KARACHI: A recently published study has shown nicotine-related de­pendence, anxiety, stress, mood changes, friend/peer pressure and weight gain as important factors preventing people from quitting tobacco use.

Titled Reasons for failure to quit: a cross-sectional survey to tobacco use in major cities in Pakistan, the research also indicates that one in seven people, who participated in the study, reported an ‘unknown reason’ for being unable to quit tobacco use while 43.2 per cent declined to elaborate on the reason (s) for their failure to quit.

The study was conducted by the Aga Khan University (AKU) and published in the International Journal of Tuberculosis and Lung Disease.

Over 12,900 people (including 97 women) participated in the study carried out at free health camps organised at two major cities of the country.

Almost two -thirds of the subjects were recruited from Karachi. More than three quarters of the tobacco users were in the 20-40 age group.

According to the study’s findings, a majority of the participants wanted to quit and nearly everyone had received advice on quitting tobacco use. More than half of the subjects reported one or more previous attempts to quit.

The most commonly cited reasons for the failure to quit were: dependence (nicotine-related) 15pc, anxiety/stress/mood changes 14pc, friend/peer pressure 12pc and weight gain 0.6pc.

“Almost one in seven people (15pc) participants reported an unknown reason for being unable to quit tobacco use whereas the remaining 43.2pc declined to elaborate on reasons for (failing to) quit,” says the study.

“On the whole, 97pc people were willing to quit/reattempt quitting,”

Of the total participants, 67pc smoked cigarettes, shisha tobacco/hookah, cigar, whereas 13pc consumed smokeless tobacco (various forms of tobacco including betel quid, chaalia and gutka etc).

Tobacco kills

According to the study, tobacco dependence has been defined by the WHO as a chronic relapsing disease that is potentially treatable. The use of tobacco leads to many health complications and is a risk factor for the occurrence of many diseases, including cardiovascular accidents, lung and oral cancers and chronic bronchitis, among others.

“Tobacco kills one-third to half of its users. Around five million annual tobacco-related deaths have been reported worldwide. Tobacco users die on average 10 to 15 years prematurely,” the study says.

According to a 2011 WHO report, 32.4pc males and 5.7pc females in Pakistan were active tobacco smokers. A study conducted in Karachi estimated the prevalence of tobacco use to be at 32.7pc while a survey of university students in Peshawar reported the prevalence of smoking at 36pc in males and 11pc in females.

Answering a question that why many people declined to explain the reasons for their inability to quit tobacco use, Dr Javaid A. Khan, a professor of medicine at the AKU, who led the research, said: “Many smokers couldn’t answer this question. Perhaps, they were not sure about the reason why they are still smoking or why they could not give up this habit. Many have no good reason to continue smoking. They were addicted to tobacco but failed to admit this fact.”

According to Prof Khan, also the chair of the National Alliance for Tobacco Control, quitting smoking is well connected with weight gain and was reported as a factor preventing some people from quitting tobacco use.

“People, particularly women, who smoke are very much conscious about how they look. Quitting smoking is well connected with weight gain. Research shows that on average a person gains about 6kg of weight within 12 months of successful quitting. Nicotine is an appetite suppressant. Once you give up smoking, a person tends to taste food better as sense of smell is restored, which cause people to eat more,” he said.

The study results could guide the development of more targeted intervention programmes for smokers who wish to quit smoking, he said.

Published in Dawn, May 16th, 2016