Mindfulness Practice to quit smoking

  • Professor Dr Maung

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Poisonous-roll alias Double-Headed snake
The name ‘cigarette’ is the misnomer.
In fact, there is nothing medicinal inside. The finger size paper roll is full of poisons in it. It should be called ‘Poisonous roll’.
A snake has only one head which is poisonous. A cigarette, though, is poisonous at the smoking end as well as at the burning end because of releasing poisonous gas for those who is smoking and for those who are nearby inhaling the smoke. It is really like a double-headed snake.
WHO says in its Tobacco Key facts in 9 March 2018 as “Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the results of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke”.
Tobacco users are those who inhale the smoke of the tobacco in the form of cigarettes, pipes, cigars or cheroots. Betel nut chewing and snuffing tobacco are the smokeless ways of using and results in same consequences.
According to the American Lung Association, there are 7,000 chemicals in the cigarette smoke, 60 of which are capable of causing cancer and many have harmful effects on health. Nicotine is the principal chemical causing these effects, which is also highly addictive.
In Myanmar, 65 651 people are dying due to tobacco which contribute 17.6 % of all deaths, according to WHO report in FACTSHEET 2018 MYANMAR. Majority of deaths are due to cardiovascular diseases. Cancers and lung diseases in combine cause more than half of all deaths.

Let’s quit smoking
It is hard to quit smoking as nicotine dependence is the combination of behavioral, psychological and physiological phenomena.
The very first thing required to quit smoking is the deep understanding on adverse effects of smoking. Based on the deep understanding, a firm and committed decision should be made. Then the best working method should be looked for. After having the best method to quit, with the practice of mindful perseverance, nicotine dependence can be overcome.

Deep understanding
Almost everybody knows that smoking is the bad habit. But that much amount of knowledge is superficial and is not enough to quit.
A real deep understanding is needed.
Understanding is the kind of wisdom and cannot be achieved by itself. It needs effort and study.
It requires to read, discuss, argue, think and learn on smoking and its ill-effects. Newspapers, books, talks, and journals are the sources of information.
Information technology nowadays is very much helpful for this purpose. Those who are quitting smoking all over the world can be met on-line via Blogs and Forum and share the experiences and knowledge.
Knowledge obtained from the real-life events is much vivid and lasting. It is better to meet the persons who are suffering from the smoking-related diseases to learn their lessons. Those who have successfully quit the smoking can also give ideas and methods.
There are evidences that deep understanding is crucial for cessation of smoking.
Dr Walter Mischel was a professor in psychology at Harvard and then at Stanford Universities, USA, in the nineteen-fifties and sixties. He was a three-packs-a-day smoker, supplemented by a pipe. It was not until one day, when he saw a man with lung cancer in the hall of Stanford’s medical school, chest exposed, head shaved and green ‘x’ marks all over his body, marking the points for radiation. The image of this patient touched him. From then on, he started to explore all about smoking and its consequences. Not long ago he hasn’t had a smoke. As he described, “I changed the objective value of the cigarette. It went from something I craved to something disgusting”.
A brain imaging study using fMRI done in Duke University School of Medicine supports the importance of intelligent control over craving for smoking. The Duke neuroscientists published their finding in Neuropsychopharmacology Journal in April 2015, that people who were able to give up smoking showed greater connectivity between the ‘insula’ (the area of brain from which the desire for smoking originates) and somatosensory cortex (the area of brain that helps with the processing of sensory input and higher order thinking).

Mindfulness Practice to quit smoking
Nicotine dependence is a tough addiction to beat.
For now, there are three standard methods for cessation of smoking.
The first one is by using nicotine substitute such as nicotine plaster, nicotine gum, nicotine spray and nicotine inhaler. These can help reduce withdrawal symptoms by slowly decreasing the amount.
The second method is by using drugs having nicotine like action, such as bupropion or varenicline.
The third method is quitting without nicotine replacement or drugs.
However, with all these methods, the success rate hovers around only 4% to 7%.
But a promising news emerged. A group of researchers from Yale University School of Medicine, USA, led by Dr Judson Brewer reported in Drug Alcohol Depend journal in December 2011, the 36% success rate by using Mindfulness Training.
Mindfulness is paying nonjudgmental attention to examine the craving to accept this moment. By giving mindfulness training to notice and pay attention to the emotional states and the cravings, the smokers learn to let these feelings pass over. They also learn to control rather than act impulsively. Moreover, the article described that continuing mindfulness practice at home significantly reduce smoking behavior. The authors also found that the nonjudging aspect of mindfulness is the unique aspect of this method that makes it successful.
Dr Judson Brewer suggests that mindfulness is successful over smoking cessation because standard treatments only focus on the surface level, whereas Mindfulness Training really gets to the root of the problem. He used the acronym R A I N:
• Recognize the craving that is arising, and relax into it.
• Accept this moment. Don’t ignore it, distract yourself, or try to do something about it.
• Investigate the experience as it builds. Ask yourself, “What is happening in my body right now?”
• Note what is happening. As you note pressure, dullness, tightness, or whatever, it becomes clear that these are nothing more than body sensations. You can simply ride out the sensations until they subside.
By teaching smokers to be present with their suffering and cravings, they learn to ride them out
instead of impulsively acting upon them. Mindfulness Training for smoking cessation is having greater success rate than traditional methods.
That Mindfulness Practice is nothing new to Myanmar culture. The practice of mindfulness, called it as Satipathana Vipassana was the well- known discourse of the Buddha, delivered well over 2500 years. The Buddha declared thus: “This is the sole way for the purification of beings, for the overcoming of sorrow and lamentation, for the destroying of pain and grief…” .
This form of meditation may be practiced with benefit by all, Buddhist and non-Buddhist alike, because its aim is simply to expand the practiser’s consciousness and bring him face to face with whatever is having in his mind.

References:
1. The Venerable Mahasi Sayadaw, Agga Maha Pandita. The Satipatthana Vipassana Meditation. Department of Religious Affair. 1979. Rangon Burma.
2. World Health Organization. Tobacco Fact sheet. 09 March 2018.
3. World Health Organization. Factsheet 2018 Myanmar. Quit Tobacco Use Now-For a Healthy Heart.
4. Merideth A. Addicott, Maggie M. Swietzer, Brett Froeliger, Jed E. Rose and Francis J. McCiernon. Increased Functional Connectivity in Insula-Based Network is Associated with Improved Smoking Cessation Outcomes. Neuropsychopharmacology 40, 2648-2656 (2015).
5. Judson A. Brewer, Sara Malik, Theresa A. Babuscio, Charla Nich, Hayley E. Johnson, Cameron M. Deleone, Candace A, Minnix-Cotton, Shannon A Byme, Andrea J. Weinstein, Kathleen M. Carroll and Bruce J. Rounsaville. Mindfulness Training for smoking cessation: result from a randomized controlled trial. Drug Alcohol Depend. 2011 Dec 1: 119(1-2): 72-80.

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