Why early smokers find it difficult to quit

Ken Muoki, aged 45, has been an avid smoker for over 20 years. He has tried countless times to break the habit to no avail.

“It’s an uphill task but I am trying. This time around, I would like to give it my all and try to be disciplined so I can stop smoking,” he says.

Just as a majority of adult smokers, Ken notes that he started using tobacco in his younger years.

“I used to smoke on and off in high school so as to be considered cool by my friends. Back then, I didn’t care and I thought I would be able to stop any time I wanted,” states Ken.

He eventually became addicted to nicotine derived from tobacco cigarettes that he now has to buy daily.

John is among the thousands of adult smokers in Kenya who despite being aware of the adverse effects of tobacco use, are struggling to quit the habit.

According to the World Health Organisation (WHO), tobacco kills up to 50 per cent of its users and is a major risk factor for non-communicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes and chronic respiratory ailments.

Studies show that 90 per cent of adult smokers begin the habit while in their childhood or teenage years. And just like Ken, many usually think they can break the addiction, only to realise that they are stuck in a hole too deep to climb out of, when it is already too late.

It is for this reason that health experts are calling for enhanced awareness creation and regulations that protect children from being lured into tobacco use which will become hard for them to stop in adulthood, hence jeopardising their future.

A new study published in the Journal of the American Heart Association shows that people who begin smoking early in life find it hard to quit the habit, as they grow older.

Findings of the study indicate that individuals who start smoking when they are young, are more likely to smoke daily as adults, even into their 40s.

During the study, researchers analysed smoking information provided by 6,600 individuals in the 1970s to 1980s, as well as recently in 2018. These people were followed up in their childhood, teenage and adult years (six years to above 40 years).

Findings of the study revealed that adolescents who smoked the most and children who started smoking at younger ages were more likely to be daily smokers in their 20s and were less likely to quit smoking by their 40s.

Even children who only tried smoking at a very minimal level by taking a few cigarettes were more likely to end up as daily adult smokers.

Specifically, the results showed that the percentage of participants who smoked daily during their 20s was 50 percent among those that first tried smoking when they were between six and 12 years old.

The figure dropped slightly to 48 percent in individuals who began taking cigarettes at the age of between 13 and 14 years.

"Based on our data, coupled with a variety of other evidence, we found that childhood smoking leads to adult smoking," said Dr David Jacobs, the author of the study and Professor of Public Health at the US based University of Minnesota in Minneapolis.

He states: “Cigarette smoking, even experimentally among children of any age should be strongly discouraged."

Although the current study was conducted in three developed nations (Finland, Australia and the United States), the researchers believe that the results likely apply more broadly.

"Even in low income and developing countries, the societal reinforcement of smoking, the basic addictive qualities of nicotine, and the maturation of children and children's judgment through adolescence are universal," said Dr Jacobs.

He noted that cigarette smoking is an avoidable health risk, and its “seeds” are in childhood.

“As children mature through adolescence, they may have developed a better ability to resist impulses and to reject social pressures,” said Dr Jacobs.

"This is a very important study. It re-emphasizes the importance of keeping tobacco products out of the hands of children to prevent long-term addiction," said Dr Rose Marie Robertson, the deputy chief science and medical officer of the American Heart Association's Tobacco Centre for Regulatory Science.

Joel Gitali, chairperson of the Kenya Tobacco Control Alliance (KETCA) noted that since children learn from observation, those taking care of them should act as good role models.

“Parents, teachers and other caregivers should discourage tobacco use and also refrain from using them. When children see adults smoking, they assume it’s a good thing and will therefore seek to emulate the behaviour.”

He notes that in accordance with the Tobacco Control Act in Kenya, children should not be exposed to tobacco products in any way.

“This is why the law prohibits the sale of cigarettes near schools or residential areas.”

In addition, Gitali notes that shops selling tobacco products are required to place them behind the counter, where they will not be visible to children.

“Some people place them next to sweets, biscuits or soft drinks that children love. When this happens, children begin associating cigarettes with their favourite snacks. This lures them into smoking.”

He notes that flavoured tobacco products should also be banned as they tempt children to experiment with smoking.

“When the smoke released smells like vanilla or strawberry, children may innocently associate them with food products such as yoghurt or cakes that usually have those flavours,” states Gitali.

As stipulated in the Tobacco Control Act, he notes that the sale of single stick cigarettes, which is often affordable to children or teenagers, should also be prohibited.

“If we want to protect our children, then the law needs to be enforced at all times. Those found breaking it should be severely punished,” he says.