Workplace ideal for tobacco cessation

The workplace is an excellent setting to conduct a tobacco cessation programme, says a review paper titled 'An Overview of tobacco problem in India.'

This appears to be a very relevant recommendation considering that 17.5 per cent of adults in Kerala were exposed to tobacco smoke at the work place. The Global Adult Tobacco Survey (GATS) 2009-10 shows that 21.5 per cent of men and 3.7 per cent women were exposed to second-hand smoke at the workplace.

Having a tobacco cessation at the workplace will give an opportunity to interact with large number of people simultaneously, help to train the industrial medical staff in tobacco cessation activities, promises positive peer pressure and a stable population for follow-up. 

Several cessation activities have been conducted at a variety of workplaces in both urban and rural India, demonstrating a good quit rate, the study states.

Other methods of cessation, like the group counselling, behavioural interventions in adolescents and pregnant women, technology-driven interventions, such as telephone counselling, dedicated quit lines, and mobile and web-based technologies have recently gained popularity. 

Combining different interventions gives good results as compared with a single intervention, adds the study that has been published in the Indian Journal of Medical and Paediatric Oncology. 

Source: PubMed

Image Courtesy: Eorthopod

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Apex Bank's recommendation to check contraband tobacco products

The Reserve Bank of India (RBI) has recommended to the government that a special clause in the Foreign Direct Investment (FDI) policy needs to be introduced to check foreign funds clandestinely flowing into the tobacco sector under the guise of brand building and marketing activities.

RBI in a letter sent to the finance ministry has highlighted the fact that there is a need to check "circumvention of FDI norms by international tobacco companies and their conduits", sources said.

The central bank has recommended that the government should incorporate a specific clause to plug this loophole. RBI has cited the example of the lottery business, in which the government has banned FDI and also introduced a specific clause pertaining to marketing as well.

The FDI notification related to the ban on lotteries states, "Besides foreign investment in any form, foreign technology collaboration in any form, including licensing for franchise, trademark, brand name, management contract, is also completely prohibited for lottery business and gambling and betting activities."

The note further states, "A notification akin to that in the lottery business should be issued in order to prevent such FDI in the guise of current account flow into the tobacco/cigarette industry."

According to the new clause, "Foreign fund investment received by an Indian company in any form, including that in the guise of current account transactions for the purpose of creating band awareness, brand building, promotion and management contract, is also completely prohibited for cigars, cheroots, cigarillos and cigarettes of tobacco or of tobacco substitutes etc."

The issue is considered controversial as even the Federation of Indian Chambers of Commerce and Industry (FICCI) has alleged that although the government has prohibited FDI in the tobacco sector since May 2010, multinationals have set up entities in India for wholesale trading. This serves as a platform for creating demand for their brands, which is then met through large-scale contraband/smuggling, according to FICCI.

"This adversely impacts domestic farmer income, employment and revenue interests. Hence, the existing ban on manufacturing must be strengthened by extending the ban to cover FDI in manufacture as well as wholesale trade in these products," according to FICCI.

Source: India Today

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Gutkha ban: Supreme Court seeks compliance report from states

The Supreme Court on Wednesday sought compliance reports from all state governments that have banned the sale and manufacture of gutkha and paan masala containing tobacco. They have been given four weeks to submit their reports.

Gutkha, zarda, pan masala, gul, bajjar and such other toxic and addictive forms of chewing tobacco are mandated to be banned by various states, as per Regulation 2.3.4 of the Food Safety and Standards (Prohibition and Restrictions on Sales) Regulations of 2011, made under the Food Safety and Standards Act. Presently, 23 states and five Union Territories in India have banned the gutkha products.

The bench comprising Justices G S Singhvi and Kurian Joseph issued notices to the health secretaries of all the 23 states and 5 Union Territories to file compliance reports on the implementation of the ban. The court also asked why the products have not been banned in other states and why Regulation 2.3.4 has not yet been implemented. The order was given in the case of Ankur Gutkha vs. Indian Asthma Care Society.

The Supreme Court passed its order after the submissions by additional solicitor general Indira Jaisingh on behalf of the Centre that gutkha is being manufactured and sold in these states, including Delhi, Uttar Pradesh and Maharashtra, in violation of law. She also claimed that the rules are not being properly implemented by the state authorities.

Shri Prashant Bhushan, appearing for Health for the Million Trust, in his submissions underlined how the ban is not being properly enforced as there is no control over manufacturing units. The banned products are also easily available from states where gutkha has not been banned. Advocate Vishnu Behari Tewari, appearing on behalf of Indian Dental Association, demanded a nationwide ban on all forms of chewing tobacco products.

Source: Down to Earth

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Smoking right after waking up raises cancer risk

Smoking a cigarette immediately after waking up in the morning may increase the risk of developing lung or oral cancer, a new study has warned. This finding is critical in Kerala, where 58.6% of daily tobacco users in Kerala consume tobacco within half an hour of waking up, according to the Global Adult Tobacco Survey (2009-10).

The study found that smokers who consume cigarettes immediately after waking have higher levels of NNAL — a metabolite of the tobacco specific carcinogen NNK — in their blood than smokers who refrain from smoking a half hour or more after waking , regardless of the number of cigarettes smoked per day. 

The study was conducted by said Steven Branstetter, assistant professor of biobehavioural health in Pennsylvania State University, and his colleague Joshua Muscat, professor of public health sciences. The researchers examined data on 1,945 smoking adult participants from the National Health and Nutrition Examination Survey who had provided urine samples for analysis of NNAL. These participants also had provided information about their smoking behaviour, including how soon they typically smoked after waking. researchers.

The researchers found that around 32% of the participants they examined smoked their first cigarette of the day within 5 minutes of waking; 31% smoked within 6 to 30 minutes of waking; 18% smoked within 31 to 60 minutes of waking; and 19% smoked more than one hour after waking.

According to Branstetter, other research has shown that NNK induces lung tumours in several rodent species. Levels of NNAL in the blood can therefore predict lung cancer risk in rodents as well as in humans. In addition, NNAL levels are stable in smokers over time, and a single measurement can accurately reflect an individual's exposure.

In addition, the researchers found that the NNAL level in the participants' blood was correlated with the participants' age, the age they started smoking and their gender. 

Branstetter said, "Most importantly, we found that NNAL level was highest among people who smoked the soonest upon waking, regardless of the frequency of smoking and other factors that predict NNAL concentrations. People who smoke sooner after waking inhale more deeply and more thoroughly, which could explain the higher levels of NNAL in their blood." 

Source: Times of India

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