The troubles of tobacco smoke addiction

Why do people smoke?

It is a question that those who have never puffed a cigarette — and loathe the habit — may never get a satisfactory answer to. At least not an answer that can fully explain the benefits of permeating the human lungs with smoke from dried tobacco leaves.

But for Owen, a smoking addict, such benefits cannot fit into words. “What I do know is that if I do not smoke I get headaches. I become anxious and uncomfortable. I shake and my hands cannot keep steady,” he says.

His smoking, he says, is not for entertainment. Often, Owen will quickly dash to a smoking zone adjacent to GPO in Nairobi, close to where his office. “It is a necessity. I feel better after smoking.”

In medical terms, observes Dr Waweru Munyu, a Pulmonologist and Critical Care Specialist at Aga Khan University Hospital’s Smoking Cessation Clinic, Owen is addicted. And so are the many other people in our lives who, every so often, step aside to quickly puff a cigarette stick or two.

Dr Munyu says: “A smoker becomes dependent on nicotine which is among the 4,000 elements found in a cigarette and the one that makes the person become an addict.”

When taken in small quantities, nicotine creates a pleasant excitement. This feeling, the medic adds, does not last for long and wears off quickly causing the need to light up another cigarette.

“This eventually becomes an addiction, at which point smoking becomes a need, and the addict will smoke despite knowing that it affects their lives, their health, and their families,” he says.

Records (generated locally) on smoking in Kenya are nearly nonexistent. This, Joel Gitali - Chairman of Kenya Tobacco Control Alliance adduces to lack of funds to carry out research.

The World Health Organisation has warned that smoking is increasing rather than declining in Kenya. Data in WHO’s possession indicates that eight billion sticks of cigarettes were being smoked yearly by 2015 in Kenya compared to 6.4 billion sticks of cigarettes by 2013.

According to the American Lung Association, 90 per cent of male lung cancer patients got sick because of smoking. In Britain, Cancer Research UK documents that one person dies every 15 minutes from lung cancer.

“Smoking is related to diseases which are not curable: Cancers of the throat, mouth, nasal cavity, oesophagus, stomach, pancreas, kidney, bladder, and cervix,” says Dr Munyu.

He adds: “Smoking has also been found to cause strokes, heart attacks and impotence in men. Bad odor and loss of taste are among the obvious results of smoking.”

Again, there are no statistics in Kenya to show the number of deaths directly linked to smoking. But in Joel’s mind there is no doubt that thousands, if not millions, of Kenyan lives are lost because of smoking every year.

Veteran journalist Ngumbao Kithi, from Mombasa died at the beginning of May 2016. He was a documented victim of cigarette smoking.

Kithi, it was reported, had developed breathing problems and an abnormal heart beat. He was pronounced dead on arrival at a hospital in Mombasa.

Before his death, Kithi had documented his health struggles, precipitated by three years of heavy smoking. “I started smoking in 1997 after my first employment. It is in 2000 when I began experiencing health problem: I couldn’t sleep at night. One day I collapsed,” he is captured saying in a video in KTCA’s possession.

Kithi had to travel to Kenyatta National Hospital (KNH) in Nairobi for proper evaluation and diagnosis. It is at KNH that Kithi says a Dr Samuel Munene, a heart specialist, told him he had developed a cardiovascular heart problem – that one of his valves had collapsed – caused by “heavy smoking of cigarettes”.

The only solution to Kithi’s malfunctioning valve would be to replace it through a life threatening surgery. Kithi mentions that he began smoking as a fad. Because it was ‘cool’ for a young person to smoke at that time. He would buy the high end brands to serve as a statement of his stature in society among his peers.

Research shows that male smokers are 23 times more likely to develop lung cancer than those who have never smoked. Female smokers are 13 times more likely to develop lung cancer than those who have never smoked.

For an expectant woman, smoking increases the chances of the baby being born with an abnormality.

According to Centers for Disease Control and Prevention, babies whose mothers smoke while pregnant and babies who are exposed to secondhand smoke after birth are more likely to die from sudden infant death syndrome. Such babies are also likely to be born with birth defects.

For these reasons Dr John Ong’ech, a gynecologist at KNH, admonishes that pregnant women keep off cigarettes.

A recent study published in the journal Nature, shows that smokers, on average, experience one mutation to their DNA for every 15 cigarettes smoked.

“Stopping smoking”, Dr Munyu says, “it is the only recourse to avoiding bad health associated with the habit”. But, this is where it gets tough for while getting into the habit is more or less a person’s choice, quitting is a different ball game.

According to sociologist, Prof Halimu Shauri, young people develop habits they are exposed to especially in the home environment.

The Kenya Global Youth Tobacco Survey conducted in 2007 among students aged 13 to15 in standard 7, standard 8, form 1 and form 2 found out that one in 10 currently use some form of tobacco.

Of 6,768 students interviewed for the survey, 24.7 lived in homes where a member of the family smoked while 48.2 per cent were exposed to smoking within spaces outside their home.

Those who wanted to quit smoking were 85.3 per cent. Of these, 79.9 per cent had tried in the previous year to stop but failed.

“Smoking is difficult to stop. Multiple processes are involved such as counselling, medication, nicotine replacement therapy and joining support groups. There will be physical and emotional withdrawal symptoms which include depression, irritability, nervousness, headaches, trouble sleeping and weight gain,” says Munyu.

At the Smoking Cessation Clinic, the programme to quit smoking may last up to three months.

Dr Munyu, however, promises a better life afterwards, where an individual will appreciate life more as their health improves and will channel their cigarette money to more important needs.