Understanding yourself
Smoking and nicotine
“I’ll quit after Eid. I said that last Eid too.”
In 2017, over a third of adults in Bangladesh used tobacco. Quitting is hard, and more likely with support.
Shafiq is a senior reporter, and the newsroom runs on tea and cigarettes. Two packs on deadline days. He has quit four times, once for six months after his daughter was born. Every Eid he promises his mother it will be the last one. Every time, stress at work brings him back to the tea stall downstairs.
An illustration drawn from common experience. The person is invented; the pattern is not.
Understanding nicotine dependence
Nicotine is highly addictive. Smoking and other tobacco use, including zarda, gul and betel quid with tobacco, are tied to routines, stress and social life, which is why quitting by willpower alone so often fails. Many people who smoke also live with anxiety or depression and use cigarettes to manage them.
How common is nicotine dependence?
In Bangladesh, the Global Adult Tobacco Survey 2017 found that 35.3% of people aged 15 and over, about 37.8 million, used tobacco in some form: 46.0% of men and 25.2% of women.
Signs and symptoms of nicotine dependence
- Smoking within minutes of waking
- Several failed attempts to quit
- Irritability, anxiety and craving when you cannot smoke
- Smoking to manage stress or low mood
Treatment for nicotine dependence
Quitting works best with a plan: behavioural support, help with triggers and stress, and, where suitable, medicines that reduce cravings and withdrawal. Anxiety or depression, where present, is treated at the same time.
What getting better can look like
Shafiq’s next deadline might be met with tea and no cigarette, and the next Eid might be one where the promise is already kept.
Common questions about nicotine dependence
Why is it so hard to quit smoking?
Nicotine is highly addictive, and smoking is tied to routines, stress and social life: the tea stall, the deadline, the break with colleagues. That is why quitting by willpower alone so often fails. A plan that deals with triggers and stress, and medicines that ease craving where suitable, make quitting more manageable.
Do zarda, gul and betel quid count as tobacco use?
Yes. Zarda, gul and betel quid with tobacco are forms of tobacco use, just as cigarettes are, and they are part of the same nicotine habit. Support to quit can cover them too.
When to see a psychiatrist
If you have tried to quit and could not, that is the nicotine, not a weakness. A doctor can help you build a quit plan.
Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.
If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.
If some of this sounds familiar, a first conversation is a good place to start. You do not need the right words, or to be certain.
Dr. Tajreen is consulting in Uttar Badda now, until 8:00 pm. Call +880 1847-331010Every address and its hours
Sources
- Global Adult Tobacco Survey Bangladesh 2017, Bangladesh Bureau of Statistics, National Tobacco Control Cell and WHO
You do not need to have everything figured out before you begin.
