Time to nail tobacco to save youth and kids from cancer grip

In India, tobacco-related cancers contribute nearly half of the total cancers in males and one-fifth in females in India. Twenty years ago, who would have thought that people would stop smoking in most public places and offices! If an ashtray in any office was a common sight, smoking motivated by Bollywood scenes was considered as a fashion statement.

Today you won’t find an ashtray anywhere whether in an office or shop; or a person smoking freely in a bus or open venues. Thanks to the government’s proactive tobacco-control measures like implementation of Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce Production, Supply and Distribution) Act or COTPA Act, which has restrained people from smoking in public places; in the process, common people have also been protected from the harmful effects of second-hand smoking to a great extent.

However, a lot more is yet to be done. Every life is precious and we are losing 1.3 million Indians every year to tobacco-related diseases. Apart from cancer, tobacco is also a major cause of a wide range of chronic and life-threatening conditions such as lung diseases, cardiovascular diseases and strokes to name a few. Talking about cancer, which is becoming an epidemic in the country, tobacco consumption is the single largest preventable cause of cancer and discouraging its use, the most cost-effective intervention.

We know tobacco in actuality is equivalent to poison that kills in a few years if not immediately. In fact, while poison consumes only one life, tobacco and cigarettes kill even those who are forced into passive smoking. But for several other reasons, an immediate complete ban on tobacco is not practical. We have to continuously increase legal restrictions against it so that its use is reduced rapidly and those who make a profit by playing with the lives of people are away from this trade.

Various studies have found that tobacco — whether smoked or chewed is blamed for at least 17 types of cancers -- of the mouth and throat, voice box, food pipe, stomach, kidney, pancreas, liver, bladder, cervix, colon and rectum, and a type of leukaemia (acute myeloid leukaemia).

While breast cancers have seen a rising trend globally as well as in India, oral cancers, head and neck cancers along with lung cancers are also on the rise, and most of them have been found to be tobacco-related. In fact, tobacco-induced cancers constitute the highest burden among all types of diseases in India. As many as 27 per cent of cancer cases were caused due to tobacco consumption, according to the latest report released in 2020 by the National Cancer Registry of India (NCRI), which functions under the Indian Council of Medical Research. In India, tobacco-related cancers contribute nearly one-fifth of the total cancers in females and half in males. If the hazards of tobacco are more widely understood, we may see a large number of cancers potentially avoided.

The economic burden of diseases and premature deaths attributable to smoking and smokeless tobacco use by persons over 35-years of age in India is at over 1 per cent of India’s GDP, estimates the Economic Costs of Diseases and Deaths Attributable to Tobacco Use in India, a study by the World Health Organisation (WHO).

It is unfortunate, and of serious concern, that tobacco firms are targeting through various marketing strategies vulnerable group including children as young as 10 while a few Bollywood and cricket celebrities are recklessly promoting surrogate advertisements of items like gutka and paan masala.

Media and doctors too have an important role to play in helping phase out more tobacco items while the government can gradually take steps to remove these products. Still, due to some loopholes in the legal provisions, the tobacco industry is successful in drawing people to this product. The Union Health Ministry has identified these loopholes and is considering ways to plug them through amendments to the existing tobacco control act COTPA. It is hoped that COTPA amendments. which are awaiting approval from Parliament, further tighten the leakages and help our youth and kids escape from the cycle of tobacco and addiction so that they can enjoy the gift of health.

(The writer is an oncologist and former head of the National Cancer Institute, India.)