Tobacco causes 40 per cent of cancers in India

Around two fifths (40 per cent) of all cancers in India are attributable to tobacco use, and the economic costs of illness and premature death due to tobacco consumption exceed combined government and state expenditure on medical and public health, water supply, and sanitation, a new report on cancer care in India published in The Lancet Oncology revealed.

The report points out that India is facing a cancer crisis, with smoking, belated diagnosis and unequal access to treatment causing large-scale problems. Every year in India,around one million new cancer cases are diagnosed and around 600,000 to 700,000 people die from cancer in India, with this death toll projected to rise to around 1.2 million deaths per year by 2035.

The report compiled by Professor Richard Sullivan and Professor Arnie Purushotham from King's Health Partners Cancer Centre at King's College London with the help of senior Indian colleagues including Professor CS Pramesh and Professor Rajan Badwe at the Tata Memorial Cancer Centre, Mumbai.

Although India has a relatively lower incidence of cancer (around a quarter of that in the USA or Western Europe), the rate of deaths from cancer, adjusted for age, is similar to that seen in high-income countries, the report said.

 

Less than a third of patients with cancer in India currently survive for more than five years after diagnosis.

 

Around 95 per cent of the medical colleges in India do not have comprehensive cancer care services, comprising Surgical, Medical and Radiation Oncology departments, in the same campus.

 

Currently there are around 2,000 medical and radiation oncologists in India one per 5000 newly diagnosed cancer patients and in almost all remote or rural areas even the most basic cancer treatment facilities are non-existent, it said.

 

As a result, urban cancer centres are overcrowded and under-resourced, leading to long waiting times, delayed diagnoses, and treatment that comes too late for many patients.

"Cancer research needs to be central to plans for national cancer control, and cancer needs to be one of the focuses of national research agendas and priorities," said Professor Richard Sullivan, King's College London, series coordinator and lead author of the series paper on cancer research in India.

 

Abstracted from Manoramaonline

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Tobacco control long neglected from poll manifestos: Medico-legal experts

As the state and the country are teeming with pre-election activity to usher in the 16th Lok Sabha of Independent India, noted personalities from eminent walks of life wonder why tobacco use - a crying public health issue – has for long been neglected in the intent document of various political parties.

The irony, the social experts say is that while tall promises such as “focus on preventive rather than curative measures”, “health security for all” and “health for all families/habitations” have been made, nothing has come forth to address a heavy but controllable tobacco health burden. 

Justice Smt D Sreedevi, former Chairperson, Kerala Women’s Commission points out, “Tobacco use is not just a public health issue; it is also a matter of social injustice. There is substantial proof that tobacco use leads to multiple health problems such as cancers, cardiovascular diseases and stroke. 

Allowing people to freely use these dangerous products and making them vulnerable to dreadful diseases is a case of social injustice. Macroeconomic policy changes through measures such as higher tobacco taxes coupled with no-holds-barred implementation of Indian tobacco control law, COTPA to protect youth from tobacco initiation is needed in earnest. This intent is not reflected in the poll manifestos of any political party.”

Calling for strict implementation of legal provisions and directions made, Justice Sreedevi added, “The High Court has ruled that smoking in public places should be prohibited. A person smoking in a public place is liable for punishment under Section 278 of the Indian Penal Code. Political parties and those in power should ensure that these directions are met by giving strict instructions to enforce the law and orders of the High Court.” 

Eminent oncologist and Founder Director Regional Cancer Centre here Padma Shri Dr M Krishnan Nair said, “Tobacco causes one million deaths in the country annually. The rate of cancers as a result of tobacco use is 40 per cent in men and 15-20 per cent among women, but various political parties have not taken up this preventable public health issue seriously. A look into the poll manifestos of leading parties in the Lok Sabha elections from 2004 – the year in which India ratified the World Health Organisation’s Framework Convention on Tobacco Control (FCTC) – shows that none of them has shown the political will to remedy this health malady.”

The FCTC, the first international treaty negotiated under the auspices of WHO, was developed in response to the globalisation of the tobacco epidemic. It is also an evidence-based treaty that reaffirms the right of all people to the highest standard of health. India ratified FCTC on 5 February 2004. 

Exhorting various political parties to sincerely consider inclusion of matters that will bring larger public good such as tobacco control Dr Nair pointed out, “Our medical resources are severely stretched. We have now one doctor serving 1,800 people as against the WHO guideline of 1:600. There is a resource gap of approximately 1.4 million doctors and 2.8 million nurses. Hospital bed density in India is significantly short of WHO guidelines of 3.511 per 1000 patients’ population. Collective will is required to limit preventable tobacco-induced diseases and save our medical resources for more genuine needs.” 

Padma Shri Dr G Vijayaraghavan, Vice Chairman and Director, Medical Services, KIMS Hospital here said, “Health has been defined as a state of complete physical, mental and social well-being and not the absence of disease or infirmity. Physical, mental and social well-being cannot be achieved if citizens are under the influence of harmful substances such as tobacco. Tobacco control needs to form a part of the socio-political discourse if it has to be meaningfully curtailed. All states should strictly ban tobacco from public places such as restaurants, bus stations and railway stations in addition to all offices. This should be part of the manifesto of all political parties.”

Noted media person Smt Leela Menon said, “The media has rightly highlighted the harms caused due to tobacco use and has pointed out the need for multiple efforts to bring down its use and resultant diseases. Media coverage on tobacco control matters have especially gone up in the last couple of years. It is interesting to note that in spite of the wide media pressure; none of the political parties have thought it fit to come out in open support of this cause. Political parties do not seem to be interested in people’s health or welfare concerns; they are only interested in generating votes.”

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