Use of Tobacco can be controlled with support of media: Kerala’s top cop

Tobacco use in the State could be more effectively countered if the media would give strong support to the police, said Kerala police chief Shri T.P. Senkumar IPS.

He was inaugurating a media workshop on the ‘Role of Media and Police for Sustainable Tobacco Control in Kerala’ organised by Kesari Memorial Journalists Trust and Tobacco Free Kerala, here on Tuesday.

According to Shri Senkumar, the media should take the initiative to better bring to the public’s notice the benefits of not using tobacco. “Sustainable tobacco control can be achieved in Kerala only through awareness campaigns to students on its dangers,” he said.

“Though social media, which is hugely influential, can be used for creating awareness, there are also several underlying threats. It is seen that while smoking is on the decline in Kerala, other dreaded drugs are in rampant use,” Shri Senkumar said.

However, he added, social media is also prone to being misused – for such activities as the sale of drugs. “There are even cyber quotation teams functioning in the state,” he said.

Though there will be impediments, Shri Senkumar said momentum must not wane. Recalling that he had faced hurdles when he imposed the ban on smoking in jails during his tenure as DGP (Prisons) – “the Home Minister received around 250 complaints in a month”, he said “as soon as the prisoners recognised its good effects there were no complaints”.

Shri P.G. Sureshkumar, Asianet News co-ordinating editor, moderated of the workshop. He emphasised the need for joint efforts by health, police and excise officials along with the intervention of responsible media for effective tobacco control.

“A positive result can be achieved only if awareness is created that the use of tobacco is not only injurious to our health, but also for others around us,” he said.

Dr A.S. Pradeep Kumar, former additional director of health services (Public Health) and former nodal officer of tobacco control in Kerala, said, “The media should play a proactive role to inform the public about the products containing tobacco that are available in the market.

“There have been instances in social media, magazines and newspapers where products like e-cigarettes, which are more dangerous than ordinary cigarettes, were being promoted.”

As part of protecting children from the dangers of tobacco use, said Shanghumugham ACP Shri Jawahar Janard, the police have formed school protection groups, installed complaint boxes, held tobacco control rallies and conducted Teens Mission Safety programmes with the help of psychologists and doctors.

“Statutory warnings against smoking will be placed at Kesari Memorial building and it will be made a smoke-free area,” said Kesari Trust president Shri C. Rahim. “In following the example of their elders, the new generation is going down the same dangerous path. The use of tobacco by women, in particular, will have far-reaching consequences,” he added.

“Around 42 per cent of cancers seen among men in Kerala is due to tobacco use,” said Regional Cancer Centre Asst Prof Dr R. Jayakrishnan, who expressed hope that Kerala could be transformed into a model state in controlling tobacco use with the support of the police, the media, the youth and the society at large.

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Kerala Police tightens the noose on public smokers

Indicating and reinforcing their strong commitment for public health, the 56,000-plus Kerala Police force has tightened the noose on public smokers. 

Figures of police action against public smoking for this July-September quarter show over 85 per cent jump as compared to the same period last year. As many as 47,282 persons were fined during the quarter for violating the no-public smoking provision of the Indian tobacco control law COTPA, 2003.

This is a record-high number ever since Kerala Police started an online system of COTPA violations reporting in October 2012.

Of the total 20 police districts, 17 districts have recorded action against public smokers in September 2015, as per the latest figures in the official police website. For the sake of administrative convenience, 14 revenue districts of the state have been divided into 20 police districts.

The impressive performance showcased during the quarter also comes from doubling and tripling of efforts by six district police teams as compared to July-September 2014. These include, Thiruvananthapuram City; Pathanamthitta; Ernakulam City; Thrissur City; Palakkad and Malappuram.

In Malappuram, for instance, the number of persons fined has increased from 52 during last July-September quarter to 5,726 in the same period this year. Palakkad has witnessed an over nine-fold increase, from 503 to 4,619.

The State Police Chief Shri TP Senkumar IPS said, “Kerala Police takes its commitment of safeguarding the health of our people very seriously.  We realise the dangerous impact of second-hand smoke and do not want our non-smoking population to suffer silently in public places. Action against COTPA violations are reviewed every month in the crime review meetings.” The Clean Campus, Safe Campus programme launched by the Government on 30 May 2014 has strengthened COTPA implementation and tobacco control, Shri Senkumar added.

In the interest of non-smokers, Section 4 of COTPA prohibits smoking in public places including bus stands, cinema halls, restaurants, hotels, pubs, and bars. It also mandates setting up of 60 x 30 cm signages in white, black and red colours. Violations including public smoking and absence of requisite signages can be fined up to Rs 200 on the spot.

As per figures of the Global Adult Tobacco Survey (GATS) 2009-10 of the Union Ministry of Health & Family Welfare and the World Health Organisation, 30 per cent of men and 8.5 per cent of women are exposed to second-hand smoke in public places. 

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Tobacco litter a potential threat

Tobacco use has not only been inducing cancer but is also leaving the environment polluted, spreading diseases and possibly contaminating food, says a body of oncologists in Kolkata. 

Cigarette and bidi butts, along with chewing tobacco spits littered on streets, should be classified as toxic wastes, they have claimed, pointing to a recent application filed by a doctors' organization with the National Green Tribunal. The possibility of tobacco litter was sharper in Kolkata since the city has more smokers that most other metros, according to Bengal Oncology Foundation. 

Responding to an application filed by Mumbai-based NGO Doctors for You, the NGT has directed the Union ministries of environment and health and the Central Pollution Control Board to file their response on the harm caused by cigarette, bidi butts and chewing tobacco to the environment. 

"Cigarette butts consist of carcinogens, nicotine and toxic metals such as cadmium, arsenic and lead in a highly concentrated form. All these pose high risk to public health. Action must be taken at the earliest to contain such hazardous litter, said Subir Ganguly, Vice President, Bengal Oncology. 

He added that the possibility of cigarette butts transmitting diseases couldn't be ruled out. "In Kolkata, it is not uncommon for people, even children, to smoke cigarette or bidi ends picked up from the road. Apart from the metals that the ends contain, they could also transmit diseases. Tobacco spits, on the other hand, are even more infectious since they have saliva which helps to transmit diseases," explained Ganguly. 

Research has shown that about 25%-50% of litter accumulated from the streets comprises tobacco residues. A 100 billion non-biodegradable butts are released in the environment every year. 

The possibility of tobacco contamination was a real one, said oncologist Gautam Mukhopadhyay, Secretary of Bengal Oncology. 

"Food sold on the streets is vulnerable since they remain uncovered. 

Utensils used by hawkers are often washed and stored very close to garbage dumps full of tobacco wastes," he added. 

Doctors for You cited the example of the Howrah Bridge, whose pillars are corroding due to acids in tobacco spit. "We need to build awareness on the of littering. Unless habits change, it will be difficult to curb tobacco litter," said Kalyan Rudra, Chairman of the State Pollution Control Board. 

Even though smoking in and around hospitals, government offices and educational institutions is prohibited, the rule is routinely flouted in Kolkata. 

Most hospital staircases and corridors in the city are heavily smeared with tobacco spits and peppered with cigarette ends. "Nothing could be more unhealthy than this since patients are more susceptible to infections. Unless smoking in public was banned, it would be difficult to control tobacco litter, felt Ganguly.

Source: Times of India

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Seek adventure in sports and higher career goals, not tobacco: Manisha Koirala

Children should find adventure in sports and higher career goals and not be drawn to tobacco use for the temporary excitement it provides, popular pan-India actress Ms Manisha Koirala said.

In a personal message addressed to “dear people of Kerala” in connection with Children’s Day, Ms Koirala who has successfully battled cancer, urged children to keep away from dangerous vices such as tobacco use.

The ‘Dil Se’ actress also wished “all children a very healthy and joyous life.”

Ms Koirala, a Goodwill Ambassador of the United Nations Population Fund (UNFPA), hailed the Tobacco Free Kerala campaign as a model worthy of emulation by the rest of the country.

“I take this opportunity to congratulate the Kerala Government headed by the Hon’ble Chief Minister Shri Oommen Chandy for initiating this campaign for promoting healthy lifestyles,” she wrote.

Significantly, it was on Children’s Day last year that Kerala was declared the first state in India to become tobacco advertisement-free at the points of sale. This achievement driven by the Health and Police Departments has brought Kerala fame both nationally and internationally.

Ms Koirala has portrayed roles of chain-smoking characters. Numerous scientific studies have shown that smoking, exposure to second-hand smoke and tobacco use causes cancer.

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Tobacco responsible for 90 cent of lung cancers: Dr VP Gangadharan

Tobacco was responsible for 90 per cent of lung cancers as well as some 30-40 per cent of general cancers, said Dr V.P. Gangadharan,  head of Medical and Paediatric Oncology, Lakeshore Hospital.

Total tobacco ban was thus the single-most public health intervention which could have a major impact on the cancer scenario, anywhere in the world he said while addressing a cancer awareness programme organised for the employees of Kerala Legislative Assembly in Trivandrum.

Among male cancer patients in Kerala, 32 per cent have lung cancer and 28 per cent, head and neck cancers. Among women patients, 34 per cent had breast cancer and 20 per cent, cancer of the uterine cervix. Generally, prostate cancer, colorectal and thyroid cancers are on the rise in Kerala.

Not just cancers of the breast/head and neck/cervix, those of colorectal and prostate too could be detected early. This meant that 60 per cent of cancers among males and over 50 per cent of cancers among women in the State were treatable if detected early.

Dr. Gangadharan said that today one in three women coming to the OP clinic were being diagnosed with breast cancer. According to a projection by NCRP-ICMR, Kerala could have 8,500 cases every year by 2030.

Breast cancer increase is clearly linked to lifestyle – obesity, lack of physical activity and a diet which was predominantly meat-based and less in plant foods and dietary fibre. 

“A woman should realise that she stands a one in eight chance of developing breast cancer during her lifetime. Regular self examination is the best way to detect breast cancer early,” he said.

Source: The Hindu

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Tobacco Control Champion citation conferred on Kerala Chief Minister

Dr Paul Sebastian, Director, Regional Cancer Centre and Vice Chairman, Tobacco Free Kerala and Shri Sukumaran, a tobacco-induced oral cancer victim conferring the citation of 'Tobacco Control Champion' on Hon'ble Kerala Chief Minister Shri Oommen Chandy at his official residence Cliff House on
2 October. 

The citation is signed by Dr Sebastian and Dr KR Thankappan, Prof and Head, Achutha Menon Centre for Health Science Studies of SCTIMST. 

It is a token of appreciation and gratitude by Kerala's tobacco control fraternity for the Chief Minister's outstanding leadership to the cause of public health in Kerala through far-reaching tobacco control measures over the past four years. 

A note on Global Adult Tobacco Survey (GATS) 2016 was also submitted to the Chief Minister. GATS is the global standard initiated by the World Health Organisation to systematically monitor adult tobacco use and track key tobacco control indicators. The next round of GATS is expected to begin in India and Kerala during January 2016.

62-year-old Sukumaran also shared his experiences with Shri Chandy. 

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Government to launch 'M Cessation' to help kick tobacco habit

There is good news for people wanting to quit tobacco. 

The government will soon offer a mobile phone-based intervention to tobacco users where they will be counselled to kick the habit.

The Union Health Ministry will launch "Mobile(m) Cessation" to develop tobacco use abstinence among people interested in quitting. 

As part of the programme, tobacco users can enroll themselves by giving a missed call to a particular phone number after which they will be asked three to four questions through SMS like their educational qualifications, work status and the age of onset of tobacco use. 

After these details are fed into the system, the tobacco users will start getting three to four messages daily which will counsel and consistently motivate them to quit tobacco, said Additional Director (Health) S K Arora, who is coordinating this project on behalf of the Delhi government. 

"We can quit smoking and chewable tobacco use or any other substance abuse by strengthening our will power, the way we stop use of such products suddenly during religious days like Navratra etc. 

"This m cessation will strengthen the will power of a tobacco user through counselling and consistently motivate them to quit the habit," said Dr Arora. 

"Mobile phones are used by a large number of people because of which we believe that these will play a key role in encouraging people  .. 

India is home to the world's second largest number of tobacco users (around 275 million). The Government of India had last year set a target of reducing tobacco use by 20 per cent by 2020 and 30 per cent by 2025. 

Forty per cent of all cancers, 90 per cent of oral cancers and 30 per cent of TB cases are due to tobacco use. In India, 9-10 lakh people die every year due to tobacco habits, according to government data. 

Source: Economic Times

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Economic burden from tobacco-induced heart diseases highest in Kerala amongst southern states

Cardiovascular diseases (CVDs) account for a staggering Rs 226 crore economic burden annually, the highest among four major tobacco-induced ailments in Kerala, contributing to 51 per cent of total direct medical costs.

Significantly, the total direct medical costs from tobacco-induced CVDs in Kerala are the highest among south Indian states, says a latest report.

The report is based on study called ‘Economic Burden of Tobacco Related Diseases in India’ developed by Public Health Foundation of India (PHFI) with support from the Union Ministry of Health & Family Welfare and the World Health Organisation (WHO).

The study report covers both direct medical costs and indirect morbidity costs of four specific diseases – CVDs, cancer, tuberculosis, and respiratory disease.

The direct medical costs from tobacco-related heart diseases in neighbouring Tamil Nadu is 46 per cent, while those in Andhra Pradesh and Karnataka are at 48 and 40 per cent, respectively.

Smoking tobacco contributes to the highest economic burden among Kerala males with direct costs of Rs 123.5 crores, and indirect costs of Rs 62.7 crores.  

The report estimated the economic costs on persons in the 35–69 age group in 2011.

Direct medical costs include direct healthcare expenditure for inpatient hospitalisation or outpatient visits such as medicines, diagnostic tests, bed charges, and surgeon’s fees. Indirect costs accrue from expenses on transportation and lodging for caregivers and loss of household income due to inpatient hospitalisation, besides costs from premature deaths. 

According to the Global Adult Tobacco Survey (GATS) 2009-10, the global standard to systematically monitor adult tobacco use, 35.5 per cent of males use tobacco in some form, 27.9 per cent males smoke and 13.1 per cent use smokeless tobacco products.

The economic burden study has suggested a host of measures to deal with the tobacco menace. These include strengthening implementation of Indian tobacco control law, COTPA, 2003 and imposing uniform taxes on all tobacco products like cigarettes and bidis. It has also recommended prohibition of sale and manufacture of all forms of smokeless tobacco products/chewing tobacco and high visibility public awareness campaigns to consistently reach out to different target audiences.

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Smokers at increased risk of tooth loss

Regular and heavy smokers have a significantly increased risk of tooth loss, warns a study. 

Male smokers are up to 3.6 times more likely to lose their teeth than non-smokers, whereas female smokers have 2.5 times greater risk, the findings showed. 

“Most teeth are lost as a result of either Caries (tooth decay) or Chronic Periodontitis (gum disease). We know that smoking is a strong risk factor for Periodontitis, so that may go a long way towards explaining the higher rate of tooth loss in smokers,” said Lead Author Thomas Dietrich, Professor at University of Birmingham in England. 

Tooth loss remains a major public health problem worldwide. Nearly 30 percent of 65-74 year olds in the world are Edentate (have lost all of their natural teeth), the study said. 

Smoking can mask gum bleeding, a key symptom of Periodontitis. As a result, the gums of a smoker can appear to be healthier than they actually are.

“It is really unfortunate that smoking can hide the effects of gum disease as people often don’t see the problem until it is quite far down the line,” Dietrich noted.

“The good news is that quitting smoking can reduce the risk fairly quickly. Eventually, an ex-smoker would have the same risk for tooth loss as someone who had never smoked, although this can take more than ten years,” Dietrich pointed out.

The findings are based on data from 23,376 participants.

The study aimed to evaluate the associations between smoking, smoking cessation and tooth loss in three different age groups.

The association between smoking and tooth loss was stronger among younger people than in the older groups.

In addition, the results clearly demonstrated that the association was dose-dependent; heavy smokers had higher risk of losing their teeth than smokers who smoked fewer cigarettes.

The study was published in the Journal of Dental Research.

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India among 11 South Asian countries to sign anti-tobacco declaration

Health ministers from 11 countries of the WHO South-East Asia region, including India, on Monday signed a declaration pledging to accelerate hard-hitting measures to reduce tobacco use, the WHO said in a statement. With tobacco killing 150 people every hour in the region, the ministers — gathered in the Timor-Leste capital of Dili for the inaugural session of the 68th Regional Committee Meeting of the WHO South-East Asia region — expressed their concern over high tobacco consumption. 

‘Tobacco use in South-East Asia is alarmingly high, triggering major health and economic consequences. Tougher actions are needed for tobacco control and prevention,’ said Poonam Khetrapal Singh, regional director of WHO South-East Asia region. ‘Countries must equally tax all tobacco products, ban tobacco advertisements, enforce pictorial warning on cigarette packs and implement ban on public smoking,’ she added.

The Dili Declaration called on governments, United Nations agencies and partners to accelerate tobacco control in the region which accounts for over one-third of the world’s tobacco use. ‘Tobacco kills 1.3 million people in the region every year, including people who were exposed to second-hand and third-hand tobacco effects. It is also home to 25 percent of the world’s smokers and 90 percent of the world’s smokeless tobacco users,’ the statement said. 

Tobacco use has been identified as one of the major risk factors for serious diseases of the lung, heart, and cancer. In 2012, an estimated 62 percent deaths in the region were attributed to non-communicable diseases; of these 48 percent were below 70 years. Highlighting the fact that premature deaths were not only a loss to the families, but also have a huge economic impact on the country, Singh said there was an urgent need to ‘enforce stringent policies and measures to help people reduce and eventually quit tobacco’. 

‘WHO recommends enhancing awareness on the ill-effects of all types of tobacco products; effective control measures to reduce tobacco consumption and counter-interference of tobacco industry; strengthening taxation systems on tobacco products to reduce consumption, and enhancing surveillance, research and cessation of tobacco use,’ she said. 

Source: The Health Site

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Never tried to promote tobacco and alcohol: Sachin Tendulkar

Master blaster Sachin Tendulkar, who has been an inspiring cricketer and ad icon for nearly three decades, has said that he as a brand ambassador has never tried to promote tobacco and alcohol.

"One thing my father told me... try not to promote tobacco and alcohol. So those are the two things I stayed away from," he said at the final day of a three-day summit organised by International Advertising Association (India chapter) in Kochi as part of its silver jubilee celebrations.

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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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Rajasthan Health Department to make brothers 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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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 10^th 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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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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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.

Source: International Business Times

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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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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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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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8-9 Lakh Deaths Can be Attributed to Tobacco Use: Health Minister JP Nadda

Nearly 8-9 lakh people die every year due to diseases related to tobacco use, the government today said while assuring the Rajya Sabha that a number of multipronged initiatives to reduce its consumption in the country have been undertaken.

"As per the report of Tobacco Control in India (2004), each year 8-9 lakh deaths in India can be attributed to tobacco use," Health Minister JP Nadda said in a reply.

He said that as per the findings of the study "Economic Burden of Tobacco related Diseases in India" (2014), commissioned by the Health Ministry, the total economic costs attributable to tobacco use from all diseases in India in 2011 for persons aged 35-69 accounted for Rs. 1,04,500 crore.

Replying to another question, he said that the government had notified a few new rules on October 15, 2014 as per which, health warnings shall cover at least 85 per cent of the principal display area on both sides of the tobacco products.

The committee on Subordinate Legislations, 16th Lok Sabha is currently examining the rules. The committee submitted its interim report in Lok Sabha on March 18, 2015 recommending to keep in abeyance the implementation of the rules till the committee finalises the examination of the subject and arrive at appropriate conclusions and present an objective report in the House.

"Considering that the report of the committee is interim in nature, the Ministry decided to keep the notification in abeyance. Accordingly a corrigendum was issued on March 26, 2015 suspending the date of implementation and stating that the rules shall come into force on such date as the central government may by notification in official gazette appoint," the Minister said.

Other initiatives include ratification of WHO framework convention on tobacco control, launch of national tobacco control programme, launch of pilot project titled 'Alternative crops for 'bidi' and chewing tobacco in different agro-ecological sub-regions' and notification of rules to regulate depiction of tobacco products of their use in films and television programmes.

"The government is not under any pressure from the tobacco lobby," Mr Nadda said.

Replying to another question, Mr Nadda said the government has constituted an inter-ministerial committee of secretaries under the chairmanship of Cabinet Secretary to review and develop a comprehensive policy on tobacco and related issues.

He said the government got an external evaluation done of the National Tobacco Control Programme through Public Health Foundation of India (PHFI).

"Recommendations of this evaluation have been suitably incorporated in the 12th Five Year Plan for national tobacco control programme to make the outcomes more effective," Mr Nadda said.

When asked whether the government has stakes in cigarette manufacturing companies in the country, he said information is being collected and will be laid on the table of the House.

Courtesy: NDTV

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Study: E-cigar a ‘gateway to addiction’

Swapping regular cigarettes with electronic cigarettes is not a safer option among young people as e-cigars are a potential gateway to addiction, claim scientists at the University of Illinois, Chicago.

According to a new study, e-cigarettes, though promoted as an aid to quit smoking as well as a safer cigarette, deliver nicotine that pose particular risks to developing organs and brains in children.

Dean E. Schraufnagel, MD at the UIC, provides a detailed look at the composition and varieties of electronic cigarettes and what makes them so appealing to youths.

He described electronic cigarettes as a potential “gateway to addiction,” as they are often the first tobacco product a youngster tries, with nicotine dependence a common lead-in to abuse of other addictive substances.

Mary Cataletto, MD, Professor of Clinical Pediatrics, State University of New York at Stony Brook said that pediatricians play a critical role in the education of children and families, and are considered an important and reliable source of healthcare information.

This review provides practitioners with comprehensive information about the dangers of electronic cigarettes and highlights the vulnerability of children to both the intense marketing surrounding e-cigarettes and their pharmacologic effects.

The review article ‘Electronic Cigarettes: Vulnerability of Youth’ is published in a peer-reviewed journal Pediatric Allergy, Immunology, and Pulmonology.

Source: TheNewsReports

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How do much does a smoker lose?

Source: India Today

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Tobacco indeed causes cancer: Kerala medical community

Amid widespread shock and anguish over misinformed statements on tobacco’s association with cancer, Kerala’s medical community have rebuffed these and have stated that tobacco use indeed causes cancer. Public pronouncements mooted by self-contained interests cannot dispel years of revalidated study and research by scientific and medical community, they say.

Kerala’s medical community have also congratulated the Hon’ble Prime Minister for his timely intervention in keeping up to the commitment of the 15 October 2014 notification requiring tobacco companies to devote 85 per cent of all tobacco product packs including bidis, cigarettes and smokeless to pictorial warnings.  

Dr Paul Sebastian, well-known surgical oncologist and Director of Regional Cancer Centre here said, “No less than the World Health Organisation has categorically said that tobacco causes cancer. Independent research conducted by Indian organisations has only strengthened this.”

He points out to the cohort study in Karunagappally taluk started in the late 1980s to study the potential health effects of high background radiation. 

“The study that covered 65,829 men aged 30–84 however showed an elevated lung cancer incidence among bidi smokers, strengthening the association of lung cancer risk with bidi smoking,”

“Karunagappally is known for high background radiation from thorium-containing monazite sand and the study set out to explore the lung and other cancer risks increased by exposure to high-level natural radiation, and the synergistic effect between radiation and other factors including bidi smoking. However, our cohort study showed that the relatively high lung cancer incidence in this area is unlikely to be due to high-level natural radiation,” 

Dr Sebastian added.

Eminent oncologist and Founder Director of Regional Cancer Centre Padma Shri Dr M Krishnan Nair said, “The Prime Minister’s assurance that the Government will go ahead with 85 per cent pictorial warnings is reassuring. It sends out a clear message that tobacco is indeed to harmful to health and it speaks volumes of the Government’s commitment to reducing tobacco consumption.” Dr Nair also remembered the Prime Minister’s tweet on World No Tobacco Day 2014 about working to “reduce tobacco consumption in India.”

“Baseless statements that tobacco does not cause cancer cannot take away from established facts of science, and collective efforts of the scientific and medical fraternity. Reports of the National Cancer Registry Programme (NCRP) have a dedicated chapter on tobacco related cancers. The 2011 Report shows 45.4 per cent tobacco related cancers among males and 16.8 per cent among females in India,” Dr Nair added.

The Indian Council of Medical Research with a network of cancer registries commenced the NCRP across the country in December 1981 to generate reliable data on the magnitude and patterns of cancer.

Dr. VP Gangadharan, pioneer medical oncologist and HoD of Medical and Paediatric Oncology, Lakeshore Hospital, Kochi said, “Tobacco use is the leading preventable cause of death and disease and strategies such as large pictorial warnings can save one million precious Indian lives every year. Tobacco snatches away the best years of a user’s life, hampering productivity and social well-being. Pictorial warnings of 85 per cent can go a long way in preventing youngsters, migrants, and illiterates from getting addicted to tobacco products.”

Citing a 2014 report of the Union Ministry of Health & Family Welfare and the World Health Organisation on the economic burden of tobacco use, he added, “Tobacco use not only impairs health of individuals; it also badly affects the health of the economy. The economic burden for four specific diseases including cardiovascular diseases, cancer, tuberculosis, and respiratory disease in Kerala for the year 2011 was Rs 545 crores.”

Twenty-eight-year-old tobacco control crusader Ms Sunita Tomar, who made a public appeal for large pack warnings through the online campaign #LivesBachaoSizeBadhao, succumbed to oral cancer on April 1 – the same day when large-sized pack warnings were to be implemented in India. Sunita has made a dying request to the Prime Minister for 85 per cent pack warnings.

As many as 38,735 persons including doctors, tobacco victims, bidi workers unions, international and national public health experts and youth across the country had appealed to the Union Health Minister to implement 85 per cent pack warnings. 

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