Lets talk about smoking

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Once in a group discussion, a girl was talking about the financial losses caused by smoking.  To counter her argument, a boy came up with an objection about the cost of cosmetics used by girls. According to him, girls use expensive cosmetics and probably spend more money than boys do on smoking! Obviously this statement turned the discussion into a fierce “boys versus girls” debate! Most of us would think that the point raised by the boy was irrelevant. It is not logical to compare smoking with cosmetics. We can see that this boy had perceived smoking as the “male” issue and cosmetics as the “female” issue. In India, where smoking is much more common in males as compared to females, smoking is considered as an issue related to men. This lead the discussion in the wrong direction and the focus drifted away from the ill effects of smoking. Many of us must have experienced a similar situation. Talking about smoking to a friend, relative or family member who smokes is usually a tough task. They come up with strange counterarguments, get irritated or do not speak up at all.  We need to dig deeper into the issue to understand why it is difficult to convey that smoking is a bad.

It is proven beyond any doubt that smoking is injurious to health. Many smokers have experienced it too. Most of them agree to it but still one may find it hard to talk to someone about his/her smoking. The reason could be lack of proper communication. As it happened in the above example, unnecessary generalisation could be one reason that we may lose an opportunity to communicate effectively with a person who smokes. It is true that in some countries, the proportion of men is significantly more than women amongst smokers. In such a case, one should be very careful. By going with statistical correlation, we might inappropriately attribute the cause and effect of smoking to male gender. Nobody smokes just because he is a man! No woman smokes to state that she is a feminist. Similarly, ‘stress’ is a common trigger for smoking but it is not necessary that every smoker will have underlying stress. Every individual can have a different reason to smoke. Not that any reason could be valid for smoking but it is important to know why someone smokes. Then it would be easy to address the cause of smoking. Assumptions make conversation difficult.

Generalization of the effects of smoking could also have a similar effect. For example, imagine someone who doesn’t mind getting a cancer due to smoking.  He/she might argue that cancer may be caused by multiple reasons other than smoking. Many people choose to smoke in spite of knowing most of the health hazards associated with it. Talking to them about the ill effects of smoking could annoy them or make them believe that you are just another preacher. This doesn’t mean that the discussion is a waste. They may have some concerns which no one has spoken to them about. It is a good idea to assess their knowledge and concerns first and then talk about the specific issues.

I agree that it could be difficult at times, not to get mad at your loved ones who smoke. It is exceptionally hard to see your family member/friend to lose their perfect health to smoking. But we need to be sympathetic towards people who smoke. A person addicted to tobacco will develop a craving for it. Sometimes the craving is so severe that they need help. So, in spite of a strong resolution, they may fail to quit smoking. Family or friends get so irritated with this, that they start accusing the person for their attitude. Being gentle and trying to keep them motivated can help in such situations. For example, consider that someone has cut down on the number of cigarettes but hasn’t completely stopped. In this case we should congratulate him/her for this effort and encourage him/her further to quit smoking rather than blaming and criticising for the continued smoking. In such instances we should get into details. Check whether the person is really motivated or not. If the person isn’t really motivated, we should not get frustrated but instead start working on motivation again. Being a non-smoker, it is difficult for me too, to understand a smoker’s point of view. But as a doctor, I need to accept smoking as a lifestyle chosen by the patient. I can try to convince or warn a patient, but forcing an opinion can be counterproductive. It is the individual’s will to quit smoking which matters the most. Our role in smoking cessation is that of a facilitator and the process is driven by the individual. If we take the driver’s seat then it could become a problem. Smoking cessation experts and support groups can help as well. I would like to mention that being sympathetic does not mean that you should risk passive smoking. Being sympathetic and to allow someone to smoke are not the same. You can ask them not to smoke when they are with you or around children.

I think that talking to someone about smoking cessation is really challenging. Some of our assumptions make it tougher. It is widely believed that it is impossible to quit smoking. Many of us might have given up our attempts to convince someone after a while. It is true that smoking cessation is difficult and people may start smoking again. It is also true that chances of smoking cessation are higher in persons who continue to try. So, it is prudent that we continue to try to convince our loved ones to stop smoking with the same spirit. Many people quit smoking successfully. I have seen a grandpa quit smoking very easily after his grandson asking him to quit. When I asked how he managed to quit so easily, his answer was simple. “Nobody had ever asked me to quit. So when my grandson asked me, I just quit “. No two smokers are same. Not all elders are intimidating and not all youngsters are difficult.  Our previous unpleasant experiences with smoking talks could be due to communication barriers and prejudices we carry. It is natural to get anxious or scared about the health of our loved ones but planning our smoking talks instead of speaking out your worries and anger can help. We need to fight smoking together. This article is written to share my experiences and concerns with friends and families of people who smoke. Please comment and share your experiences.

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