Keeping youth away from tobacco

May 31 was observed as 'World No Tobacco Day' around the world. This year the theme for this day was ‘protecting youth from industry manipulation.’ India is home to approximately 120 million smokers and this constitutes 12% of the smokers in the world. Without a doubt, this has a significant implication on the general health of the population.

For decades, the tobacco industry has been strategically and aggressively trying tactics to attract youth to use tobacco and nicotine products. Leading companies in the sector have been using various resources at their by innovating with different flavours, celebrity/influencer sponsorships and sale of single stick cigarettes and other tobacco and nicotine products near schools. E-cigarettes were proposed as a suitable alternative to regular cigarettes. However, some side effects associated were worse and proactive governmental policies to ban e-cigarettes thwarted this effort.

According to a recent report, India suffers from a huge burden of substance abuse and associated morbidity and mortality. Among all substance use, tobacco consumption was found to be the most common. The study further highlights that the use of tobacco peaked among people in the age group 24 to 34 years, smoking was prevalent among 15 to 24-year-olds. It also highlights how in recent years, the prevalence of smokeless tobacco has been higher (47.5%) as compared to the prevalence of smoking (28.2%). With changing trends, we can see changing trends in lung cancer with more distal cancers, changing subtype of cancers and the occurrence of disease at a younger age.

Behavioural sciences have also highlighted how young people sometimes make irrational decisions because these are manipulated. Due to exposure to various marketing campaigns through several offline and online mediums, a large percentage of youth in India consume tobacco at a very young age. However, most adolescents smoke lesser than adults. As a consequence, since the nicotine dependence by dosage is lower, any early intervention directed towards this subgroup will have a great impact.

There are several causes behind addiction. A leading cause is industry manipulation and enticing advertisements in mass media. According to the Journal of ConsumerResearch, studies have shown that 1) mass media can have a large influence on consumers, potentially affecting their health, 2) media also exerts a strong influence on teens, 3) and can influence consumers more than changes in prices. Moreover, social and behavioural factors, peer dynamics, the lack of awareness and an overall lack of belief in the existing tobacco control measures lead to dependency on tobacco.

The high consumption of tobacco can lead to various problems like oral, lung cancer and fertility problems among the youth. While many people are aware that tobacco use increases the risk of cancer, there are alarming gaps in knowledge of the cardiovascular and respiratory risks of tobacco use.

The problem of addiction compounds as it is not widely discussed in families. Parent counselling is also weak. Apart from occasional advice, there is no sustained pressure on the youth to quit smoking unlike the pressure on alcohol consumption.

In schools, there are no special classes for students to discuss and demonstrate problems with tobacco. Nor is there much psychological counselling. School-based interventions can play a major role in reducing or postponing smoking. School-based prevention programs must have classroom curricula that is age-specific, peer education programs, special programs and media literacy training. These programs have to create awareness among participants about the dangers of smoke, build their capacity to identify and resist the influence of peers and tobacco marketers. The cessation programs focus on supporting students in their efforts to quit using tobacco products and teach students refusal skills and avoidance techniques.

The way forward is to encourage community and statewide programmes, mass media campaigns, launch policy-driven approaches which seek to limit the access of tobacco products to the youth and launch policies that affect product labelling, create smoke-free environments and restrict advertising.

(The writer is a consultant Interventional Pulmonologist)