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.
