Unmasking the appeal, countering tobacco addiction

SEGUN started smoking at the age of 15 to escape the chaos of the constant domestic violence at home, the financial obligations he has to bear, and the fatigue from hawking every day after school. By 17, he was smoking a pack daily. By 19, he’d tried to quit five times and failed. By 21, he knew he was addicted but couldn’t stop. Now, he’s 25 years old and has been diagnosed with chronic bronchitis, severe nicotine dependence, depression, and anxiety disorders.

Chioma is a 16-year-old 100 level student who started having panic attacks, sleeplessness and began to find it hard to concentrate in school. Her friends took her to a party where she smoked weed for the first time. That night, she had her best sleep in a long time. Since then, she has started smoking cigarettes and weed to cope. Instead of getting treatment for what might be undiagnosed generalized anxiety disorder, she now smokes weed and cigarettes regularly to cope. When she is anxious, she smokes cigarettes to calm herself down. Now, she needs more wraps per day to help her feel calm and sleep well. She becomes very irritable and restless when she does not smoke.

According to Tobacco Tactics (2020), while tobacco consumption globally is decreasing, by 2030 the number of smokers in Africa is anticipated to rise by nearly 40% from 2010 levels. This is the largest expected increase in the world. Nigeria has one of the highest rates of smoking in Africa and the prevalence increases with the proliferation of shisha spots and cheap cigarettes in the country.

The theme for this year’s World No Tobacco Day commemorated on the 28th of May is “Unmasking the appeal – countering nicotine and tobacco addiction”. It spotlights the need to show the hidden dangers of nicotine and tobacco addiction.

Discussion

Even though the common narrative about smoking is that it is done by weak and wayward people, this is not completely true. Many Nigerians use nicotine as a medication for mental health challenges. They use it to numb unwanted feelings or to improve focus. People with untreated and undiagnosed mental illness like ADHD, anxiety, depression and even stress may use nicotine as a fast relief from the symptoms of their undiagnosed conditions. The lack of an adequate mental health system and the difficulty in accessing care as well as the stigma around mental illness makes people look for alternatives to mental health care. Seeing a therapist might not be cool but smoking cigarettes may seem cool amongst youth especially. Cigarettes are also cheaply available, easily accessible, socially acceptable and provide a perceived sense of relief. The sad reality is that this often worsens their conditions instead of providing the relief they need. Indeed, even when ti appears helpful initially, the relief is transient, wears off easily and leads to addiction and increasing use.

Tobacco and nicotine is advertised to young people using cool and rebellious branding. They’re free at some music events and parties. They’re easy to purchase and many celebrities endorse the use directly and indirectly. Women are deceived by associating nicotine use with independence and modernity. Nowadays, there are new products marketed to seem safer but which are often more dangerous. These include e-cigarettes, flavored nicotine products, heated tobacco products, and Shisha that is commonly viewed as more social, fun, and less harmful. Vapes seem chic to young females and some guys but still contains nicotine and tobacco.

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Health consequences of tobacco and nicotine use

Short-term physical health effects can include respiratory problems, reduced immunity, reduced fertility, poor wound healing, tooth decay, bad breath and smell. If not addressed, long term consequences like cancer, strokes, heart attacks, diabetes, osteoporosis, blindness, erectile dysfunction, and rheumatoid arthritis may develop. 90% of lung cancer is caused by smoking. Tobacco and nicotine addiction is also linked to other types of cancer like throat, mouth and esophageal cancer, pancreatic cancer, leukemia, kidney cancer and others.

Smoking also has a vicious cycle with mental health.

Mental health problem → smoking (self-medication) → temporary relief → addiction develops → mental health worsens → more smoking needed → addiction deepens → mental health deteriorates further → desperation and hopelessness → harder to quit → cycle continues

It can worsen existing mental health problems or create new ones. Nicotine withdrawal includes depression symptoms. Smokers also report higher rates of depression and higher stress levels than non-smokers.

Countering the appeal: A mental health-centered approach

Youth mental health services need to be prioritised and made more accessible. Youths should also be taught important skills like emotional regulation, stress management, and conflict resolution. They should also learn healthy coping mechanisms like exercise, creative expression through art, writing music or dance, social connections and getting hobbies. Importantly, we must increase anti-smoking campaigns, make the products less accessible, and provide harm reduction and rehabilitation services. We need to counter the harmful propaganda to protect our children and youth