LETTER TO EDITOR
Year : 2022 | Volume
: 4 | Issue : 1 | Page : 48--49
Nicotine Replacement Therapy Commercials: Pros and Cons
Adesh Kumar Agrawal1, Partha Pratim Daimary2, Soumitra Das3,
1 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
2 Department of Psychiatry, Lokpriya Gopinath Bordoloi Institute of Mental Health, Tezpur, India
3 Emergency Mental Health, Sunshine Hospital, Melbourne, Australia
Dr. Adesh Kumar Agrawal
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
|How to cite this article:|
Agrawal AK, Daimary PP, Das S. Nicotine Replacement Therapy Commercials: Pros and Cons.World Soc Psychiatry 2022;4:48-49
|How to cite this URL:|
Agrawal AK, Daimary PP, Das S. Nicotine Replacement Therapy Commercials: Pros and Cons. World Soc Psychiatry [serial online] 2022 [cited 2022 Sep 27 ];4:48-49
Available from: https://www.worldsocpsychiatry.org/text.asp?2022/4/1/48/344116
Tobacco is the most common substance of abuse in India regardless of the sociocultural differences throughout the country. It is an important health concern as its effects vary from simple gum ulcers to life-threatening malignancies. It is sold openly in the market in different forms, which is easily accessible to all ages and classes of people, including minors. As per the global adult tobacco survey 2016–2017, 28.6% of all Indian adults use tobacco either in a smoked or smokeless form. As per the survey 33%–38% of tobacco users tried to quit it in the last year. Substance use disorders are not merely a habit, these are psychiatric disorders. These disorders are due to aberrant connections and abnormalities of various brain circuits. A man may start using tobacco at some point in time regardless of the presence or absence of any precipitating factor but sooner or later realises he must quit the tobacco use. To change his habits of tobacco abuse, each person goes through various stages of motivation, namely, (i) not ready (precontemplation); (ii) unsure (contemplation); (iii) ready (preparation); (iv) action; and (v) maintenance.
Nicotine replacement therapy (NRT) is an FDA-approved therapy and has shown a beneficial effect in the cessation of tobacco. At present, nicotine gum, nicotine lozenge, and nicotine patches are popular and are commonly used NRTs. Indian television advertisements and online video sharing platforms broadcast NRTs advertisements. There are positive factors associated with the streaming of these advertisements. It raises awareness about the harmful effects of smoking. It is letting people know that there is a way to get rid of this habit. As a person with tobacco use disorder goes through the contemplation or preparation stage of motivation and sees these advertisements, he might be motivated even more to cease tobacco use and there is a higher probability that he will accept the treatment offered by the advertisement.
We went through these advertisements and found that they are very captivating and influential. They are in audio-visual mode and the contents are emotional, humorous or have celebrity endorsements. Those who use tobacco correlate the content of these advertisements with their own life's experiences and emotions. For example, one particular commercial depicted how a person felt shame and guilt after being criticized for stained lips as a result of chewing gutka (chewing tobacco). In another short, it was portrayed how chewing tobacco led to low confidence and frustration. These common negative affective states of a person with tobacco use disorder might lead him to easier influence by such advertisements.
Various forms of NRTs can be readily purchased over the counter from numerous commercial drug stores without prescriptions. Most importantly, tobacco users can try giving up smoking without the help of a psychiatrist or any other health professional. Although it appears as a much feasible way of quitting tobacco, there are several negative factors to be considered. These commercials could complicate the situation. The most concerning issue is that the success rate of cessation of tobacco by using NRT might be overestimated by the person, seeing his favorite celebrity or a fellow user like him becoming successful in those shorts. It is good to be motivated but one must be aware of the ground realities to be able to avoid frustration and hence keep oneself safe from the possible development of a helpless behavior in future, in case the tried method fails. Since these shorts of a few seconds duration cannot sufficiently explain the right method, for example, the park and chew method in case of the nicotine chewing gums, the person may not benefit fully from the NRT. The success rate of tobacco cessation with the use of NRT could be overestimated by the assurance in the commercials and one can get frustrated with failures. Furthermore, studies found that adherence to NRTs is low. The cycle of motivation is a dynamic process and a person usually encounters multiple failures in attempts to give up on substances. Psychiatrists play a vital role in keeping the person in the system and leading him towards abstinence from tobacco. Here, without the support system, there is a higher chance of developing learned helplessness. Even if the person seeks the help of a psychiatrist on a later period and gets prescribed with NRT, he might carry a negatively biased preconceived notion about its efficacy and this may result in poor acceptance of this FDA-approved treatment option.
Suggestions by the authors on possible improvements in such future advertisements: Creating interesting longer videos covering other related issues like the method of using, following the guidelines, facts, advice to seek psychiatrists' help, more realistic results, etc.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||Tata Institute of Social Sciences (TISS), Mumbai and Ministry of Health and Family Welfare, Government of India. Global Adult Tobacco Survey GATS 2 India 2016-17. Available From https://ntcp.nhp.gov.in/assets/document/surveys-reports-publications/Global-Adult-Tobacco-Survey-Second-Round-India-2016-2017.pdf [Last accessed on 2022 Apr 04].|
|2||Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot 1997;12:38-48.|
|3||Silagy C, Mant D, Fowler G, Lodge M. Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation. Lancet 1994;343:139-42.|
|4||Psychosocial Paediatrics Committee. Impact of media use on children and youth. Paediatr Child Health 2003;8:301-17.|
|5||Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev 2018;5:CD000146.|