Hence, smoking is a habit that takes some effort to break since "cigarettes are highly efficient nicotine delivery device and is as addictive as cocaine"(2)
"Nicotine is a drug of addiction" (3) and therefore the smoker becomes chemically addicted to it and consequently drawn into both a physical and psychological partnership with cigarette and thus the more the person smokes the more difficult it is to quit!
The WHO rightly defined addition as "a state, psychic and sometimes also physical, resulting in the interaction between a living organism and a drug, characterized by behavior and other responses that always include a compulsion to take the drug on a continuous or period basis in order to enhance its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present"(4).
"Tobacco use is the single leading cause of death in the United States, and the risk for smoking attributed disease increase the earlier in life smoking begins"(5)
"Cigarette smoking, as it exists in the world today, is most remarkable phenomenon. It is a habit of the most widespread proportions, and a product of the twentieth century"(6).
Thus, the social habit developed as a result of tobacco smoking is gradually developing into a culture. A culture in this sense could be seen as a way of life which reflects the inner thoughts and feelings of a person or group of persons. "Already there is a trend toward smoking among teenage girls and boys. It is likely that the smoking patterns among women and girls in the developing countries will follow the same trends as in developed countries."(7)
This smoking culture is strong, resilient and capable of forging a reputation for a person. For instance, in the nineteenth century, in the western world, tobacco was smoked by gentlemen only in the form of cigar. The smoking culture may still survive for a long time since the avant-garde themselves are seen as a symbol of sophistication and maturity and the urge to conform to this culture is ever there. So, this culture has become a socially acceptable practice.
"In the survey to study the incidence of initiation of first cigarette smoking and of first cigarette smoking and of first daily use in the USA during the 1965 - 1996 among persons aged less than or equal to 66 years, and to estimate the number of new smokers aged less than 18 years. The findings from the analysis indicated during 1988 - 1996 among persons aged 12 - 17 years, the incidence of initiation of first use increased by 30% and of first daily use increased by 50% and 1,226,000 persons age less than 18 years became daily smokers in 1996"(8). With such an astounding number of cases of smokers amongst adolescent aged less than 18 years calls for lots of concern on part of the society and the government! This support the fact that, really, apart from the social dimension to smoking, it is equally a learnt habit, most probably through psychosocial pressures when the smoker begins to rely on cigarette for what he or she believes to stimulating, relaxation or stress relief!
"In most cases, learning to smoke occurs in adolescent age, parental control is less, and the individual acquires habits which depend largely on peer group"(9).
Therefore, the overall picture shows that adolescents are the ones mostly involved in this act, since this is a stage in life where they experiment with lots of ideas and behavior and always want to conform to the lifestyle of friends.
However, "trends in the initiation of cigarette smoking are important indicators for directing and evaluating prevention activities"(8). Thus, if cigarette smoking could be stopped, there would be immediate benefit for smokers, mostly adolescents, who when prevented from smoking the attendant morbidity and mortality associated with tobacco use will be greatly reduced.
For example, "tobacco is the most clearly defined cause of cancer, this cause more than 50,000 deaths per year in the U.K - one third of all cancer deaths"(10). In addition, "Cigarette smoke contains tar, consisting of over 4,000 chemicals. Of these chemicals, 43 are known to cause cancer. Among them are cyanide, benzene, wood alcohol and acetylene. Cigarette smoke also contains nitrogen oxide and carbon monoxide, both poisonous gases. Its main active ingredient is nicotine, a highly additive drug"(11).
Smoking prevention and/or cessation programs are of immense benefit if initiated and sustained! In the past, helping people quit smoking was the primary focus of efforts to reduce tobacco use. This strategy has been a critical one, since smoking cessation at all ages reduce the risk of premature death. In recent years, the focus on tobacco control has expanded to include strategies to prevent individuals from even starting to smoke particularly young people, since the decision to use tobacco is nearly always made in the teenage years.
Thus, a broad-based spectrum of federal, state and local governmental agencies, professional and academic institutions have joined together to advance the element of a comprehensive approach to tobacco use, which includes: 1. to prevent initiation among young people. 2. To promote quitting among adults and young people. 3. To eliminate exposure to environmental tobacco.
This comprehensive approach involves the following: state and community interventions, counter-marketing, policy and regulation, surveillance and evaluation.
In view of these preventive measures, the following suggestions are important for the government and all concerned parties to note of.
Firstly, to the government, the ban on cigarette smoking in public places should be re-evaluated. It is necessary for the avoidance of doubt to spell out these public places and to enforce the ban vigorously. Penalties should also be redefined and make known to general public through accessible and effective means.
Secondly, certificate of cigarette manufacturing industries should be reviewed, taxes re-evaluated, and if possible laws monitoring the operation of these industries should be redefined - all these with the goal to discouraging smoking.
Thirdly, the government should provide both financial and legal support - in the form of constitutional laws - at the federal, state and local levels, and this support should extend to professional and voluntary organizations, academic institutions.
Fourthly, health education should be carried out to the doors of our communities.
Equally important, the school authorities should be actively involved in the following ways: 1. public campaign within the campus against cigarette smoking. Services of voluntary organization within and outside of the campuses should be employed.
2. Re-evaluation of the orientation programmes for new intakes. For instance, films, health talk should be included in the orientation programme to further emphasize the hazards of cigarette smoking.
3. Laws should be established to safe-guard the health of others - the society. Smoking should not be allowed in class rooms, hostels, libraries, laboratories etc. In cases where these laws are already in place, efforts should be made to prevent breach of law.
4. Penalties should be stated, in the admission letter to new intakes against breach of school laws.