CANSA Service Spotlight – Lorraine Govender (National Manager: Health Promotion)

Lorraine Govender

I am currently the National Manager: Health Promotion at the Cancer Association of South Africa (CANSA).

I am a professional nurse, working for CANSA at grassroots level for the past 16 years, assisting communities in understanding cancer risk reduction, disease management and support.

I am involved in tobacco control at local, provincial, national and international levels and am involved in advocacy work with organisations such as Campaign for Tobacco-Free Kids, Africa Centre For Tobacco Industry Monitoring And Policy Research, the National Council Against Smoking & the South African Medical Research Council, to strengthen CANSA’s role as a tobacco control advocate.

What do you like most about your work at CANSA?

I am privileged to be working for a community-driven civil society organisation. CANSA’s comprehensive research programmes assist in the develoment of health programmes, and public education. Care and support are also offered to the most vulnerable. My previous experience as a national advocacy coordinator has allowed me to see the plight of many people when they seek cancer services. Partnerships and alliances form the cornerstone of the work that CANSA does. Taking a lead in representing CANSA in the Tobacco Control Alliance, ‘Fix the Patent Laws’ and various other leading advocacy organisations has strengthened my ability to work at this level and assists at a strategic level to influence policy changes on behalf of CANSA, from which the public may benefit.

What do you find the most difficult about your job?

Securing funding to carry out the life-saving work we do is the most challenging aspect of my work. With funding comes opportunities for resources that can add value, especially human capital. There are so few of us to carry out the work needed to reduce the cancer burden.

It also pains me to see cancer patients using tobacco products while undergoing cancer treatment. This is the addictive nature of nicotine. Smokers often feel helpless in trying to quit.

What inspires you?

Work is very important to me, because I enjoy doing things that either help someone or potentially changes someone’s life, even in a small way. Helping people to find solutions to their challenges gives me a sense of purpose in my work.

When challenges are encountered at work, I am motivated by the satisfaction that comes from helping others to resolve various issues. I enjoy the diversity that my position affords me, thus allowing me to work across various platforms e.g. print, radio and face-to-face education at grassroots level and through partnerships and alliances.

Is it important to be aware of the facts and myths around smoking?

Some myths stem from misunderstanding; but others are deliberately promulgated by the tobacco industry to induce people, especially children, to start smoking and to keep them smoking as adults. These myths undermine tobacco control. However, comprehensive tobacco control programmes that include anti-smoking public education campaigns can effectively counter these myths and prevent illness and premature death.

Many myths about smoking have arisen — myths that encourage people to begin or continue smoking or that deter them from quitting. These myths are believed to be true (not only by many smokers) but also by some physicians and policy makers, and this hinders development of effective tobacco control policy and treatment for individuals who are dependent on tobacco.

Myth 1: People have free choice whether or not to smoke

We all like to think we are creatures of complete free will. However, free will in the case of tobacco is overturned by advertising, which can result in addiction.

Cigarettes deliver an addictive drug — nicotine — to the body. The tobacco industry has shown its awareness of this fact by referring to cigarettes as a “nicotine delivery device” and by acknowledging that it is the nicotine in cigarettes that makes people want to smoke.

Myth 2: Smoking helps to relieve stress

Research has shown that smoking increases stress levels overall.

Much of the apparent calming effect of a cigarette is simply due to the relief of symptoms (such as irritability, anxiety and restlessness) caused by nicotine withdrawal. Also, some of the relaxation from smoking is from taking a break and a few deep breaths, not the cigarette itself.

Smoking increases stress by causing frequent withdrawal periods during the day between cigarettes. Further stress is created by the guilt and shame of smoking and by concerns about the health effects. Furthermore, nicotine is a stimulant and releases stress hormones such as adrenaline. Research studies have shown that ex-smokers report feeling less stressed than when they were smoking.

Myth 3: Cutting down your cigarettes or smoking mild cigarettes reduces the harm from smoking

Cutting down your cigarette intake or changing to milder cigarettes does not improve your health and does not significantly reduce your risk of dying from a smoking-related disease. The reason is that smokers subconsciously adjust their smoking when they cut down or smoke weaker cigarettes (compensatory smoking).

When you smoke fewer or weaker cigarettes, you smoke each cigarette more intensely to extract more nicotine and keep your nicotine level in the comfort zone. You take more puffs and deeper puffs from each cigarette to compensate for the reduced number or weaker cigarettes.

Myth 4: It is too late to quit as the damage is done

The damage from smoking improves quickly after quitting at any age. Many of the health effects of smoking reverse quite rapidly after quitting. Quitting before the age of 50 reduces your risk of dying in the next 15 years by half. The risk of having a heart attack falls by 50 % after about 3 years. In the case of lung cancer, your risk drops to half in 10 years.

The benefits of quitting are greatest when you stop earlier. However, even quitting at 60 years of age increases life expectancy by 3 years compared to those who continue to smoke.

Myth 5: Smoking helps me reduce weight

A popular belief among both smokers and non-smokers is that smoking is an efficient way to control bodyweight.

Studies indicate that heavy smokers i.e. those smoking a great number of cigarettes have a greater body weight than light smokers.

Smoking’s effect on body weight could lead to weight loss by increasing the metabolic rate, decreasing metabolic efficiency, or decreasing caloric absorption (reduction in appetite), all of which are associated with tobacco use.

The metabolic effect of smoking could explain the lower body weight found in smokers. The risk factors associated with this myth is the hormonal imbalance that may lead to long term insulin resistance as a result of altered metabolism due to smoking.

One must also take into consideration that tobacco use is a risk factor for 15 different types of cancer. The benefits of quitting far outweighs using this method to lose weight.

Can CANSA’s e-KickButt online smoking cessation programme help?

CANSA’s eKickButt programme is a unique online smoking cessation programme. Through a series of emails, surveys and downloads, one is guided and mentored as you quit smoking and non-smoking becomes a lifelong habit, not merely the time interval between two cigarettes. This programme supplies a series of handy tools – tried and tested – to help you quit for good.

It’s really very simple to get started. Just complete the sign-up form and you will automatically be enrolled in CANSA’s eKick Butt programme. FOR FREE…

Quitting tobacco may seem like a big challenge, but you need to trust that your journey to new health and unbelievable freedom from addiction will be worth it. With help from drill sergeant, Sergeant Kick Butt you are all set for success.

Additional points you’d like to make:

In July 2020, South Africa had an estimated population of approximately 59.62 million people. Approximately 44,000 South Africans die from tobacco-related diseases annually.

Although tobacco companies are banned from advertising their products in South Africa, they exploit loopholes in the legislation to market their next generation products. Using social influencers, they promote their products on social media platforms. The tobacco industry heavily markets these products as “reduced harm.”

CANSA urges the public to support the Protect our Next (PON) campaign for the Control of Tobacco Products and Electronic Delivery Systems Bill to be passed by Government.