Saturday, 15 August 2015

Transport services in Kerala to become tobacco smoke-free and COTPA compliant

After becoming India’s first tobacco advertisement-free state, Kerala is fast heading to be the first in the country to have its transport services free from the noxious, carbon-monoxide laden tobacco smoke. A series of far-reaching directions issued under the leadership of Hon’ble Kerala Transport Minister Shri Thiruvanchoor Radhakrishnan by the surface and water transport wings in the last couple of months are significant in propelling Kerala to the forefront in public health.
In compliance with the provisions of Indian tobacco control law COTPA, 2003, the Transport Commissioner Smt R Sreelekha has issued directions to all Deputy Transport Commissioners, Regional Transport Officers and Joint Regional Transport Officers to take action against any instances of smoking in public conveyances, bus depots and transport bus stands.
Officials including and above Ticket Conductors/Collectors have been authorised under COTPA to fine smokers in public conveyances. Violations can invite a fine of up to Rs 200.
Pictorial ‘No Smoking’ signages have to be displayed in all public vehicles at a prominent place, as mandated by Section 4 of the Act. Inspections for vehicle registration and fitness certificate issuance will check that the said pictorial signages are exhibited in the vehicle.
Similarly, directions have been issued to ensure that there are no direct and indirect advertisements, sponsorship of tobacco products on public conveyances, as mandated by Section 5 of COTPA.
Transport Commissioner has also ordered that offences under COTPA – violations of Section 4 and 5 – will form part of the monthly checking report of the Department. These directions are binding on all public conveyances including autos, taxis, and private buses.
Smt Sreelekha said, “The World Health Organisation has said that only 100 per cent smoke-free environments will adequately protect the public from dangers of second-hand smoke. We are determined to create a healthy and safe public transport in Kerala and are in the process of creating sustainable and transparent systems of implementation.”
The Kerala State Road Transport Corporation (KSRTC) has strictly prohibited smoking and sale of tobacco products in all their buses, bus stations, and offices. All Unit Heads have been directed to ensure that no tobacco products are sold in any stall or canteen inside KSRTC depots and ‘No Smoking Area’ boards placed in all KSRTC bus stations.
All serviceable boats under the State Water Transport Department in Kerala have displayed ‘No Smoking’ signages as a measure of warning and protecting passengers from the ills of tobacco smoke. Special squads have been formed to inspect any cases of smoking onboard.
Railways have also implemented a ban on smoking and Kerala Railway Police and Railway Protection Force have been keeping a strict vigil on smoking in trains.
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Wednesday, 12 August 2015

Rajasthan Health Department to make brothers to quit tobacco through Rakhi vows

Bringing in innovation to tobacco control, the Rajasthan Government is using Raksha Bandhan - an ancient Hindu festival that ritually celebrates the love and duty between brothers and their sisters - to curb tobacco use.

Ahead of 'Raksha Bandhan' festival, Rajasthan government launched a special anti-tobacco campaign asking girls to make their brothers to take a pledge not to consume tobacco.

Girls after tying Rakhi on the wrist of their brothers should ask them to write a sworn statement that they will not consume tobacco, Health Minister Rajendra Rathore said while launching the campaign.

"The aim of this campaign is to raise awareness among people at all levels against the use of tobacco," he said. 

To participate in the campaign,  girls need to click a selfie with their brothers along with the written oath and email it to the medical and health department, the Minister said.

Image courtesy Sikh Heritage
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Monday, 27 July 2015

WHO calls for complete tobacco smoke-free environments

The World Health Organisation (WHO) has called upon Governments to enact and enforce comprehensive smoke-free laws to protect people from the harms of second-hand tobacco smoke. Smoke-free laws are relatively easy to pass and enforce. Besides improving health, they are also business friendly, says the new WHO Report on the Global Tobacco Epidemic 2015.

The Report, which coincides with the 10th anniversary of coming into force of the WHO’s Framework Convention on Tobacco Control (FCTC), also calls for decisive action by countries to end tobacco use – an epidemic that is a significant hurdle to development gains worldwide.

Smoke-free laws and environments find favour with both smokers and non-smokers as it improves the health of both these groups, besides encouraging smokers to reduce tobacco use and quit successfully in the long-term.

Scientific evidence has long proven that there is no safe level of exposure to second-hand smoke – the smoke emanating from a smoker. Its exposure leads to serious and often fatal diseases, including cardiovascular and respiratory disease as well as lung and other cancers. Children, foetuses, and newborns may also suffer severe, long-term harm – or even die due to second-hand smoke exposure.

Over 1.3 billion people across the world were covered by strong and comprehensive smoke-free legislation in 2014 – an increase of about 200 million since 2012, the Report says pointing out to the popularity of these laws. A total of 49 countries have implemented smoke-free laws covering all public places and workplaces.

Globally, educational facilities are the best-protected public place with two thirds of countries legislating such a ban, followed closely by health facilities. Employees and patrons of restaurants, pubs and bars have the lowest level of protection from second-hand smoke, according to the Report, the fifth in the series of WHO reports on the global tobacco epidemic.  

“Political will, coupled with effective enforcement, can sharply reduce smoking and exposure to second-hand smoke in all venues where smoking is outlawed”, the Report notes giving highlighted mention to Russia – a trendsetting country by becoming 100 per cent smoke-free.

In less than three years, the country not just passed and implemented its 2013 legislation but also demonstrated that smoke-free laws do not hit businesses. Compliance monitoring six months after the law was extended to cover restaurants, cafes, and bars revealed an overall increase in business in these establishments year-on-year.  The setting up of required ‘no smoking’ signages in all public places played a significant part in achieving the smoke-free status.

The WHO has described Indian tobacco control law COTPA, 2003 as a comprehensive legislation consistent with the FCTC for protecting the public, especially the youth, from tobacco harms.

It hails India’s National Tobacco Control Programme (NTCP) as the cornerstone for advancing tobacco control in a large and complex tobacco producing country and an excellent model for replication. The NTCP, piloted in 2007 to enforce COTPA and to build awareness on tobacco harms, is now being expanded to cover all 36 states and 672 districts in phases between 2012 and 2017.

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Tuesday, 23 June 2015

Children exposed to second-hand smoke may end up with weight issues

Children exposed to second-hand smoke are more likely to face weight and metabolic issues, according to a new study from researchers at the University of Montreal, Canada, which concludes that smoking around young children may be just as harmful as smoking while pregnant.

Lead author Linda Pagani, a professor of psycho-education at the University and a researcher at the CHU Sainte-Justine, found that children whose parents smoked when they were toddlers were more likely to have a thicker waist and a higher body mass index (BMI) by the time they reached the age of 10.

She says some 40 per cent of children are exposed either sporadically or continuously to second-hand smoke in their own homes and that, by the age of 10, the children who had been exposed to smoke were likely to have waists that were up to three-fifths of an inch wider than their peers.

And their BMI scores were likely to be between .48 and .81 points higher.

“This prospective association is almost as large as the influence of smoking while pregnant,” Pagani said. “Everybody loves their children but sometimes we close our eyes to risk factors. We need to face these risk factors and stop this behaviour.”

Waist circumference in youth in particular, she said, has become an important risk factor for obesity-related diseases in adulthood — so the findings indicate that public health initiatives and parental sensitization aimed at reducing home-based second-hand smoke exposure during the critical early childhood years are needed.

Pagani believes women who are bold enough to smoke while pregnant will likely smoke after birth as well. And there are even more women who stop during pregnancy but revert to it after giving birth.

“We are looking at second-hand smoke where children live and play and sleep,” she said. “Most people smoke because they just can’t kick the habit. People rely on smoking for the psychological effects, the idea that it calms them down. That has to be rethought. There are other ways to calm down.”

For the study, Pagani used data collected from the Quebec Longitudinal Study of Child Development, a vast survey of children born across the province which allowed her to focus on the behaviour of 2,055 families.

Furthermore, Pagani believes the statistics linking childhood obesity to exposure to parents’ smoking may underestimate the effect due to parents under-reporting the amount they smoked “out of shame,” she said.

With those parts of the brain that regulate metabolism not as finely tuned as they should be, Pagani explained, those who were exposed to second-hand smoke will find themselves putting on weight easily. Too easily.

“If you have an unhealthy fat distribution before puberty, your chances of being obese are quite high for the rest of your life,” said Pagani. The study published in Oxford Journal called Nicotine and Tobacco Research is the first to look at the effect of second-hand smoke on unhealthy body fat distribution.

While the increase she found may not sound significant, it occurs during a critical period of development which signals that the weight gain could have serious long-lasting effects. The exposure to second-hand smoke, she says, could cause endocrine imbalances or affect immune, neuro developmental and cardiovascular processes.

Pagani has also studied links between household tobacco smoke exposure and anti-social behaviour in later childhood, as well as the connection with attention deficit/hyperactivity disorder.

“This is kind of a wake-up call,” she said, adding that it reinforces ongoing debates about smoking on terraces or about parents smoking in a car with children.

“Yes, it is our business, these are public health issues,” she said. “And in a system like ours, where taxpayers support the health system, I’m interested in any risks that can be controlled. It’s important.”

Courtesy: Montreal Gazette
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Tuesday, 16 June 2015

Singapore to ban existing and emerging tobacco products as pre-emptive measure

Singapore's Ministry of Health has announced plans to ban existing and emerging tobacco products in two phases as a "pre-emptive measure to protect public health against the known and potential harms of such products".

"Besides protecting the public from the health risks associated with the consumption of emerging tobacco products, the ban is aimed at ensuring that the targeted emerging tobacco products do not gain a foothold or become entrenched in the Singapore market," the statement said.

In addition to preventing these products from "stimulating demand for and thereby increasing the prevalence of tobacco consumption", it will also prevent such products from becoming "gateway" or "starter" products for non-smokers, it added.

In a statement released on 15 June, the ministry said under the first phase, tobacco products that are currently not available in Singapore will be banned with effect from 15 December 2015.

The second phase will cover a ban on products already available in the market and will take effect from 1 August 2016. The delay in the ban is to allow for businesses to "adjust their operating models and deplete their existing stocks of such products."

On 9 June, the Welsh government announced plans to put in place legislation to ban e-cigarettes in public places.

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Saturday, 6 June 2015

World No Tobacco Day 2015: Joining forces for a cause

Oncologists, cardiologists, researchers, Government, and civil society groups joined forces on World No Tobacco Day (WNTD) today – an annual occasion to drive home the harms of tobacco use and advocate policies to reduce tobacco consumption.

Dr MKC Nair, Vice Chancellor, Kerala University of Health Sciences while inaugurating the event said, “There is undisputable evidence that tobacco use causes cancer. The key is preventing initiation to tobacco products and refraining from developing this bad habit.” He appealed to children to be wary of these products and dissuade family members from its use. 

Dr Paul Sebastian, Director, Regional Cancer Centre (RCC) in his presidential address said that developing sensitivities is critical in our society. “There are high levels of knowledge and awareness but people continue to use these products. Tobacco use victims sharing their experiences could be a powerful means of developing sensitivities.” 

Dr Sebastian also read out a message from the Hon’ble Chief Minister of Kerala Shri Oommen Chandy. 

The theme of WNTD 2015 is “Stop illicit trade of tobacco products”. Dr KR Thankappan, Professor and Head, Achutha Menon Centre for Health Science Studies dealt on the theme as he delivered the keynote address on “Preventing illicit trade through 85 per cent pictorial warnings on all tobacco product packs”.

“Illicit tobacco trade creates huge revenue losses to the Government; during the year 2014-15 the Government lost Rs 2363 crores.” He also spoke about the rampant use of banned tobacco products by migrants in Kerala and called for speedy implementation of 85 per cent pictorial warnings on all tobacco product packs.

Dr N Sreedhar, Director of Health Services highlighted the various tobacco control activities of the Health Services such as making Kerala the first tobacco ad-free state in the country.

Former Secretary of Regional Cancer Association Shri Janardhana Iyer was honoured on the occasion. Shri Renjith Chathoth, Editor, Mathrubhumi Arogyamasika was given away the Best Cancer Awareness article instituted by Regional Cancer Association. 

The inaugural session was followed by a panel discussion on ‘Multi-sectoral interventions to counter illicit tobacco trade’ in which representatives of Police, Excise, Health, Food Safety, youth, media and tobacco use victim shared their thoughts. The panel discussion called for de-glamourisation of tobacco use and sustained, proactive and coordinated efforts at various levels.  

Shri PV Muralikumar, Joint Excise Commissioner; Dr AS Pradeep Kumar, Retd.Additional Director of Health Services; Shri D Shivakumar, Assistant Food Safety Commissioner; Shri Jawahar Janard, Assistant Commissioner of Police; Shri Rahul Easwar, Kerala Youth Mission Outreach Programme Coordinator; Shri Renjith Chatoth and Shri Jawahar, tobacco use victim were the panellists. Shri Surendran Chunakara, PRO, RCC moderated the session.

Dr Padmalatha, Deputy Director, Public Health, Directorate of Health Services; Dr M Sivaraman, Vice President, Regional Cancer Association; Shri S Jayaraj, State Coordinator, Tobacco Free Kerala; Shri Johnson J Edayaranmula, Director, ADIC-India and Dr R Jayakrishnan, Assistant Professor, RCC also spoke.

Kerala State Health Services; Sree Chitra Institute for Medical Sciences and Technology; Regional Cancer Association; Tobacco Free Kerala; ADIC-India and Kerala Voluntary Health Services (KVHS) partnered with RCC for WNTD 2015.

More than 200 participants including women members of Kudumbashree; Mahila Samakhya; National Savings Department; Student Police Cadets; Health Inspectors and Health Supervisors attached to Directorate of Health Services were present.

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Friday, 29 May 2015

Kerala’s water transport becomes tobacco smoke-free

Kerala’s famed inland water transport that provides a cheap, efficient and pleasant mode of transport to over 25 million passengers a year has another feather to its cap — it is now completely tobacco smoke-free.

Reply to an RTI query filed with the State Water Transport Department reveals that all its 56 serviceable boats in Kerala have displayed ‘No Smoking’ signages as a measure of warning and protecting passengers from the ills of tobacco smoke.

These boats ply in the waterlogged districts of Alappuzha, Kollam, Kottayam, Ernakulam, Kannur and Kasargod.

Alappuzha district has 28 boats, accounting for 50 per cent of the total boats and servicing around 35,000 passengers a day.  The other boats are in Ernakulam (9); Kottayam (7); Kollam (4); Kasargod (2); Kannur (1) and 5 spare boats.

Shri Shaji V Nair, Director of Alappuzha-based State Water Transport Department, said, “We have taken strict measures to ensure that smoking is not permitted in any of the boats under the Department. This is done for two reasons: safeguard passengers from second-hand smoke and keep the water bodies free from cigarette and bidi stubs litter.”

Shri Nair stated that “the boat master who is the captain of the boat has been directed to keep a strict vigil. Special squads have been formed to inspect any cases of smoking onboard. Action is taken against the errant staff member if the inspection reveals inaction against any complaints of smoking in the boats.”

Shri Anilkumar Pandala, an expert in the transport sector, said, “Kerala’s water transport being smoke-free is a significant step forward towards achieving total smoke-free public places.”

Shri Pandala, who is Associate Vice President, IL&FS Transportation Networks Ltd., noted that public transport in the state is mostly free of smoking. “We have a strict law that prohibits smoking in public places; it provides a strong foundation. Strict enforcement of the law and making it uniformly applicable to all is important.”

Shri Pandala also called upon enforcement officials to ensure that smoking is prohibited in public places such as bus stands and bus stops.

Smoking is prohibited in all public places under Section 4 of the Indian tobacco control law, COTPA, 2003. Public conveyances fall under the definition of a public place of this legislation. 
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Tobacco use on rise by 130 per cent

The widespread habit of chewing tobacco has taken a heavy toll on the Indians as not only the incidences of mouth cancer has increased by 130 per cent between 1990 and 2013, but mouth cancer mortality too doubled in the same period.

Not only chewing tobacco, smoking, too, kills millions in India. The incidence and mortality due to pharynx (throat) and lung cancer went up alarmingly in the last 23 years, says the latest global cancer estimation.

While there is nearly 90 per cent increase in the absolute number of cancer cases, from 6.24 lakh in 1990 to 11.7 lakh in 2013, the actual increase comes down to 30 per cent when adjusted against population growth in the same period. But either way, tobacco emerged as the most important culprit as it contributes significantly for mouth, throat and lung cancer.

“Mouth cancer, the commonest cancer among men in India, is preventable as it has a strong association with tobacco chewing. Cigarette and bidi smoking are associated with lung and throat cancer,” said Lalit Dandona, one of the co-authors of the study who is professor at the Institute for Health Metrics and Evaluation and the Public Health Foundation of India.

Mouth cancer was not ranked in the top ten for incident cases globally but ranked second in India for men and women combined.

For both sexes, the mortality due to throat and lung cancers has increased by 70 and 135 per cent respectively. For both types of cancer, the incidences shot up by 160 and 81 per cent.

In absolute number, lung cancer was the leading cause of cancer deaths for men, and breast cancer was the top cause of cancer death for women. Male deaths from lung cancer outnumbered deaths from other cancers in India while breast cancer took more female lives than other cancers.

“Breast cancer is the most common cancer among women in India, which is easier to tackle if detected early. Better awareness about this and more effort by health programmes to facilitate early detection of breast cancer are needed,” Dandona said.

Besides tobacco, another preventable cause of cancer, particularly among the men, is alcohol abuse as liver cirrhosis is a key contributor behind liver cancer, whose incidence increased by 97 per cent among men. 

The only happy story comes from the cervical cancer load in women as it remains static in India unlike the global trend, which shows a rise of 8.5 per cent. The estimate was published in the latest edition of the journal JAMA Oncology. 

Source: Deccan Herald
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Friday, 15 May 2015

Smoking advisory: Deliberate attempt to create disturbing, lingering images

For a six-year-old Ammu seated in the multiplex waiting to watch Despicable Me, what preceded the yellow multitude of minions was a gory advertisement. Her eyes were glued to the mucky sponge being squeezed on the big screen during the anti-tobacco health advisory issued in public interest by the Government of India. 

Wide-eyed and startled, she nudged her father, “Is this how your lungs are, Papa?” The beaker on screen was now brimming with tar; her father, wearing a cold smile, fumbled in the dark for the right words.

What you and I and filmmakers misunderstand is the underlying intention of the advisory. It is not a means to inform us that smoking is harmful; it is, instead, a deliberate attempt to create a distinct disturbing image that will linger.

Why does one smoke anyway? In Chapter 8 of his much acclaimed book The Tipping Point, Malcom Gladwell calls smoking an epidemic and goes on to explain that a possible reason people get addicted to nicotine is depression. When you are depressed, your serotonin levels are usually low; a cigarette, a dose of nicotine, prompts your brain to produce more serotonin, giving you momentary solace, sometimes a faint high.

Chandrasekhar Rath was seven when he first saw a cigarette, 17 when he first smoked one. Right hand clasping one of the rusty bars of the window, left hand holding a cigarette; pausing occasionally to take drags as he hummed along with the transistor: ‘Chalo ek baar phir se ajnabi ban jaaye hum dono’ (Come, let us become strangers once again). This image -- watching his uncle smoke by the window -- is still vivid in Rath’s memory.

He doesn’t remember the first film in which he saw a hero smoke. A documentary maker by profession, his daily count was five packs, sometimes six. He quit smoking after he went to Tata Cancer Hospital to record footage for an anti-smoking advertisement he made for the Cancer Patients Aid Association.

“As I watched them wriggle in their beds regretting every drag, I knew they would give up anything to exchange places with me. Something inside me churned; I walked out and threw [away] the entire packet. I haven’t smoked since then. In the initial few months there were days when I had to drag myself away from the shop near the alley where I usually bought my daily quota from. I even had to stay aloof from my friends who smoked and parties and fun for a while,” Rath says. He was 37 when he quit.

Courtesy: Open Magazine

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