AMLENDU BHUSHAN KHAN / New Delhi : To check this menace, the World Health Organisation has fixed “Tobacco –a threat to Development ” as theme for 2017 . Today the whole world will resolve not to use tobacco to save its coming generation and its development. we should also resolve to say goodbye to smoking so that we can change the statistics in coming days. As per available data one single cigarette reduces up to 11 minutes of our life, while a full packet of it cause us to lose three hours 40 minutes of our life. Every hour 137 people are dying in our country due to use of tobacco and tobacco products while in world a person die every six second due to these products.
According to a 2010 Global Adult Tobacco Survey (GATS) report, 24.3% population or 30.73 Lac people in New Delhi use tobacco in any form, while lakhs of these people die each year due to tobacco related diseases. Nationwide, 85% men and 20% women in India use tobacco in any form, which include urban as well as rural women of Delhi area. According to the GATS survey, 10 percent girls have accepted that they use to smoke cigarettes. The World Health Organisation report, the Global Tobacco Epidemic warns us that the tobacco consumption among women is on the rise, and it includes youths also. When this survey was done in 2010, 35% people were taking tobacco in any form, and six years later, today, there must be a huge rise in this data. Remarkably, GATS survey in India is planned this year.
Almost 50% of young smokers, both boys and girls, become victim of tobacco related diseases leading them to untimely death. Average life of smokers is 22 to 26 percent less compared to that of non-smokers. Delhi daily registers almost 81 new tobacco consumers. Here, the average age of initiation in tobacco consumption is 17 years in case of male while it’s only 14 years in females. It’s a very serious matter that each year almost 10,600 persons die untimely in Delhi due to tobacco related diseases and leave their family helpless and destitute.
Global Adult Tobacco Survey – India 2010 report acknowledges that tobacco use is a biggest preventable cause of premature death and disease. Globally, 1 in each 10 adult deaths is caused by tobacco consumption. Also, globally, 55 lakh people die each year due to tobacco consumption. And approximately, one fifth of these deaths occur in India. According to WHO till the 2050 estimated tobacco consumer will be 2.2 billion.
In the World Health Organisation (WHO) Framework Convention for Tobacco Control, 178 countries of the world had consented to frame their own policy on tobacco control. In 2014, the WHO appealed these countries to raise the taxes on tobacco to save lakhs of lives annually.
Dr. Harit Chaturvedi, patron of the Voice of Tobacco Victims and Max Foundation cancer surgeon, says that the tobacco industry daily unleashes new efforts to attract youths towards the world of tobacco. With the aim of catch ‘em young, it projects tobacco products as a synonym of adulthood, modernism, affluence, classiness and superiority.
Recent initial researches suggest probability of partial genetic changes among tobacco consumers which raises not only the vulnerability of that person, but also that of coming generation towards cancer. With the consumption of tobacco products, impotency among males are increasing while reproductive capacity among females decreasing.
Dr. Chaturvedi said that tobacco increases the risk of mouth, throat, stomach, liver and lungs cancer. Most of the tobacco related diseases are lungs and blood related, treatments for which is costly as well as complicated. An Indian Council of Medical Research (ICMR) study report reveals that 50% cancer cases in males and 25% cases in females are caused by tobacco consumption. 90 percent of it is oral cancer. Smokeless tobacco contains more than 3000 chemical compounds, of which 29 are carcinogenic. Largest number of oral cancer patients resides in India. Consumption of gutka, chewing tobacco, pan, and cigarette may cause oral cancer.
Sanjay Seth, Trustee, Sambandh Health Foundation demanded the state government to implement the Cigarette and Other Tobacco Products Act (COTPA) strictly in the state so that tobacco products remain out of reach of children and youths. It’s necessary for all the modern and progressive states to implement COTPA strictly to provide a healthy atmosphere to their citizens. Police in states like Karnataka and Kerala has played a very commendable role in restricting the consumption of tobacco and other tobacco products. In several states, police has played a commendable role in announcing all educational institutions as tobacco-free to restrict tobacco consumption among children.
He told that each day, 5500 children in India initiate tobacco consumption and before reaching to the age of adulthood, they become tobacco addict. Only 3 percent of tobacco consumers are able to free themselves from tobacco addiction. So, it’s necessary to stop children from initiation into tobacco consumption. that globally one out of each 5 deaths is caused by tobacco and every 8 seconds one person dies of consumption of tobacco and tobacco products. World Health Organisation estimates 2.2 billion people consuming tobacco or tobacco products in 2050.
Notably, the World Bank has also proposed developing countries to impose 75 to 100% tax on tobacco to discourage its consumption.
Dr Surender Dabas, Director, Head, Neck and Thorax Surgical Oncology, Fortis Memorial Research Institute, presents some key facts and prevalent trends around tobacco consumption in India:
· 34.6% of adults (out of which 47.9% is males and 20.3% is females) are smokers
· 14% adults (out of which 24.3% males and 2.9% females) use smoking tobacco
· 25.9% adults (out of which 32.9% males and 18.4% females) use smokeless tobacco
· The absolute number of male smokers has grown from 79 million in 1998 to 108 million in 2015
· According to the National Family Health Survey (NFHS-4) 2015, Government of India, among the 13 States surveyed, tobacco use among men has fallen from 50 per cent in 2005-06 to 47 per cent in 2015. At least 11 of the 13 states in the report have reported a decline in the numbers between 2005-06 and 2015-16.
· In Sikkim, there is up to 20% dip in tobacco use. The only two states that showed increase in consumption were Manipur and Meghalaya.
· Haryana specifically has a 32% prevalence of tobacco usage, with about 3.2 million smokers in the year 2015.
· Smoking cessation remains uncommon as only about 5% of men aged 45–59 years are ex-smokers.
Trends in Tobacco use
· Cigarettes are replacing bidis, among young younger men and also illiterate men.
· Among upper classes, cigarettes are being replaced by cigars which have a high concentration of tobacco-specific nitrosamines (TSNAs) that are the most potent cancer causing substances.
Smoking tobacco hazards
· Tobacco smoke is made up of thousands of chemicals, including at least 70 known to cause cancer. These cancer-causing chemicals are referred to as carcinogens. Some of the chemicals found in tobacco smoke include Hydrogen cyanide, formaldehyde, lead, arsenic, benzene, ammonia and radioactive elements.
· Many of these cause cancer and some can cause heart disease, lung disease, or other serious health problems, too. Most of the substances come from the burning tobacco leaves themselves, not from additives included in cigarettes (or other tobacco products).
· Nicotine, the addictive drug that is the key stimulant people are looking for is one of the harshest chemicals in tobacco smoke.
Smokeless tobacco hazards
· These include snuff and chewing tobacco placed in the mouth or nose but is not burned like cigarettes or cigars. Still, smokeless products contain a variety of potentially harmful chemicals, including high levels of TSNAs.
There are also other cancer-causing agents in smokeless tobacco, such as benzo[a]pyrene and other polycyclic aromatic hydrocarbons (PAHs). These carcinogens are absorbed through the mouth and are linked to oral cancers. Like other forms of tobacco, smokeless tobacco also contains radioactive substances.
Tobacco-related diseases
· The most common, nearly half of all, are cancers of the lung and oral cavity in men, and of the breast and cervix in women.
· The rate of occurrence of lung cancer is 11 per 1, 00,000 individuals and of oral cavity cancer, 10.1. The rates of occurrences of breast and cervical cancers are 25.8 and 22.0 per 1, 00,000.
Which is riskier? Smokeless tobacco or cigarette smoking?
· Smokeless tobacco products are less deadly than cigarettes. On an average, they kill fewer people than cigarettes. Smokeless products are often promoted as a less harmful alternative to smoking, but they are still linked with cancers, especially oral and are deadly. And they have not been proven to help users quit.
E-cigarettes and Electronic Nicotine Delivery Systems (ENDS)
· E-cigarettes and other electronic nicotine delivery systems (ENDS) are used as substitutes for cigarettes or other tobacco products. Marketers of e-cigarettes and other ENDS often claim the ingredients are safe.
· But the aerosols these products contain addictive nicotine, flavorings, and a variety of other chemicals, some known to be toxic or to cause cancer. The levels of many of these substances appear to be lower than in traditional cigarettes, but the nicotine and other substances in these products can vary widely because they are not standardized. The long-term health effects of these devices are not known, but they are being studied.
