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Psychiatric Counselor – Cadabams’ Psycho-Social Rehabilitation Centre



In India, Tobacco Consumption is most popular form of both smoke and smokeless. Global cigarette consumption has been rising steadily since James Bonsack invented the first cigarette-rolling machine in 1881. By the 1960s, the incontrovertible health consequences of smoking had become apparent. The total number of smokers is increasing mainly due to expansion of the world’s population. Unless smoking prevalence rates decline dramatically, the absolute number of smokers will continue to increase (WHO).

In Tobacco Consumption, the male percentage is 20 – 29.9%, according to the estimate of WHO in the year of 2008 & according to Global Adult Tobacco Survey (GATS) 2009 – 2010, the male percentage of tobacco consumption is 47.9%. The Female Percentage in tobacco consumption is below 20% according to the estimate of WHO in the year of 2008 & according to Global Adult Tobacco Survey (GATS) 2009 – 2010, the female percentage of tobacco consumption is 20.3% (WHO, 2008; GATS 2009 -2010).

Tobacco Consumption harms nearly every organ of the human body. The tobacco consumption may give rise to adverse health effects such as cancer, respiratory diseases, cardiovascular diseases, reproductive diseases & other diseases.

In India, everyday 2500 people per day were dying due to tobacco consumption & every year 9 lakh people were dying due to Tobacco Consumption. A man who consumes tobacco may increase their risks of dying from bronchitis by nearly 10 times, from emphysema by nearly 10 times and from lung cancer by more than 22 times.

A woman who consumes tobacco may increase the risk of dying to heart disease and lung cancer by nearly 12 times. The people who are consuming more number of tobacco in any form is to be taken seriously and immediately tobacco cessation programme is to be evaluated on them through various assessments.

Since the consumption of tobacco is increasing day-by-day, this study aims to bring awareness about harmful effects of tobacco consumption & suggests suitable measures to prevent people from consuming tobacco and to promote tobacco cessation counseling.

India is second among top 20 countries with highest male smoking populations. In India, 229, 392, 725 male smokers are using all tobacco products according to Global Tobacco Survey of 2008 estimate. India is third among top 20 countries with female smoking populations according to Global Tobacco Survey of 2008. In India, 11, 908, 517 female smokers are using all tobacco products.




Cigarettes contain 4,000 chemicals which causes various sorts of diseases. The some of the important chemicals are:

Carbon Monoxide       –           Poisonous Gas                                                             Ammonia                    –            Used in fertilizers                                                                    Formaldehyde             –           Poison used to preserve dead animals                         Nicotine                      –           Addictive Drug                                                                       Cyanide                       –           Poisonous Gas                                                             Tar                               –           Used to make roads                                                                Arsenic                        –           Poison used to kill weeds & insects                           Phenol                         –           Toilet Cleaner



Compared with non-smokers, smoking is estimated to increase the risk of

  • Coronary heart disease by 2 to 4 times
  • Stroke by 2 to 4 times
  • Men developing lung cancer by 23 times
  • Women developing lung cancer by 13 times
  • Dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.

Smoking causes the following cancers:

  • Acute myeloid leukemia
  • Cancer of the esophagus
  • Kidney cancer
  • Cancer of the larynx (voice box)
  • Lung cancer
  • Cancer of the oral cavity (mouth)
  • Cancer of the pharynx (throat)
  • Stomach cancer

Smoking is associated with the following adverse health effects:

  • Infertility
  • Preterm delivery
  • Stillbirth
  • Low birth weight
  • Sudden infant death syndrome (SIDS).



Tobacco Cessation is an effort to quit tobacco use at an individual level that may or may not be supported by external help i.e., family, community or health professionals. It can be described as an act, requiring good deal of will power to overcome immediate discomforts that accompany the withdrawal of Nicotine.

Tobacco cessation (colloquially quitting) is the process of discontinuing the practice of inhaling a smoked substance. Tobacco cessation programs mainly target tobacco smoking, but may also encompass other substances that can be difficult to stop using due to the development of strong physical addictions or psychological dependencies resulting from their habitual use. This study focuses mainly on cessation of Tobacco smoking. However, the methods described may apply to cessation of smoking other substances.

A person with Tobacco addiction along with some manifest diseases such as cancer, cardio vascular disorder, peripheral vascular diseases, diabetes, mellitus, lung disease, psychiatric conditions etc.

The available treatment formats are:


  1. Self-help Treatment: Self-help strategies may include written materials, audio or videotape, computer programs and telephone hotlines. Materials can be tailored to particular populations such as different ages or ethnic groups, or to individual smoker characteristics.


  1. Nicotine Replacement Therapy: Nicotine replacement therapy (NRT) is available in gum, transdermal patches, intranasal spray, inhaler devices and sublingual tablet. The total duration of treatment was examined and the use of patches beyond eight weeks was no more effective than stopping treatment at eight weeks. Gum was found to be least effective in the hospital setting. The results for patches were more consistent between settings suggesting that patches may be more suitable in the hospital setting.


  1. Other Medications: A range of anxiolytic and anti-depressant medications has been tested for effectiveness in smoking cessation. Of these, only bupropion was found to be effective when compared with placebo or NRT.

It is believed that very few smokers can successfully quit the habit in their very first attempt. Many studies indicated that many smokers find it difficult to quit, even after they get afflicted with tobacco related diseases. A serious commitment and resolve is required to arrest nicotine dependency. For that Tobacco Cessation Counseling is needed.


The stages of Tobacco Cessation Counseling are:

  • Pre-Contemplation Stage: The person has never thought of quitting or has never listened attentively to smoking/chewing tobacco and health information.
  • Contemplation Stage: The person is thinking about stopping and it thinking about harmful effects of continued tobacco use as well as thinking about the ways to stop.
  • Preparation Stage: The person has already worked out ways to stop tobacco use.
  • Action Stage: The person is no longer using tobacco & has managed without any form of tobacco for up to 6 months.
  • Maintenance Stage: The person not only has stopped using tobacco for over 6 months but had made changes towards long-term abstinence. This is called maintenance. The person returns to a regular tobacco use after a period of abstinence. Once relapsed, the person may go to any of the previous 4 stages. This process is called relapse.

The Intervention techniques used in this Tobacco Cessation Counseling are:


  1. Behavioral Counseling
  2. Ventilation
  3. Psychological Support
  4. Motivation


This Study reviews the current status of tobacco related problems and suggests that Tobacco Cessation Programme as an effective method to quit the habit of consuming tobacco and provides an information about Tobacco withdrawal treatment. The persons who receive Tobacco Cessation Counseling training were significantly more likely to intervene with persons who use tobacco in any form.


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