use her nose, have a real, face-to-face conversation when child comes home after hanging out with friends. If there has been drinking or smoking, the smell will be on their breath, on clothing and in their hair.

Furthermore worldwide, the mass media have been used intensively for the public briefing about the dangers of smoking, because a great proportion of children and adolescents make an intense use of them. Despite the importance of the information these means of intervention provide, the results that they have had are not so enthusiastic. In the Kashmir, for example, the radio and the television have been used for the information of the children and adolescents, but their results did not satisfy the scientific community. It has been observed that these informative programs if they are not combined with anti-smoking programs in the school environment are not so effective.  In addition, the effectiveness of the information campaigns that are associated with the traditional mass media has to be reconsidered. Many adolescents do not use any more television for their information and many also avoid commercial and informative messages when they do watch. For this reason, the designers of the anti-smoking programs should consider these   aspects when they design these programs. As a regulatory part at government  level to check the smoking in public places and around educational institutions, Cigarettes and Other Tobacco Products Act (COTPA)-2003, makes it mandatory for all the tobacco products to depict pictorial health warnings on the tobacco product packs stating that smoking causes cancer and is injurious to health. These pictorial warnings   have   to be effective so as to repel the user and should occupy 50% of the display area and should be clearly visible. COTPA also prohibits smoking in public places and prohibits direct and indirect advertisement. It also prohibits sale of tobacco products to minors below 18 years and within 100 yards of educational institutions”. Government has authorized many authorities for the implementation of the Cigarettes & Other Tobacco products Act, such as Sarpanch, Panchayat Secretary, teacher, principal, headmaster  and many other a to compound offences of Smoking  in their respective jurisdictions. Lets stand together to fight, the evil of Tobacco and Drugs…..