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Nip it in the bud

On World No Tobacco Day, RAKESH MEHAR writes that there is an urgent need to evolve newer, more comprehensive methods of dissuading young people from picking up the habit

Photo: V. Sreenivasa Murthy

PRIMARY PROBLEM Anti-smoking drives tend to be one-off events. Ideally they should be a continued, sustained effort

According to one estimate by the WHO, in the next two-and-a-half decades, almost half a billion new people will light up, adding to the already 1.3 billion-strong global smoking population. Elsewhere, scientists predict that by 2030, 10 million peopl e per year will die from using tobacco.Still, these are numbers we’ve heard before, numbers that are rolled out regularly by the media, particularly on No Tobacco Days such as today. What hasn’t been pointed out before is information coming out from studies such as one published in The Lancet last year, which found that in Delhi and Chennai, sixth-standard students showed significantly higher rates of tobacco use as compared to eight-standard students. Or that coming out o f WHO reports such as one that points out each day, 55,000 children start using tobacco.

There, say experts, lies the crux of our problem. While no one denies that anti-smoking and anti-tobacco campaigns have had something of an effect, it is also obvious that these campaigns have not managed to make enough of a dent on the growing population of young smokers. One of the primary problems with the current mode of anti-smoking drives, points out Dr. Ravi Diwakar, a Consultant in Medical Oncology at the Bangalore Institute of Oncology and Mallya Hospital, is that they tend to be one-off events. “It has to be a continued, sustained effort,” he counters. “It has to be carried out day in and day out, like giving education on any other processes.” The message has to be put out in the public domain again and again.

Others point out that while information-led campaigns do have a role to play, providing information alone isn’t sufficient. Dr. Vivek Benegal, Associate Professor of Psychiatry at the NIMHANS De-Addiction Centre, points out that information-led campaigns focussing mostly on long-term effects such as cancer tend to be susceptible to the law of unintended consequences.

More effective, he says is to equip adolescents with skills that they do not possess at their age, so that they evolve longer-term ways of coping with deficiencies rather than turn to a drug as a quick fix. “We need to equip them with strategies to handle boredom, sadness, anger, frustration, teach them to cope.”

Dr. Nandini Mundkur, Director of Centre for Child Development and Disabilities associated with the Perot System India Foundation points out that their projects with students of government schools have thrown up similar, heartening results.

The essence, she says, is to empower children with life skills that help them critically evaluate their lives and make choices based on their own evaluations. The key is not to wait until a crisis situation occurs, but rather to begin at a young age and build these life skills at a young age so that children may “make the right decisions at the right times”, she says.

Another crucial step that needs to occur at the individual and familial level, says Dr. Kumaresh Krishnamurthy of Apollo Hospitals, is for adults to lead by example.

When children are exposed to fathers or other relatives who smoke, they begin to make associations with the habit that lead them to develop the habit themselves, he says. While agreeing on this front wholly, Dr. Benegal adds that parents need to send out a strong message even if they are unable to quit the habit.

“They need to be parents more than friends. Children have enough friends but only one set of parents. But you have to be open about and provide a good, strong argument with strong value attached to staying away from the habit.

And you have to be honest about it. Don’t deny that you’ve tried it. Explain that you’ve done it and tell them why it’s not good for them to repeat your mistake.”

As for the media and public service advertising, says Dr. Benegal, the most effective advertising for youth often focuses not on long-term consequences such as cancer and heart disease but on more immediately discernible effects.

Public service messages should focus on the social effects as much as the medical effects he argues, pointing out that problems such as bad breath, rotting, yellow teeth, wrinkles and aging skin often make more of an impact than the possibility that disease may strike in the somewhat-distant future.

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