The tobacco conundrum

The tobacco conundrum

The tobacco conundrum

Consumption of tobacco products has soared dangerously among children and the youth in Bangalore and the State, raising serious questions over the government’s ineffective measures to curb the unhealthy trend

Tobacco is an addiction. Ask over eight million people in the State who chew tobacco, breathe tobacco and swear by its rivetting attachment. But when you find 80,000 of them are children under 15 years, and an equal number in the age group of 15 to 24 years, you ought to get disturbed, scream out for some action. May 31, World No Tobacco Day, should surely be a day to revisit this dangerous trend, and find ways to curb it, fast!

From half-hearted attempts to arrest public smoking to sweeping generalised talk-down messages, the actions so far haven’t been effective enough. That’s not what you expect when the health risks are high, even for passive smokers. To make matters worse, Karnataka is a leading State in cultivating, consuming and exporting tobacco, according to the Consortium for Tobacco Free Karnataka.

Smoking in public places is a strict no-no according to the Cigarette and Other Tobacco Products Act (COPTA). Though the rules were enforced in 2009, not everyone is aware of the law.

Although the BBMP’s tobacco cell has conducted several raids since 2009, smoking continues to be open and rampant in Bangalore. Section 4 of the Act bans smoking in public places, which include hotels, coffee houses, pubs, bars, shopping malls, workplaces, auditoriums, hospitals, libraries, stadiums and bus stops. The BBMP has registered 534 cases and collected Rs 97,000 as penalty from April 2010 to May 2012.

Section 6 of the Act prohibits the sale of tobacco products near educational institutions. The Palike says it has registered 325 cases and the total penalty collected is Rs 1,54,650.

But the statistics don’t tell the full story. Palike sources reveal that although the penalty amount is used to check violations, tobacco products seized from vendors have been sold back in market by BBMP workers themselves. The BBMP’s inspection squad also faces many problems from elected representatives in removing tobacco vendors located near educational institutions, sources say.

Uphill task for police

Besides the BBMP, the City police are also entrusted with the task of booking cases for smoking in public. While the BBMP has set up special squads to implement the ban, the police are expected to complement the efforts. Additional Commissioner T Suneel Kumar says police stations have been instructed to take up special drives for effective implementation of the law, but no targets have been set.  

Kumar feels enforcing such social legislation is an uphill task as penalty wouldn’t work. It is the mindset that has to change. He wonders why only the police should be expected to enforce it when there are 20 other authorities. With limited human resources, the police cannot go looking for smokers in public places all the time. “The best we can do is penalise anybody found smoking in public areas in the course of other duties,” he says.

Schedule III of the COTPA lists 21 authorities who can enforce the law and collect penalty from smokers. Strangely, the list includes Income Tax and Central Excise officials, all gazetted officers of both the State and the Central governments, and even post masters. Also included are Panchayati Raj representatives, medical officers, heads of institutions, transport officers and school principals along with police officers not below the rank of sub-inspectors and traffic superintendents.

Industry interference

This year, No Tobacco Day has a World Health Organisation (WHO) mandated theme, ‘Tobacco Industry Interference’, that focuses on influential tobacco companies disrupting public health policies. According to Dr Upendra Bhojani, member, Consortium for Tobacco Control, Karnataka, there has always been a conflicting mandate within the government. 

The Health Ministry’s attempts to curb the tobacco menace is at cross purposes with the Commerce Ministry promoting the tobacco trade and industry development through the Indian Tobacco Board. “The tobacco industry provides huge donations to political parties.

In the last two years, the biggest player in cigarette industry in India donated over Rs 6.7 crore to major political parties. Five of the top 10 shareholders in this firm are government-owned companies,” Bhojani points out.

The WHO cites an inherent contradiction in the corporate social responsibility by the tobacco industry. The industry’s core function is production and sale of lethal tobacco products against public health interests. No wonder, the statutory picture health warnings on tobacco packs have been diluted to include relatively less effective pictures than what was proposed. A recent remark by WHO’s director general, Dr Margaret Chan, is telling: “The enemy, the tobacco industry, has changed its face and its tactics. The wolf is no longer in sheep’s clothing, and its teeth are bared.”

Beedi, gutka and cigarettes are the main tobacco products easily available in the market. Women and children constitute the majority of over four lakh beedi workers in the State, suffering the harmful effects even without chewing tobacco or smoking. Beedi rollers work in enclosed areas in their houses and are constantly exposed to the smell and dust which in turn cause respiratory infections and allergies.

Consumption of gutka or the smokeless tobacco in chewing form is the most prevalent and the most harmful. This, despite the Food Safety and Standards (Prohibition and Restriction on Sales Regulations, 2011) notified on August 1, 2011, prohibiting the use of nicotine and tobacco in any food product. 

Tobacco-related cancer growing

Dr C Ramesh, professor and Head of the Department, Cancer Epidemiology, Kidwai Memorial Institute of Oncology, says 40 per cent of cancer cases that reach Kidwai are related to tobacco consumption. Among men, nearly 50 per cent of cancer cases are tobacco-related.     

“The number of tobacco-related cancer cases has increased in the past two years mainly due to the awareness about the disease in the public domain. Although most cases are of patients with cancer from tobacco chewing, the number of cancer cases due to tobacco smoking is also increasing,” says Dr Ramesh.

Not many are opting for tobacco cessation centres, which helps in preventive measures.

Dr Prathima Murthy, head of Tobacco Cessation Centre at Nimhans,says many smokers keen to quit the addiction are not even aware of de-addiction centres. “We are seeing patients in the age group of 20-40 years with severe addiction coupled with psychological problems. Although nicotine supplements help in giving up the addiction, regular follow-up by a patient is very important.  There is a need for greater awareness in schools, colleges to nip the menace in the bud,” she adds.

(With inputs from Aditya Bharadwaj and Skandashree Bali)

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