Say no to tobacco

Cigarettes are the world’s most widely smuggled legal consumer products

Tobacco is single most preventable cause of death in world today. Globally, nearly 6 million people die from tobacco-related causes every year. If the present pattern of tobacco use persists, it is estimated that there could be one billion premature deaths globally during 21st century. Although tobacco deaths rarely make headlines, tobacco (smoking or smokeless) kills one person every six seconds. It is estimated that there are 274.9 million tobacco users in India with 163.7 million only smokeless (Gutkha , Khaini, Mawa Gudakhu) tobacco users, 68.9 million only smokers and 42.3 million users of both smoking and smokeless forms of tobacco. Higher rate of tobacco consumption of 38.4% are seen in rural areas as compared to 25.3% in urban areas. Use of smokeless forms of tobacco is more common now in both the sexes, reason behind – it is socially acceptable.  Various forms of smoking tobacco include cigarettes, beedis, hookah and chillum, for smokeless form they are gutkha (tobacco with betel nut, catechu, lime and flavorings) or zarda paan (betel quid with tobacco)and khaini (tobacco lime mixtures).

Costs of tobacco globally- “Economy”

Tobacco estimated $500 billion drain on the world economy, is so large that it exceeds the total annual expenditure on health in all low & middle resource countries.  Tobacco’s economy costs extend beyond the direct costs of tobacco related death & related productivity losses. Tobacco’s total economic costs reduce national wealth in terms of GDP by as much as 3.6 percent.

Costs to the smoker

Smokers expose their homes and workplaces to unnecessary fire hazards and they often pay higher premiums for health & property insurance. In many low resource countries, hospital treatment can absorb a family’s life savings and visit to hospital may involve days of travel & burdensome expenses.

India is second largest consumer of tobacco, that’s why it is the capital of oral cancer. All sections of Indian population consume tobacco though the prevalence of habit and types predominantly used vary across different geographical areas. The mean age of initiation of habit varies between 15-25 years for different tobacco products. According to survey it is seen that children’s at the age of 15-19 years get more attracted towards this consumer product, either influenced by their parents, siblings or film stars.

Recently, various studies have been done which show that tobacco consumption had been a problem from long back not only in our country but it is becoming a global problem. In the US, smoking is more in females compared to males of middle age.

In urban areas, the young often smoke because of their peer pressure, stress and on trial basis. Their most common reason was film hero and heroine who smoke on glamorous screen. Young rural boys often take to smoking to appear modern, tough and smart and to show that they are educated.

Rising use of smokeless tobacco among women is globally upcoming health issue. In South Asian countries which include India as well traditional values and social norms do not favor smoking by females so use of smokeless form of tobacco is more prevalent because it is very well hidden from society. Use of tobacco is more in illiterate, low socio economic group of females.

Use of tobacco is associated with various killer diseases which includes lung cancer, oral cancer and cervical cancer in females. Nicotine, a major component and the most pharmacologically active agent of tobacco plays significant role in exacerbation of all tobacco related diseases.

There is dire and compelling need to save many lives from falling prey to tobacco addiction and the urgent

Imperatives of avoiding the huge health, economic, social, environmental burdens that would be imposed by tobacco on a nation like India that aspires for accelerated development.

While the prevalence of tobacco use has been slowly declining in the developed countries, rates have been steadily rising in the developing countries. Hookah parlor is in fashion among youngsters.

Given the high morbidity and mortality associated with tobacco consumption, regulatory authorities need to enforce firm laws that ban the advertisement and promotion of all forms of tobacco. There should be pictorial health warnings on all tobacco products as the prevalence is more common in illiterate population. Meanwhile, there should also be a nationwide campaign in educating the masses against the dangers of using tobacco. Doctors and media should play their roles in creating awareness and spreading information regarding its ill effects.

Effective cessation programs are also necessary as majority of people are willing to quit. Periodical surveys and interventional studies are recommended to stop this tobacco epidemic.

 

Dr. Sachin Sinha, Dr. Anshu Choudhary

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