World No Tobacco Day – red alert in Tamil Nadu

By K. Manjula

The World Health Organisation (WHO) observes World No Tobacco Day on May 31 every year. According to WHO, the global tobacco epidemic kills more than 7 million people each year, of which close to 8,90, 000 are non-smokers. Tobacco smoke contains more than 4000 chemicals, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. There is no safe level of exposure to second-hand tobacco smoke. In adults, it causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death.

The Global Audit Tobacco Survey (GATS) has stated that there is both smoking and smokeless tobacco use prevalent in India. Smoking tobacco products include beedis, manufactured and hand-rolled cigarettes, pipes, cigars and hookah. Smokeless tobacco is used either by chewing or applying to the teeth and gums, or sniffing. Smokeless tobacco products used in India include chewing tobacco products, such as, betel quid with tobacco, Chaini, gutkha, paan masala, and other such products like mishri, mawa, gul, bajjar, gudakhu and snuff.

The WHO has declared that India has the highest incidence of mouth cancer in the world. The Indian Council of Medical Research (ICMR) has reiterated this fact and even pointed out that 90% of the oral cancers are related to the use of chewable tobacco. Besides oral cancer, smokeless tobacco use is also associated with cancers in food pipe, pancreas, kidney, throat and stomach. There is also increased risk of death from cardiovascular diseases among smokeless tobacco users.

In the last few decades, small, attractive and inexpensive sachets of mixtures of tobacco have become widely available in India. Aggressively advertised and marketed, often claimed to be safer products, they are consumed by the young and old alike. These products have been strongly implicated in the recent increase in the incidence of oral submucous fibrosis (pre-malignant tumour which could later transform into cancer). In fact, the paan masalas advertised by many actors claiming to be manufactured without tobacco and areca nut have also been classified as carcinogenic to human by various studies on carcinogenic products.

Though the use of Gutkha and its related products have been banned in Tamil Nadu since 2013, it is still available easily, even for juveniles. Many petty kadais are selling them illicitly including some shops in Adyar neighbourhood. In fact, according to GATS (2016-17) the overall usage of Tobacco products has increased by 4% in Tamil Nadu compared to the previous survey in 2009 -10.

Apart from the various suggestions given by WHO to control tobacco usage in India, like ban on smoking in public places, warning about the dangers of tobacco by implementing large graphic health warnings on all tobacco packages, and implementing effective anti-tobacco mass media campaigns, WHO also suggests raise in taxes on tobacco products and make them less affordable.

Indian Government has levied a GST of 28% in addition to cess charge (around 5 %) on tobacco-related products in 2017. This could be a major factor for the overall decrease in tobacco use by 6% in India, as pointed out by the GATS. But still the taxation is not enough as per the recommendation of the WHO which suggests a tax burden of 75% on all tobacco-related products to discourage users from buying.

To sum it all, there is no denying that tobacco use is harmful to one’s health. While the Indian government is doing what it takes to educate people about the harmful effects of tobacco and curb its usage, it is entirely left to the user to commit oneself to kick the habit. A habitual user may want to stop, but the body demands it continuously due to the addictiveness of tobacco which results in a routine indulgence. While withdrawal symptoms last only for a few weeks, staking it out helps to quit and lead a healthy tobacco free life. So friends let’s take the pledge today for a Tobacco Free living.