It's time to shun tobacco to protect youth

The killer nature of tobacco is a known fact. But did you know that annually India loses around 10 lakh people to tobacco-related diseases? In Karnataka alone, around 6,000 people have succumbed to cancer caused by tobacco in 2011. As per the Global Adult Tobacco Survey by the World Health Organisation, 28 per cent of people in Karnataka use tobacco, which accounts to around 1.5 crore of the state population. It is estimated that 30 per cent of these patients will die 10-12 years prematurely due to various diseases such as cancer or heart or lung ailments.

Consider these statistics about Karnataka’s tobacco consumption:
• New cases of cancer every year: India – 10,44,242; Karnataka – 51,070

• Total number of cancer cases at any given time: India – 28,19,457; Karnataka – 1,37,889

• Estimated number of tobacco-related cancer deaths yearly (2011): India 1,43,141; Karnataka – 6606

• Annually 2,688 people die only because of chewing tobacco in urban and rural areas (Directorate of Economics)

• Every day nearly 70 patients develop cancer and 20 die owing to tobacco in Karnataka (assuming 50 per cent of cause of cancers are related to tobacco).

• Chewing tobacco consumption in Karnataka is 20 per cent, beedi 8 per cent, and cigarettes 4 per cent

Karnataka spends close to Rs 1,000 crore yearly on health-related issues to tobacco from cancer, heart attacks or lung problems as was stated by the chief minister recently. This figure reaches 1 lakh crore for India. This is both a serious financial and health concern. Most of this expenditure is unaffordable for our citizens. As doctors, we often observe that it is not only the patient but also his entire family that bears the brunt both emotionally and financially.

India is the world capital of oral cancer. Hence, reducing use of chewing tobacco is an important part of reducing tobacco- related deaths and diseases. Chewing tobacco prevalence across the state is disproportionately higher among economically poorer sections of society and women. Chewing tobacco and related illnesses are a huge health burden particularly among the poor who often do not have the ability to meet the healthcare costs.

The Karnataka government banned gutka under the Food Standards and Safety Act of India, Section 2, 3, 4. This Act states that no food product should contain tobacco or nicotine, and since gutka is a food products, it was banned under this Act. States were asked to implement the ban under directions received from the Centre and the Supreme Court. However, these products remerged in the market and are being sold in separate pouches.

Hence, the Centre requested for implementation of ban on all forms of processed/ flavoured/ scented chewing tobacco, whether going by any name or form of gutka, zarda, etc. under the FSSAI Act. Recently, the Centre asked all chief ministers to comply with this order. Under the above directions, 13 states have banned these products and other states are considering the same.

Checking loose sale
Loose sale of cigarettes is another issue that is being discussed. This is the single most important step that will impact and reduce cancer and other serious tobacco- related illness in our society for some obvious reasons, as stated below:

• The incidence of cancer today is rising in the age group of 20-30s, and this is a very serious concern for our society. This is happening because youngsters start consuming tobacco related products at an early age. Tobacco companies generally target this age as it is easy to entice them.

• Youngsters will find it difficult to afford these products if sold only as packets.

• Tobacco is a gateway to drugs. More than 75 per cent drug addicts initially start with tobacco. To prevent drug addiction, tobacco control is a pivotal step. Health warnings are important and loose sale does not carry such information.

A common reason quoted for inaction on this issue is the concern for the well being of tobacco farmers. There is no doubt that this is vital. While it is our duty to protect the interest of farmers who may suffer, it is also our responsibility to not ignore the lakhs of patients and their families who already suffer from dreadful illness contributed by the promotion of these products. Farmers in our country are called ‘anna daata’. We have the greatest respect for them and also stand to protect them.

Practice of medicine entails a simple principle “Treat the cause and not only the effect”. In order to safeguard the health of the youth of the state, it may be important for the government to consider these essential steps seriously. Instead of “trying to find a new antidote, we need to rather eradicate the poison!”

(Dr Vishal Rao U S is Consultant-Head & Neck Surgeon and member, high-powered committee on tobacco control, Government of Karnataka)