Find and replace in xml tag

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Perl

Dear Sir/Madam,

<effect><emphasis emph-type="italic"> Smoking:</emphasis> May increase, risk of CV effects, Urge patient to stop smoking, or, discuss, alternative therapy.</effect>

Here in the above coding line for every occurrences of ' comma(,) ' the content should be replaced as below .

What is exact coding line in PERL...

<effect>

  <agent>Smoking</agent>

    <action> May increase</action>
    <action> risk of CV effects</action>
    <action>Urge patient to stop smoking </action>
    <action> or</action>
    <action> discuss</action>
    <action> alternative therapy</action>
    <action>Monitor patient for withdrawal symptoms.</action>


</effect>