Gurkhas get to grips with lifelong chewing habit

A smokefree programme is getting to the heart of an old tradition, and helping to tackle health inequalities, for Nepalese veterans.

Maha Rai, manager of the Nepalese Community Centre in Folkestone.

“Chewing tobacco has been very popular in our culture for generations and it’s hard to change,” said Maha Rai, manager of the Nepalese Community Centre in Folkestone. “But knowing that the NHS is here to help and that they understand, makes a huge difference. I’m hopeful that with their support, people can finally quit.”

To provide that support, we are adapting a smokefree programme to take in cultural differences. We are also going directly to the Nepalese community, instead of waiting for people to find help on their own. This approach is especially important when language can be a barrier and when many in the community do not see healthcare warnings and advice online.

Advisors from our Lung Cancer Screening Smokefree Team, which is run in partnership with Kent and Medway Cancer Alliance and Kent County Council, recently visited the centre and spoke with around 70 people about giving up tobacco. The event was held with the Kent and Medway Lung Cancer Screening Programme. Next there are plans to set up quitting tobacco group sessions, running over seven weeks.

Mohankumar Rai, 65, who served with the British Army for 15 years, is one of those who hopes to go along.

He said: “I started chewing tobacco when I was in the army. I want to stop as it smells and for my health. I have given up before, so I know I can do it, but having support from the NHS will be helpful.”

Manikumar Rai

Manikumar Rai, 71, also wants to kick the habit. He started smoking tobacco leaf as a teen and cigarettes when he joined the British Army, serving for 18 years. He started chewing tobacco as he wanted to stop smoking.

He said: “Now I want to stop chewing tobacco, for my health and also because it’s messy, I want my mouth to feel clean and fresh and to save money.”

Working closely with Maha, our Lung Cancer Screening Smokefree Team is delivering a programme that helps individuals understand the risks associated with chewing and smoking tobacco while offering practical advice on how to quit. Smokeless tobacco has high levels of chemicals and other substances that can cause gum disease, mouth and throat cancer, and contribute to serious health problems, such as heart conditions.

Maha said: “It is very helpful to have the NHS come to our centre which supports retired veterans and their families and more than 800 households in Folkestone. This is easier for people and more effective, having the NHS come to us.”

One You Smokefree Supervisor Helen Robinson said: “We know that for many in the Nepalese community, chewing tobacco is a deeply ingrained habit. Our goal is to offer guidance and assistance, while still highlighting the importance of quitting for better health.

“Our advisors are helping individuals at the community centre understand that chewing tobacco can be just as harmful as smoking. We are keen to adapt the programme for our Nepalese community.

“After talking with members of the community, we found using specialist gum or lozenges might be a popular way to help people quit, as this is held in the side of the mouth, similar to the chewing tobacco.”

Mohankumar Rai who would like support to stop chewing tobacco.

Fact file:

• Chewing tobacco contains more nicotine than smoking tobacco and could lead to a stronger nicotine addiction.
• Chewing tobacco for 30 minutes equates to around the same as chain smoking three cigarettes.
• Health problems associated with chewing tobacco include cancer of the mouth, oesophagus and pancreas, along dental issues, with teeth being worn down quicker.
• Chewing tobacco is a lot cheaper than smoking tobacco.
• Chewing tobacco is popular in the armed forces.
• More men than women chew. Women are more likely to smoke.