SAY NO & MEAN IT.....WORLD NO TOBACCO DAY

Santanu Saraswati
Subhojit Ghosal, Shreya Chakraborty, and Sonia Ramachandran, all post graduation students of University of Calcutta, finally discovered the high cost of intake of tobacco products—both physical and financial—digested statistics and decided to bid adieu to tobacco.

Subhojit, Shreya and Sonia started smoking while in school just as an experiment—that finally became a habit. They decided to quit after one of their closest friends had voice-box cancer. They are now talking to public health officials and non-government organisations that are working to snuff out the problem.

“There are 70,000 new cases of cancer reported every year in this state, out of which more than 90 per cent patients are tobacco consumers. It has been found that 54 per cent of tobacco consumers in Bengal started their habit before the age of 10-12, while the age group is 12-15 in Kolkata. We celebrate ‘World No Tobacco Day’ every year on May 31, but tobacco use has given rise to more lifestyle related diseases like larynx cancer, oral cancer, respiratory disorder, premature wrinkling of skin, recurrent pregnancy loss, and hundreds of diseases more. There is no way out except saying a big ‘NO’ to tobacco,” said Subir Ganguly, head (radiation oncology), N R S Medical College & Hospital.

Tobacco is the only legal consumer product that kills. Through promotional campaigns, the industry continues to divert attention from the deadly effects of its products. More countries are fighting back by requiring that tobacco packages graphically show the dangers of tobacco, a requirement called for in the World Health Organization Framework Convention on Tobacco Control (WHOFCTC). Effective health warnings, especially those that include pictures have been proven to motivate users to quit and to reduce the appeal of tobacco for those who are not yet addicted.

The theme of World No-Tobacco Day on May 31, 2009, “Tobacco Health Warnings” cautions people about nicotine as a highly addictive substance. Requiring warnings on tobacco packages is a simple, effective strategy that can vastly reduce tobacco use and save lives. If left unchecked, the lung cancer burden of tobacco will more than triple in the next 25 years.

“We must help and convince current smokers to quit and prevent the tobacco industry from using its marketing techniques to lure the world’s children into deadly cigarette addiction. We have to act now to eliminate the global scourge of tobacco and save hundreds of millions of lives in the next decades,” Ganguly added.

Smoking causes more than 85 – 90 per cent of lung cancers and there is a clear dose - response relationship between risk and daily cigarette consumption. People who smoke more than a pack of cigarettes per day have a risk that is as much as 20 times that of non-smokers. If the smokers are exposed to other carcinogens like asbestos, or Uranium the risk of lung cancer is raised in synergistic fashion. In Kolkata, lung cancer even in women is increasing and in 1980s it has become the leading cause of cancer death and even surpassed breast cancer.

According to Ganguly, smoking is more prevalent among men, while city women tend not to smoke but use smokeless tobacco. Areca nut is also used along with tobacco especially betel leaf (pan). Areca nut has mildly addictive quality and there is now sufficient evidence that by itself it is carcinogenic and used with tobacco the mixture becomes even more addictive and carcinogenic.

Cancer caused by smokeless tobacco use includes cancers of the oral cavity (mouth), oropharynx (throat) and oesophagus (food pipe). India has the highest rates in the world for causes of oral cavity i.e. men and women and a very higher burden of tobacco related cancers and number of people getting affected by these deadly diseases are increasing in geometrical progression while it is witnessing a downward trend in other parts of the world. In Kolkata an increase has been seen among men in young age groups, attributed to increasing popularity of chewable mixtures of tobacco and areca nut, observed Gautam Mukhopadhyay, head (surgical oncology) Ruby General Hospital.

“Second Hand tobacco smoke are passive inhalation of tobacco smoke has been found to pose significant health hazard, lung cancer incidence has been found to be higher in non-smokers exposed to second hand tobacco smoke. Children are found to have increased list of asthma, ear infections and pneumonia,” said Mukhopadhyay.

Apart from different forms of carcinoma, toxins in the blood from tobacco smoke contribute to the development of atherosclerosis. In atherosclerosis, blood vessels are narrowed as plaques of lipid material build up in them, typically when ravaged by harmful substances contained in high concentrations in tobacco. Atherosclerosis reduces blood flow through the coronary arteries supplying the heart muscles leading to heart attacks and strokes, observed Abhijit Banerjee, former head invasive cardiology, SSKM Hospital. “This city has witnessed a rise in heart attacks and strokes by 12 per cent, especially among the 25-40 years age group—who are mostly tobacco product consumers,” Banerjee added.

Even city’s rising number of younger generations suffering from reproductive diseases and erectile dysfunction is because of tobacco use in any form. It has been found that more than 25 per cent of people in the age group of 21 to 35, and 40 per cent of people in the age group of above 40 years are suffering from erectile dysfunction—more than 80 per cent of whom either smoke or take gutka, observed consultant Arnab Krishna Deb, consultant andrologist, Bhagirathi Neotia Women & Childcare Centre.

If one goes by the figures of people suffering from lifestyle diseases because of tobacco in Kolkata—it could even frightened the health experts of the World Health Organisation. “Tobacco intake is even one of the major causes of few gastrointestinal problems like ulcers. We observe the World No Tobacco Day every year, but we have miles to go to put a curb on the use of tobacco in any form. Time has really come when government agencies should act wisely—for saving human lives,” said Kinsuk Das, head, department of gastroenterology, Ruby General Hospital.
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