BREAKING THE SMOKING ADDICTION: PERSONAL TESTIMONIES

Smoking is an addiction many people find hard to break even when they know that tobacco is the leading cause of cancer. For some, it is only when faced with life-threatening choices that they make a decision to quit. This is a story of two people who conquered their smoking habit. THE signs were all there for Raphael Makowane to quit smoking but he would not. For him, the good life entailed drinking and smoking and if he suffered minor ailments along the way, it was a simple matter of taking a painkiller and another cigarette-until his doctors told him he had a life-threatening disease as a direct result of his heavy smoking.

Life-threatening encounter with cigarettes
For most of his adult life, Makowane, 44, believed that drinking alcohol and smoking cigarettes epitomised good living until death stared at him in the face when he had a partial heart attack.
At that point, Makowane, a business executive, was smoking up to 30 cigarettes a day. Even when a young man threatened him with a knife “unless I give him a cigarette”, Makowane did not think to quit. Instead, he cursed the young man for depriving him of his pleasure!

He recalls an incident when he was almost burnt to death for smoking while driving; he unknowingly flicked hot ash on the car seat. A little while later, the car was on fire.

“I had to stop and run for help. Fortunately, I was alone in the vehicle,” he remembers.
Makowane says his family complained about his polluting the home with cigarette smoke, his clothes would never smell fresh and his diet was poor. “My teeth and fingers were yellowing and stained,” he says, but even then he confesses this could not deter him from smoking.

His body gave him other warning signs; tight chest, wheezing coughs that would not go away and headaches. He refused to associate them with his smoking habit.

A divorce from his wife and losing his job at the same time saw him plunge into a deeper abyss. Without an income, he began to beg for cigarettes from casual labourers, security guards and call-boys.
“I was a real addict,” he confesses.

Makowane collapsed in the home of a friend one day and was compelled to seek medical attention. An X-ray showed that his lungs were diseased. His doctor warned that the lungs would not hold out for much longer if he did not take immediate action.

“I saw certain death staring at me in the face. I thought of my children and the life ahead of me. I told myself that I had to stop smoking,” Makowane, whose smoking had also affected his hearing, explains.
He underwent a year of therapy for addiction at Chainama Hills Hospital and stopped smoking, but says it was not easy. “I suffered terrible withdrawal symptoms; insomnia, vomiting after eating, headaches, temper tantrums and depression. But I had no choice. It was a terrible period. Even now, I still wish for a cigarette when I see someone smoking, but rather than ask for a stick, I walk away.”

Fighting addiction
Cinder Mwale (not real name) is a 15-year-old former street child who started smoking at the age of eight. She began by smoking ‘balan’, a type of unprocessed tobacco sold by the sack. She would sneak into the dump sites at Soweto market after dark and steal from the sacks. Now, she has a debilitating lung disease and a chronic cough.

Cinder was living under the bridge at Manda Hill when she had her first cigarette. “I will never forget that first pull, I felt the smoke go straight to my head and I felt light-headed. I didn’t feel the hunger pangs or the hurt of abandonment anymore, I was just happy,” she says.

She began to crave cigarettes. She would do anything to experience that rush that came with smoking. She also felt grown up. “I saw big people in their nice fancy cars smoking and I envied them. I thought smoking was what made someone rich,” she says.

Cindy rolled up balan which she scavenged from the market, after the marketeers had left. She picked up ‘stompies’ (cigarette butts) that had been thrown in garbage cans. She also “scored” from other street children with whom she exchanged sexual favours.

It was only when she fell pregnant and was taken in by an NGO running a shelter for girl street children that she was forced to quit smoking temporarily, because she could no longer access cigarettes or balan.
“The house mother kept us under strict supervision, I could not move but being pregnant, I also lost the appetite for cigarettes, they made me feel nauseous and sick,” she remembers.

But when she gave birth, the addiction came back in full force. She began to beg or steal money to hustle cigarettes. But it was difficult. “I rarely had money to buy cigarettes. I was not on the streets so I was no longer under the influence of my friends,” she says.
On the insistence of the housemother, and to save her health (her weight had dropped to a dangerous 40kg), Cinder underwent therapy and learnt how she had been abusing her body.

She began to force herself to eat three meals a day to repair her malnourished body and took up knitting to keep her hands and mind busy. She denied herself any activities like watching television which would lull her into relaxation and crave a cigarette. Most importantly, however, she stopped associating with smokers or being in places (streets) which were associated with cigarettes.

The road to fighting the addiction was not easy. She had severe withdrawal symptoms which would manifest in different ways on different days. Sometimes, she would be depressed, other times light-headed, sometimes she would have an appetite, other times she would get nauseous at the mere sight of food.
It has been three years since she last smoked but she says she is still not quite smoke-free. “There are days when I don’t even think about smoking, and then there will be a day when I crave for just one puff,” she says with a wistful smile, “but I look at how far I have come and instead I just pick up my knitting needles.”

What medical experts say
Dr Fastone Goma, Dean of the School of Medicine at the University of Zambia and a tobacco researcher, says Mwale is lucky that she had a baby without complications. With her addiction, she could have suffered vaginal bleeding, placenta eruption, or an ectopic pregnancy and the baby could also have suffered lung damage.

One cigarette contains 4,000 different chemicals which foster the addiction to people who smoke, thereby enslaving them because their lives become fully dependent on it.
The different chemicals blend with the bio-chemistry of the central nervous system, which is part of the brain. This blending happens in such a way that when a person who is addicted to smoking has not smoked, the nicotine levels go down and the receptors in the brain “complain”, sending a signal to the whole body that there is need for smoke and re-stocking the nicotine.

During the time that the nicotine levels are low in the body, a smoker would start experiencing short attention span, poor concentration and they are easily irritated. Further, they also get anxious, the heart pumps faster, which is an indication that nicotine levels are low, while there will also be memory lapses, low mood and withdrawal symptoms.

Chief mental health officer and National Tobacco Control Focal Point person in the Ministry of Health, John Mayeya, says although the symptoms manifested by cigarette smokers are similar to those by people who have a mental disorder, tobacco does not cause mental illness.
Even then, for people who are prone to depression, smoking can easily send them into a spiral. This is so because once an addict smokes, the nicotine levels go high and the system is stabilised, bringing the person back to their ‘normal’ self.

Quitting smoking
Mr Mayeya admits that, like any addiction, quitting smoking is difficult but people can do it with the help from health care professionals at Chainama Hills Hospital or therapy groups. There are medications available, like patches, which are stuck onto the arm, or nicotine replacement therapy, like nicorettes, which are a kind of chewing gum.
Many people eat sweets in the place of cigarette, which brings its own problems of too much sugar, but people usually find an equilibrium. “Although stopping smoking can cause short-term side effects such as weight gain, the positive health benefits far outweigh the danger of cancers,” Mr Mayeya emphasised.