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The session duration was gradually increased to enhance physical and mental well-being [] Padanshika Krama (Gradual Tapering): A tobacco substitute was provided to mimic the chewing habit, supporting gradual reduction in consumption, as shown in Table 3 Ayurvedic Medicines and Shamana Gandusha Therapy: Aushadhis (medicines) and therapeutic gargling ( Gandusha ) were administered as detailed in [Table 4] Counseling and behavioral support: Patient counseling: Weekly sessions focused on educating the patient about the harmful effects of Gutka , withdrawal symptoms, and the benefits of cessation Family counseling: The patients family was informed about his condition, challenges during de-addiction, and strategies for providing emotional and behavioral support

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But a study published Friday in the Journal of the American Heart Association(link opens in new window) found that starting nicotine replacement therapy in the first two days of hospitalization did not affect a patients short-term outcome in death, length of stay, readmission or hospital expenses

However, EPR regulations have not yet been considered at the Federal level in the United States [56]

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