(31 May is celebrated as World No-Tobacco Day. This year's theme is 'commit to quit'. If you or someone you know has been struggling with tobacco addiction, take the pledge to quit, or help them quit today.)
The pandemic brought with it unprecedented loss, grief and stress on top of the mental distress of being confined to small spaces for months together.
Unsurprisingly, data shows that the sale of cigarettes has gone up during the pandemic. It makes sense. A mixture of anxiety, boredom, stress, and being in the middle of an apocalypse like situation is enough to do one's head in.
According to a Lancet study, 25 percent of smokers reported smoking more during the pandemic.
But there is another side to this coin.
While overall smoking has gone up, many young people in India have quit smoking all together during the pandemic.
FIT speaks to some of these young Indians about how the pandemic fascilitated their efforts to kick the habit and what has helped them stick with it.
Lockdown, Accessibility, and the Lack of Social Cues
"Those days were the hardest because we had no time to prepare," says Ankit, speaking of the first few weeks of lockdown.
In India, when the nationwide lockdown was announced in April 2020, as life came to a standstill, sales of tobacco products were temporarily banned.
"I ran a fever for a couple of days, it was scary because I thought I had COVID. The withdrawal was bad, but I had no choice but to power through it because I couldn't buy any cigarettes," he says. "It really just forced me to quit cold turkey."
This is something many people, especially 'casual smokers' who weren't in the habit of stocking up on packs went through at the time.
Harsh (name changed) has a similar story to tell. "I had been thinking about quitting for a while. But it was the pandemic that finally pushed me to."
Apart from access, which eased in a few weeks, there were also other factors at play, like being at home with family, and a lack of social cues, that forced many young smokers into quitting at this time.
“Mostly smoking for me is a way to hang out with my friends who are naturally smokers. So not hanging out with them and FOGO (fear of going out) has meant no smoking.”Harsh
'It became a de-stress button'
In Shivani's case, this fear of going out and the looming fear of COVID only made her smoking habit worse before she decided to quit cold turkey.
Shivani had never thought of herself as a 'smoker'. She explains, "I don't know where the distinction lies, but during the pandemic I saw a behavioural change in me."
Where she would earlier buy the odd loose cigarette now and then, now she found herself buying whole packs.
“The way I controlled my smoking habits earlier was by only buying single cigarettes, so when I got the urge to smoke, I would have to go downstairs around the street corner to get it, which was a lot of effort especially during the lockdown. That helped me control how much I was smoking in a day," she says.
“But in the pandemic, buying loose cigarettes became scary. That’s when my behaviour really changed. Because of the uncertainty and anxiety of catching COVID, I started buying whole packs thinking that was the safer option and that it would last me days, if not weeks.”Shivani
"But having the whole pack on me made all the difference. I went for having one a day at the most to 3-4 a day."
"Even when I did start noticing it, I didn’t feel inclined to do anything about it, because at the time, it became like a de-stress button, a one-stop solution to all my stresses, and it was always accessible," she explains.
On top of this, being stuck indoors, working from home with no other outlet to blow off steam pushed her further to smoking.
“I know that a lot of these times when I was feeling stressed or overwhelmed, it would have helped immensely to visit a friend or hang out somewhere, but because that wasn’t an option, I naturally leaned more on cigarettes for comfort.”Shivani
What made her stop then?
"I started noticing its impact on my health. My throat started feeling really dry, I would feel breathless and anxious, and I slowly realised that all of these developments were pointing to the new change in my behaviour," she says.
Both Ankit and Harsh talk about how they had thought about quitting multiple times before. "Almost every time I lit a cigarette, the thought crosses my mind," says Ankit.
But it was the very palpable fear of COVID and the pandemic that was the major driving force behind them quiting.
There were also instances of people they knew getting seriously sick that made the fears of the times all the more palpable.
"In the second wave it's been even scarier with so many young people having lung damage and needing oxygen support," adds Ankit.
Does Smoking Lower the Risk of COVID-19?
In a word, no.
Since the pandemic began, its correlation to smoking has been much debated.
It started with the idea that blowing smoke could spread the virus—the rationale behind the temporary bans.
Then came studies that said smoking may actually decrease the risk of catching COVID.
The findings of these studies have since been refuted as inadequate misinterpretations.
About this, Dr Vikas Maurya, Director, Pulmonology, Fortis Hospital Shalimar Bagh, Delhi, says, "these were just observational studies, and one or two studies are not enough to come to a definitive conclusion. There is a whole scientific process that needs to be followed when it comes to clinical studies."
All the confusion, he explains, comes as a result of a lack of substantial clinical data, and any link that has been drawn between the two is largely observational.
“So far there is no evidence linking smoking to an increased risk of contracting COVID. This is because there haven’t been any substantial studies. What we need is peer-reviewed clinical studies.”Dr Vikas Maurya, Director, Pulmonology, Fortis Hospital Shalimar Bagh, Delhi
How does smoking impact COVID positive patients?
Dr Maurya explains this. "Considering COVID affects the lungs and smoking weakens the lungs, it is likely to increase the severity of the infection in smokers."
The WHO, too, has stepped in with a statement saying, “Smokers have up to a 50% higher risk of developing severe disease and death from COVID-19, so quitting is best thing smokers can do to lower their risk from this coronavirus."
Adding to this, a recent study conducted by Indus Health Plus has found that 38% males and 42% females in Maharashtra alone maybe at high risk of developing severe COVID-19 outcomes due to tobacco consumption.
Establishing a definite correlation, however, has been hard because of how difficult it is to collect substantial data on the number of COVID patients that have a history of tobacco use.
"People don't reveal this to us even when we ask them," says Dr Maurya.
Quitting in the Pandemic
All three of them talk about how much better they feel physically and mentally since they quit.
"I don't feel the urge to smoke any more. I feel a dead weight has been removed," says Harsh.
What are some coping mechanisms they practice that has helped them through their quitting journeys?
Don't stock up
"For me, stopping cold turkey meant stopping myself from buying a whole pack, before I quit altogether." says Shivani.
“Having constant availability can cause you to smoke a lot more than you otherwise might have.”Shivani
"This is especially true in the case of casual smokers", she adds.
Replace it with a less harmful habit
Shivani who is also a psychologist talks about how substituting cigarettes with gum has helped train her mind off the urge to smoke.
“In my closet, where I used to keep my pack of cigarettes, I now keep a small pack of gum. When I get the urge to smoke, I deliberately make the walk to my closet and pull out a piece a gum.”Shivani
"It might sound ridiculous, but it helps," she adds.
Find other distractions
"Spending time with my family during the pandemic, has actually helped me quite a bit because it kept me distracted," says Ankit.
Other activities such as listening to music, taking a shower or even playing an instrument or painting can help you distract yourself from the urge to smoke.
Cold turkey may not work for everyone...
"... but can help those on the cusp of addiction," says Shivani. "It worked really well for me because I caught myself in time. I was able to stop completely without any adverse withdrawal symtpoms."
But for someone who has been a heavy smoker for years, they might need to start small and ween off the habit slowly, she adds.
Sweat it out
"During the pandemic I started working out regularly, and honestly its really helped with the cravings," says Harsh.
“I suppose its like a cycle. Since I’ve quit I feel like my stamina has improved, and I’m able to work out better which puts me in a better mood overall, and helps fight the urge to smoke.”Harsh
Deep breathing and meditation
According to the WHO's tips on quitting, deep breathing exercises when you feel the urge to smoke can help, so can setting aside some time for meditation every day.