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Up In Smoke

Giving up smoking to the non -smoker seems like an easy task, but to the addicted, it's a terrifying decision. AW's Kate Kelly gives us the low-down on her personal battle with tobacco

Why should I quit?
I've been smoking for 12 years and I'm only 27. That's almost half my life already. I'm a young woman, but when I wake up in the mornings, my chest feels tight and I can't climb a flight of stairs without feeling breathless. When I look in the mirror, my skin is grey and my eyes are circled in dark, tired patches. There are also fine lines beginning to creep across my previously unmarked face. My body is aging and dying prematurely, and it's because of the cigarettes. My grandfather died of lung cancer. My aunt died of lung cancer and my father had treatment for throat cancer several years after he'd stopped smoking, but that's not why I've made up my mind to quit. No. The worst thing - the very worst thing of all, is that I can no longer imagine my life without cigarettes. It's officially out of control. That is why I have to stop.

Week 1: Resolution begins on Sunday 23rd March, 2002
Okay, so I made up my mind to quit - but that doesn't mean I can't bid a celebratory goodbye to my little tobacco friends. After all, they were the ones that comforted me before my school exams, that accompanied me on many a great girlie night out and filled the dull moments of my days for over a decade. We had a solid and long-standing relationship, my cigarettes and I.

I decided that the Dubai World Cup day - the night of the world's richest horse race - would be the eve of my new independence. I smoked heartily that night, enjoying every toxic drag, knowing that the next day would be the beginning of my new free life.

As planned, the following morning I felt terrible. My eyes were sore and itchy, my upper back hurt when I inhaled, and my mouth - well it's probably best not to discuss what my mouth felt, or smelt like.

Perfect. In this poisoned state, smoking a cigarette would be tantamount to drinking a bottle of cold cod liver oil mixed with raw eggs after a heavy meal - absolutely disgusting!

I knew full well at this point that my aversion to cigarettes was only very temporary. If I was lucky it would last all day. If I was unlucky, I'd be craving again after lunch. In my sorry night-after state, I took a hasty trip to the local pharmacy and bought a supply of nicotine gum. I knew it tasted horrible from the many other half-hearted times I'd attempted to quit - but this time I was determined not to fail. Luckily, the craving held off for a full 24 hours. Feeling triumphant, I passed through my first day without a single smokey drag.

The following day also went okay. in fact, it was far easier than I thought it would be. As I sat in the office feeling smug, I watched my former smoking buddies light up and puff without a twinge. It had never been this easy in the past.

True, I was chewing nicotine gum like it was going out of fashion, but it had to get harder. Four days into the fast, the craving hit. Whoever said it only takes 24 hours to rid your body of the physical symptoms of nicotine addiction has obviously never smoked. And the pangs hit when I was least expecting them.

Without even realising, I began to become restless and agitated. I found it difficult to concentrate on my office tasks and became more and more irrationally bad tempered as the day wore on. Then I smelt a whiff of smoke, and the desire to light up hit me like a truck.

As I gobbled down squares of gum, I realised I had to occupy my body as well as my mind. Rising from my desk, I grabbed my handbag and dashed from the office. I ran the gauntlet of the corridor smokers, who called out to me, wandering where I had been for the past few days. I didn't stop to talk. I didn't dare. Once out in the sunlight I stopped short. My heart was racing, but I knew that if I didn't calm down, I'd reach for the cigarettes again. Expanding my chest, I took in great gulps of fresh air.

As the oxygen flowed into my lungs, I realised for the first time how clear they felt. The tight pain below my left shoulder blade, which had been worrying me for some time, had also disappeared.That moment was a major turning point.

Week 2: A breath of fresh air
Like every smoker, I'm a hypochondriac, believing every twinge and ache is an indication of the Big C. I say smoker, because although I haven't puffed in quite a while, I strongly believe the adage ‘once a smoker, always a smoker'.

But strangely, after a few days on the wagon, positive changes began taking place in my body. Mornings - the bain of my life since those early school days - suddenly became a pleasure. I began to wake almost an hour before my set alarm, feeling refreshed, well-rested and revitalized.

This early morning energy was alien to me. Somewhere in my youth many years before, I could half remember taking pleasure in the sound of singing birds at sunrise, but it was faint indeed.

Another change was my sense of cleanliness. Okay. Call me a hypocrite, but even as a regular smoker, I've always hated the smell of cigarettes on my clothes. Suddenly, I felt so much cleaner. After just a few days my lungs felt fresher, but I realised I smelt much better too.

As though waking after a long doze, my senses became stronger. In terms of smell, for the first few days, it wasn't a pleasant experience. People, I realised, have odours. And they aren't always nice. The stench of sweat from the maintainence man seemed to fill the house for a whole half hour after he'd gone. The woman in front of me at the supermarket check-out was wearing Miss Dior - and far too much of it, while the bloody scent on the butcher's apron turned my stomach under the cool AC's. But sadly, the worst smells I observed were from my former fellow smokers.

Don't get me wrong. I'm not one of those people who despisesa all smokers because I'm not smoking. In fact, I actually enjoy the smell of a freshly lit cigarette. But the stale scent of tobacco smoke on clothing, as well as on the breath, became almost intolerable. I committed the smells to memory and used them to help me fight the cravings. I didn't want to smell like that anymore.

Luckily, this particular symptom only lasted a few days, and my sense of smell settled down into a refined but less potent format.

My sense of taste also improved, but my digestion began to play up. Having been used to that post-lunch cigarette, I found I felt bloated after meals. I began to eat lighter portions and I upped my vegetable intake. After a few days the situation eased and I felt better. One of my main concerns was also putting on weight through compensation eating - but up to the end of week two, it still hadn't happened.

Week 3: Getting physical
After two weeks without cigarettes, I realised one of the hardest parts about quitting was filling my mid-week evenings. Previously the routine had run something like this:

7pm: Get home from work
7:15pm: Smoke cigarette
7:30pm: Eat evening meal
8pm: Smoke cigarette
8:10pm: Watch TV
9pm: Smoke a cigarette or two and watch more TV
10pm: Check emails
Midnight: Have one last cigarette and get ready for bed

Something had to change so I decided to start working out.

I've always been into fitness, but lately I had let things slide. When I got back on the treadmill after six months away, it was hard work. I began my new routine with a 20-minute walk and a three-minute run. Three minutes was the best I could do before my congested lungs began to rasp and ache in exhaustion, but at least it was a start. After a few weights and a spell in the sauna I'd managed to take my mind off smoking, which was still difficult to do. The exercise also made me feel more positive about my decision. Every night that week I spent time in the gym, and after about the fourth session, I began to look forward to it. The euphoric high after exercise and the sense of pride at having not succumbed to my craving for yet another day, helped my resolve immensely.

Week 4: Another milestone
By this time, people had begun to comment on my appearance. ‘You look different - you look so well,' they'd say. It was true. The skin problems that had dogged me since puberty had suddenly and miraculously cleared up. I'd always assumed I was destined to live with a complexion plagued by erratic greasiness, rogue spots and a sickly grey sheen. I soon discovered that all the cash I'd spent onexpensive creams and lotions to remedy these problems, had been entirely wasted. With more oxygen in my blood and the lowering of poisonous toxins, everything improved dramatically. My skin became smooth, the greasy patches evened out, the spots disappeared and I even acquired a rosy glow.

But the best thing - the very best thing of all, was the difference not smoking made to the fine lines on my face. By nearly a month after quitting they had all but disappeared. The dark patches around my eyes had also cleared up, and I was no longer having to pack on the concealer cream in attempts to cover them. In short, I looked, healthier, fresher, cleaner and much younger.

I suppose it was around this period that I began to get a little complacent. After all, I'd stayed off my beloved fags for almost four weeks. ‘Would it really hurt to have one occasionally? You can control the addiction now' I reasoned with myself.

Luckily, sense prevailed, but it wasn't easy. A strange depression descended over me as I realised that I would probably never be able to enjoy a cigarette again. The novelty of counting the days of abstinence had begun to wear thin and I wanted to smoke again.

I knew what the trade off would be: bad skin, breathlessness, smelling awful, and being terrified of every ache and pain. Then there is the undeniable fact that no matter what a smoker says, he or she always wants to quit. You make excuses. You tell people that you love smoking. But all the time you're wishing you had control over that part of your life.

So, I did something I've never done before. I bought a self-help book. I don't know whether it was the deed itself of actively seeking external advice on my addiction, or whether it was the book that prevented my fall from grace. It didn't matter. Either way, I didn't start again and I passed the month-long finish line.

Did I start again?
So far, I haven't and I couldn't be happier. Im already into my third month in 12 years without cigarettes. For the non-smoker, this seems like a tiny victory, but for all those out there who are addicted, it's pretty groundbreaking stuff. How do I do it? I take every day as it comes. I don't ever tell myself I'll never smoke again. I just say: ‘today, I won't smoke' and so far it's worked.

My hopes for the future are many. They are no longer clouded with the distant possibility of a slow and painful death from cancer. When I have children they won't be set a bad example, and when I have grandchildren, I'll be around for them. Not smoking is great.

But, for all those out there who are finding that first step of quitting too daunting, I have these words to say. You have nothing to fear but fear itself. Giving up smoking is not that hard. The cravings are over-rated, blown out of proportion by tobacco companies, who make billions by poisoning people. Believe me, if I can, you can.. AW

Why you should quit
By Rabiah Talib Baderoen

Annually, more than four million people die of tobacco related sicknesses and smoking is the greatest cause of lung cancer. It also causes heart disease and increases the risk of hardened arteries and blood clotting, leading to heart attacks and strokes. Smoking also causes increased heart rate, blood pressure and the narrowing of blood vessels. Nicotine causes decreased oxygen levels in the blood due to increased levels of carbon monoxide. In men, poor sperm mobility is often attributed to smoking thus causing fertility problems. In fact, according to the WHO ranking of addictive drugs, nicotine was found to be even more addictive than heroin, cocaine, alcohol, caffeine and marijuana. The fact is, ultimately smoking kills, but smokers become chronic sufferers before they die.

Sarah is 30-something and has been smoking: 'for a long time'. After school she went to university in Riyadh and made as she describes 'friends forever'. They were a close group of five and although she never smoked before, she started smoking because the others did. She says smoking made them feel sophisticated and independent. She still treasures an expensive Dunhill lighter she received as a birthday gift from her friends.

To-day Sarah is married with three children and still smokes. She has no desire to quit. According to her own assessment she is not an addicted smoker. She smokes with new friends and still likes the form of socialising that involves smoking. She smoked during pregnancy though less than usual but only because it eased her nausea.

Sarah says a year ago one of her university friends died of breast cancer but she does not attribute the cancer to smoking at all. Sarah admits she feels agitated if she can't light up and is restricted in public places.

Sarah's casual approach to her smoking habit is evidence of the lack of strong campaigning against smoking. There is inadequate access to quitting methods. A psychiatrist, in private practice is Jeddah says she sees a connection between some of her patients depressive moods and their smoking habits.

Live event
An intermediate Girls School in Makkah, Saudi Arabia suffered a fire in which 15 girls died. Immediately after the incident, the Presidency for Girls Education was held responsible for allocating poor premises for housing schools. It was assumed an electrical short circuit caused the fire. An investigation later revealed the horrendous truth that the fire was actually caused by a school girl stubbing a cigarette butt on a file of papers This incident proves the success of the tobacco industry at targeting the young. Statistics show youngsters start the habit between the ages of five and 10 years. Most children that start smoking from an early age, are from homes where either one or both the parents smoke. Accessibility to cigarettes poses no problem at all for them.

Women and tobacco abuse
Cigarette addiction is as prevalent amongst women as it is amongst men. In the Middle East, women of all socio-economic groups smoke, which is different to industrialized countries where women with limited education and low income groups are more prone to smoking. Smoking affects the reproductive organs of women causing serious problems in conceiving.

Women who smoke during pregnancy are at a higher risk of miscarriage. Babies born to smoking mothers have a significantly lower birth weight and suffer from slow development. Parental smoking also contributes to sudden infant death syndrome. The nicotine in tobacco, causing the dependence, is transmitted from mother to baby exactly the same as any other drug addiction. Breast feeding is recommended up to the age of two years by the WHO, but Cotinine, a chemical derivative of tobacco, is present in the urine of babies of smoking mothers who breast feed. Smoking mothers would actually benefit their babies by not breast feeding so the babies of smoking mothers would be deprived from the benefits of breast milk.

Often women that suffer from depression increase cigarette smoking in an attempt to alleviate the depressive symptoms. Because nicotine is a stimulant, the depressives feel better for a while. Unfortunately the body starts craving more to continue the effect.

A University of Michigan study revealed the startling fact that mothers who smoke have a 50-70 per cent greater chance of delivering a baby with a cleft palate, than mothers who don't smoke. This condition affects a child's ability to speak, hear, breath and eat besides the impairing the facial appearance. A toxin in tobacco is responsible for the mutations.

It is estimated perinatal mortality could be reduced by 25 percent if women abstain from smoking during pregnancy. Children inhaling second-hand smoke are prone to suffer from bronchitis, pneumonia, asthma, middle ear infections and 'glue ear', which causes deafness in children.

Cessation
To stop smoking at any time, no matter how advanced the addiction, has good health benefits. One year after quitting, the risk of coronary heart disease (CHD) decreases by 50 percent. The risk of developing lung cancer, chronic obstructive lung disease and the possibility of suffering a stroke is also decreased. Ten to fourteen years after smoking cessation, the risk of dying of cancer decreases to that of a person who has never smoked.

Smoking facts
Rough estimations suggest that the Kingdom has in excess of six million smokers spending daily about SR3.5 million on cigarettes.

The anti-smoking lobby has to target the young in their formative years since the ability to grasp information is much better as scientifically proven.

Wearing a pink ribbon during the month of October is in solidarity with the fight against Breast Cancer. The red ribbon in awareness about Aids and perhaps a black ribbon on the 31st May to depict the colour of a smokers lungs will start awareness.

Help and support
For more information on stopping smoking, contact:

  • ASH (Action, smoking and health) on www.ash.org

  • The Saint Helena Centre for Health, USA at www.quitsmokingsupport.com

  • The British National Health Service at www.givingupsmoking.co.uk

  • The American Lung Association at wwwstateoftheair.org

  • The Boston University smoking awareness website at www.quitnet.com

For help in the UAE, contact Dr Taher Khalil Stop Smoking Programme on 00971 4 2687655

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