A man demonstrates a breathing technique that could help control tobacco craving
New Delhi, Sept. 11: A 10-minute lecture on the dangers of smoking and breathing exercises to control craving have shown promise as a low-cost option to get tobacco users to quit, Indian and British researchers have claimed.
Their study suggests that an intervention combining a single lecture with breathing exercises performed at the right time can get a significantly higher proportion of tobacco users to quit the habit than short messages about the risksof tobacco.
The researchers from the Public Health Foundation of India (PHFI), New Delhi, presented their findings today at an international conference here that is discussing strategies to sharply reduce the use of tobacco around the world.
“These are only preliminary findings, but we believe they’re encouraging,” said Bidyut Sarkar, a physician and public health specialist with the PHFI, and first author of the study conducted among a sample of 1,185 tobacco users in the capital.
Over the past decade, India has tried to discourage the use of tobacco through laws that have banned smoking in public places, imposed stronger pictorial warnings on tobacco product packs, and ordered cautionary messages in films depicting the use of tobacco.
But public health experts say India’s support infrastructure to help users to give up the habit does not match the scale of the problem — only 19 accredited tobacco-cessation clinics for the country’s estimated 270 million tobacco users.
The PHFI study was aimed at investigating alternatives to standard tools such as nicotine-laced gum or physician-prescribed medications to assist in tobacco use cessation efforts.
“While medication and nicotine gum work, such solutions could cost tobacco users more than the tobacco addiction itself,” Sarkar said. “We’re evaluating this lecture and breathing exercises as a low-cost option that can be scaled up.”
In their study, Sarkar and his colleagues segregated tobacco users into two groups — half were informed about the risks of tobacco in three sentences, while the other half heard a 10-minute lecture about how the habit could hurt their health and finances.
Members in the second group were also asked to perform two breathing exercises — borrowed from Pranayama: kapalbhati, or slow deep inhalation with quick forceful exhalations on an empty stomach in the morning, and anuloma, or inhalation and exhalation through alternative nostrils each time they felt a craving for tobacco.
At the end of the fourth week, 14 per cent of those who had performed the breathing exercises reported they had quit using tobacco, in contrast to 7 per cent of those who had listened to the short anti-tobacco messages.
Monika Arora, a faculty member at the PHFI and a senior author of the study, said the participants would be again examined later this month to determine whether their claims of abstinence from tobacco are genuine and long-term.
Doctors campaigning against tobacco say that while the findings are interesting, a well-structured advisory by physicians remains “the most powerful proven tool” that can get tobacco users to quit their habit.
“Whether it’s cardiologists, gynaecologists, or gastroenterologists — all doctors should ask patients about tobacco use and advise them against it,” said Pankaj Chaturvedi, a cancer surgeon at the Tata Memorial Hospital, Mumbai, who was not associated with the study but spoke at the three-day conference on physicians’ role in anti-tobacco campaigns. The conference is discussing possible strategies towards what some public health experts call “an endgame for tobacco” — a global effort to sharply reduce tobacco use in some countries and accelerate the decline in tobacco use in others.
“Most of the proposed endgame strategies depend on a strong capacity for regulatory control and enforcement,” said Margaret Chan, the WHO director-general, delivering a keynote address at the conference. "Throughout much of the developing world, this capacity simply does not exist at present."
India's health ministry last week announced that it is working with other ministries on a plan to reduce tobacco consumption in India by 15 per cent by 2020 and 30 per cent by 2025 from baseline consumption in 2015.
“Increased excise tax is likely to be one of the most effective techniques to sharply cut consumption,” said K. Srinath Reddy, a cardiologist and president of the PHFI which is hosting the conference.
The PHFI study in Delhi was preceded by a smaller study on 96 smokers in the UK. The other team members of the study are Lion Shahab and Robert West at the University College, London, Jasjit Ahluwalia at the University of Minnesota in the US.