What is tobacco?

• Tobacco contains an alkaloid, nicotine, it's main addictive agent, which results in physical and psychological dependence.
  
• Nicotine is a deadly poison in high doses. One drop (70 mg) can kill an average adult.
  
• Apart from nicotine, tobacco contains 230 toxic chemicals that play a role in the onset of cancer.

Forms of Tobacco

Tobacco can be classified into smoking and smokeless tobacco.

Smoking

In India , tobacco is smoked in various forms like cigarettes, bidis, cheroots, chuttas, dhumtis, chillums, hookahs, etc.

Cigarettes

• 1 billion cigarettes are smoked every day in India.
  
• Cigarettes in the Indian market have higher levels of tar & nicotine content than those found in developed countries.
  
• Every cigarette takes 7 minutes of your life.

Tobacco smoke contains over 4000 chemicals


 

Smokeless Tobacco

Smokeless tobacco is consumed in the following ways:

• Chewed: gutkha, pan, mawa, mainpuri tobacco, khaini, click, etc
  
• Applied on gums, and teeth: mishri, gudhaku, bajjar, tooth paste
  
• Inhaled: snuff
  
• Smokeless tobacco is not a safe alternative to smoking. Smokeless does not mean harmless.
  
• Chewing tobacco is far greater health hazard than filtered cigarettes as the concentration of tobacco is significantly higher.
  
• According to a survey, the use of smokeless tobacco (compared to smoking) is higher among females and teenagers.
  
• Studies have shown that pan masala causes a condition called oral submucous fibrosis that makes it 400 times more likely for a person to develop cancer than normal people. This is true even if the pan masala does not contain tobacco.
  
• Use of smokeless tobacco is most prevalent in people between the ages of 20 and 44.
  
• Smokeless tobacco users find it harder to quit and to withstand withdrawal than those who smoke.
  
• School personnel believe that tobacco companies deliberately encourage youth to use smokeless tobacco.
  
• Smokeless tobacco manufacturers target adolescents with “low nicotine” products with the intent of graduating them to high nicotine products over time.
  
• Smokeless tobacco users are more likely to smoke cigarettes in future  

Gutkha

• Gutkha is available in more than 100 brands.
  
• Gutkha has become an Rs 3,000-4,000 crore industry since the eighties.
  
• It is growing at a staggering rate of 25% annually.
  
• Gutkha leads to Oral sub-mucous fibrosis (SMF), a pre-cancerous disease that is a first step to cancer. This has increased 20 to 30 times across the country. SMF has been linked to the chewing of areca nut (supari), one of the main components of gutkha along with tobacco.
  
• The health effects of gutkha show up in shorter periods than those from other forms of tobacco.
  
• This could be due to a combination of factors – higher intake, younger age during first intake and contents of the product itself.
  
• The predicted epidemic of oral cancer almost completely attributable to gutkha, has already begun. It is especially affecting the young.

Passive smoking

• 2/3 of smoke from a burning cigarette does not reach the smoker's lung but instead goes directly into the air. The effects of this smoke are similar to smoke inhaled by active smokers. Inhaling of air containing tobacco smoke is called passive smoking.
  
• An increased risk of lung cancer has been shown in wives of husbands who smoke.
  
• The risks of passive smoking do not stop with cancer. There is an increased incidence of heart disease in passive smokers. Children of parents who smoke have an increased incidence of cough, bronchitis, ear infection and pneumonia. Children exposed to their parents cigarette smoke have six times the number of respiratory infections.

What is cancer?

• Cancer is a disease of the body's cells. The old, worn out cells are replaced with strong new ones. A cancer cell is a different cell and does not do the job it is supposed to for the body. This cell divides to produce more cancer cells and destroys normal cells.
  
• The change from a normal cell to a cancer cell is brought about by various factors. One of the major factors is the toxic chemicals in tobacco.
  
• A group of abnormal cells is called a tumour and it can be either benign or malignant. A malignant tumour is cancer. It can also spread to other parts of the body. This process is known as metastasis.

Statistics

• Worldwide, tobacco kills one human being every six seconds.
  
• That works out to 560 people every hour, 13,440 people per day and 49 lakh people per annum.
  
• Tobacco kills 15 times as many people as suicides, murder or manslaughter.

Tobacco in India

• India is the second largest producer of tobacco in the world.
  
• A large part of the production is consumed within the country.
  
• 14 crore men and 4 crore women in India are regular tobacco users.
• Tobacco kills 900,000 people per year.
  
• 1 out of 10 Indian adults is dying of tobacco related diseases.
  
• Total tobacco consumption in the country is 4300 lakh kg. 2320 lakh kg of this is bidi, 1160 lakh kg is chewing tobacco, Gutkha and snuff, 820 lakh kg is cigarettes.
  
• Tobacco worth Rs 24,000 corers is sold annually and the government has to spend Rs 27,000 corers annually on free health services to offset the harm caused by it
  
• In Maharashtra , in the year 2000, 35% males and 18% females consumed smokeless tobacco. These prevalence rates are higher than the national average.
  
• Annually, the sale of gutkha in Maharashtra is around Rs.450 crore.

Tobacco and cancer in India

• India has the highest incidence of oral cancer in the world.
  
• Tobacco chewing has made cancer of the head and neck the number one cancer in India
  
• Every 30 seconds, one person in India dies of diseases related to tobacco or gutkha.
  
• 90% of oral cancer cases are caused by tobacco products.
  
• 40% of the cancers in India are mouth and related types of cancer.
  
• One third of all cancer patients in the world are in India.
  
• 90 % of them use chewing tobacco.
  
• According to a survey conducted by de-addiction centres in Mumbai, there are over 2-3 lakh Gutkha victims registered in their centres today. These are a very small proportion of the number of actual gutkha users in the city.
  
• It costs an average of Rs 3.5 lakh to treat a cancer patient. In a poor country with no healthcare benefits, tobacco snatches breadwinners from many families. Any economic contribution that tobacco companies claim to be making should be seen in this light.

Tobacco and children

• Every two seconds, 1 Indian child tries tobacco for the first time.
  
• As you read this sentence 4 children will be having their first tobacco experience.
  
• 4 million children below the age of 15 years use tobacco regularly.
  
• There are children in their teens who consume 5 to 15 packets of gutkha each day
  
• Due to easy availability and low pricing, children begin consuming it while still in school.

Before the Gutkha ban in Maharashtra in 2002 

• 75% of municipal school students were estimated to be trying tobacco by the age of 10.

• 30% of municipal school students were addicted to gutkha.
  
• In a study done with 30,000 municipal school children in Mumbai, 50% of them consumed 1-2 sachets of gutkha every day
  
• There had been an upsurge of smokeless tobacco consumption, especially Gutkha, by children and adolescents after its introduction in the 1980's and its cheap availability at every nook and corner of the country.
  
• According to a study, 50% of 13 to 15 year-olds in Mumbai and Maharashtra still think tobacco use makes them look attractive.
  
• Since children started using gutkha 6 or 7 years ago, doctors fear an epidemic of oral cancer will soon hit India . 11 and 12 year old children are getting pre-cancerous growths after just 2 years of consuming tobacco.
  
• A daily intake of an average of ten pouches of gutkha per day would mean exceeding the recommended daily intake of lead, arsenic and copper. Lead is particularly dangerous for the younger age group, as excess of it lowers the IQ. So it could also affect the scholastic performance of children.
  
• Almost half of 15 year-old street children spend a significant part of their daily income on gutkha.
  
• The primary concern is the fact that with a significant portion of the children's daily income being spent on tobacco, the disposable income available for other purposes, particularly food, is much less.

Tobacco and women

• There has been an increase in prevalence among females for both smoking and smokeless tobacco.
  
• Women who consume 3 cigarettes per day double their risk, not only of heart attacks but also of death from other causes
  .
• Mishri use, which is common in women can lead to low birth weight babies and a reproductive effect of lower male to female sex ratio.
  
• When pregnant women smoke, carbon monoxide and nicotine passes into their lungs and bloodstream, reducing the oxygen supply to their unborn baby. This means that their babies are:
  - more likely to suffer from asthma attacks, chest infections and
  colds in later life
  - more likely be born prematurely
  - more likely to be born underweight
  
• If all women quit smoking during pregnancy, 4,000 babies would not die each year.
  
• Paan chewing among women in India has made oral cancer more common than breast cancer.