Smoking killed 100 million in 100 years

Nearly 45 trillion bidis and cigarettes manufactured over the past 100 years in the country are expected to be responsible for nearly 100 million deaths of adult Indians, a recent study has found.

"Our calculations are derived from using the most conservative estimates and yet present mortality estimates which are significant and alarming," researchers Pranay G Lal, Nevin C Wilson and Prakash C Gupta said in a study published in Current Science.

The study concluded that of the estimated 100 million deaths due to tobacco use, smoking bidis alone contribute to 77 million deaths.

The researchers have pressed for an urgent review of tobacco control interventions and re-examination of policies that promote the tobacco industry in India.

They said since it takes three to four decades for a smoker to die after he starts smoking, the current tobacco use was expected cause deaths only in the coming decades.

"For consumption in the last four decades, the mortality may be partially realised and some of the deaths will occur in near future", they said.

"Since the bulk of manufacturing and consumption occurred in the latter part of the last century, the early deaths of these smokers will happen in the first half of this century."

The study has estimated that there were about 190 million and 41 million lifetime bidi and cigarette smokers, respectively, in the country from 1910-2010.

"So in effect, if we were to cease all production and consumption in 2010, deaths would continue to take place. Less than one-fourth of the deaths from 100 year of smoking (from 1910-2010) have already taken place, and the three-fourths of the deaths will take place in the next 40 years", the study said.

The reseachers have reviewed 23 data sources including industry reports, trade and academic journals, paid internet databases, repositories and reports prepared by market research firms from 1920 to arrive at the estimated number of cigarettes manufactured over the last 100 years.

To derive total bidis produced, they used total bidi tobacco produced in India using data from the Ministry of Agriculture and divided it by the average tobacco contained in each bidi. These estimates were compared with 14 other sources.

While Lal and Wilson are associated with the South-east Asia office of the International Union Against Tuberculosis and Lung Disease, Gupta is with the Healis-Sekhsaria Institute for Public Health, Navi Mumbai.

Original story published in the Indian Express

Image courtesy: http://2.bp.blogspot.com

Read more ...

India falls short of FCTC guidelines on tobacco products’ packaging

A new report has revealed that pictorial warnings in tobacco products in India do not meet the internationally stipulated size parameters, at a time when health warnings on tobacco products have come to be recognised as a cost-effective means of communication.

Called ‘Cigarette Package Health Warnings: International Status Report’, it points out that pictorial warnings in packets of tobacco products in India fall short of the stipulated 50% of the display area, even after two rounds of revisions of warnings in 2009 and 2011. 

The report released in the Conference of Parties to the WHO Framework Convention of Tobacco Control (FCTC) that concluded in Seoul, South Korea on November 17, shows that health warnings in cigarette packets in India only cover 40% of the front face of the packet. 

Brought out by leading Canadian non-government organisation, Canadian Cancer Society in October 2012, it also brings out that India has fallen 23 places in the ranking of countries on depiction of health from 100 in 2010 to 123 in 2012.

Article 11 of World Health Organisation’s FCTC, which India ratified in 2004, requires that health warnings “should be 50% or more of the principal display areas but shall be no less than 30% of the display areas” – the principal display areas being front and back of the package. It further stipulates that such warnings should be applied to all categories of tobacco products.

India’s current pictorial warnings, notified by the Union Government in 2011 under Section 7 of the country’s tobacco control legislation – COTPA 2003, have designated picture and text warnings for smoking and smokeless tobacco products. In September, India brought out a revised set of warnings that will take effect from 1 April 2013.  

On the relevance of pictorial warnings, the report that provides a ranking of 198 countries notes, “A picture really does say a thousand words. Pictures are especially important for individuals who are illiterate or who have low literacy. Pictures are also important to immigrants, temporary workers as well as individuals from minority language groups who may not yet be able to read the national language(s).”

The International Status Report also has that Australia leads the pack with pictorial warnings occupying an impressive 82.5% of the principal display area. India’s neighbour in the Asian region, Sri Lanka has notched up the second rank, with pictorial warnings covering 80% of the front and back covers of the packet. Thailand sells tobacco products with warnings spread over 55% on its front and the back faces. 

Read more ...

Poor more susceptible to smoking in India

The poor in India are more susceptible to smoking, as a recent study reveals. Called ‘Socioeconomic Inequality in Smoking in Low-Income and Middle-Income Countries: Results from the World Health Survey’, the study was conducted to assess the socio-economic inequality in smoking in low and middle income countries.

The study based on data from the World Health Survey (WHS) of the World Health Organisation (WHO) found that 46.7 per cent of the poorest men smoke in India as against 21.8 per cent of the richest men.

Though the findings are in line with common knowledge regarding smoking prevalence, what is distressing that well over a quarter of India’s population are under the addictive spell of tobacco. According to figures of the Planning Commission, GoI, there are as many as 3546.8 lakhs people below the poverty line in India, which is nearly 29 per cent of the total population.

A total of 213,807 men and women of 48 low and middle income countries were covered in this study that was initiated in the context of the fact that the risk of dying from smoking is significantly higher in the lowest socio-economic groups as compared to higher socio-economic groups. 

Commenting on the study, Dr R Jayakrishnan, Assistant Professor, Community Oncology Division, Regional Cancer Centre said, “The findings reinforce the trend seen during clinical practice. Majority of tobacco-induced cancer patients who visit the Centre are from the lower income strata of the society. The need of the hour is to develop prevention strategies that specifically focus on the more vulnerable sections.”

Outlining some possible prevention strategies, Dr M A Oommen, renowned economist said, “While linking high incidence of smoking with poverty is a simplistic correlation, the issue has to be tackled in a multi-pronged manner such as incentivising the poor to get out of the habit, moral suasion, higher incidence of excise duty on tobacco products, expanding capability building of the poor and structural reforms through better employment opportunities.”

Image courtesy http://www.nytimes.com

Read more ...

Prime Minister, Sonia on tobacco use in India

India is the second largest consumer of tobacco products in the world. 

This post excerpts what our national leaders have said on tobacco use in India.

Dr Manmohan Singh, Hon'ble Prime Minister of India said, "It is clear that we need to heighten our concern about tobacco usage being a leading cause of death and debilitating disease in our country. The increasing prevalence of tobacco consumption among high risk groups, including women and children, and the exposure to second hand smoke, either in homes or in public places, is a matter of serious concern."   

Smt Sonia Gandhi, Chairperson, United Progressive Alliance (UPA) notes, "The consumption of tobacco in various forms is a threat to public health. There is strong evidence to link tobacco use with the incidence of cancer. A massive public awareness campaign has to be sustained at various levels to deal with this malaise."

Shri Ghulam Nabi Azad, Hon'ble Union Minister for Health and Family Welfare states, "As one of the lagest consumers of tobacco in the world, India is faced by human costs, including cancers, cardiovascular and chronic respiratory diseases, which require the urgent attention and intervention of the Government on both regional and state levels." 

"We must also consider the economic burdens that the usage of tobacco imposes on our country's health care systems. As may as one million deaths annually can be attributed to tobacco consumption forcing health facilities to spend an even greater share of their precious resources on treating largely preventable diseases."

According to Global Adult Tobacco Survey (GATS) India 2009-10 Report, India has nearly 274.9 million tobacco users, age 15 and above, making the country the second largest consumer of tobacco products in the world. 

Among them, 197.0 million are males and 77.9 million are females; and 216.0 million tobacco users from rural areas and 58.8 million from urban areas. 

Compiled from Messages in from GATS India Report 2009-10, available here

Read more ...

Knock the Cigarette Out, says Dr Siddhartha Mukherjee

"If cancer is the quintessential product of modernity, then so, too, is its principal preventable cause: tobacco," writes Siddhartha Mukherjee in his 'The Emperor of all Maladies'.

This book, which won the Indian American cancer researcher and physician the Pulitzer Prize for Non-Fiction for the year 2011, is a profound biography of cancer - a disease humans have lived with - and perished from - for more than five thousand years.

A staunch advocate of anti-tobacco movement, Dr Mukherjee goes to write, "The classification of tobacco smoke as a potent carcinogen - and the slow avalanche of forces unleashed to regulate cigarettes in the 1980s - is rightfully counted as one of cancer prevention's seminal victories."

In this embedded video, Dr Mukherjee says the first five things of preventing cancer are "Don't smoke, Don't smoke, Don't smoke, Don't smoke, Don't Smoke."

He adds, "There's a new study that makes the argument that if you take people who are high risk -- smokers that are high risk -- and you perform CAT scans, you can detect cancers. The problem is that for dollar for dollar, it's much better to knock the cigarette out of the person you see smoking outside... than to perform a 6000 dollar CAT scan."

Image courtesy http://stanmed.stanford.edu

Read more ...

Fight transitory withdrawal symptoms for health

The findings of Global Adult Tobacco Survey (GATS) conducted in Kerala brings out that a significant 70.6 per cent of male smokers in Kerala are planning or thinking about quitting.

As successful quitters will testify, breaking free from this addictive habit is not impossible. Experts say that the withdrawal symptoms can be easily managed with will and are only transitory. Mild discomfort for approximately two weeks after quitting is nothing compared to the benefits it can bring to one's health. 

Nicotine's chemical properties are addictive. If nicotine is kept away from the body, it may manifest as the following physical and mental withdrawal symptoms. 

Knowledge of the symptoms will make management of the symptoms more comfortable and help with the quitting process. 

Physical withdrawal

Nicotine obstructs the flow of oxygen and nutrients to various parts of the body. 

• Bowel discomfort: It's time to change your diet and fitness once you quit smoking. Quitting smoking can cause cramps, nausea, flatulence and constipation, therefore it is important to increase roughage and exercise your body.

• Nasal and throat problems: When you stop smoking, your nose and throat will try to clear the mucous that has accumulated over the years. You may experience coughing, dry throat and mouth. Fluids are the key to clearing this process.

• Increase in appetite: Craving for cigarettes can be confused with hunger cravings. The best way to stay healthy is to consume fluids and low calorie snacks.

• Headaches: Lack of nicotine can lead to headaches, the way out of it is with massages, plenty of water and rest. Gently massage your temple, drink water, take a hot shower and take a deep breathe.

• Lack of sleep: You may experience insomnia after you quit smoking. Take a hot shower before you hit the sack, do breathing exercises too and most importantly avoid coffee closer to bed-time.
  
• Restlessness/lack of concentration: You feel like there is energy bursting in you, transfer this energy into something constructive. In these situations smokes would calm your nerves, but now switch off that thought and cultivate a new habit. You may feel you can't concentrate too; try listening to music or take a break from your routine life.

• Weight gain: Increase in craving can lead to weight gain, especially if you indulge in unhealthy food. But don't be dejected, you can cut it out with exercise and the right diet.

• Sweating and shaky hands and feet: You will feel that your hands and feet tremble. It is a passing phase that will stop. If you experience these withdrawals you know your body is simply shedding an addiction and leading you to a much healthier life.

• Skin trouble: While quitting smoking is associated with healthier skin, the period of withdrawal will cause some skin trouble. Some people with sensitive skin might break out into a fresh acne case or suffer from some ulcers in the inner-cheeks, tongue and mouth. The reason is simply that your body is letting go of the toxins and levelling up.

Emotional withdrawal

Some of the most common symptoms are ...

• Depression: You may feel low, sad and hopeless. Hence it is important to surround yourself with people, preferably non smokers and friends who will support your decision to quit smoking.

• Angry: Emotional upheaval can make you angry. Others may not be aware of it, but you know what's happening to your body. The age-old remedy of counting till 10 isn't such a bad idea. Stop, think, regain your calm and composure before losing your cool.

• Bored: You may have noticed that when you were bored, tired or depressed you tend to smoke. Now that you are on your way to a smoke free life replace these voids with hobbies or get involved with people around you. Pay more attention to your loved ones.

• Lonely: Withdrawal of smoking can make you feel lonely, impatient and irritable. If your friends are busy, take up a dance class or cooking class. It is important to expect these feelings of loneliness, so stay prepared.

• Mood swing: Tempers will flare and tantrums will increase. These are not exactly PMS symptoms. Nicotine was once your evil friend but now you have to bear with the loss of the addiction. This will throw your emotional reactions to daily happenings into a tizzy. Most quitters will need help with these mood swings. Replace the smoking placebo with something else. Invest in some great music and strong coffee, maybe?

Instead of losing motivation, after reading these withdrawal symptoms, the one thought any quitter must focus on is this: The fact that your body is changing so much when quitting, simply showcases how much it is continuously changed and affected while you still smoke. 

Avoid poor health and dangerous diseases - and call it quits today!

Source: www.healthmeup.com

Image courtesy: http://cdn1.wn.com/vp/i/18/3468c674464d25.jpg

Read more ...