Tobacco consumption has been in vogue for hundreds of years. With the spread of tobacco to Europe and other parts of the world from 16th century, it soon gained popularity in India. Tobacco is a major health problem associated with a growing number of illness worldwide. It causes 4million deaths per year and it is estimated that this figure will rise to10million deaths per year by 2030, making tobacco single biggest cause of death causing more deaths than HIV, maternal mortality, automobile accidents, homicide and suicide combined.In India, tobacco is used in Smoking as well as in Smokless forms. Smoking includes use of Cigarettes, Beedis, Hookahs, Cigars etc. where Beedis and Cigarettes are consumed the maximum. While Guthkha, Khaini and Zarda are the most common forms of Smokless tobacco. On a large scale, these products are manufactured industrially. Around 4700 poisonous chemicals are used in preparing tobacco where 60 of these chemicals are responsible for causing cancer. Chemicals like nicotine, hydrogen cyanide, arsenic, acetone, carbon monoxide, tar, formaldehyde etc. are present in all types of tobacco products. Due to high contents of nicotine, tobacco becomes addictive. Once you get addicted to chewing or smoking tobacco, it becomes very difficult to quit.
Some people become addicted to relieve stress, tension and depression while few do it just for the sake of enjoyment and thrill without realizing how hazardous tobacco becomes to health. Smoking as well as Smokless Tobacco use can cause many dangerous health problems. Used in smoking form, it increases the risk for cardio vascular diseases like heart attack, blood pressure, blood clots, hemorrhages etc. It also leads to strokes, coronary heart diseases, peptic ulcers, asthma, diabetes and cataracts.
Chronic Obstructive Pulmonary Diseases such as chronic bronchitis and emphysema can also result from smoking. 80% of lung cancer cases are also caused due to cigarette smoking. While chewing tobacco increases the risk of oral health problems such as periodontal disease, mouth ulcers, oral lesions etc. Tobacco use in pregnancy causes harmful effects on the health of both, the mother and the baby. It increases the risk of miscarriages as well as pregnancy related complications with a possibility of low birth weight and still births. And those people who come in contact with smokers are more prone to health problems and illness due to passive smoking.
10% of the world’s smokers live in India and around 1million people die every year due to tobacco consumption. About one third of Indian men smoke cigarettes, beedis and more than half either smoke or chew tobacco. Thus, diverse anti-tobacco efforts have been initiated by World Health Organisation. The theme for 2011 World No Tobacco Day is The WHO Framework Convention on Tobacco Control. As a part of commitment towards Framework Convention on Tobacco Control (WHO, 2003) Ministry of Health and Family Welfare, Govt. Of India undertook several steps towards effective control over use of tobacco. The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 was put in affect by the government and due to the effective implementation of this law, Chandigarh has become the first city in the country to be declared “Smoke Free City” from 15th July, 2007. the Indian Government has been perusing a proactive and bold strategy for tobacco control.
The Indian Act, whose enactment preceded the adoption of the FCTC by the World Health Assembly, goes beyond the obligations set out in the FCTC in many respects. The government provides clearly prescribed requirement in key areas such as smoking at public places is banned. Advertisement of tobacco products packaging and labelling and sale to minors is banned. Whoever found smoking or throwing half burnt butts is liable to be fined. Recently govt. also banned packaging of tobacco products in polythene sachets. In 2009, India ran an advertisement showing images of smoker’s lungs which are like sponge full of tar, illustrating that smoking is more harmful than many people realize. It depicted the amount of cancer producing tar that an average smoker’s lungs soak up in just one year. UT Administration has formed a special Tobacco Control Cell, which supervises and co-ordinates all the tobacco related activities in the city.
Under the World Health Organisation’s Tobacco Free Initiative, Tobacco Cessation Programme was initiated in the country. Under this Service Development Delivery programme, 13 Tobacco Cessation Centres were established in the first phase and 5 were added in the second phase. Tobacco Cessation Centre at Post Graduate Institute of Medical Education and Research, Chandigarh started functioning in March 2001 and is one of the 18 centres across India. In 2007, Tobacco Cessation Centre was upgraded to Resource Centre for Tobacco Control (RCTC). It’s primary objective is to improve and develop processes and procedures that will help existing organisations perform these tasks more efficiently and at the same time have a better success rate. It focuses on three most notable areas of our society – community areas, hospitals and media. Different demographics are targeted in the community. Talks and lectures are delivered while camps and rallies are held in schools, colleges, villages and slums of Chandigarh. During these talks and camps, it sensitizes, counsels and educates the public on reasons for the addiction and methodologies on how to quit. Anti-tobacco films are shown and posters are also displayed. RCTC also takes opportunities to sign up volunteers from the community and registers tobacco users on the spot. In the hospital the process of assessment and treatment of tobacco users is done by registering them in the program and providing self-help tips, behavioural counselling brief and motivational enhancement therapy for quitting tobacco. Studies show that few people understand the specific health risks of tobacco use. For example a 2009 survey in China revealed that only 37% of smokers knew that smoking causes coronary heart diseases and only 17% knew it causes stroke. Among smokers who are aware of the dangers of tobacco, most want to quit. Therefore, Counseling and medication can more than double the chance that a smoker who tries to quit will succeed. RCTC also liaison’s with medical departments to undertake tobacco cessation and control activities, posters are displayed depicting hazards of tobacco use throughout the hospital, anti-tobacco films are played regularly in the waiting rooms and faculty members from respective departments have been informed to undertake treatment advocacy, training, research activities and educational services related to tobacco cessation at PGIMER. Anti-Tobacco messages are also conveyed through write ups in printed media and talks and advertisements with anti-tobacco messages are delivered via radio and television. Various assessment and intervention tools were developed like screening questionnaire, self-help tips (English and hindi), brief interventions in tobacco cessation : a physician’s manual, module of behavioural counselling for tobacco users and tobacco cessation manual for primary care physicians, nurses and health workers. Recently RCTC team also developed training programme for health professional on tobacco cessation to empower them with the knowledge and skills that enable them to undertake tobacco cessation in their respective clinics. This programme is conducted by RCTC on regular basis.
RCTC runs in the Psychiatric Outpatient Clinic and Drug De-addiction and Treatment Centre (DDTC). In total 3960 patients have been registered. On an average every year around 50% of smokers and about 28% of smokless tobacco users either quit or reduce tobacco use by half. This year more than 5million people will die from a tobacco related heart attack, stroke, cancer, lung ailment or other diseases. That does not include more than 600,000 people, more than a quarter of them children ,who will die from exposure to second hand smoke .Having killed 100 million people during the 20th century, tobacco use could kill 1 billion during the 21st century.
Treatment of tobacco dependence helps tobacco user quit and those who succeed in quitting experience immediate and profound health benefits and can reduce most of the associated risks within a few years of quitting. So, on this day, World No Tobacco Day, let’s make a promise. A promise to strive towards making the rest of the days in your life tobacco free and protect what we value the most – our health and our loved ones.
THE GOVERNMENT OF INDIA MUST ALSO KNOW THAT NOT ONLY TOBACCO BUT ADULTERATED EATABLES & DRINKS ARE CAUSING MORE DISEASES BUT THE GOVERNMENT IS SLEEPING OVER THIS MOST HEINOUS ACTS OF THE ADULTERATORS, THOSE WHO ARE NOT SPARING MEDICINES & FODDERS OF THE ANIMALS EVEN.
SHOULD THERE BE NOT A PROVISION OF CAPITAL PUNISHMENT- DEATH BY HANGING IN PUBLIC VIEW, FOR ADULTERATION, IF THE GOVERNMENT IS SO SERIOUS ABOUT THE HEALTH OF THE PEOPLE OF THE NATION BUT OUR LEADER WILL NOT DO IT, AS THEY ARE HUNGRY OF VOTES ONLY, THUS THEY TAKE AN EXCUSE THAT IN DEMOCRACY SUCH DEATH ARE NOT DESIRABLE & LET THE PEOPLE DIE OF DISEASES BEING CAUSED BY ADULTERATION, AS IT HARDLY MATTERS TO THEM.
LET THERE BE AN OPEN NATIONAL DEBATE & DELIBERATIONS, TO SEEK PUBLIC OPINION ON THIS ISSUE THROUGH *THE INDIA POST*, SO THAT RIGHTEOUS SENSES MAY PREVAIL UPON THE CARE TAKERS OF THE AFFAIRS OF THE NATION , THE PARLIAMENTARIANS IN THIS CONTEXT—dr.amritgaur