Tobacco Free Kerala: October 2012

Wednesday, 17 October 2012

Keralites spend 9 per cent of their income on smoking

Smokers in the state spend nearly 9 per cent of their income on smoking tobacco products, point out the Kerala findings of the pioneering Global Adult Tobacco Survey (GATS).

Shri Oommen Chandy, Hon’ble Chief Minister of Kerala formally released the Kerala report of GATS by handing over the first copy to Dr Paul Sebastian, Director, Regional Cancer Centre and Vice Chairman of Tobacco Free Kerala – a coalition of like-minded organisations formed to fight tobacco use in the state.

The GAT Survey, conducted under the coordination of the Union Ministry of Health and Family Welfare in 2009-10, points out that the monthly expenditure by a smoker on cigarettes is Rs. 484 and on bidis is Rs.139.

According to the latest figures of the Government of India, Kerala’s per capita income at current prices for the year 2011-12 is Rs 83,725. The per capita income of Kerala for the year 2009-10 was Rs. 59,179.

GATS is the global standard for systematically monitoring adult tobacco use and includes information on patterns of tobacco use (smoking and smokeless), cessation, second-hand smoke, economics and perceptions towards tobacco use, among others.

Mumbai-based International Institute for Population Sciences (IIPS) conducted the household survey on persons 15 years of age and older using hand-held devices. The findings on Kerala are based on 1,825 completed interviews of males and females.

The Survey also throws light on the fact that 58.6 per cent of daily tobacco users consume tobacco within half-an-hour of waking up. In Kerala, 21.4 per cent of adults including 35.5 per cent of males and 8.5 per cent of females use tobacco in any form.

It further reveals that there is no escaping the deleterious impact of tobacco even at home. As high as 41.8 per cent of adults - 47.2 per cent of males and 36.8 per cent of females – are exposed to tobacco smoke at home.

In spite of COTPA, 2003 – the comprehensive Indian tobacco control legislation – banning smoking in public places, GATS shows that 18.7 per cent of adults in Kerala are exposed to second-hand smoke in public places. At the workplace, 21.5 per cent of males and 3.7 per cent of females have to put up with toxins smoked by others.

The Global Adult Tobacco Survey - conducted using a consistent and standard protocol across countries - is a critical tool to help our nation fulfil one of its obligations of generating comparable data under the Framework Convention on Tobacco Control (FCTC) of the World Health Organisation (WHO).

The Kerala Fact Sheet can be viewed here

Malayala Manorama, 14 October 2012

The Hindu, 12 October 2012

The New Indian Express, 12 October 2012

Mathrubhumi, 11 October 2012

Times of India, 11 October 2012

Thursday, 4 October 2012

FAQs on pan masala/gutkha ban

Kerala has banned pan masala and gutkha containing tobacco and nicotine under the Food Safety and Standards Act, 2006 with effect from 22 May 2012. The Hon'ble Kerala High Court has also upheld the ban.

But still doubts linger.

Given below are some FAQs and answers compiled by Dr Pankaj Chaturvedi, Head and Neck Cancer Surgeon, Tata Memorial Hospital, Mumbai. Dr Chaturvedi has also been honoured with World Health Organisation Director’s Recognition Award (South-East Asia region) for initiating a campaign to ban tobacco products in India.

Why is gutka Banned and bidi/cigarette are still there?

As per law (FSSAI regulation 2.3.4), gutkha is a prohibited FOOD substance and state governments have no option but to enforce that. Bidi and cigarette are tobacco products but there is no constitutional provision to prohibit them. Bidi and cigarettes are regulated under COTPA with intention to remove tobacco from society.

Is the ban necessary?

Under section 2.3.4, Manufacture/Storage/Sale of gutkha and Pan Masala is prohibited. In case of violation, arrest is the punishment. This basically turns a profitable industry into an illegal industry! Eventually people will lose interest in gutka/Pan Masala business. It will also decrease free and cheap availability especially for kids. In states with ban, the consumption has gone down dramatically in matter of few months.

Which other states have done it?
Apart from Maharashtra, Madhya Pradesh, Bihar, Kerala, Himachal Pradesh, Rajasthan, Chhattisgarh, Jharkhand, Chandigarh, Haryana, Punjab, Sikkim, Delhi. Public Interest Litigations (PILs) have been filed in UP, West Bengal, Andhra Pradesh and Karnataka urging the state governments to ban it.

Has the ban in these sates been challenged in respective high courts?
Gutka/Pan Masala Industry filed writ petitions in the High Courts of Maharashtra, Rajasthan, MP, Bihar and Kerala for stay on the ban. All the High Courts have upheld the ban and declared it constitutionally valid . Delhi high court ordered the Delhi government to enforce ban in two weeks.

Why is Pan Masala banned in Maharashtra even though it does not contain tobacco?

a. It contains supari that causes cancer and several illnesses.
b. Supari is addictive
c. Gutkha Industry sells gutka under the name of pan masala
d. Pan masala glamorises supari as a mouth freshener.

What about smuggled Gutkha?
It is a genuine problem as long as gutka ban isn't enforced all over India. It is sad that all state governments are failing to enforce a central law. Smuggled gutka is only available to hard core addicts and not to kids/youth or first time users.

What about black market availability?

This pushes the cost of Gutka/Pan Masala 5-6 times its retail price. This increase in price causes -

decrease in consumption among addicts
no free availability for kids and youth who are not addicted.
reduced over all availability in the market that adversely the profitability of this business.

Do we have infrastructure to enforce ban? Why Maharashtra is better?
Maharashtra is one of the states that has engaged to Police to enforce the ban. It seems it will be an additional support to FDA.

What happens after one year?
The ban on gutkha is permanent (section 2.3.4).

What are the health effects of smokeless tobacco?

Highly addictive with dismal quit rates of 5%.
International Agency for research on Cancer, World Health Organization has classified Smokeless tobacco as confirmed cancer causing substances.
Contains 3095 chemicals and 28 well proven carcinogens
Causes severe impairment of the oral and dental health
Strongly associated with precancerous lesions and cancer of mouth that is a leading cancer in India.
Apart from mouth cancers, smokeless tobacco usage is associated with cancers of oesophagus, stomach, pancreas, larynx, pharynx and lung.
It is associated with hypertension and Ischaemic heart disease.
Its use is associated with increased risk of Stroke.
It adversely affects reproductive health in women and also seriously affects the foetus.

What are the adverse effects of Areca Nut/Supari/Pan Masala?

Highly addictive
Usually taken along with smokeless tobacco
International Agency for research on Cancer, World Health Organization has classified Arecanut as confirmed cancer causing substances.
It contains several polyphenols and nitrosamines that are confirmed carcinogenic.
It causes impairment of oral and dental health.
Its usage is strongly associated with precancerous lesions and cancer of mouth that is a leading cancer in India.
Studies have shown association between Supari chewing and cancers of the Liver, oesophagus, stomach and lung.
Supari use is associated with hypertension and ischemic heart disease.
Usage of Supari adversely affects reproductive health in women and also affects foetus.
Supari chewing is associated with diabetes, obesity and several metabolic disorders.
Supari chewing is associated with causation of certain psychological disorders.

Wednesday, 3 October 2012

Make educational campuses tobacco free, says Padma Shri Dr G Vijayaraghavan

Educational campuses and offices should be made tobacco-free to prevent the increasing incidence of tobacco-induced heart diseases in Kerala, said renowned cardiologist Padma Shri Dr G Vijayaraghavan, Vice Chairman and Director Medical Services of KIMS Hospital, on the occasion of World Heart Day.

“Nearly 60 per cent of the patients in Intensive Cardiac Care Unit of KIMS are current or old smokers. More than 30 per cent have smoked over 2 packs a day for more than 10 years,” said Dr Vijayaraghavan referring to high linkage between smoking and heart diseases.

Dr Vijayaraghavan said he had one of his most shocking experiences when he walked into a smoke-filled room at the college where his son was studying. “The staff room was stuffy with the smell of smoke and I felt compelled to walk out of the room.”

The Indian tobacco control legislation – COTPA, 2003 has spelt out the guidelines for tobacco-free educational institutions. Under Section 4 of the Act, it is mandated that educational institutions set up a board of 60 cm x 30 cm at the entrance and other conspicuous places. It should read, “No Smoking Area – Smoking Here is an Offence,” in the local language.

Also Section 6 of the Act requires that a board specifying that “sale of tobacco products in an area within a radius of 100 yards of educational institutions is strictly prohibited” be displayed at a conspicuous place outside the premises.

“In USA today, it is difficult to find a seat in the non-smoking area of a restaurant, as they always remain crowded. The smoking areas on the contrary remain empty,” said the physician who holds Fellowships of the American Heart Association and the Royal College of Physicians, UK, among others. “Stoppage of smoking has been the main factor in the decrease of deaths due to heart attack in major countries, especially USA,” he added.

“When one smokes, the heart rate jumps up and the blood pressure rises. Continuous smoke to the lungs make the smoker feels warm, but that is due to high penetration of carbon dioxide in the blood. When you shake hands with a person and if it feels too warm, you can know that he is a smoker. Smoking makes one a little alert, but that is short-lived,” said Dr Vijayaraghavan.

On the role of the media, Dr Vijayaraghavan said, “Many youngsters have been tempted to take up this addictive habit following depictions in the media. One always sees a Churchill with a cigar, Sherlock Holmes with a pipe, and a Dev Anand or a Raj Kapoor with cigarettes. Thankfully, media has reversed its gear in the last 20 years.”

“Chewing, smoking, snuffing or any form of tobacco use is harmful not only to heart but also to the lungs and intestines. Educational campuses and offices should be made tobacco-free along with strong pressure from wives to make husbands quit use at home. Public awareness is a key to this,” he said.