I have been a smoker for 11 years and I cannot imagine a single day without a cigarette. I am aware that it is a very bad habit that endangers my health and interferes with my daily activities. Casual apologies to non-smokers, asking questions about whether and where I am allowed to light a cigarette - still cause me great discomfort.
With those words Bojana (26) describes how smoking has become an integral part of her life, but also her years of attempts to, as she tells "Vijesti", "free herself from nicotine addiction".
"I tried many ways to quit smoking. I even read a book Alana Kara and managed to, as an addicted smoker, quit smoking. The only reason I went back to smoking, unrelated to the book, was because I was in the company of smokers and I thought I could smoke a few, occasionally like everyone else. And I did it out of boredom, which was my cardinal mistake", says Bojana.
Escape from reality and apparent calm, a psychotherapist told the editorial team Dragana Djokic, are just some of the ways in which tobacco and nicotine products “mask the real problems of citizens”.
Health experts also point out that cigarette use in Montenegro is still among the highest in Europe, adding that "the tobacco and nicotine industry is targeting children in order to recruit new consumers among them."
They also add that the tobacco cessation program in Montenegro was developed almost 20 years ago, emphasizing that the smoking cessation process is adapted to the needs of each user.
Entry into risky behaviors
Đokić, in his responses to "Vijesti", points out that the biggest problem is not the substances themselves, but the messages that young people send to themselves.
“By using these products, they unconsciously say: 'I can't handle this pressure on my own'. In the long run, this creates a passive attitude towards life that does not solve problems, but rather 'burys' them with momentary pleasure. In plastic terms, instead of learning how to deal with stress, boredom or anxiety naturally, young people who use tobacco and similar products teach their brains to seek a 'quick fix' for every unpleasant emotion in the form of nicotine smoke.”
This, she says, creates a psychological dependence on the "trained nervous system":
"Where a person loses faith in their own coping mechanisms and relies on their chemical ally."
Data from the World Health Organization (WHO) shows that almost 750 million people worldwide want to quit smoking, and more than 90 percent of smokers try tobacco products before reaching adulthood.
Đokić states that the use of tobacco and nicotine products often serves as an entry point into other risky behaviors among young people.
"In psychology, we look at it through the prism of belonging to a group and pushing boundaries. For example, when a young person crosses the first line and tries something that is socially unacceptable or forbidden for their age, a barrier breaks down in their mind. The next step, whether it's skipping classes, experimenting with other substances, or more aggressive behavior, becomes much easier. In addition, a nicotine crisis (even a mild one, which the person is not even aware of) causes irritability, decreased concentration, and impulsivity, which directly affects relationships with parents and success in school," she said.
Brajović: The impact of nicotine on children is worrying
The head of the World Health Organization (WHO) office told "Vijesti" that a new generation of addicts to tobacco and nicotine products is being sought. Mina Brajovic.
Under the "cloak of innovation," he points out, today a new generation of users is being sought through electronic cigarettes, nicotine pouches, "colorful packaging and aggressive digital marketing."
"What we are seeing today is no longer just a market competition and an attempt by the tobacco and nicotine industry to find new customers in the adult population... The industry has moved to social media, hired influencers and created products that look more like technological gadgets or candy than addictive products. The harsh reality is that globally, children are on average nine times more likely to use vaping and electronic cigarettes than adults. So, we are no longer talking about consumer choice, but about an industry that has tied its future to the addiction of our children," she said.
He reminds that European regulations "classify nicotine as an acute toxin," and its impact on children and adolescents is of particular concern.
“A particular problem is the fact that these products are designed to appeal to young people. The industry uses a large number of flavors that mask the bitterness of nicotine and create an impression of harmlessness. Hundreds of different flavors are available on the market - from fruits and candies to flavors that imitate alcoholic beverages and energy drinks. Research shows that taste is one of the most important reasons why young people first reach for electronic cigarettes and other nicotine products. The development of new technologies for nicotine delivery is also of concern. Nicotine salts, capsules and so-called 'pearls' allow for faster release and absorption of nicotine, increasing the potential for addiction. In other words, we are not just talking about new products, but about products that are carefully designed to deliver nicotine faster, more efficiently and in a way that is more attractive to young users,” Brajović points out, adding that “with heated tobacco products, it is important to emphasize that the absence of combustion does not mean there is no risk.”
Protection of children and young people a priority
The WHO's position, Brajović points out, is clear - protecting children and young people must be a priority. She also says that nicotine sachets are a relatively new product on the market, emphasizing that "the problem is old - nicotine and addiction."
“The difference is that now we have products that are discreet, attractive and difficult to control in practice. We have to be realistic: in Montenegro we already have challenges with the implementation of regulations and existing bans, including the sale of tobacco and alcohol to minors. Therefore, we cannot rely on the assumption that the control of nicotine pouches will be perfect. We cannot build public health policy on the idea of effective control that does not exist in practice.”
According to her, if we want fewer young smokers and users of nicotine products, "we must first stop viewing the problem as a matter of individual choice."
"The data is alarming. Today, more than 40 million children aged 13 to 15 in the world use some tobacco or nicotine product, and at least 15 million adolescents are already using electronic cigarettes. This is not the result of a lack of information. It is the result of aggressive marketing by the tobacco industry, attractive flavors, social networks and products designed to make addiction attractive," said Brajović.
Education, information and raising public awareness, he says, are part of the solution, but "they cannot be the only ones."
"It is therefore important to emphasize that education, information and awareness-raising are an important part of the solution, but they are not and cannot be the only solution. If education alone were sufficient, no country would introduce advertising bans, warnings on packaging, bans on use in public spaces or excise taxes on tobacco products. Quite the opposite - the experience of all countries that have made the most progress shows that success comes exclusively through a comprehensive approach," said Brajović.
Withdrawal requires long-term monitoring
From the Ministry of Health (MoH), which is managed by Vojislav Šimun, told "Vijesti" that they are continuously improving the system of measures aimed at reducing the use of tobacco products.
"Current activities include the development of national protocols, expert guidelines and operational procedures for smoking cessation, based on modern scientific methods and internationally recognized recommendations. In parallel, a strategic framework is being developed that will precisely define the goals, measures, performance indicators and coordination mechanisms of all relevant institutions involved in tobacco control. The goal is to ensure a uniform, high-quality and sustainable approach to smoking cessation support at all levels of healthcare, with strong cross-sectoral cooperation between the Ministry of Health, the Institute of Public Health, the Health Insurance Fund, health centers and other partners," the health ministry said.
They remind that it is very difficult to measure long-term effects in smoking cessation programs, because success, they claim, requires monitoring users for many years.
"At the same time, professional practice shows that success largely depends on the motivation of the smoker himself, while the best results are achieved through a combination of professional counseling, psychological support and, if necessary, pharmacotherapy. Therefore, in the coming period, special focus will be placed on strengthening the availability of services, promoting programs and their even stronger integration into the primary health care system," they told "Vijesti".
They added that the Podgorica Health Center, as part of its activities, has counseling capacities "through which various health promotion and disease prevention programs are implemented." They emphasized that counseling work is an integral part of the primary health care system in the country, adding that health centers in all municipalities have counseling centers.
"When it comes to specific data on the number of people who have completed a structured smoking cessation program, such records are currently not available. However, the Podgorica Health Center continuously conducts preventive and educational activities aimed at reducing the use of tobacco products, especially among children and young people."
Habit assessment, counseling, therapy...
They claim that during 2024, through the activities of the Youth Counseling Center, they organized lectures on the topic of drug addiction prevention and the harmful effects of tobacco use in six elementary schools (ES):
"Which were attended by 1.204 students, as well as in two secondary schools with a total of 424 students. These activities represent an important segment of preventive action and the development of healthy lifestyles among young people."
Responding to a question from "Vijesti" about how the counseling process works, the health department said that the first step involves assessing habits, the degree of addiction, and motivation to quit smoking.
"This is followed by counseling aimed at identifying situations that encourage smoking, developing strategies for overcoming challenges, and strengthening motivation for sustained abstinence. Modern approaches particularly emphasize the importance of cognitive-behavioral methods that help users change behavioral patterns and adopt healthier lifestyle habits."
If necessary, they reply, the process can be supplemented with "pharmacological therapy and additional psychological support."
"International experience and professional practice confirm that the best results are achieved by programs that combine professional support from health workers with the active participation and motivation of the users themselves. That is why special attention is paid to the development of accessible, high-quality and sustainable programs that will provide citizens with adequate support on the path to quitting smoking," the Ministry of Health said.
Tobacco and nicotine among leading causes of preventable death
Brajović points out that when talking about tobacco and nicotine, "we are not talking about habit."
“We are talking about one of the leading causes of preventable death. Tobacco is not an ordinary product, it is a product that kills up to half of its long-term users. We must not forget a basic fact: tobacco products, including cigarettes and hookahs, contain more than 7.000 chemicals, at least 250 of which are known to be toxic or carcinogenic. This is not a matter of opinion, but a scientifically proven fact,” she said.
In his responses to "Vijesti", Brajović warns that the tobacco industry "does not sell ordinary goods".
“It manufactures and markets products that create nicotine addiction and have severe health consequences for almost every organ in the human body.
"Smoking over a lifetime shortens life by at least 10 years on average. This means that not only is the quality of life lost, but also an entire decade of life," said Brajović, adding that in the European region, "as many as one in five premature deaths from chronic non-communicable diseases is linked to tobacco use."
More than a third of Montenegrins smoke
The acting director of the Institute of Public Health (IJZ), Ivan Samardžić, announced at the beginning of the month that tobacco is consumed by almost 36 percent of the population in the country, while 47 percent of citizens say that they have abstained from such products throughout their lives.
According to him, the use of tobacco products "among young people is extremely high", emphasizing that "every fifth sixteen-year-old uses them".
Samardžić also emphasized that "around 2.000 lives are lost in Montenegro annually, with almost half of them being people under the age of 70."
The high prevalence of tobacco and nicotine products among youth and children, he stated, is attributed to their easy availability and relatively low prices.
"It is necessary to ensure the active and coordinated participation of all relevant entities in the field of tobacco control," said Samardžić, adding that health education programs are of great importance.
Đorđije Krnjević, medical director of the Clinical Center of Montenegro (KCCG), said that "smoking is a leading risk factor for many chronic diseases."
“The problem of an increasing number of young people encountering tobacco products at an early age is becoming apparent... Adolescents are rebellious, those who explore and try forbidden and illicit things.”
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