Cape Town - Every smoker or former smoker would agree – it takes a special person to quit this highly addictive behaviour.
For most smokers restraint is not always achievable and has to be supplemented with anti-smoking aids. Some have resorted to homeopathy, acupuncture, hypnosis and even counselling, while others have tried nicotine replacement therapy, such as nicotine patches, gum and the increasingly popular e-cigarettes.
But Cape Town smoking cessation expert Isabella Dreyer is offering a new technique – hi-tech auricular therapy. It uses electronic stimulation of the outer ear to block nicotine cravings.
Similar to acupuncture, but not using needles, the I Quit Smoking (IQS) method is pain-free and uses an electronic device called a Reflection Instrument Scanning Electro-Pulse (Rise) to block addiction receptors in the brain. The machine stimulates the release of beta endorphins – the feel-good hormone. These in turn cover the problematic nicotine receptors, giving a smoker the happy and relaxed feeling usually achieved with cigarettes.
Dreyer, who runs the programme with her business partner, Walter Hart, explains that the procedure releases so many “feel-good hormones” that these last for three days.
“The therapy releases so many endorphins that the nicotine receptors are covered by them for three days, giving a smoker’s body enough time to get itself off the addictive nicotine,” she says.
By the time the endorphins wear off, the body no longer craves nicotine. “A smoker just has to deal with the habit of smoking, which we also help them with,” Dreyer says.
The therapy, introduced in Joburg more than three years ago and in Cape Town in the past year, is well known in developed countries, where it is claimed to have a 90 percent success rate.
Smoking remains one of the world’s leading causes of death, with the World Health Organisation estimating that one third of the world’s population are smokers. Apart from breathlessness and bronchitis, it is linked to serious diseases, including lung and liver cancer, and diabetes, and, in men, erectile dysfunction.
Smoking prevalence in South Africa is at 22 percent of the population. While the country has commendable tobacco control legislation, experts have raised concerns about the lack of cessation programmes, with those in place being sporadic and largely privately run.
Ceasing to smoke is associated with a number of health benefits, such as more oxygen in the blood and the reduced risk of cancer.
“(Smoking) needs to be treated just like any other addiction,” says Hart.
“Those nicotine receptors don’t die, they merely go latent and one can be successful in quitting smoking only by not smoking ever again.”
How well does IQS work?
Kicking a bad habit after more than a decade was never going to be easy. But I figured no one has ever been worse off for not smoking.
Isabella showed me how much damage I’d done to my body. According to a chart, based on 20 cigarettes a day, I’d smoked a 6km-long cigarette over 15 years. I’d ingested about 10kg of tar, and 7.5kg of nicotine. I’d sent about 11kg worth of carbon monoxide through my body, give or take.
In the past few years, I’d managed to quit only once for a significant period, by going cold turkey. Subsequently, the best I could do was to cut down to fewer than 10 a day.
We found that while my addiction levels were low, the habit would be most difficult to break. Isabella confiscated my cigarettes and lighter. Then we proceeded with the treatment, flooding my system with dopamine and breaking the nicotine hold on my body.
Usually the first few days are the hardest, but for weeks I was fine. I could sit next to someone puffing away without a craving.
After a month, I had to test whether I had quit because of the treatment, or willpower. I had three cigarettes on separate occasions. Still, no cravings.
Two weeks ago I bought a pack of 10 for a party night, thinking it would be okay. This is where things unravelled. I’ve managed to stay away from cigarettes since then. But without the treatment, the cravings are back and I’m finding it a lot more difficult not to smoke. - Esther Lewis
Hookahs are not harmless after all
For a long time, the use of hookahs was accepted because they were thought to be less harmful than cigarettes.
Several health organisations have found they have the same effects as cigarette smoking, along with additional risks.
Provincial Department of Health spokesman Mark van der Heever says a unique concern is that because people are breathing in the breath of others, there is the possibility that infections can be transmitted from one individual to everyone else in the group.
“There is preliminary data to suggest that tuberculosis can be acquired this way,” says Van der Heever.
National Council Against Smoking executive director Dr Yussuf Saloojee adds herpes to the list of infections that can be transmitted through group smoking sessions.
The available evidence, although scant, suggests that water pipe tobacco smokers, like cigarette smokers, are at risk for nicotine addiction, cardiovascular disease and cancer.
Van der Heever says the harmful effects in children are even worse because their lungs and immunity are developing, making the potential for harm greater.
Saloojee emphasises that the hookah uses tobacco, and allowing children younger than 18 to smoke is illegal. Illustrating the addictive nature of the “social ritual”, Saloojee says there are children in Riverlea, Joburg, where children refuse to go to school until they have had a hookah pipe fix.
The Cancer Association of South Africa (Cansa) has noticed the growing popularity of the hookah among smokers and non-smokers, and particularly young people, its chief executive Sue Janse van Rensburg says.
The Cansa website explains that the smoke that emerges from a water pipe contains several toxins known to cause lung cancer, heart disease and other diseases. Also, the charcoal burned often produces toxins, including high levels of carbon monoxide.
“This means that all people exposed to the smoke produced by a water pipe, whether they are smoking the pipe or just passively exposed to the smoke of others, inhale a double dose of toxins,” says Janse van Rensburg. - Esther Lewis
E-cigarettes – adding fuel to the fire
E-cigarettes are growing in popularity, and to the disdain of health experts, are threatening to make smoking socially acceptable again.
Dr Yussuf Saloojee, executive director of the National Council Against Smoking, says the e-cigarette issue is cause for great concern.
He admits that there are fewer chemicals in the device, but there hasn’t been enough research about e-cigarettes to declare it absolutely safe.
While normal cigarettes contain about 4 000 chemicals, the liquid which is vapourised in the e-cigarette contains propylene glycol, vegetable glycerin, polyethylene glycol 400 mixed with concentrated flavours, and in some, nicotine.
“Some of them do contain cancer causing chemicals, but in very small quantities. They are probably safer than cigarettes, but the science isn’t in and we can’t say that for sure,” says Saloojee.
Provincial Health Department spokesman Mark van der Heever says they do not encourage the use of either normal or e-cigarettes. He echoes Saloojee, stating that e-cigarettes may be safer than normal ones, but cautions that it does contain chemicals and there can be harmful effects associated with both.
Saloojee is also worried about the damage done to strides made in the anti-smoking campaign.
Smoking cigarettes has become socially unacceptable and even illegal in certain public places while e-cigarettes are normalising smoking again.
Reuters reported in January that four US Democratic senators are taking the Golden Globes to task for showing celebrities Leonardo DiCaprio and Globe nominee Julia Louis-Dreyfus smoking the devices.
The senators wrote a letter, asking that future broadcasts do not intentionally feature images of e-cigarettes to avoid the glamorisation of smoking.
Back in Cape Town, as malls spilled over with people this past December, clouds of white vapour surrounding shoppers was a common sight – although this hasn’t been seen in malls since the introduction of the anti-smoking laws in the 1990s. The Tobacco Products Control Act was passed in 1993 and implemented in 1995. In 1999, an amendment to the act drastically restricted smoking in all public places. Since its implementation in 2001, smoking inside any public facility would result in a fine for the transgressor and possibly the owner of the establishment.
Bianca Rousseaux, spokeswoman for Kenilworth Centre, says while the use of e-cigarettes inside the mall isn’t banned, it is frowned upon. “We can’t discriminate because the laws are specific to tobacco products, and hasn’t been extended to e-cigarettes,” says Rousseaux.
Cavendish Square spokeswoman Lana Maree says it is allowed in the centre, restaurants and stores. “It is, however at the store and restaurant’s discretion whether they allow it,” says Maree.
While research is still being conducted, and even though the department discourages its use, Van der Heever says the use of e-cigarettes in public places is legal. For now.
But some centres, like Blue Route Mall and Canal Walk, have already banned its use.
The dual use of real and e-cigarettes has not gone unnoticed by health experts.
Eugene Benjamin, 33, has been a pack-a-day smoker for eight years. He bought the e-cigarette for R450 last April to cut back on the real thing and save money.
Since then he has gone from 20 to 10 cigarettes a day. However, Benjamin admits that puffing the device just isn’t the same.
“I do smoke less but I still crave actual cigarettes,” says Benjamin. - Esther Lewis