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Tobacco use is a major preventable cause of premature death and disease worldwide

Harmful effects of Tobacco

 Tobacco smokers are at greater risk of developing cancers than non-smokers 

Tobacco Use in India 
Tobacco use in the Indian subcontinent is centuries old, the two main forms of use are chewing and smoking [1].

India is the second largest consumer and third largest producer of tobacco in the world [2].
The prevalence of overall tobacco use among males is 48% and among females is 20% [3].

Data show that, in India more than 35% of adults (274.5 million) use tobacco, of this 163.7 million use only smokeless tobacco; 68.9 million are only smokers while 42.3 million users of both smoking and smokeless tobacco. Over 30 percent of Indian population above the age 15 uses some form of tobacco which includes 14.6% of children in the age group of 13-15 years. Smoked tobacco use is more in men compared to women who are more likely to use smokeless (chewed) tobacco. Beedis are smoked more than cigarettes [4,5].

More than 4,000 different types of chemicals have been found in tobacco and tobacco smoke. Over 60 of these chemicals have been classified as carcinogens (cancer causing agents) by International Agency on Research in Cancer (IARC) [6]. The main chemical found in tobacco is nicotine which is a highly addictive chemical. Its usage over a long period makes a person physically and psychologically dependent on it [7].

Tobacco use affects almost every major organ and system in the body causing a great deal of morbidity and untimely death. Tobacco use in any form can cause cancers in different organs/sites in the body including the mouth, throat, larynx (voice box), brain, esophagus, lungs, gall bladder, kidney and breast. Tobacco also causes many other disorders such as heart disease, chronic obstructive pulmonary disease, stroke, blindness, tooth and gum diseases etc [6,7].

Nearly 45% of all cancers among males and 17% among females in India  and more than 80% of oral cancers are directly attributable to tobacco use [8].

Women and Smoking

Women and Smoking

The latest Tobacco Atlas, shows that India ranks third in the top 20 female smoking populations across the globe. Female smokers in India die an average eight years earlier than non-smoking women of the same age [9].

Tobacco use in Young India Population

Tobacco Use in Young Indian Population

Despite efforts by both Government of India (GOI) and World Health Organization (WHO) in controlling the tobacco menace, prevalence of tobacco use in India is reaching alarming proportions among children and adolescents.
A survey done by the National Sample Survey Organization of the Indian Government puts children of ages 10-14 addicted to tobacco at 20 million and about 5,500 new users (approximately 2 million new users every year) are added every day to this astounding figure [10].

Types of Tobacco

Types of Tobacco Products Commonly Used in India [13]

 

Tips to quit Tobacco


 

 A few tips to quit smoking/betel squid/ pan [14]

  • Think of the benefits of quitting tobacco in any form: you save money, smell better, cough less and your food tastes better.
  • Get help from family and friends by informing them about your plans to quit and seek encouragement.
  • Avoid the sight of smoking/betel squid/ pan to ease your resolution to quit these.
  • Avoid the company of people who smoke or chew to reduce the craving for these products. 

Tips to Prevent Relapse


Tips to prevent relapse [14]

  • Keep yourself occupied and busy to avoid craving.
  • Try using stress balls, indulge in games etc.
  • Switch to oral substitutes: you can have things like carrot, hard candy etc whenever there is an urge for smoke/betel squid chewing.
  • Brushing teeth several times also helps since toothpaste alters the taste of these products.
  • Drinking lots of water helps in flushing out toxins from your body in addition to minimizing the withdrawal symptoms and helps in reducing the urge.

References

References

[1] Prasad, LK. Tobacco control in India: Where do we stand? J Orofacial Sciences 2012;4:79-81
[2] Jhanjee S. Tobacco Control in India-Where are we now? Delhi Psychiatry Journal 2011;14:26-32
[3] Global Adult Tobacco Survey (GATS) Geneva, World Health Organization, 2010
[4] Raut DK, Soni P. Prevalence and Pattern of Tobacco Consumption in India. Int Res J Social Sci 2012;1:36-43
[5] Global Youth Tobacco Survey (GYTS) Geneva, World Health Organization, 2009
[6] Tobacco smoke and involuntary smoking/IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2004: Lyon, France) (IARC monographs on the evaluation of carcinogenic risks to humans;vol. 83)
[7] Tobacco Habits Other than Smoking; Betel-Quid and Areca-Nut Chewing;and Some Related Nitrosamines/IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (1985 : Lyon, France). (IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans,vol. 37)
[8] NCRP-Consolidated Report of Hospital Based Cancer Registries 2007-2011, National Cancer Registry Programme (Indian Council of Medical Research), Bangalore, 2013
[9] Jha P, Jacob B, Gajalakshmi V et al. A Nationally Representative Case–Control Study of Smoking and Death in India. N Engl J Med 2008;358:1137-47
[10] Chadda RK, Sengupta SN. Tobacco use by Indian adolescents. Tob Induc Dis 2002;1:111-19
[11] WHO report on the global tobacco epidemic 2013. Geneva, World Health Organization, 2013
[12] Panda B, Rout A, Patil S et al. Tobacco Control Law Enforcement and Compliance in Odisha, India-Implications for Tobacco Control Policy and Practice. Asian Pacific J Cancer Prev 2013;13:4631-37
[13] India Cancer Initiative. Tobacco use in India: An evil with many faces. American Cancer Society. 2009
http://www.cpaaindia.org/infocentre/acs/eng/Tobacco%20Abuse.pdf accessed on 28th January 2015.
[14] Stay away from Tobacco. American Cancer Society. http://www.cancer.org/healthy/stayawayfromtobacco/index

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