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 a fashion statement.
However, today, you won’t find an ashtray anywhere whether in an office or shop. Or say, a person smoking freely in a bus or open venue is looked down upon. Thanks to the Government’s proactive tobacco-control measures like the implementation of Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce Production, Supply and Distribution) 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.
In fact, due to many stringent measures in smoke-free policies, out of 17 tobacco-causing cancers, now only seven have remained a major public health challenge. Certainly, the credit goes to the COTPA Act which has ensured the implementation of tobacco control policies.
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 like lung diseases, cardiovascular diseases and strokes to name a few.
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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, is 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 the 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 smoking or chewable 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 leukemia (acute myeloid leukemia).
While breast cancers have seen a rising trend globally as well as in India, oral cancers, head and neck cancers along with lung cancers have a rising trend, 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 would see that a large number of cancers are potentially avoidable.
The economic burden of diseases and premature deaths attributable to smoking and smokeless tobacco use by persons over 35-years of age in India at over 1 per cent of India’s GDP, estimates to the Economic Costs of Diseases and Deaths Attributable to Tobacco Use in India study by World Health Organization (WHO).
The direct health expenditure on treating tobacco-related diseases alone accounts for 5.3% of total private and public health spending in India in a year.
It is unfortunate and serious that tobacco firms are targeting through various marketing strategies this vulnerable group including kids as young as ten years old while a few Bollywood and cricket celebrities are recklessly promoting surrogate advertisements of health hazardous 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 make these products out of reach of people. Still, due to some loopholes in the legal provisions, the tobacco industry is successful at attracting people towards this deadly product. The Union Health Ministry has also identified these loopholes and thought of ways to remove them as amendments to the existing tobacco control act COTPA. Hence, it is hoped that COTPA amendments which are awaiting approval from Parliament further tighten the leakages and help escape our youth and kids from the cycle of tobacco and addiction so that they can enjoy the gift of health.
Dr GK Rath is an Oncologist and former head of the National Cancer Institute, India. He has also served as Professor & Head at the Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi. The views expressed in this article are those of the author and do not represent the stand of this publication.
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