Distress and drags: Inside the valley of smoke

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There has been a complex picture of smoking patterns since the 2019 lockdown in Kashmir.

The winter sunlight gently hits the ground, sprinkling its beautiful golden shades on the Jhelum. On the banks of the iconic river stood a cheerful group of five teenagers — cracking jokes while sharing a pack of Four-Square.

At just a stone’s throw distance from them, an aged man selling “masal-chxot” lights his 7th cigarette
of the morning as he awaits his customers.

Six-year-old Moosa giggles as he holds his pencil with two fingers trying to imitate his father who tries his best not to smoke in front of his children. His mother immediately passes him a furious stare
and asks him to get back to his online classes.

From people of all age groups, Kashmir has the highest number of passive smokers in all of India. In line with a survey conducted by the Ministry of Health and Family Welfare, Kashmiris are known to spend a whopping Rs.600 crores on the purchase of tobacco products annually.

More than two in every five adult males and one in every five adult females in the valley, according to many studies, use tobacco and tobacco related material.

Further, a survey ‘Tobacco Use in School Going Adolescents of District Srinagar of Kashmir’ by Government Medical College (GMC) Srinagar, found that 23% of adolescents are active smokers while 18% of studied population had started smoking when they were just 14-15 years old in the region.

Experts believe that the trend has risen to a great extent post lockdown in August, 2019. Even though no empirical study has been conducted in Kashmir that can support their belief, there has been a complex picture of smoking patterns since the lockdown.

With high rates of quitting, there’ve been high levels of relapse and signs of a rise in smoking rates among the masses.

“Cigarette daeb ditta (Give me a packet of cigarette),” Junaid asks a busy shopkeeper handing him a hundred rupees note. The acrid, smoky smell of cigarettes hung in the air as he impatiently cools his heels for the order.

It started as a fun for Junaid before he knew it he was addicted to an extent that he couldn’t get a wink of sleep at night without puffing a few cigarettes. He was barely 11, and smoking 4-5 cigarettes a day.

And now at 21, he says, the political lockdown of 2019 caused him to smoke around 20 cigarettes.

“After the Article 370 got scrapped, I was caged at home when the anxiety and depression kicked in,” Junaid recalls that harrowing captive period of his life when Kashmir had become an ‘information black-hole’.
“The inability to meet my friends and the unavailability of mobile network and internet connection worsened the situation. I had no way out.”

Junaid, however, is not proud of this habit. He’s well aware of the impact that smoking was having on his mind and body. He knows that cigarettes will never be able to heal him.

Health specialists across the valley believe that the impact of tobacco on health is extremely underestimated and its prevention to this date also remains ignored.

Besides causing life-threatening diseases, tobacco consumption also drains families and communities economically. Smoking is considered as a gate-way drug which leads to other hard core drugs like cannabis and heroin.

“In the last year or two,” Junaid goes on to say, “most of my friends and cousins who didn’t smoke, have started smoking. No one is really addicted to it. It’s more of a vent, a tension-diffusing routine.”

Following the political lockdown, the subsequent “untouchable” pandemic lockdowns have only escalated the mental distress in Kashmir. Preventive measures like social distancing have led to feelings of increased loneliness and deprivation. Besides, the ebb and flow of an almost 30-year-old armed conflict has had an enduring psychological impact on the Kashmiri population.

“These three years of lockdown were quite stressful,” says Faraz, 29, who began smoking as a teenager but hadn’t smoked in six years before 2019. “And it definitely had something to do with my coming back to smoking.”

Tobacco comes under stimulants class of drugs and it may enhance concentration or make one feel calm for a temporal period. However, experts warn, there’s no safe level of smoking and it’s not a healthy way to relax or relieve anxiety.

“We very well know that there is bidirectional link between tobacco use and mental health problems,” says Dr. Yasir Rather, a noted psychiatrist at IMHANS, Srinagar. “So increase in mental health issues will definitely lead to increase in tobacco use as people turn to them in order to self-medicate sadness and stress.”

Faraz lives in Downtown, Srinagar and owns a garment store. Fidgeting with the front pocket of his olive trousers and fumbling for a cigarette, he looks distraught. Life in isolation has made him agitated. He’s now openly relieving his distressed mind, like others, with desperate drags.

Psychology professor, Ujjwal Sharma, is of the opinion that smoking is generally accepted in the Kashmiri society.

“Young children are increasingly getting attracted towards smoking primarily due to the fact that they’ve role models who smoke, such as, brothers, fathers and uncles,” she explains. “As everyone else also approves of their smoking behaviours, young children are more likely to experiment with smoking.

Moreover, easy access to cigarettes (being available at home) is another factor that encourages this habit.”

In 2009, the government of J&K passed a law prohibiting smoking at public places under the Cigarettes and Other Tobacco Products Act (COTPA).

According to this act, anyone who advertises tobacco products shall on first conviction be punished with up to 2 years of imprisonment or be charged with a fine of Rs.1000. And in case of subsequent conviction, the imprisonment would last up to 5 years and would be fined Rs. 5000.

Similarly in 2017, a complete ban was imposed on the sale and distribution of e-cigarettes in the valley. The Health department also launched a “yellow line campaign” within a radius of 100 meters from any educational institution to ban the sale of tobacco products.

But despite these measures, the laws have not been enforced strictly and the sale of loose cigarettes continues unrestricted, prompting many to ask—how serious the government is in implementing the laws when it earns in crores as tax on the import of tobacco and other products.

Absence of stringent law-enforcement in this case, many say, is leaving people gasping for breath now.

Amina, a brave 13-year-old, had seen her father battle lung cancer since a very young age.

Looking at her mother tear her hair with despair every second day would make her heart ache. Her father, whom she loved so ardently, was admitted in SKIMS for yet another chemotherapy session in May 2021.

“Mama came to me one night with heavy drops of hopeless tears in her eyes, ‘Winn chu asè wariya wuchun’ (We’ve to endure a lot still). She cried and fell into my arms, wailing. I couldn’t see Mama cripple like that. I didn’t know what life without Baba would be like. I looked into Mama’s eyes and couldn’t help but notice how suddenly they look so old and weary,” says Amina, almost choking.

Amina thinks about all the times her mother begged her father to quit smoking when he got diagnosed with stage-IV lung cancer in October 2019. “Winkenas cha wariyah paresheni, saarni chu kaar bihit. Sakhet noksaan chum gasaan (These are very tense times, everyone is sitting idle. We’re facing crippling losses), he would always say,” the distraught daughter recalls.

At times, out of concern, Amina would hide her father’s cigarette boxes. But it would backfire and leave him desperate and frustrated. The doctors had informed them that there were no chances of survival.

“Just then, Mama got a call and that was when we knew that we had a long life ahead of us, filled with challenges and struggles of our own. Baba betrayed us. He left us all alone,” Amina’s voice broke.

Collecting every ounce of strength in her soul and body, the daughter having nothing more to offer, muttered, “Sourey gasè theek, Mama (Everything will be alright, mother).”

Use of tobacco, according to a report by Indian Council of Medical Research, was the third leading cause of death and disability in J&K.

What’s more worrying is that Kashmir for long has been standing at top among all states when it comes to tobacco consumption.

Medics say tobacco use causes many types of cancer, including lung, larynx (voice box), mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix, as well as acute myeloid leukemia.

The growing urge for smoking further makes Kashmir as the region with one of the highest number of Chronic Obstructive Pulmonary Disease (COPD) cases in all of India.

As per various studies, J&K is one among few north Indian states which report COPD figures equal or greater than 4,750 per 100,000 population.

A study conducted in September 2018 reveals that COPD prevalence was 2.7%, 22% and 28.2% among non-smokers, ex-smokers and current smokers respectively in Kashmir.

“Smoking is the main aetiological factor responsible for COPD,” Dr. Naveed Nasir, head of department, Chest Disease Hospital, linking COPD directly with smoking, says. “A very small percentage of such cases are due to some genetic abnormality. Smoking basically disturbs each and every system in the human body.”

Notably, a GATS India survey proved that 81 per cent of smokers in Jammu and Kashmir are aware that smoking causes lung cancer, “only 58 per cent know that smoking can trigger a heart attack and only 44 per cent smokers know that smoking can cause a stroke”.

Apart from the significantly negative health impacts of tobacco, cigarette smoking also causes consequential environmental pollution.

“Cigarette smoking gives rise to three types of wastes — cigarette butts, the smoke and ash,” says Inam Sabha, an environmentalist and researcher.

The cigarette butts are made up of non-biodegradable synthetic fillers. They litter the environment and the toxic chemicals in the residues seep into soils and waterways, thereby causing soil and water pollution.

“Cigarette smoke generally contains traces of heavy metals like lead and cadmium, and certain carcinogenic radioactive compounds which are detrimental to human health causing disorders of heart, kidneys, liver and other vital organs if inhaled,” Inam says.

Ash is primarily composed of benzene, which again is very harmful for the ecosystem. “It persists as dust in the soil, thereby decreasing its fertility. The ash particles also remain suspended in the air, causing contamination of the air,” she says.

This growing menace also pushes Kashmiri parents into yet another pit of distress.

Amid the growing ‘mist of melancholy’ in Kashmir, Rafiq Ahmed, a 54-year-old businessman and a father of two, reminisces about the ‘good-old-days’ of his childhood.

“Those caught with a cigarette in their pocket would be severely punished by the teachers. We would receive a good beating,” he laughs.

“Times have changed now. Teachers cannot treat students like that anymore. Children aren’t as fearful of their teachers as we were back in our time. Parents need to level up their parenting.”

Top medical experts have warned that teens whose parents smoke are 4-times as likely to take up smoking and early teens whose parents smoked were more than twice as likely to have tried cigarettes.

“By stopping smoking now, parents can help break the pattern of smoking in their family across generations and protect their children,” Rafiq suggests with a fatherly concern.

“Even if we believe we are hiding our smoking by not directly smoking in front of them, it can still have a major impact and children can pick up the behavior without even being aware that you have had an influence. Action speaks louder than words.”


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