The common Indian practice of chewing ‘paan’ (betel quid) after a meal comes with high cancer risk, the World Health Organisation has cautioned.
Studies from India confirm a strong association between smokeless tobacco use (which includes betel quid with tobacco) and cancers of the oral cavity and pharynx, said a WHO report released at the ongoing global anti-tobacco summit at Greater Noida.
Expected on Saturday, the outcome document of the WHO summit on the Framework Convention on Tobacco Control is likely to have strong references on the menace of smokeless tobacco.
The reference is required to determine counter strategies and find out resources as the FCTC focuses predominantly on smoking. At least two studies in India have shown an association between use of smokeless tobacco containing areca nut and oesophageal cancer and one of these showed an association of plain tobacco use with oesophageal cancer, says the report.
“In India, over 350,000 people are dying due to exclusive use of smokeless tobacco, of which over 100,000 are dying due to cancer,” said Dhirendra Sinha, senior consultant, National Institute for Cancer Prevention and Research and one of the editors of the report.
A fact-sheet prepared by the USA’s Centre for Disease Control, Atlanta, notes betel quid — a combination of betel leaf, areca nut, slaked lime and some other flavourings — is consumed by over 600 million people in the Indian subcontinent and south east Asia.
The adverse health effects include development of pre-cancerous conditions, oral cancers — predominantly carcinomas of the lip, mouth, tongue, and pharynx — cancer of the esophagus and some other effects including nicotine addiction. Three studies from India along with two studies each from Sweden and USA demonstrate a higher risk of death among smokeless tobacco uses.
“India is the first country to prohibit the sale, storage and manufacturing of smokeless tobacco products like gutkha across all states. However, stronger measures are required for effective implementation of the law,” said Amal Pusp, director in charge of tobacco control at the Union health ministry. India is the world’s biggest market of smokeless tobacco, which is taxed at a low rate despite carrying a substantially high health risk.