Uzizwa Udabukile: Ingabe Kubangela Ukufinyelela Ugwayi?

Abangabhemi kungenzeka bangabuqondi umfutho wokulangazelela i-nicotine etholwa ababhemayo, noma umfutho wemizwa emibi lapho obhemayo ezama ukuyeka. Emzamweni wokutadisha lo mlutha, umphumela we-nicotine ekuguquleni isimo somuntu obhemayo, nomphumela wesimo esingokomzwelo ekubangeleni isidingo sokubhema, sekufundwe kabanzi.

Ngabe ukubhema kuyayiqeda imizwa yokudangala nokukhathazeka? Ukubuyekezwa kwakamuva kwezifundo zamanje ezibheke ebudlelwaneni obuphakathi kokubhema ugwayi nemizwelo e-dysphoric kubalula ukuthi eNgilandi, ama-42% abantu ababhemayo banesifo sengqondo. Futhi yize ukubhema kwehlile eningini labantu, akubanga khona ukwehla phakathi kwalabo abanezifo zengqondo. Ngaphezu kwengxenye yezifundo ze-148 ezibuyekeziwe zathola ukuhlangana phakathi kokudangala, ukukhathazeka nokubhema; cishe kokuthathu kwezifundo ezishiwo, abantu abanalezi zinkinga ezimbili zengqondo babekwazi ukubhema esikhathini esizayo, kunalezo ezingenazo lezi zinkinga. Kungenzeka yini ukuthi labo abaqala ukuhlangabezana nezinguquko zemizwa, ezingakafiki ukubaluleka komtholampilo, basebenzise i-nicotine ukusiza "ukwelapha" imizwa yabo?

Lobu budlelwane obuphakathi kwezinguquko ezinzima kwemizwa nokubhema busafundwa ngenkuthalo. Kokunye ukufunda okunjalo, abafundi bezokwelapha abangabhemi banikezwa uchungechunge lwezivivinyo ezazenzelwe ukudala imizwa yengcindezi. Babe sebetshelwa ukuthi babheme ngaphansi kwezimo ezilawulwayo (inani lokuzikhukhumeza kwaqashwa) kanye nemizwa yabo uma kuqhathaniswa nemizwa yabo yangaphambi kokubhema. Imiphumela yayingalindelekile: Abafundi besifazane babhekana nokwehla kwengcindezi yabo ngemuva kokubhema, kepha imizwa yezifundo zesilisa yaya iba yimbi. Abesilisa baba nobutha, bathukuthela, bazola kancane futhi abaneliseki ngokwengeziwe ngemuva kokuchayeka ku-nicotine. Ukuthi imiphumela efanayo ngabe itholakele yini kubantu ababhemayo abangafundanga.

Olunye ucwaningo lukhombisile ukuthi ababhemayo bayazifunela osikilidi babo ezimeni ezicindezelayo uma kunjalo, basendaweni evumela ukubhema.

Olunye ucwaningo oluthokozisayo olwaluthungatha imizwa yababhemayo besilisa izinsuku ezimbalwa, lwathola ukuthi isimo esibi (ukuthinteka okungekuhle) sihambisana nokubhebhetheka kokubhema, kepha esikhundleni sokuqeda imizwa ecindezelekile, ekhathazekile noma ecindezelekile, ukubhema kwayenza yambi kakhulu. Lokhu okutholakele kufana ncamashi nalezo ezitholakala phakathi kwabesilisa abangabhemi okukhulunywe ngabo ekuqaleni.

Ukuqinisekiswa okuthakazelisayo kwesifiso esiphoqayo sokubhema ngokuhambisana nomoya ongemuhle kuvela ezifundweni ezimbili ezazibheka izimo ezithile zomzwelo nesifiso sokubhema. Babalelwa kwabangu-120 abesilisa nabesifazane ababebhema, abanye babo ababephethwe yingcindezi, bakhonjiswa amavidyo kliphu amabili. Esinye sasimayelana nokufa kukababa, kanti esinye kwakuyisigcawu esivela epaki kazwelonke. Labo abanesifo sokudangala babhema kakhulu ngokuphendula ifilimu edabukisayo kuneqembu elingacindezelekile. Enye ifilimu engokomzwelo engathathi hlangothi ayizange ibe nomthelela esifisweni sokubhema phakathi kwanoma yiliphi iqembu.

Lokhu okutholakele kuqinisekisiwe futhi kwandiswa ezifundweni ezibandakanya ucwaningo lwabangaphezu kuka-10 000 ababhemayo nokuhlolwa kwelabhorethri. Imininingwane yocwaningo ithole ukuthi ukudabuka bekungukuphela kwabantu ababhemayo ababikiwe okuhlobene nesidingo sabo sokubhema, kanye nembangela yokubuyela kwabo emuva kweminyaka engamashumi amabili noma ngaphezulu ngemuva kokuyeka.

Amavidiyo aklanyelwe ukuvusa izimo ezithile ezingokomzwelo futhi ethulwa kwababhemayo kubangela ukubhema kuphela lapho okuqukethwe kudabukisa (ukufa kukazakwethu) kodwa hhayi lapho okuqukethwe kungathathi hlangothi ngokomzwelo (ukusebenza ngokhuni) noma kuyenyanyeka (ukuhlanza indlu yangasese engcolile).

Ukukhomba ukudabuka ngasese, kunezinye izimo ezingokomzwelo ezingezinhle njengokucindezela isimilo somuntu obhemayo, kungaba wusizo ekubasizeni bayeke. Izindlela zokuziphatha zokusiza obhemayo ekuguqukeni ziyeke zisungulwe emashumini eminyaka adlule, kanye nezidakamizwa zokwehlisa izifiso mhlawumbe nokusiza ekuguqukeni kwemizwelo kwesinye isikhathi okuhambisana nokuhoxa ukubhema. Kepha lokhu okutholakele okukhombisa ukuthi ukudabuka kungakhuphula isidingo somuntu obhemayo i-nicotine kungabaluleke kakhulu ekutholeni isikhathi esifanelekile sokuqala uhlelo lokuhoxa ukubhema (kanye nokuvimbela ukubuyela emuva okungahle kwenzeke.) Ngokusobala ukudabuka okubangelwe yisimo sempilo (ukugula, ukudumazeka okukhulu, ukufa) kanye / noma ngokudangala uqobo kumele kubonwe njengengozi yokuphinda abuyele kowayebhema. Futhi ukuzama ukunxenxa umuntu obhemayo ukuthi ayeke i-nicotine, ngaphansi kwalezo zimo, nakho kungaba yize. Ukungenelela okusiza umuntu anciphise noma anqobe amandla alo muzwa kungaba yindlela engcono kunezinhlelo ezijwayelekile zokuhoxa ukubhema.

Kodwa-ke, njenganoma iziphi izincazelo ezizama ukuqonda ukusebenza okuluthayo, kuyadingeka ukuthi udlule ngale kobufakazi benkomba echaziwe. Into eyodwa entulekayo kuzo zombili lezi zifundo zosizi nokubhema ukuthi ngabe, noma kanjani, isimo somuntu obhemayo sishintshile ngemuva kokudla i-nicotine. Ngabe umuntu obhemayo ubephatheka kabi? Uma kunjalo, lo mphumela ugcine isikhathi esingakanani? Wawuyini "umthamo" we-nicotine owawudingeka, okungukuthi, kwakudingeka ukuthukuthela kangaki, ngaphambi kokuba isimo somzwelo sishintshe? Futhi kuthiwani, uma ezinye, izimo ezingokomzwelo bezinconywe yiziqeshana zamafilimu noma amavidiyo afana nokwesaba, ukucindezeleka, intukuthelo, ukudideka, ukukhathazeka nokukhathazeka ukubala nje ezimbalwa, ngabe lezi bekungaba yizimbangela ezingokomzwelo zokubhema? Ngabe izihloko ngabe zisebenzise ugwayi ukushintsha isimo sabo semizwa?

Kuningi esisazokufunda ngokuqeda lo mkhuba.

"Ucwaningo ngokuxineka nokubhema: inqubekela phambili nezinkinga," uPomerleau O noPomerleau C, iBritish Journal of Addiction (1991) 86, 599-603.

"Ukubhema kuhlotshaniswa nesimo esibi kakhulu ngezinsuku ezicindezelayo: Imiphumela evela kuNational Diary Study," u-Aronson K, Almeida D, Stawski R et al, Annals of Behavioral Medicine 2008; 36: 259-269.

"Ukucindezeleka kukala ukuziphatha kokubhema ekuphenduleni imizwa yokudabuka," kusho uFucito L, uJuliano L., Psychol Addict Behav. 2009; 23: 546-551.

"Ukudabuka, kepha hhayi yonke imizwa engemihle, kukhulisa ukusetshenziswa kwezidakamizwa okuluthayo," uDorison C, uWang K, uRees V et al, iProceedings of the National Academy of Sciences 2020 117: 943-949.