Wheel power for Will Power

Dussehra marks the triumph of good over evil, and for the Salaam Bombay Foundation, the main evil that needs to be defeated is tobacco - be it in the form of cigarettes or khaini. On Tuesday (October 23), the eve of Dussehra, the foundation launched its latest initiative to help people fight their addiction to tobacco: a mobile clinic - housed in a Mahindra Bolero - and a helpline. The launch took place at Jamboli Maidan at Worli and compelled curious residents of the nearby BDD Chawl to flock to their windows overlooking the grounds.

Social reformer: The mobile van that will travel across the state to spread awareness about the harmful effects of tobacco addictionu00a0

Says Devika Chadha, programme director, Salaam Bombay Foundation, "We have been working with children on tobacco awareness for the last 10 years. They tell us during our informal chats that their older family members consume tobacco. That's when the idea for the tobacco cessation van came about.

If you want someone to quit, you can't tell them to come and take our services. You have to go to the person. That's why the van and a group of counsellors will go to various communities and help people quit tobacco."

Doc power: Dr Farhana Chougle (left) and Shrradha Sidhwani

Why the need
Explaining the need for the van, Padmini Somani, director of the foundation said at the event, "Tobacco is such a substance that its addiction affects the entire family, especially when the addict is the only breadwinner in the family." Politician Sachin Ahir, who, with Bollywood singer Shaan, was the chief guest at the function, said, "Law alone is not enough to stop addiction. Awareness is necessary. If we can make our state tobacco free, it would be a great achievement." Shaan, on his part, focused on the large number of school students present at the event. "You children are more powerful than the van," he said. "And why not? Won't you tell your parents to stop chewing tobacco? Won't you tell your uncle to quit?" He was answered with a resounding ‘Yes!'

Off with his heads: Shaan and Sachin Ahir fell a life-size cutout of Raavan to symbolise the end of harmful tobacco products.u00a0Pics/ Sunil Tiwari

Revved to go
The van will eventually be driven across Maharashtra, but it will begin its journey in Mumbai. Says Chadha, "We have already received enquiries from NGOs in Bandra and Goregaon." The launch was the culmination of efforts of the past 10 months. "We started raising funds during the Mumbai Marathon in January this year. That's when Shaan and various corporates came forward. We had to then train the right people and get the project off the ground. It has been a long learning process."

Docs speak up
Two ladies eager about the initiative are Shrradha Sidhwani and Dr Farhana Chougle. The former is a clinical psychologist affiliated to the counselling centre Mind Temple and the latter is a doctor working with cancer patients at Prince Aly Khan Hospital, but both claim they prefer to be known as ‘tobacco treatment specialists'. They and other counsellors whom they have trained will take turns providing counselling in the van. Says Sidhwani, "When we talk about tobacco, we mean both smokeless tobacco, such as gutkha and other chewable forms of tobacco, as well as cigarettes. Our basic aim is to create awareness but also go one step forward and help people quit tobacco. It is very difficult to quit because the addiction is due to a psychological as well as a physiological dependency on nicotine. There are two ways of quitting: one way is when you quit cold turkey - you just stop consuming it completely - while the other way is when you start cutting down on the number of cigarettes or tobacco packets you are chewing. In both processes, you need a lot of social support and psychological support. One of the reasons people get addicted to tobacco is stress. We are going to try and tackle all the reasons for stress so that the emotional dependency on tobacco goes down. We are largely focusing on counselling rather than giving medication."

All are equal
Their target audience is, well, everybody - from children who see their parents consuming tobacco, to youngsters who get into the habit due to peer pressure, to older addicts who have been habituated to the substance for the past 30 years or so and are now feeling the effects of it. Says Dr Chougle, "At the hospital, I mostly deal with cancer patients who have a high motivation to quit tobacco, but even their plight is not motivational enough for their family members to quit the habit. That's why at the hospital we also focus on their relatives."

All these efforts, however, are often not enough to stop someone from slipping back into the abyss of tobacco addiction. As Sidhwani says, "The cases of relapse from tobacco addiction are very high. People who have quit for months start smoking again when it is festival season or it's their friends' wedding. We tell them, it is only a slip, that doesn't mean you have to return to the habit."

While one can understand that a person who smokes 10 packets of cigarettes a day or chews that many packets of gutkha in a day is an addict, surely, the same can't be said for someone who has a cigarette puff once in six months? Dr Chougle disagrees. "If you are funnelling the nicotine, that means your body is still dependent on it. The therapy required may not be that intensive as for someone who has been smoking for years together, but they would also require some amount of counselling to finally kick the habit. Even one puff is not allowed."

How hookah harms
And that puff is not just for a cigarette, but also for hookahs. Sidhwani calls hookahs "worse than cigarettes". Agrees Dr Chougle, "They say it contains only 0.5 per cent tobacco and it may be so, but then, you are having it for 45 minutes or one hour; a cigarette is over in five minutes. So the damage is much worse." According to Sidhwani, "One hour of hookah is equal to 10 cigarettes. Plus you are consuming the coal (that heats the tobacco) with it. But it is a big trend among the youth. They need to stop and understand that they are damaging their health."

Try safe options
It is not a completely bleak scenario for addicts. There are alternatives available such as nicotine patches, gums and lozenges that can help them get out of the habit. However, points out Sidhwani, "Appropriate doses need to be taken. A lot of people just take the patch for one week and say it didn't work. It has to be taken according to the number of cigarettes and tobacco packets you are taking for the day. A general physician may not be aware of these aspects. You need to consult someone who is aware of it." That's why the two ladies and their third colleague underwent a certified training programme on deaddiction in the US as part of this initiative. Says Dr Chougle, "We have been given a background on how to prescribe medicines that are basically nicotine replacement therapies and other treatments such as motivational interviewing." They are definitely ready to help addicts get rid of their harmful habit.

The mobile clinic will visit various parts of the city between 4:30pm and 7:30pm every day. Those who wish the van come to their area can call the helpline at 9820066665.

Are you an addict?
According to Dr Farhana Chougle, "Any person who is smoking at the moment, we'll ask them to get treated for tobacco de-addiction. You don't need to have taken it for years to be addicted. Even if you start off with hookah, which is a mild form, there are changes happening in the body, that will make you crave more and more tobacco. Even one puff is not allowed. Even if a patient is having one puff a day, it means the person is a tobacco addict."

Tips for parents
>> Children between the ages of 13 and 15 years are the most vulnerable to get addicted due to peer pressure.
>> Start talking to your children from an early age about the effects of tobacco and alcohol. That way, they can be assertive and say no when they are offered a cigarette or a gutkha.
>> Set an example for the children. Show that you don't consume tobacco because it is bad. Simply telling them not to smoke but doing it yourself is not going to work with them.u00a0