Male smokers in India cross 100 million, second only to China

More men are smoking in India than ever before, with the number rising by more than a third from 79 million in 1998 to 108 million in 2015, report researchers in the journal BMJ Global Health.

Smoking rates haven’t increased for women, though, with 11 million women smoking in India in 2015, the study found.

Only China has more adult smokers — 300 million — than India, where more than one in four adults also uses smokeless and chewing tobacco.

Tobacco-control measures, such as banning smoking in public places, haven’t helped much. They led to a fall in smoking prevalence from 27% in 1998 to 24% in 2010 among men aged 15-69 years, but the modest gains were offset by rising population and incomes.

“During this period, India added about 1.7 million male smokers each year, with roughly an equal number smoking cigarettes and bidis,” said the study’s co-author Dr Prakash C Gupta, director, Healis-Sekhsaria Institute of Public Health, Mumbai.

The study found that 61 million Indian adult men smoked cigarettes (40 million exclusively) and 69 million smoked bidis (48 million exclusively).

Tobacco use, including smoking, accounts for 10% of all deaths in India. “In 2010, tobacco use caused about one million deaths in India, with about 70% of these deaths killing people in their prime, between ages 30 and 69,” said co-author Dr Prabhat Jha, professor at the Dalla Lana School of Public Health at the University of Toronto.

Smoking causes about 30% of all cancer deaths (including 90% of lung cancer deaths), 17% of heart disease deaths, and at least 80% of deaths from bronchitis and emphysema.

But cessation is uncommon in India. Last year, in the 45-59 age group, there were roughly four current smokers for every person who quit. In comparison, in the US and countries where cessation support is available, there are more quitters than current smokers.

“Raising tax on tobacco is the single most effective intervention to lower smoking rates, increase cessation and deter future smokers,” said Dr Jha.

The Tobacco Institute of India disagrees: “As a result of discriminatory taxation, the share of legal cigarettes in total tobacco consumption declined from 21% in 1981-82 to 11%, but overall tobacco consumption increased 38% during this period.”

For the BMJ Public Health study, researchers used data from three nationally representative surveys — Special Fertility and Mortality Survey (1998), Sample Registration Survey - Baseline data (2004) and Global Adult Tobacco Survey (2010) — covering about 14 million people from 2.5 million households, and made forward projections to 2015.

Source: Hindustan Times

Read more ...

Cancer deaths have increased by 60 per cent in India, says government

With the number of new cases of cancer doubling between 1990 and 2013, cancer has witnessed a 5 per cent increase in its rate between 2012 and 2014. Cancer is world-wide the second-leading cause of deaths after cardiovascular diseases.

In 2013, death proportion due to cancer increased by 15 per cent which was earlier 12 per cent in 1990 around the globe. In last two decades, Indian government says that deaths due to cancer have increased by 60 per cent in India.  

Health Minister JP Nadda reported in Lok Sabha that there can be several factors behind such death rise which are ageing population, unhealthy lifestyles, tobacco consumption, unhealthy diet etc.

Nadda said the Indian Council of Medical Research (ICMR) is implementing a National Cancer Registry Programme based on 29 population-based and 29 hospital-based registries.

Source: Nagaland Post

Read more ...

Quit tobacco for a healthy heart and family budget

More than half of Indians without a medical insurance experience financial catastrophe if any family member suffers a heart attack, suggest one of Asia's biggest studies on the economic burden of acute coronary syndromes.

Carried out on 1,635 patients from 41 hospitals, the study says average out of pocket expenditure for a single case of heart attack is about Rs 1,41,000 ($ 2600).

The financial burden hits almost 60 per cent of the families with no medical insurance. Even for those with medical insurance, one-fifth of the families are crushed under the medical costs associated with the treatment of acute coronary syndromes.

When a patient spent more than 30 per cent of annual household income as out-of-pocket treatment cost, it is defined as catastrophic health expenditure. 

Though insurance helps to tide over the difficulties, the latest data from the central government shows less than one-fifth of Indians – just about 22 crore – have medical insurance. Similar trends due to the absence of insurance were seen from National Family Health Survey results from 15 states.

Acute coronary syndromes are caused by sudden, reduced blood flow to the heart muscle, which are a major cause of mortality and morbidity in the Asia-Pacific region, accounting for around half of the global disease burden.

“In Indian sub-continent, 60 per cent of un-insured and 20 per cent of insured participants, reported catastrophic health expenditure,” said Jitendra P S Sawhney, chairman of the cardiology department at Sir Ganga Ram Hospital, who was the principal investigator from India.

The Indian data is part of an Asian survey which looks at the economic fallout of heart attack in eight nations, including India and China. It found Asians on an average spend Rs 175,769 ($ 3237) as out of pocket expenditure for heart attack treatment, which is one of the highest. 

The World Heart Federation has classified tobacco as a totally avoidable risk factor of cardiovascular diseases. Its use, whether by smoking or chewing, damages blood vessels, temporarily raises blood pressure and lowers exercise tolerance. Moreover, tobacco decreases the amount of oxygen that the blood can carry and increases the tendency for blood to clot. Blood clots can form in arteries causing a range of heart diseases that ultimately result in a stroke or sudden death.

Source: Deccan Herald

Read more ...

ICPO becomes WHO-FCTC knowledge hub on smokeless tobacco use

The World Health Organisation (WHO) has made Noida based Institute of Cytology and Preventive Oncology (ICPO) a Knowledge Hub in India for "Smokeless Tobacco Use." This is the seventh knowledge hub of WHO-FCTC (Framework Convention on Tobacco Control) around the globe.

The six hubs are in Australia, Finland, Lebanon, Korea, South Africa and Uruguay. The Knowledge Hub in Korea is self-funded. These centres are however, working on different areas of tobacco control like trade and tobacco litigation, surveillance, policy monitoring, illicit trade in tobacco products.

The ICPO, a cancer research institute which works under Indian Council of Medical Research (ICMR), will be a specialised centre on Smokeless Tobacco use. Smokeless tobacco is used orally which results in absorption of nicotine and other chemicals across mucus membranes. This leads to severe health complications and also to mouth cancers.

Ravi Mehrotra, ICPO Director, said that the Knowledge Centre will have expertise on tobacco control. "This will be developed as a vital platform for information sharing. We will develop and implement work plan for intervention. The Knowledge Hub will also report and evaluate the existing plans of the government of use of tobacco products," he said. The WHO will fund the Hub for initial two years. The government of India will then take bear the financial cost.

WHO FCTC is a global public health treaty aiming to tackle some causes of that epidemic related to the use of tobacco products. This advocates price and tax measures as effective means to reduce the demand for tobacco. It also demands for adoption and implementation of effective measures to provide protection from exposure to tobacco products to minors.

The idea to set up a Knowledge Hub in ICPO was due to rising number of smokeless tobacco users in India. A report of National Cancer Institute, United States, entitled Smokeless Tobacco and Public Health, A Global Perspective (2014), prepared by 32 experts from around the world, revealed that at least 80% of smokeless tobacco users globally live in India and Bangladesh. 

"Smokeless tobacco is used by about 300 million people in at least 70 countries, 89% of whom live in the South-East Asia Region, all low and middle-income countries," the report states.

The Noida based WHO FCTC Knowledge Hub will work on the education, communication, training for public awareness on tobacco control issues.

Read more ...

Increase taxes on tobacco products substantially to make them less affordable: Study

Prices of tobacco products in India have not increased substantially over a period, making them easily affordable, and even cheaper than essential food items, says a study.

The study 'Tobacco Taxes in India: An Empirical Analysis', commissioned by the ministry of health and World Health organization (WHO) India, was conducted by the Institute for Studies in Industrial Development and Public Health Foundation of India, that covers the period 2006 to 2013, and includes cigarette, bidi and smokeless tobacco (zarda /kimam/surti, paan masala and chewing tobacco) products, says a WHO statement.

The study corroborates the recent WHO Report on the Global Tobacco Epidemic 2015, which indicates cigarettes have become more affordable over 2008-14.

The study revealed that the current excise and value added tax (VAT) rates are insufficient to increase the prices of tobacco products, therefore making these products easily affordable. In recent times, the share of tax burden has also declined - for cigarettes it declined from 55.3% in 2008 to 36.8 % in 2013, while for bidis from 7.2% in 2011 to 5.3% in 2013.

The study recommends that tax on all type of tobacco products should be increased substantially, and tobacco tax regime should be broadened to include unorganized sector manufacturing under the tax net. It has also recommended that the tax exemptions on production of less than two million bidis should be eliminated and tax slabs on cigarettes based on length should be eliminated in a phased manner.

Highlighting that tobacco taxation as a fiscal policy is a win-win for both public health as well as revenue generation, Dr Henk Bekedam, WHO Representative India, said, "A comprehensive tax policy leads to reduction in tobacco use especially among young people and at the same time provides increased revenues to the government."

It has also been seen that affordability, in relation to income, of tobacco products is increasing at the national level, except for recent years. This is true even for the poorest households in the country.

According to Article 6 of the WHO Framework Convention on Tobacco Control (WHO FCTC) to which India is a signatory, prices of tobacco products must be increased periodically to make them inflation-adjusted, and there should be a uniform increase in tax rates across products.

The tax burden on tobacco products is also not in line with the WHO FCTC recommendations, which says, excise levies should account for at least 70% of retail prices of tobacco products.

"Tobacco taxation policy is the most cost effective strategy for tobacco control and has the ability to affect consumption, prevalence and affordability. Higher prices of tobacco products can promote cessation and prevent initiation among young people. This study reiterates the need for development of comprehensive tax policy for tobacco products to make them progressively less affordable over time by indexing tax increases on tobacco products to inflation. A simplified tax structure that uniformly taxes all tobacco products from the organized and unorganized sectors will have the greatest public health benefit for both consumers and the government," K Srinath Reddy, president Public Health Foundation of India, said.

Another health ministry report estimated that total economic cost attributable to tobacco use from all diseases in the year 2011 amounted to a staggering Rs 1,04,500 crore, equivalent to 1.04% of the country's gross domestic product.

Source: Times of India

Read more ...

Juvenile beats his grandmother to death for objecting smoking

The police have apprehended a 14-year-old boy on charges of murdering his 75-year-old grandmother at her residence at Edappatty in Kalpetta, Wayanad for objecting to his smoking.

Alagamma, wife of Allimuthu of Chullimoola, near Edappatty, in the district, was missing since Sunday. Her body was found with a bruised forehead inside a bush near her residence in a joint search led by her relatives, Sunilkumar, Circle Inspector of police, Kalpetta, who is investigating the case, said.

The woman and her husband were living in Edappatty, and the parents of the boy were granite quarry workers at Kunnamangalam in Kozhikode district. The teenager, a boarding student in a hostel in the district, had come to Edappatty a few days back.

During interrogation, the accused revealed to the police that the incident occurred around 9 a.m. on Sunday after his grandfather went out. When the woman found her grandson smoking inside the bathroom, she warned him that if he didn’t quit smoking, she would tell her husband.

It provoked the boy and he allegedly beat the woman to death with a hammer. He then dragged the body outside and hid it in a bush and went to play with his friends near the house.

When Allimuthu returned, he found his wife missing and started searching for her. The boy also joined him in the search. The boy left for his hostel after taking away Rs.500 from the house.

However the police learned that the boy had left the hostel around 7.p.m. on the day and they started searching for him. Finally, the boy was taken into custody from the Kozhikode KSRTC bus stand in the late night, Mr. Sunilkumar said.

The boy would be produced before the District Juvenile Justice board, he added.

Source: The Hindu

Read more ...

E-cigarettes can cause heart disease: Study

Exposure to either e-cigarette aerosol or smokeless tobacco alone can increase the potential of atherosclerosis - a disease that leads to heart attack, stroke and peripheral arterial disease, says a study.

When atherosclerosis affects the arteries of the heart, it is known as coronary artery disease, a condition that affects more than 15 million Americans and causes 500,000 deaths annually.

"Currently, we do not know whether e-cigarettes are harmful. They do not generate smoke as do conventional cigarettes but they do generate an aerosol - the vapour that alters indoor air quality and contains toxic aldehydes," said Daniel J. Conklin from the University of Louisville in the US.

"We investigated the direct effects of these toxins on cardiovascular disease in the laboratory," Conklin stated.

For the study, researchers exposed one set of mice to varying levels of e-cigarette aerosol, tobacco smoke, smokeless tobacco or to an aldehyde produced by tobacco.

Another set of mice was exposed to nicotine alone to understand whether nicotine by itself had any effect.

Not surprisingly and consistent with previous studies, exposure to tobacco smoke increased the amount of atherosclerosis in mice. At the same time, the researchers found that either e-cigarette aerosol or smokeless tobacco exposure alone also increased atherosclerosis.

"These findings indicate that multiple tobacco-derived constituents have cardiovascular disease-causing potential," Conklin noted.

Source: Business Standard

Read more ...

Tobacco control a development issue

Health and development experts in Kerala have applauded India’s commitment to tobacco control reflected in the first ‘South Asian Speakers’ Summit on Achieving the Sustainable Development Goals (SDG)’ that concluded in Dhaka, Bangladesh last week.

India has endorsed the ‘Dhaka Declaration on SDG Action in South Asia’ that envisions making the region tobacco free by 2030. With this, India has agreed to “develop, strengthen and enforce tobacco-control policies, legislation and regulations” in line with the Framework Convention on Tobacco Control (FCTC). FCTC is the international treaty on tobacco control of the World Health Organisation, which India ratified on 5 February 2004.

Through this Declaration, India has also agreed to work towards decreasing the affordability of all tobacco products by increasing tobacco taxes and “endeavour to set aside revenue generated from tobacco taxes to support tobacco control efforts.”

The Dhaka Declaration emerged after two days of deliberations by the Parliament Speakers of Afghanistan, Bangladesh, Bhutan, India, Maldives, and Sri Lanka on 30 and 31 January 2016.

Hon’ble Speaker of the Lok Sabha Smt Sumitra Mahajan chaired a session on “The Role of Parliaments in Implementing the SDGs”.

Shri CP John, Member, Kerala State Planning Board said, “Addressing public health issues has become a challenge in emerging economies. Tobacco use in different forms is a major threat to public health and development. Unfortunately, tobacco abuse found in marginal communities is wrongly conceived as a tradition. So the state should come forward in controlling tobacco use by strong enforcement and regular monitoring while the responsible citizenry should take the lead in educating the masses through wide public awareness programmes.”

Tobacco control has been included as a target under Goal 3 – Health and Well-being – of SDGs 2015-30.

Dr KR Thankappan, Professor and Head, Achutha Menon Centre for Health Science Studies said, “As the country is grappling with shrinking health budgets, India’s strategy to reduce the burden of non-communicable diseases through controlling tobacco use is a welcome step. Multi-sectoral efforts to reduce tobacco use which kills 1 million Indians a year are the need-of-the-hour.”

The South Asian Speakers’ Summit also announced the establishment of South Asian Speakers’ Forum that will meet at least once a year. India will host the second meeting of South Asian Speakers’ Forum in 2017.

The Bangladesh Summit was convened and organised by the Inter-Parliamentary Union and was hosted by the Bangladesh Parliament with technical support from Campaign for Tobacco-Free Kids. 

Read more ...

ഒരു പുക കൂടി

ഒരു പുക കൂടി (കല്‍പ്പറ്റ നാരായണൻ )

പോലീസ് വരുന്നുണ്ടോ

എന്നിടം വലം നോക്കി

വലിക്കണോ കളയണോ എന്നായ എന്നോട്

ഒച്ച താഴ്ത്തി ബീഡി പറഞ്ഞു:

എനിക്ക് വയ്യ ഇങ്ങനെ നാണംകെട്ട് കഴിയാന്‍.

നിങ്ങള്‍ക്കറിയുമോ

ഒരിക്കല്‍ ചങ്കൂറ്റത്തിന്റെ പ്രതിരൂപമായിരുന്നു ഞാന്‍.

കൂസലില്ലാതെ ജീവിച്ചവരുടെ ചുണ്ടില്‍

ഞാന്‍ ജ്വലിച്ചു.

നട്ടപ്പാതിരകളും കാട്ടിടകളും

എനിക്ക് ഹൃദിസ്ഥം.

എന്റെ വെളിച്ചത്തില്‍

ഒറ്റത്തടിപ്പാലങ്ങള്‍ തെളിഞ്ഞു.

അന്നൊക്കെ ലക്ഷ്യങ്ങളിലേക്ക്

അഞ്ചും എട്ടും ബീഡിയുടെ ദൂരം.

ചുമരെഴുതാനും

പോസ്റ്ററൊട്ടിക്കാനും

പാട്ടെഴുതാനും ഞാന്‍ കൂടി.

മാറ്റത്തിന് ഞാന്‍ കൂട്ടിരുന്നു.

കയ്യൂരിലും പുല്‍പ്പള്ളിയിലും

കൈപൊള്ളുന്നത് വരെ ഞാനെരിഞ്ഞു.

നാടകവേദികള്‍ക്ക് വേണ്ടി

ഫിലിംസൊസൈറ്റികള്‍ക്ക് വേണ്ടി

ഞാനുറക്കൊഴിച്ചു.

ഞാന്‍ പ്രവര്‍ത്തിക്കാത്ത പ്രസ്ഥാനങ്ങളില്ല.

തണുപ്പില്‍, ഇരുട്ടില്‍

ചെയ്യുന്ന പ്രവൃത്തിയുടെ ഗുരുതരമായ ഏകാന്തതയില്‍

ഞാനായിരുന്നു തുണ.

അന്ന്

എന്നെ ആഞ്ഞു വലിച്ച് ആണ്‍കുട്ടികള്‍

ആണുങ്ങളായി.

എന്നെ കട്ടു വലിച്ച് പെണ്‍കുട്ടികള്‍

പുലരും വരെ മുലകളുയര്‍ത്തിച്ചുമച്ച്

സാഹസികജീവിതം എളുതല്ലെന്ന് മനസ്സിലാക്കി.

എല്ലാ കുമാര്‍ഗങ്ങളിലും

ഞങ്ങള്‍ സഞ്ചരിച്ചു.

അക്കാലത്തെ തീവണ്ടികള്‍ പോലെ

ഉള്ളില്‍ തീയുള്ളവരുടെ പുകയായി

മുന്നില്‍നിന്ന് ഞാന്‍ നയിച്ചു.

പുകഞ്ഞ കൊള്ളിയായിരുന്നു ഞാന്‍

ഭാഗം ചോദിച്ച് മുണ്ട് മാടിക്കുത്തി മുറ്റത്തു നിന്ന

ചെറുപ്പക്കാരന്റെ കൈയില്‍ ഞാനിരുന്ന് പുകഞ്ഞു.

കൂലി കൂടുതല്‍ ചോദിക്കാന്‍

മടിക്കുത്തിലിരുന്ന് ഞാനുശിരു കൂട്ടി.

തീണ്ടലും തൊടീലും ഞാന്‍ പുകച്ചുകളഞ്ഞു.

ഒരു പുകകൂടിയെടുത്ത്

നടന്മാര്‍ വേദിയിലേക്ക്

സദസ്യര്‍ ഹാളിലേക്ക്

തൊഴിലാളികള്‍ തൊഴിലിലേക്ക് കയറി.

തല പുകഞ്ഞെടുത്ത തീരുമാനങ്ങളിലെല്ലാം ഞാനും കൂടി

തീ തരുമോ എന്ന് പില്‍ക്കാലം മുന്‍കാലത്തിനോട് ചോദിച്ചു.

കഴുകന്മാര്‍ കരള്‍ കൊത്തി വലിക്കുമ്പോഴും

ഒരു പുകയ്ക്കു കൂടി ഇരന്നവരുണ്ട്

നിങ്ങളിന്നനുഭവിക്കുന്നതിലൊക്കെ

കത്തിത്തീര്‍ന്ന ഞങ്ങളുണ്ട്.

നേരാണ്

ഞാനൊരു ദുശ്ശീലമാണ്.

എങ്കിലും ആശ്വാസങ്ങളില്ലാത്ത മനുഷ്യന്

ദുശ്ശീലത്തോളം ഉതകുന്ന മിത്രമുണ്ടോ?

നരകത്തിലല്ലാതെ

സ്വര്‍ഗത്തില്‍ മിത്രങ്ങള്‍ വേണമോ?

ശവത്തിനു കാവല്‍ നില്ക്കുന്ന പാവം പോലീസുകാരന്

തൂക്കിക്കൊല്ലാന്‍ വിധിക്കപ്പെട്ട ഏകാകിക്ക്

പങ്കിട്ടെടുക്കാനാരുമില്ലാത്ത പാപഭാരത്തിന്

ഉറപ്പിന്

ഉറപ്പില്ലായ്മയ്ക്ക്

ഞാന്‍ കൂട്ടിരുന്നു,

ആടുന്ന പാലത്തില്‍ ഞാന്‍ കൂടെ നിന്നു.

എനിക്കറിയാം,

ഞാന്‍ നന്നല്ല

ആരോഗ്യത്തിന്

കുടുംബഭദ്രതയ്ക്ക്

ഭാവിഭദ്രതയ്ക്ക്.

സ്വന്തം ചിതയ്ക്ക് തീകൊളുത്തുകയാണ്

ബീഡിക്ക് തീ കൊളുത്തുമ്പോള്‍

പക്ഷേ,

ആയുസ്സോ സുരക്ഷിതത്വമോ

ഓര്‍മ വരാത്ത ചിലരുണ്ടായിരുന്നു ഒരിക്കല്‍

അവരെന്നെ അവര്‍ പോയിടത്തൊക്കെ കൂട്ടി

എരിഞ്ഞുതീരുന്ന എന്നെ നോക്കി

അവരുന്മേഷത്തോടെ എരിഞ്ഞു.

കണ്ടില്ലേ

ഞാന്‍ മാത്രം കൂട്ടുണ്ടായിരുന്ന അരക്ഷിതരെ

വേട്ടയാടിയ നിയമം

ഇന്നെന്നെ വേട്ടയാടുന്നത്?

കണ്ടില്ലേ,

ബീഡിക്കമ്പനികള്‍ വര്‍ണക്കുടകള്‍ നിര്‍മിക്കുന്നത്?

കേള്‍ക്കുന്നില്ലേ,

'ഈ പുകച്ചു കളയുന്നതിന് ഭാഗ്യക്കുറി വാങ്ങിക്കൂടെ?'

Read more ...

Cherry-flavoured e-cigarettes most harmful to users

Users of cherry-flavoured electronic cigarettes may be exposed to a potentially harmful respiratory chemical, a new study has warned.

Researchers from Roswell Park Cancer Institute (RPCI) in US found that high levels of the respiratory irritant benzaldehyde were detected in the vapour from most of the flavoured nicotine products, with the highest concentrations in vapour from cherry-flavoured products.

Benzaldehyde is a compound used in many foods and cosmetic products. While it appears to be safe when ingested or applied on the skin, it has been shown to cause airway irritation in animals and humans, and may have different effects when heated and inhaled, as when used in vaping.

Researchers measured benzaldehyde levels for 145 different flavoured nicotine products using an automatic smoking simulator and calculated daily exposure to users from 163 e-cigarette puffs.

Their analysis detected benzaldehyde in the vapour from 108 (74 per cent) of the flavoured products studied, and found concentrations of the chemical that were 43 times higher in cherry-flavoured products than in other flavours.

"For e-cigarette users, it is important that they pay attention to how the products are affecting them," said Maciej Goniewicz from RPCI.

"If they notice irritation, maybe a cough or sore throat, when they use e-cigarettes, they might want to consider switching to a different flavouring," Goniewicz said. 

The findings were published in the journal Thorax. 

Source: Economic Times

Read more ...