‘Illogical and harmful’
SMOKING BAN: PSYCHIATRIST CITES SERIOUS ISSUES WITH ‘COLD TURKEY’
Withdrawal syndrome can be so unpleasant for some that they may attempt suicide – expert.
Opposition to the ban on tobacco sales during the national lockdown is mounting, with a psychiatrist specialising in substance abuse saying that it is “illogical and harmful” and “unlikely to have any meaningful effect on the prevalence of smoking”.
“Therefore, any health-related benefits and/or relief of pressure on the healthcare system is likely to be minimal to none,” Dr Michael West, of the Akeso Clinic in Milnerton, Cape Town, said in a report commissioned by the Fair Trade Independent Tobacco Association (Fita).
The report forms part of Fita’s urgent application to have the ban lifted. It was filed in the High Court in Pretoria on Friday and is expected to be argued before a full bench next week.
In it, West pointed to the record of decision, including a cache of research and thousands of public submissions, government last week filed with an affidavit written by Cooperative Governance and Traditional Affairs Minister Nkosazana Dlamini-Zuma, outlining the reasons for the ban.
He said, in his opinion, the ban was “based on low- to very lowquality evidence for which the data is not wholly available, does not consider short-term harms associated with voluntary and involuntary smoking cessation, does not consider World Health Organisation recommended best
in supporting smoking cessation to improve successful quit attempts, does not acknowledge the negative impact [the ban] is likely to have on vulnerable South Africans and does not reference any of the more recent literature that makes reference to the complex relationship between Covid-19 and smoking.”
West outlined the “numerous physical and psychological symptoms” of nicotine withdrawal and said certain people, including those with mental illnesses, were at higher risk of protracted withdrawal.
“Some individuals are at an increased risk of suicidal ideation and suicidal behaviours that may arise during the period of nicotine withdrawal.
“The [withdrawal] syndrome can be so unpleasant for some people that they may contemplate attempting suicide. In some tragic cases, these suicide acts are completed.”
In the documents filed last week, Dlamini-Zuma cited evidence “that about 95% of smokers quit on their own without any medication or formal help”. But West dismissed this claim as “outdated and inaccurate” and said it originated from a book published in 1990.
“The statement would be relevant if it were 1990. Over the past 30 years we have improved our knowledge of nicotine dependence and have several far more sophisticated strategies to assist smokers in successfully quitting.
“[Government] has essentially forced a population of approximately eight million smokers into an unpleasant physical and psychological withdrawal syndrome without making any effort to provide support, treatment or evidence-based behavioural interventions.”
West added that “cold-turkey” withdrawal only had a success rate of about 6%. “The truth is that the vast majority of smokers will be unable to quit without some form of intervention”.
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