Sunday, December 31, 2023

Is there any Scientific Evidence Favorable to Reincarnation?

 


Written and Compiled by Ruwan M Jayatunge M.D. PhD (in progress)

Reincarnation is the belief that when a person dies, he is reborn again.  Reincarnation is regarded as the mental continuum of an individual. Belief in reincarnation is an ancient phenomenon and exists in many cultures.

The Egyptians believed in the soul's immortality. In India, the concept of reincarnation is first recorded in the Upanishads. Hinduism teaches that the soul goes on repeatedly being born and dying.   The Greek philosopher and the mathematician Pythagoras believed that the soul was immortal and was reincarnated into another living being at death. The belief in reincarnation is central to Plato's philosophy. Plato's concept of metempsychosis edifies that the soul is immortal and passes through cycles of incarnation in birth and release from the body at death.

The Christian concept of resurrection is different from reincarnation; resurrection is the coming to life again of the same being with a transformation of the body into an immortal form of being. The early Christian theologians such as Valentinus and Basilides of Alexandria believed in reincarnation. In 553 A.D. during the Second Council of Constantinople the idea of reincarnation was rejected by the theologians.  

The Italian philosopher, and cosmological theorist Giordano Bruno believed in reincarnation, and he was sentenced to be burned at the stake by the Inquisition. French Writer Voltaire (1694-1778) espoused his belief in reincarnation. Benjamin Franklin (1706-1790) believed that the human soul persisted and returned in a new body after death. Charles Dickens (1812-1870) openly supported the concept of reincarnation.

  

Reincarnation In the Buddhist Doctrine

Although the concept of Reincarnation is refuted by monotheistic religions, reincarnation (which is an ongoing process) is central to Buddhism. Johannes Bronkhorst who is a Dutch Orientalist and Indologist, specializing in Buddhist studies and early Buddhism highlights that the Buddha did believe in reincarnation. Professor K. N. Jayatilleke indicated that the Buddha’s explanation on rebirth was based on empirical grounds.

According to Buddhist teaching there is no eternal “soul,” “spirit” or “self”. Buddhist doctrine rejects the premise of a permanent, unchanging soul. There is no soul that bridges the gap between life and death. Buddhism denies the transmigration of a soul. Buddhism regards the mind as a transient mental state. The Buddha replaced the soul by the theory of mind-continuum.

In Buddhist psychology there are eight levels of consciousness.  Five of them are sense consciousness like, Visual consciousness, Auditory consciousness, olfactory consciousness, gustatory consciousness and tactile consciousness.  Sixth is mental consciousness, seventh is Manas consciousness and eighth consciousness is store consciousness (equivalent to subconscious mind).  Store consciousness is both individual consciousness and collective consciousness (Upadhyaya, 2021). The Buddha taught that consciousness is always continuing, like a stream of water. Buddhist teachings indicate that consciousness arises at the moment of conception with the forming of new life in the mother’s womb. 

Reincarnation is the mental continuum of an individual. It’s a phenomenon of a constantly changing continuity of moments of awareness. Buddhism teaches that stream of consciousness links with life. The stream of consciousness is not a single entity, but a process, and the process continues. The Buddha responded that only karma is passing from one life to another. 

When a person dies there is a causal continuum of consciousness. This consciousness is neither identical to nor entirely different from that in the deceased. Relinking consciousness is not transmigration from the previous existence. It comes into existence by means of conditions included in the previous existences. This process is regulated by the accumulated Karmas. Here the analogy is the flame of a dying candle can serve to light the flame of another.  A flame is transferred from one candle to another. Hence consciousness is a continuous birth and death of mind-states. It is linking an individual to past and future existences. The person who dies here and is reborn elsewhere is neither the same person, nor another.  

This process is known as Puranbhava aka Reincarnation or multiple incarnations. It is the process of cyclic existence or Samsara. Being born and dying continues unbroken but changes every moment. Therefore, the practice of Buddhism aims at ending rebirth.

According to the Buddhist doctrine - Chuthi Patisandhi- a thought moment occurs when a person dies. It is the mind set during death in the current existence and then grasping the next life. A dying person has a Cuti Citta which is known as exit consciousness. This consciousness is a form of transitory energy. The being to be reborn is known as Gandhabba – which is a non-biological life form or life-stream and inter being. Gandhabba is a form of consciousness. Cuti Citta or exit consciousness transforms into Gandhabba conscious form. Between Cuti Citta and Gandhabba form is called Antarābhava (Inter-becoming) or intermediate existence. These are three different stages. (some Buddhist schools believe that there is no interval -antarābhava or intermediate existence). A Gandhabba has a Manomaya kaya – nonphysical mental body. The Gandhabba can enter another womb when a matching one becomes available. Hence rebirth occurs. Three conditions are essential for conception: “the union of mother and father, the mother in season, and the presence of Gandhabba. It’s important to know that the Gandhabba concept is different from the idea of a “soul. Gandhabba is present at the point of conception as a form of consciousness. These processes are governed by the Karmic force or karmic retribution.

 

Freudian and Jungian   Perspectives on Reincarnation

Freud thought that the belief in reincarnation relates to the denial of death. For Freud rebirth fantasy seems to be a universal fantasy in the human mind, connected with the experience of both destruction and creation. According to the psychoanalytic notion the belief relates to initial hopes for a better life and the fantasy of life after death is universal.  Following the death drive man has a desire to return to inanimate matter in a form of rebirth. For Freud the concept of rebirth is an attempt to deal with the fear of death and the unknown. Freud saw belief in reincarnation is a way for individuals to come to terms with their own mortality. Human has a compulsion to repeat his life over and over again and this unconscious wish is expressed as a belief in life after death.

Carl Jung believed in reincarnation and collective unconscious. For Jung “Collective Unconscious,” is supposedly the universal consciousness of mankind that lies at a subconscious level. It apparently consists of inherited memories shared by all human beings that go back countless generations into prehistory. (In Mahayana Buddhism the store-house consciousness is known as ālāyavijñāna) Some psychologists openly argue that past life memories are merely a result of collective unconscious. Jung saw psychoanalysis as a path of redemption, of revitalization, of rebirth.

  

Does Consciousness Continue after Death?

For William James consciousness was our own personal experience of perceiving, thinking, emoting, and acting. He used the phrase “stream of consciousness”- consciousness flows linearly with time. Consciousness is directed toward an object, and it has intentionality and transience. Neuroscientists believe that the brain creates consciousness.  Neural information becomes conscious when it gains access to Global neuronal workspace. Consciousness does not disappear during general anesthesia. Consciousness requires a functioning brain. Neural activity translating into conscious experiences and after biological death this neural activity cease to exist.

Consciousness after death is not universally agreed upon. However, some experts say that we cannot find the actual conscious experience while measuring brain activity because we’re measuring from the wrong cognitive frame of reference. Moreover, they tend to say that the brain doesn’t create our conscious experience and consciousness is a fundamental property of all physical systems (panpsychism).

Disruptions of human consciousness occur due to pharmacological, neuropathological, or psychiatric causes.  The brain is structurally, and functionally connected and neurochemical processes produce subjective experiences. Is NDE (Near-death Experiences) a conscious experience after death? Near-death experiences (NDEs) are caused by reduced blood flow, coupled with abnormal electrical behavior inside the brain. Prof Carlo Fonseka - A Sri Lankan academic elucidated that there is no consciousness after biological death (Personal Communication, 2009). With biological death essential neural activity disappears.

   

Is Ian Stevenson's Work Suitable Evidence for Reincarnation?

Psychiatrist Ian Stevenson, from the University of Virginia tried to offer some evidence to support the reincarnation hypothesis. His 1966 book, “Twenty Cases Suggestive of Reincarnation” emphasizes spontaneous recall of information about previous lives by young children.  Some investigators have tried to debunk the work of Ian Stevenson by questioning his methodology. They point out methodological flaws in Stevenson’s research methods. They state that he was confirmation biased in these studies. Moreover, his hypotheses were not falsifiable, and his data was not definitive to suggest reincarnation. When investigating reincarnation cases in other counties Stevenson had no cultural competence and sometimes his translators consciously and instinctively offered data confirming reincarnation. Stevenson disregarded the role of cultural conditioning. Most of his cases were based on anecdotal evidence.


Does deja vú Explain Reincarnation?

Deja vu is the phenomenon of feeling as though one has lived through the present situation before. Deja vu is a psychological experience. Those who support the concept of reincarnation explain that déjà vu experiences are memories of past lives. However, the researchers point out that déjà vu experiences do not confirm the reincarnation hypothesis. déjà vu experiences can occur as a result of certain brain dysfunction, assimilation of information by brain’s hemispheres in two different times or in cryptomnesia. Furthermore, Déjà vu is associated with temporal lobe epilepsy.


Is Xenoglossy Evidence for Reincarnation?

Xenoglossy is a phenomenon in which a person is allegedly able to speak, write or understand a foreign language that they could not have acquired by natural means. Those who believe in reincarnation state that cases of xenoglossy provide evidence for reincarnation. Some researchers think that xenoglossy is not definitive evidence for reincarnation.  They claim that xenoglossy is likely to occur when the ability to properly monitor sources is impaired. They suggest fraud, fantasy, and knowledge acquired through normal means. The critics of reincarnation suggest that xenoglossy is merely an expression of subconscious language learning. Those who are naturally gifted in learning new languages may pick up on words and phrases without noticing. According to the researchers, foreign language syndrome and foreign accent syndrome are signs of disruption in brain function especially from small focal lesions resulting from left hemisphere strokes and tumors, traumatic brain injury (TBI), migraine, multiple sclerosis, primary progressive aphasia. 

  

Selective Thinking and False Memory Syndrome 

Some disbelievers of reincarnation explain that claims of evidence for reincarnation originate from selective thinking – a process that one focuses on favorable evidence to justify a belief, ignoring unfavorable evidence and sometimes following the psychological phenomena of false memories. In false memory syndrome, a person’s identity and relationships are affected by memories, which are factually incorrect but are strongly believed. False memory syndrome may account for the memory construction process, which leads people to remember living a past life.

  

 Are child Prodigies an Example of Reincarnation?

Those who support the concept of reincarnation point out the phenomenon of child prodigies who exhibit intelligence or talents that could not be explained by either heredity or environment. The skeptics attribute these skills to high functional autism, abnormal brain mapping due to genetic predisposition and hyper brain with enhanced brain plasticity. They point out that some children who were subject to maladaptive alterations by purely deleterious mutations, maladapted genotypes end up with high intelligence and extraordinary skills. Several researchers have indicated specific genes that contribute to high ability. Twin studies have shown that both musical ability and mathematical achievement have a substantial genetic component.

  

False Memory Syndrome and Confabulation

Some disbelievers of reincarnation explain that claims of evidence for reincarnation originate from selective thinking – a process that one focuses on favorable evidence in order to justify a belief, ignoring unfavorable evidence and sometimes following the psychological phenomena of false memories. In false memory syndrome, a person's identity and relationships are affected by memories, which are factually incorrect but are strongly believed. False memory syndrome may account for the memory construction process, which leads people to remember living a past life. 

Belief in reincarnation could be linked to an error in processing of memories or due to confabulation.  Confabulation is defined as the spontaneous production of false memories: either memories of events which never occurred, or memories of actual events that are displaced in space or time. These memories may be elaborate and detailed. Confabulation is a form of memory disorder that may occur in patients who have sustained damage to both the basal forebrain and the frontal lobes, as after an aneurysm of the anterior communicating artery.  

Another possible explanation is cryptomnesia, where a person may have experienced something similar in their current life and mistakenly attribute it to a past life.   Children suffering from dissociative disorders (hysteria) sometimes give vivid descriptions under hypnotic trances and these expressions are misinterpreted as the evidence of past lives by inexperienced hypnotherapists who have no clinical background.

 

Paramnesia: Memory Distortions 

 People with medial temporal or prefrontal lesions are more prone to Paramnesias, or misidentifications syndrome. In reduplicate paramnesia, a patient is convinced that a person, a place, or an object exists in duplicate.  A disturbed sense of familiarity may produce this phenomenon. In the reduplication of time, a patient believes that he or she exists in two different, parallel time points.

  

Can Edgar Cayce's Readings Prove Reincarnation? 

Edgar Cayce -self-proclaimed faith healer did over 16,000 readings during his lifetime. The exceptional book Many Mansions written by Gina Cerminara disclosed the patients who were treated by Edgar Cayce and their past lives. Based on modern investigations of Edgar Cayce’s readings, medical experts say that Cayce frequently connected illness to the mental and emotional states of the patients and he disregarded the etiology of certain illnesses. His clients predominantly had cancer, multiple sclerosis, diabetes, arthritis, gallstones, kidney stones, hay fever, mental and psychological problems, digestive problems, epilepsy, hemorrhoids, ulcers, psoriasis etc. and according to Cayce karmic repercussions had do with the symptoms. Cayce had stated that people suffer from epilepsy as a result of adultery that they had committed in their past lives. But modern neurophysiology explains the genesis of epilepsy that has organic courses in the brain.

Some of his readings were inaccurate and he mostly gave folk remedies. His case studies were not based on empirical evidence, and it cannot be independently evaluated. Moreover, Cayce was never subjected to proper testing. The experts often question the validity of his abilities.

  

Can Past Life Regressions Provide Evidence of Reincarnation?

Past life regressions or past life therapy is based on the argument that some people carry in their subconscious mind memories of unpleasant events of their past lives and these subconscious memories adversely affect them in their present lives. By hypnosis they can be regressed beyond their birth to their previous lives. However, medical experts indicate that past life regressions increase one's susceptibility to false memories. Also, there is a risk of implanting false memories in patients. Some hold the belief that hypnotic regression is not proof for reincarnation. Those who oppose hypnotic regression declare that in a hypnotic regression, repressed childhood memories come into action if wrongly interpreted as evidence of past life.

 

 The Theories Opposed to Reincarnation.

The English Philosopher Antony Flew highlights that reincarnation is a non-repeatable counter instance that is not amenable to scientifically controlled conditions. As claims of reincarnation cannot be validated via a laboratory experiment, the best we could do is to jettison reincarnation as untenable. 

He further argues that the basic problem associated with reincarnation as a theory of mind is not that it lacks evidence in support of its claims, but that even in the face of its claims, it runs short of a well-developed and systematic theory.

Steven D. Hales Professor of Philosophy at Bloomsburg University of Pennsylvania argues that the basic problem associated with reincarnation as a theory of mind is not that it lacks evidence in support of its claims, but that even in the face of its claims, it runs short of a well-developed and systematic theory. For Hales, there would have been not much difficulty in accepting the reincarnation hypothesis if it is empirically testable, falsifiable and subject to confirming evidence. 

  

Concluding Thoughts

Reincarnation is a highly contradictory and controversial philosophical-religious and cultural concept. Belief in reincarnation has some epistemological implications. It is a belief in the absence of valid empirical data.  There is no scientific evidence to prove reincarnation. The suggestive cases of reincarnation (past-lives” testimonies) cannot be independently verified, and there are psychological and cultural factors that can influence such claims. These testimonies are the products of social conditioning rather than actual memories of past lives. From a scientific and empirical standpoint, the concept of reincarnation remains unproven and subject to skepticism.

Biologically, reincarnation is explained in terms of the expression of dominant genes that come from the ancestors.  People acquire the genetic information of their past relatives.  Those who oppose the concept argue that reincarnation originates from selective thinking and from false memories. Reincarnation is a hypothesis and up to date it’s not an evidence-based reality. There is no definitive data supporting the reincarnation hypothesis. So far no one has done controlled experiments in reincarnation.

Can we prove that reincarnation is a fact? Ian Stevenson used to say the word proof should only be used in mathematics. In science it’s all about evidence, not proof. Science can only lay hands-on things in the physical universe. Although the existence of reincarnation is not yet a scientific truth, scientifically we don’t have the instruments to measure the process of rebirth directly. Maybe reincarnation can’t be proven within the scope of generally acceptable scientific thinking. Reincarnation is basically just an untestable claim. Some argue that reincarnation is a paranormal phenomenon transcending the boundaries of time, space and force. Reincarnation may be outside the scope of our measurements and can't be falsified. Reincarnation may be the “Great Beyond” and further research is essential to come to a valid conclusion. 



 

Saturday, December 30, 2023

දුක්ඛ යන බෞද්ධ සංකල්පයෙන් පැවසෙන්නේ කුමක් ද ?

  



( වෛද්‍ය රුවන් එම් ජයතුංග විසින් ලියන ලද The Concept of “Dukkha” in Buddhist Philosophy ලිපියේ සිංහල පරිවර්තනය. පරිවර්තනය හර්ෂිනී ජයසුන්දර  )
 
දුක්ඛ" යන බෞද්ධ සංකල්පය මගින් පැවැත්මේ (existence)  සැබෑ ස්වභාවය විස්තර කරයි. එහි ගැඹුරු දාර්ශනික අර්ථයක් ඇත. "දුක්ඛ" යන වචනය බොහො විට වරදවා වටහාගෙන ඇතිවා මෙන්ම වරදවා භාවිත කරද ඇත. "දුක්ඛ" යන වචනයේ අර්ථ්‍ය හුදෙක් "දුක්වීම " හෝ "දුක් විදීම" නොවේ. දුක්විදීම යන්නෙහි අර්ථය කායික, මානසික, සාමාජයීය, ආධ්‍යාත්මික සහ මනෝ ව්‍යාධිමය විඳවීමයි. එය කායික, චිත්තවේගීය, සහ මානසික වේදනා ඇතුලත් අත්දකීමක් විය හැක. මෙවැනි ආකාර විදවීම් චිකිත්සක හෝ සමාජ - ආර්ථික මැදිහත් වීම හරහා අවම කරගත හැක. එහෙත් දුක්ඛ" යන බෞද්ධ සංකල්පය එසේ චිකිත්සක මැදිහත් වීමෙන් හෝ සමාජ ආර්ථික ක්‍රම වේදයන් මගින් ඉවත් කර ගත නොහැක.

බුදු දහමේ එන "දුක්ඛ" යන වචනය කායික  ආත්මීය දුක්වේදනා අභිබවා යන සවිඥ්ඥානික අත්දැකීමකි. එය වචන වලට සෘජුව පෙරලිය නොහැකි සංකල්පයකි.  එය දුසාධ්‍ය  විඳවීමක් නොවේ. දුක්ඛ යනු විඳවීම් , බලාපොරොත්තු සුන්වීම්, වේදනා, අවාසනාවන්තකම් හෝ අධෛර්‍ය නොවේ. එනම් සම්පූර්ණ අශුභවාදයද නොවේ. එය බහුමාන සංකල්පයක් වන අතර භාෂාමය අර්ථයක් දිය නොහැකි සංකීර්ණ සංකල්පයකි.

දුක්ඛ යනු  මනුශ්‍ය ශරීරයේ මනුශ්‍ය පැවැත්මේ , ලෝකයේ   යථා ස්වරූපය මත පදනම් වූ විඥ්ඥානමය සහ විශ්වීය අත්දැකීමකි. එනම් "දුක්ඛ" යනු සැබෑ මනුශ්‍ය තත්වය පෙන්වා දෙන විශ්වීය සංකල්පයකි. බොහෝ බෞද්ධ භික්‍ෂූන් ද මෙම  දුක්ඛ යන සංකල්පය වරදවා වටහා ගෙන ජීවිතය දුක් වේදනා කම් කටොළු පිරි අවාසනාවන්ත තත්වයක් ලෙසට  හුවා දක්වමින්  දේශනා පවත්වති. එම නිසා බොහෝ බෞද්ධයන් ජීවිතය අශුභවාදයක් ලෙස දකිති. ඔවුන් වර්තමාන  ජීවිතය  පිලිබඳ මන්දෝත්සාහී වී මරණින් පසු ලෝකයක් පිලිබඳව උනන්දු වෙති. 

බොහෝ බටහිර උගතුන් පවා  දුක්ඛ  යන බෞද්ධ සංකල්පය අර්ථකතනය කලේ පොදුවේ දුක් විදීම / විඳවීම යන අර්ථයෙනි.  මෙයට හේතු වූයේ ප්‍රංශ දාර්ශනිකයෙකු වූ ඇනටෝල් ෆ්‍රාන්ස් විසින් එය වැරදි ලෙස පරිවර්ථනය කිරීමයි. ඔහු මේ "දුක්ඛ" යන්න souffrance ලෙස ප්‍රංශ භාශාවට පරිවර්ථනය කල අතර පසුව එය suffering  ලෙස ඉංග්‍රීසියට පරිවර්තනය කෙරිනි. එතැන් පටන් බටහිර විද්වතුන් "දුක්ඛ" යනු අශුභවාදයෙන් සහ බලාපොරොත්තු සුන්වීමෙන් පිරුනු මිනිස් පැවැත්මේ අඳුරු පාර්ශවය සංකේත්වත් වන බව  සිතූහ.

මිනිස් ජීවිතය දරාගත නොහැකි දුක් පීඩා වලින් පිරී තිබේද? මම සෝවියට් සංගමයේ ගුලාග් සිරකරුවන් , හෝලකෝස්ට් වින්දිතයන් වූ යුදෙව් ජාතිකයන්  සහ යුද සිරකරුවන්  (POW) මෙන්ම දරාගත නොහැකි වදහිංසා වලට මුහුණ දුන් පුද්ගලයන් සමග කතා කර ඇත්තෙමි. ඔවුන් ගේ ශාරීරික මානසික දුක් වේදනා සැබෑවන් වූවද   බොහෝ දෙනෙක් එකඟ වූ කරුණක් වන්නේ මෙසේ දුක් වේදනා හෝ වහල් භාවය තිබියදීත් ඔවුන්ගේ ජීවිතයේ ප්‍රීතිමත් වූද තෘප්තිමත් වූද අවස්ථා තිබූ බවයි. ඔවුන්ගේ දුක් වේදනා , විදවීම් නොතකා ඔවුන්ට තම ජීවිත වල අභ්‍යන්තරයේ තෘප්තිමත් අවස්ථා (self-content) තිබුණි. මෙය පරිනාමය හරහා මිනිසුන් විසින් ඇති කරගත් සහජ පැවැත්මේ යාන්ත්‍රණයක් විය හැක.  

ස්මිත් මහතා වසර 84 ක් ඵලදායී ජීවිතයක් ගත කලේය. ඔහුට ප්‍රීතිමත් ළමා කාලයක්, හොද අධ්‍යාපනයක්, ගෞරවනීය වෘත්තියක් සහ ඵලදායී වැඩිහිටි ජීවිතයක් තිබුණි. ඔහුගේ ජීවිතයෙන් වැඩි කාලයක් ඔහුට ප්‍රීතිය තිබුනි. ඔහුගේ ජීවිතයේ ආතතිය, නිශේධනාත්මක බව සහ බලාපොරොත්තු සුන්වීම යනාදිය නොසලකා ඔහු ධනාත්මක දෘශ්ඨියක් දැරීය. වයස 84 දී මහළු වියේ සිදුවන දුක් විදීමකින් තොරව ස්මිත් මහතා නින්දේදීම මිය ගියේය.  ස්මිත් මහතා යනු කල්පිත චරිතයක් වූවද ස්මිත් මහතාට සමාන ජීවිත ගතකල බොහෝ දෙනා අප දකිමු. ජීවිතය දුක් කම්කටොලු වලින් පිරී ඇති බව ඔවුන් කවදා හෝ පැමිණිලි කර තිබේද?

දුක් වේදනා බාහිර සාධක විය හැක. මානසික අවපීඩනයෙන් (depression) පෙලෙන පුද්ගලයෙකු ඔහුගේ වැරදි දෘශ්ඨිය, සෘණාත්මක ජීවන දර්ශණය සහ හානිකර සංජානන හේතුවෙන් දුක් විදිය හැක. යුද්ධයෙන් විනාශ වූ ප්‍රදේශයක මිනිසෙකු එහි පවතින භූ - දේශපාලණික හේතු නිසා දුක් විදිය හැක. මොළයේ රසායනික සමතුලිතතාවය වෙනස් වීම නිසා පුද්ගලයෙකු (අභ්‍යන්තර  හේතූන් නිසා) දුක් විදිය හැක. මොළයේ රසායණික සමතුලිතතාවය වෙනස් හට ගන්න විශාදය හෝ  මනෝ ව්‍යාධික රෝග තත්වයෙන් පෙලෙන පුද්ගලයෙකු ගැන සිතන්න.   ඔවුන්ට  ඖෂධ  මගින් මොළයේ රසායණික තත්වයන් යාමනය කොට ඔවුන් ගේ දුක් සහිත විඳවීමට සමාප්තියක් ලබා දිය හැකිය. "දුක්ඛ" යනු සියදිවි නසා ගැනීමේ චේතනාවන් සමග සම්බන්ධ වූ සායනික, මානසික අවපීඩනය, ලෞකික දුක් වේදනා, විරසක වීම් හෝ ජීවිතයේ වේදනාව නොවේ. මෙම තත්වයන් සදහා මානසික අවපීඩන සදහා භාවිතා කරන ඖෂධ මනෝ චිකිත්සාව මගින් ප්‍රථිකාර කල හැක. තවත් සමහරෙක් තමන් දුක් විදින බව නොදනී. නිදසුනක් ලෙස, ඇල්සයිමර් රෝගයෙන් පෙළෙන රෝගියෙකු උදාහරණයට ගන්න​. ඔහුට තම ජීවිතයේ විඳවීම පිලිබඳව අදහසක් නොමැත. මේ අනුව දුක්ඛ යනු එදිනෙදා ජීවිතය සමග බැඳී තිබෙන අප්‍රසන්නතා නොවේ. දුක්ඛ" යනු ජීවිතයේ විශ්වීය රෝග පිළිබද යථාර්ථයයි.  . 

අතීතයේ සිටි මිනිසුන් වසූරිය, පෝලියෝ, සරම්ප සහ රුබෙල්ලා වැනි රෝග වලින්  පීඩා වින්දහ. වෛද්‍ය විද්‍යාවේ දියුණුවත් සමග මෙකී රෝග ආශ්‍රිත දුක් විදීම් තුරන් කරන ලදි. ඒ හේතුවෙන් අප මේ බෝවන රෝගවලින් තව දුරටත් පීඩා නොවිදින්නෙමු.  

වයසට යෑම  වේදනාව සහ අසහනය සමග සම්බන්ධ විශ්වීය සාධකයකි. මෙය මහ​ළු විය හා සම්බන්ධ දුක් වේදනාවයි. වියපත් වීමත් සමග කායික සහ මානසික පරිහානිය නිසා දුක් වේදනා ඇතිවේ. වයස් ගත වීම දුකකි. කෙසේ වෙතත් නවීන විද්‍යාත්මක තාක්ෂණය, විශේෂයෙන් ජාන ප්‍රථිකාර මගින් වයසට යෑමේ ක්‍රියාවලිය මන්දගාමී වේ. සමහර විට ඉදිරි වසර 100 සිට  200 අතර කාලය තුළ වෛද්‍ය විද්‍යාව විසින් වයස්ගතවීම පමා කිරීමේ  ප්‍රථිකාර දියුණු කරනු ඇති අතර මිනිසුන්ට අවුරුදු 250- 300 දක්වා වූ කාලයක් ජීවත් වීමට හැකිවනු ඇත. එහෙත් මෙමගින් පවා "දුක්ඛ" යන්න නොවිසදේ. මක් නිසාද යත් වයසට යෑම සහ අභාවය නොවැලැක්විය හැකි අතර  අවසානයේ මිනිසාට මරණය නම් විශ්වීය වේදනා අත්දැකිමට මුහුණ දීමට සිදුවන බැවිනි. 

වෛද්‍ය විද්‍යාව බොහෝ රෝග සදහා ප්‍රථිකාර සොයාගෙන ඇත. සමහර විට තවත් වසර 200 - 300 ක් අතර කාලයේදී, පිලිකා ඇතුලු බෝ නොවන සහ බෝවන රෝගවලින් 95% ක් මානවයාගෙන් තුරන් වනු ඇත. එවිට ලෙඩ දුක් යනු මිනිසාට දුක් වේදනා ගෙන දෙන සාධකයක් ලෙස නොසැලකනු ඇත. 

සත්‍ය වශයෙන්ම මරණය දුකකි. වෛද්‍ය විද්‍යාවට මිනිසාගේ ආයු කාලය දීර්ඝ කල හැක. ජෛව - මුද්‍රණ තාක්ෂණය මගින්  සහ අනිකුත් අභ්‍යන්තර ඉන්ද්‍රියයන් ප්‍රකෘතිමත් කල හැක. මෙම පියවරෙන් දීර්ඝායු ලබාදිය හැකි අතර මරණය වැලැක්විය නොහැක. එබැවින් මරණය මිනිස් පැවැත්මේ කොටසක් වනු ඇත. "දුක්ඛ" යන්න මරණයේ සාංකාව සමග බැදී පවතී. 

දුක් පීඩා විදීම පුද්ගලික මෙන්ම පොදු කාරනයකි. විශ්වීය දුක් වේදනා යන්න පුළුල් පරාසයක් ඇති මිනිස් අත්දැකීම් ආවරණය කරයි. එයට මානසික, භෞතික, සාමාජීය මානයන් ඇත. මෙම විශ්වීය ලක්ශන සෑම මිනිසෙකුටම පොදු වේ. මෙහි ප්‍රථිපලයක් ලෙස මෙම විශ්වීය ලක්ශන මගින්  සවිඥ්ඥානික අවබෝධයක් ගෙන දෙයි. ජීවිතය තව​ දුරටත් අර්ථවත් නොවන බව (lack of meaning) ඔවුන්ට හැගී යයි. මෙය පැවැත්ම සමග එන සාන්දෘෂ්ඨික කාංසාවේ (existential anxiety) ප්‍රතිඑලයකි. මේ  සාන්දෘෂ්ඨික කාංසාව   "දුක්ඛ" වේ.  

ජීවිතයේ අරමුණක් නොමැති කම දුකට හේතු විය හැක. මිනිසාට සෑම පහසුකමක්ම සහ ද්‍රව්‍යමය දේ තිබුනද ඔවුන් බොහෝ විට ජීවිතයේ අරථ විරහිත භාවයට ගොදුරු වෙති.ඔවුන්ට ඔවුන්ගේ ජීවිතයේ අරමුණ පිලිබඳ පැහැදිලි හැගීමක් නැත. වික්ටර් ෆැරන්ක්ල්ට අනුව මිනිසුන්  සාන්දෘෂ්ඨිකහිස් බව පුරවන්නේ සුඛ විහරණය, බලය, ද්‍රව්‍ය වාදය , වෛරය, කම්මැලිකම, ස්නායු උමතුවෙන් සහ බලකිරීමෙනි. ජීවිතයේ අරමුණක් නොමැති කම නිසා " දුක්ඛ" ඇති වෙයි.

සමහර බෞද්ධ ග්‍රන්ථ වල සදහන් වන්නේ උපත යනු දුකක් බවයි. නමුත් ඒ සාමාන්‍ය දරු උපතක් ගැන නොවේ. දරු ප්‍රසූතියක් යනු දෙමාපියන්ට ප්‍රීතිමත් අවස්ථාවකි. බෞද්ධ සන්දර්භය තුල උපත යනුවෙන් අදහස් වන්නේ මමත්වයේ (ego) උපතයි. මමත්වයේ උපත සහ එහි පැවත්ම විශ්වීය දුක්ඛිත තත්වයට හේතුවේ. මෙමගින් මිනිසා තමා පිළිබද ව්‍යාජ හැගීමකට පත්වෙයි. ඔහුගේ විශ්වාසයන් වෙනස් වූ විට හෝ අභියෝගයට ලක්වූ විට ඔහු ඔහුගේ ව්‍යාජ මමත්වය නිසා අසහනකාරී සහ සාංකාමය තත්වයට පත්වෙයි. 

දුක්ඛ" යනු ලෞකික දුක් වේදනා, සාමාන්‍ය වශයෙන් වූ අසතුටුදායක බව නොසන්සුන් කම හෝ දැඩි මානසික වේදනාව නොවේ. දුක්ඛ යනු ලෞකික දුක් විඳීම  නම් එයද තාවකාලික වූවකි. එයද සදාකාලික නොවන දෙයකි. නමුත් "දුක්ඛ" යන්නට ඇත්තේ ගැඹුරු විශ්වීය අර්ථයකි. "දුක්ඛ" යන්නෙන් සංඛේතවත් කරන්නේ බියෙන් හා දුක්ඛිතභාවයෙන් පිරුනු මිනිස් පැවැත්මේ අඳුරු  ස්වභාවය නොවේ. එය එම පැවැත්මේ අව්‍යාජ ස්භාවයය ඉස්මතු කරයි. "දුක්ඛ"යනු මමත්වයේ අනිත්‍ය ස්වභාවයයි.  "දුක්ඛ" යනු අශුභවාදී හෝ ශුන්‍යවාදී සංකල්පයක් නොවේ. එයින් සතුටේ සිට බලාපොරොත්තු සුන්වීම දක්වා වූ චිත්තවේග මාලාවක් නියෝජනය වේ.

දුක්ඛ" යන්නෙන් පැවැත්මේ සත්‍ය වූද නිවැරදිවූද ස්වභාවය විස්තර කරයි. පැවැත්ම රැඳී තිබෙන්නේ අනිත්‍යතාවය, දුක්ඛ සහ අනාත්මභාවය පදනම් කර ගෙනය​. මේ ත්‍රිත්වය එකිනෙක මත රඳා  පවතින අතර අන්තර්සම්බන්ධිත සාධක වෙති.  

අනිත්‍ය යනු ස්ථිර සහ අඛන්ඩ පැවැත්මෙන් තොර වීමයි. අනිත්‍ය බව විසින් ස්ථිර මිනිස් ආත්ම සංකල්පය ප්‍රතික්ශේප කරයි. විශ්වය වනාහි ඇදහිය නොහැකි තරම් විශාල වූද සංකීර්ණ වූද නිරන්තරයෙන් වෙනස් වන්නා වූද ප්‍රපංචයකි. විශ්වයේ ස්ථිර භෞතික හෝ මානසික පැවැත්මක් නොමැත. පුද්ගල මට්ටමෙන් මෙන්ම පොදු මට්ටමෙන්ද ලෝකය නිරන්තරයෙන් වෙනස් වෙමින් පවතී.

බුදු දහමට අනුව හැගීම්, සහ සංජානනයන් ද අනිත්‍ය වේ. එමෙන්ම  විඥ්ඥානයද (consciousness) අනිත්‍ය වේ. යමෙක් මෙම අනිත්‍ය වූ ලෝකයේ යථා ස්වභාවය තේරුම් නොගෙන එයට ප්‍රථිරෝධය දැක්වීමට උත්සාහ කරන විට දුක උපදී. ඔහුට වෙනස් වීමට උවමනා නැත. නමුත් ඔහු වටා ඇති සියල්ල නිරන්තරයෙන් වෙනස් වීමට භාජනය වේ. ඔහුට නැවත කිසි විටෙක කලින් සිටි මොහොත හෝ අත්දැකීම වෙත ආපසු යා නොහැක. පුද්ගලයා වයස්ගත වේ. ඔහුට සදහටම තරුණ වී සිටිය නොහැක. මෙම ක්‍රියාවලිය පුද්ගලයා තුල දුකක් ඇති කරයි. පුද්ගලයාට තමාට සහ තම ආදරණීයයන් සදහා ලෝකයක් අවශ්‍ය වේ. නමුත් මරණය වැලැක්විය නොහැක. කිසිවෙකුට එයින් ගැලවිය නොහැකිය. මරණයට ඇති බිය සහ එම ක්‍රියාවලිය මෙම "දුක්ඛ" සංකල්පය සමග බැඳී  පවතී.  

ලෝකය මායාවන්ගෙන් පිරී ඇත. මිනිසා තමා   විසින්, මවා ගත් බොහෝ මනෝ සංකල්ප සැබෑ ලෙස පිලිගනී. ශාරික සහ මානසික මමත්වය සැබෑ ලෙස ඔහු පිලිගනියි. ආත්මය යනු විචිත්‍ර වූ සවිඥ්ඥානික වස්තුවක් ලෙස වටහා ගත්තද එහි ඇත්තේද "මම" යන මායාවය. මොලයේ ස්නායු ක්‍රියාකාරිත්වය හරහා මෙම මායාවන් විසින් මමත්වය නිර්මානය කරයි. මොලයේ ස්නායු ක්‍රියාකාරිත්වය හරහා මෙම මායාවන් විසින් මායාමය අනන්‍යතාවයක් නිර්මාණය කරයි. තමා පිලිබද මායාමය හැගීමක් ඇතිකිරීම සදහා මොලය එහි අත්දැකීම්, සිතුවිලි සහ හැසිරීම් යොදාගනියි. සමහර ස්නායු විශේසඥයන්ට අනුව මොලය නිර්මාණශීලී යන්ත්‍රයකි. මම යනු තනි වස්තුවක් නොවන අතර එය සංවේදනයන්, සංජානන සහ සිතුවිලි වල එකතුවකි. සියලුම භෞතික සහ මානසික තත්වයන් පාරභෞතික වශයෙන් සත්‍ය නොවේ. මම යනු මොහොතින් මොහොත ගලායන ස්වභාවයක් වන අතර මම යනු ස්ථිර ගතිකයක් බව සිතන තැනැත්තා  මෙම මායාවට හසුවූ විට "දුක" උපදී.   

"දුක්ඛ" යනු පැවැත්මේ සැබෑ ස්වරූපය තේරුම් ගැනීමට නොහැකි වීමයි. එය ජීවිතයේ විවිධ අවස්ථා නිසා ඇතිවන ආතතිය, ගැටුම්, බාධා, වෙනස්වීම්, නිසා ඇති වන වෙනස් වීමයි. එයසෑම මිනිසෙකුම අත්විදින, අධ්‍යාත්මික වූ අර්බුදයක් වන අතර සමහරු එය අර්ථ විරහිත ලෙස දකිති. දුක්ඛ යනු තාර්කික මිනිසෙකු හා අතාර්කික ලෝකය අතර ගැටුමයි. "දුක්ඛ" ලෝකයේ සමස්ථ පැවැත්ම හා බැදී පවතී. 

ලෞකික පුද්ගලයෙකු දුක් වර්ග දෙකක් අත්විදියි. පලමුවැන්න සෞඛ්‍ය ගැටළු සහ සමාජ - ආර්ථික ගැටළු නිසා ඇතිවන දුක්ඛිත ජීවන තත්වයයි. මෙවැනි ගැටළු ලෞකික  මැදිහත්වීම් මගින් නිවැරදි බවට පත්කරගත හැක. දෙවැනි දුක් වර්ගය වන්නේ "දුක්ඛ" ලෙස හැදින්වෙන දුක් වේ. "දුක්ඛ" යන්න ලෞකික දුක් විදීම අභිබවා යන්නකි.  ලෞකික    මැදිහත්වීමකින් මෙය නිවැරදි කල හෝ සහනය ලබා ගත නොහැක. 

"දුක්ඛ" යනු අශුභවාදය හෝ නරුමභාවය නොවේ. " දුක්ඛ" යන්න මානව ස්වභාවයට විශ්වයේ යථාර්ථයට සම්බන්ධ දෙයකි. "දුක්ඛ" යනු පිළිතුරක් නැති ප්‍රහේලිකාවක් නොවේ. බුදුන් වහන්සේ " දුක්ඛ" යෙහි ඇති විස්තීරණ ස්වභාවය සහ දුකින් මිදීම විස්තර කරන ලද අතර මුලින්ම දුක්ඛ සංකල්පය නිවැරදිව අවබෝධ කළ යුතු ය. එසේම  දුක්ඛ නිරෝධයට තුඩු දෙන  ආර්‍ය අෂ්ඨාංගික මාර්ගය අනුගමනය කල යුතුය​.





Sunday, December 17, 2023

The Concept of “Dukkha” in Buddhist Philosophy

  

 

Ruwan M Jayatunge M.D. PhD (in Progress) 

The Buddhist concept of “Dukkha” describes the true nature of all existence. It has a profound philosophical meaning.  The term dukka has been commonly misunderstood and misused. The word dukkha means not suffering. Suffering can be found in the pathogenic paradigm. Suffering involves somatic, mental, social, and spiritual forms of distress and causing psychopathological alterations. Suffering is a subjective experience that can involve physical, emotional, or mental pain. These types of suffering can be mitigated via therapeutic or socio-economic interventions.

Dukkha is more than subjective suffering and a vast conscious experience and words cannot fully or accurately describe it. It goes beyond the pathogenic paradigm disintegrating the internal sense of coherence.

The Buddhist concept of dukkha is not suffering, despair, anguish, misery wretchedness, or disheartenment. It is not total pessimism either. Dukkha is a multidimensional concept and a complex construct that has no precise linguistic meaning. It is a vast universal experience connected to the universal consciousness based on the reality of human life. Dukkha exemplifies the true human condition.

The mundane understanding of suffering is related to the bearing of pain, inconvenience, and distress that is connected with hopelessness. According to the Buddha, the word suffering has a deep existential meaning. It is a universal explanation of the true human condition.  

Many Western Psychologists misinterpreted the word “Dukkha” or universal suffering, and they viewed it as an agonizing human condition. This was due to the mistranslation done by the French Philosopher Anatole France in the late century. Anatole France translated the word “Dukkha” into French as “souffrance” and then into English as suffering. Ever since many Western scholars grasped the concept of “Dukkha” incorrectly. Therefore, many thought Dukkha symbolized the dark side of human existence filled with pessimism and despair.

Dukkha narrates about the veracity and the accurate nature of existence. Existence has three major characteristics: impermanence, un-satisfactoriness aka dukka, and absence of a self. These are interconnected and interdependent.

Some view Impermanence as the philosophical problem of change. It is the absence of permanence and continuity. Impermanence denies the unchanging transmigrating human soul. The universe is incredibly vast and complex and constantly changing. It is not a permanent entity. The universe has normal matter, 'dark matter', and 'dark energy' which all constantly change. Nothing is permanent in an ever-changing universe. There is no physical or mental object which is permanent. The Greek Philosopher Heraclitus once stated: "No man ever steps in the same river twice."   The world is constantly changing. Human change on the personal level as well as on the collective level.

The phenomenal world is transitory.  According to Buddhism matter is impermanent, feeling is impermanent perception is impermanent, determinants are impermanent consciousness is impermanent. When a person tries to resist the impermanent world without understanding its true nature, dukkha arises. He does not want things to be changed. But things around him change constantly. He can never go back to the same exact moment or experience again. The person is aging. He cannot stay forever young. It creates immense distress in the person. This distress is part of dukkha. The person wants an internal life for himself and his loved ones. But death is inevitable. No one cannot escape death. Fear of death and dying process is associated with dukka.

The world is filled with illusions. The person takes many imagined mental concepts as real.  The mental-physical ego-self is a mere deception.  Although we perceive the self as a distinct conscious entity there is an illusion of self. The brain creates self-identity with perceptual illusions via neural activations. The brain takes experiences, thoughts, and behaviors into a narrative to create a mythical sense of self. According to some Neurologists, the brain is a narrative-creating machine. The reality is a subjective experience. Self is not a single unified entity, but a bundle of sensations, perceptions, and thoughts lumped together. All physical and mental existence is not metaphysically real. There is no permanent mental-physical self. Self consists of the moment-to-moment flow of consciousness. When a person is trapped in this illusion dukkha arises.

The mundane understanding of dukka is suffering, related to bearing pain, inconvenience, and distress that is connected with hopelessness. Dukka is not mundane suffering or general unhappiness, uneasiness severe mental pain, or mental agony.  If Dukkha is suffering, then suffering is impermanent. It’s not everlasting or perpetual. Suffering is a subjective experience. The word dukkha has a deep spiritual, existential, and dialectical meaning. Dukkha does not symbolize the dark side of human existence filled with dread and misery. Instead, it highlights the authentic nature of all existence. Dukkha is associated with the impermanent nature of self.

Dukkha is not a pessimistic or nihilistic concept. Dukkha represents an array of emotions from happiness to despair. Dukkha refers to a state of existential confusion and fixation on deceptiveness and deviating from the reality of existence. Dukkha is an inability to understand the true nature of existence. It is the tension, conflict, friction, resistance, and change caused by circumstances of life. The illusion of self causes dukkha. It’s an existential and spiritual crisis that every man confronts, and some find the universe irrational and meaningless. Dukkha is the conflict between a rational man and an irrational universe. Dukka is a form of absurdism that men face. It is the struggle to find meaning in a meaningless world. Dukkha is about the universal un-satisfactoriness of life. Dukkha is intertwined with the whole existence.

A worldly person experiences two types of suffering; one is mundane suffering due to low socio-economic deplorable living conditions and health-related issues. These types of suffering can be fixed through worldly interventions. The second kind of suffering which is called Dukkha suffering is more than mundane day-to-day suffering. It cannot be fixed via worldly interventions.  

Is human life being full of unbearable suffering? I have spoken with the former Gulag prisoners of the Soviet Union, Holocaust survivors, and the POWs who underwent unbearable and tortuous suffering. However, most of them concurred that despite their suffering there were happy and content moments in their lives while under bondage. Despite their suffering, they had moments of inner contentment. This may be an innate survival mechanism that humans achieve through evolution.

Mr. Smaith lived a productive life of 84 years. He had a happy childhood, a good education, and a fruitful adult life with a respectable profession. He was happily married. He was a delighted man for most of the time. He disregarded some of the life stresses, negativity, and disappointment and had a positive outlook on his life. He died at the age of 84 in his sleep without any old age suffering. Although Mr. Smith is a fictitious character, we know many people who had similar lives as Mr. Smith.  Did they ever complain life is full of suffering?

Suffering can be external. A chronically depressed person might suffer due to his erroneous worldview, his negative life philosophy, and his detrimental perceptions. A person from a war-torn region might suffer due to geo-political reasons. The internal suffering could be due to disruption of brain chemistry. Think about a person suffering from drug-resistant depression with altered brain chemistry.  He is experiencing prolonged suffering.   

Some people are not aware of their suffering. For instance, patients with Alzheimer's disease are in an intriguing condition, yet these patients are not aware of their worldly suffering.

In the past people suffered as a result of various diseases such as smallpox, polio, measles, mumps, and rubella. With the progress of medical science, this suffering has been eradicated. Therefore, we don’t see suffering due to these infectious diseases. However cellular aging (the cell biology of aging) is a universal factor that is associated with pain and discomfort. There is a suffering from the consequences of old age.  due to bodily decline and physical/mental deterioration, there is suffering.

Suffering is a personal matter as well as a collective matter.  Universal suffering covers a wide range of human experiences, and it has physical, psychological, social, and existential dimensions. These universal characteristics are common to every human. As a result, these universal characteristics bring a conscious awareness of the self’s vulnerability. They feel that life no longer makes sense. This awareness is Dukkha.

Dukkha is not clinical depression, mundane suffering, alienation, or tiredness of life that is associated with suicidal intentions. These conditions can be treated with anti-depressants and psychotherapy. But Dukkha cannot be treated with anti-depressants. Dukkha is a profound and strong awareness of life’s universal maladies.

Some Buddhist texts state that birth is suffering. Here it does not refer to normal childbirth. Childbirth is often a happy occasion for parents. In the Buddhist context, birth refers to the birth of the ego. The birth of ego and fixation leads to universal suffering. Following ego fixation, the person is mentally preoccupied with fixed belief. He has grasped a false sense of self. When his beliefs are changed or challenged, his false sense of self is compromised, and he is experiencing discomfort and anxiety. This leads to dukkha.

Aging is suffering. However, modern scientific technology especially gene therapy decelerates the aging process. Sometimes within the next 100 to 200 years, medical science will develop anti-aging treatments and humans will be able to live 250 to 300 years. Even that will not resolve Dukkha. Because aging and demise are inevitable and finally people would experience universal suffering.

Sickness is suffering. But the medical science has found treatment for many diseases. Perhaps within another 200- 300 years’ time, humankind might eradicate 95% of infectious and non-communicable diseases including cancer. Then sickness wouldn’t be viewed as a factor that brings human suffering.  

Indeed, death is suffering. The medical science can prolong the human life span. Bio-printing technology can replace skin and other internal organs and rejuvenate the human body. Although these measures would give a long life death is unavoidable. Therefore, death will be a part of human existence. Dukkha is associated with death anxiety.

A lack of meaning in life can result in dukkha. Although people have every comfort and many materialistic things, often they are hit by meaninglessness in life. They do not have a clear sense of purpose. According to Viktor Frankl, without meaning, people fill the void with hedonistic pleasures, power, materialism, hatred, boredom, or neurotic obsessions and compulsions. A lack of meaning in life would bring dukkha.

Dukkha is not about pessimism or cynicism. Dukkha is connected with true human nature. Dukkha is not an enigma without an answer. The Buddha described the comprehensive nature of Dukka and its cessation.



Saturday, December 9, 2023

Health Risks of Vaping




Dr. Manoj Fernando / Dr Ruwan M Jayatunge

An electronic cigarette or vape is a device that simulates tobacco smoking. Electronic cigarettes were introduced as an alternative to cigarette smoking to save people from tobacco’s harmful effects. E-cigarettes have become a rapidly evolving product. Over the years vaping tobacco has become a harm reduction method for nicotine abuse.

The basic function of all e-cigarettes is to generate a heated aerosol typically containing nicotine, that is inhaled through a mouthpiece (Abafalvi et al., 2019). Vaporized elements go from the mouth through the upper airway, ultimately reaching the alveoli.

The use of e-cigs is constantly and rapidly growing, and it is a multibillion-dollar industry. The industry is attracting young consumers, and the e-cig market is expanding. E-cigarettes are becoming popular, and it has decreased the progress fight against tobacco use. E-cigarettes have become an obstacle to nicotine cessation.

The tobacco industry is promoting vaping tobacco as a healthy way to quit combustible cigarette smoking. However, vaping should not be considered safer than smoking (Laucks &Salzman, 2020).  E-cigarettes are believed to have similar toxicity as existing nicotine replacement therapies (Cahn & Siegel, 2011). 

New research demonstrates that vaping is not risk-free.  The general health consequences of vaping have been identified.  There are potential health-related problems related to vaping. E-cigarettes emit a number of potentially toxic substances. Most e-cigarettes contain nicotine which is addictive. E-cigarettes contain chemicals including acrolein which can cause acute lung injury and COPD (Bein & Leikauf,2011).

E-cigarette smokers endure an acute inflammatory process in the lungs that disrupts the lung endothelial and epithelial barriers (Marrocco et al., 2022). E-cigarette aerosol can negatively affect multiple aspects of lung cellular and organ physiology and immune function (Gotts et al., 2019). Moreover, e smoking can cause cytotoxicity and neutrophilic inflammation (Park et al., 222). Peruzzi and team (2020) concluded that vaping can increase cardiovascular risk.

At the beginning e-cigarette users were current smokers attempting to quit smoking. Nonetheless, the demography changed drastically. The E-cigarette industry is mainly targeting teens.  Adolescents have misperceptions about vaping, and they are not fully aware of the addictive nature of e-cigarettes.  The epidemic of teen vaping has caused a large number of vaping-related lung injuries. Teen vaping could lead to subsequent use of tobacco cigarettes. Smoking is dangerous to teens. Nicotine can be harmful to the developing adolescent brain by interfering with memory and attention processing (Printz, 2020).

Intervention for vaping and smoking cessation has become a public health matter. Health professionals ought to pay attention to vaping in young people.  Health education, counseling, and behavioral management play a key role in curbing smoking habits. Youth cessation interventions should be implemented. Physicians can use motivational interviewing techniques in smoking cessation. Some patients may need pharmacologic assistance in quitting. The media should educate the public about the possible health risks associated with the use of e-cigarettes. 

  

Dr Manoj Fernando

 

Dr Manoj Fernando studied at the Faculty of Medicine, University of Colombo, and then worked with Professor Diyanath Samarasinha attached to Mel Medura - Addiction Treatment Center in Colombo. Currently, he is working as a  Senior lecturer at Rajarata University of Sri Lanka


References

Abafalvi, L., Pénzes, M., Urbán, R. et al. Perceived health effects of vaping among Hungarian adult e-cigarette-only and dual users: a cross-sectional internet survey. BMC Public Health 19, 302 (2019). https://doi.org/10.1186/s12889-019-6629-0.

Bein ,K., Leikauf GD. (2011) Acrolein - a pulmonary hazard. Mol Nutr Food Res 55(9):1342-60. doi: 10.1002/mnfr.201100279.

Cahn Z, Siegel M. Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? J Public Health Pol. 2011;32(1):16–31. doi: 10.1057/jphp.2010.41.

Gotts JE, Jordt SE, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019 Sep 30;366:l5275. doi: 10.1136/bmj.l5275. Erratum in: BMJ. 2019 Oct 15;367:l5980. PMID: 31570493; PMCID: PMC7850161.

Laucks P, Salzman GA. The Dangers of Vaping. Mo Med. 2020 Mar-Apr;117(2):159-164. PMID: 32308243; PMCID: PMC7144697.

Marrocco A, Singh D, Christiani DC, Demokritou P. E-cigarette vaping associated acute lung injury (EVALI): state of science and future research needs. Crit Rev Toxicol. 2022 Mar;52(3):188-220. doi: 10.1080/10408444.2022.2082918. Epub 2022 Jul 13. PMID: 35822508; PMCID: PMC9716650.

Park JA, Crotty Alexander LE, Christiani DC. Vaping and Lung Inflammation and Injury. Annu Rev Physiol. 2022 Feb 10;84:611-629. doi: 10.1146/annurev-physiol-061121-040014. Epub 2021 Nov 1. PMID: 34724436; PMCID: PMC10228557.

 Peruzzi, M., Biondi-Zoccai, G., Carnevale, R. et al. Vaping Cardiovascular Health Risks: an Updated Umbrella Review. Curr Emerg Hosp Med Rep 8, 103–109 (2020). https://doi.org/10.1007/s40138-020-00219-0. 

Printz C. Fighting the teen vaping epidemic: With rates of adolescent vaping on the rise, experts caution that new federal rules targeting e-cigarettes may not be strong enough. Cancer. 2020 Mar 15;126(6):1147-1148. doi: 10.1002/cncr.32779. PMID: 32108947.


 

 

 

 

 

 

 

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