Govt to take lead role in making Kerala tobacco free: Health Minister

Kerala Government will take the lead in the campaign for making the state tobacco-free, Hon’ble Health Minister Smt K K Shylaja said here today on the World No Tobacco Day (WNTD), while announcing some immediate steps to move in that direction. 

Highlighting the significant achievement of over 8 per cent reduction in overall tobacco use among adults in the state, as revealed in the second edition of the World Health Organisation’s Global Adult Tobacco Survey (GATS -2), the Minister said all Government health institutions including those in the AYUSH sector will be made tobacco free.

Infrastructure for tobacco cessation would be enhanced by starting tobacco cessation clinics in all Family Health Centres and AYUSH clinics, besides integrating tobacco control with ‘Swaas’ under the ‘Aardram’ programme of the Government.

“Increasing use of tobacco products amongst our youngsters is an area of concern,” the Minister said, and called for a war against drug-laced candies that are now easily available to students and youngsters.

Kerala’s cricket sensation Shri Sanju V Samson, who was the star attraction at the event organised jointly by Government agencies and civil society groups to mark the day, affirmed that he will refuse any tobacco products endorsement offers, triggering a loud applause from the audience.

He called upon children to develop the mental strength to be able to say a strict “no” to tobacco. 

Shri Samson also led a pledge against tobacco use and appealed to all participants to put the oath into practice. “Pledge to protect at least two of your friends from tobacco,” he exhorted the youngsters present.

Inspector General of Police Shri P Vijayan pointed out that India has over 40 crore children below the age of 15. “If groomed correctly, these youngsters can be shining ambassadors for the country, else India would have to take the blame for creating a generation with eroded values,” he cautioned.

A committed tobacco control advocate, Shri Vijayan added that it is important to give the needed support to youngsters prone to tobacco use, rather than condemning them.

Dr Asha Kishore, Director, Sree Chitra Tirunal Institute of Medical Sciences and Technology (SCTIMST), spoke about the association of tobacco use with stroke and cardiovascular diseases.

Dr Paul Sebastian, Director, Regional Cancer Centre, also emphasised the importance of targeted tobacco control interventions for youngsters.

Dr V R Raju, Director of Health Services (in-charge), delivered the welcome address, and Dr V Ramankutty, Director, Achutha Menon Centre for Health Science Studies (AMCHSS), proposed a vote of thanks.

In the technical session earlier, experts spoke about tobacco problems in Kerala as revealed by GATS 2, control opportunities for the Government and the civil society, problems in educational institutions, role of social media and tobacco industry tactics. 

In line with this year’s theme of ‘Tobacco Use and Heart disease’, the technical session detailed how tobacco use endangers heart health and about the Government’s plans for augmenting tobacco control. Findings of a recent study assessing the sales and purchase patterns of cigarettes and other tobacco products in three cities of Kerala were also presented.

Dr KR Thankappan, Professor Emeritus, AMCHSS; Dr S Sivasankaran, Professor of Cardiology, SCTIMST; Dr AS Pradeep Kumar, Former Addl Director of Health Services; Dr Kamala Rammohan, Member, Health Action by People; Dr Manu MS, State Consultant, National Tobacco Control Programme; Shri RS Shibu, Joint Director, DPI; Dr Nelson Joseph, Info Clinic, Mr Saju Itty, Executive Director, Kerala Voluntary Health Services were the speakers. Dr Sanjeev Nair, Associate Professor, Government Medical College, Trivandrum moderated the technical session.

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Lighters can very well light up incense sticks

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Tobacco use down in State, reveals survey

The second round of Global Adult Tobacco Survey (GATS) reveals that overall tobacco use has declined significantly among adults in Kerala from 21.4% in 2009-10 to 12.7% in 2016-17.

The survey data was released here on Wednesday by Health Minister K.K. Shylaja.

The data shows that smoking has decreased among adults from 13.4% to 9.3% during this time-period while the use of smokeless tobacco also came down from 10.7% to 5.4%.

GATS-2 survey found that cigarette and betel quid with tobacco were the two most commonly used tobacco products in the State with 6.7% of the adults smoking cigarette and 4.4% of adults using betel quid with tobacco.

The survey, which has set global standards for systematically monitoring adult tobacco use and tracking key tobacco control indicators, covered all persons above 15 years across the country.

The first round of GATS was conducted in 2009-10. GATS 2 was conducted in 2016-17 under the stewardship of the Ministry of Health & Family Welfare (MoH&FW), Government of India, with technical assistance from World Health Organisation (WHO), Centres for Disease Control and Prevention (CDC) and Tata Institute of Social Sciences, Mumbai, using a multi-stage sample design.

In Kerala, GATS 2 covered a total of 783 males and 1,403 females.

One encouraging result from GATS-2 is that there has been a significant decline in exposure to second hand smoke (SHS) from tobacco use in the State in public places from 18.7% in 2009-10 to 13.7% in 2016-17. SHS exposure at home fell sharply from 41.8% to 16.0% while at workplaces, it increased from 17.5% to 20.8% during the same period.

Source: The Hindu

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പുകയില പാക്കറ്റുകളിലെ ക്വിറ്റ്ലൈന്‍ ടോള്‍ ഫ്രീ നമ്പര്‍: ശക്തമായ പിന്തുണയുമായി ഡോക്ടര്‍മാരും പുകയില ഉപേക്ഷിച്ചവരും

2018 സെപ്റ്റംബര്‍ 1 മുതല്‍ എല്ലാ പുകയില പാക്കറ്റുകളിലും ക്വിറ്റ് ലൈന്‍ ടോള്‍ ഫ്രീ നമ്പറായ 1800 11 2356  ചേര്‍ക്കണമെന്ന കേന്ദ്ര സര്‍ക്കാര്‍ തീരുമാനത്തിന് ശക്തമായ പിന്തുണ നല്‍കി ഡോക്ടര്‍മാരും പുകയില ഉപേക്ഷിച്ചവരും.  പുകയിലയെ എന്നെന്നേയ്ക്കുമായി ഉപേക്ഷിക്കാന്‍ ആഗ്രഹിക്കുന്ന, അതേസമയം  അത് എങ്ങനെ ചെയ്യണം എന്ന് അറിയാത്തവര്‍ക്ക് കേന്ദ്ര ആരോഗ്യമന്ത്രാലയത്തിന്‍റെ ക്വിറ്റ്ലൈന്‍ സേവനം ഒരു ഫോണ്‍കോളിലൂടെ നേരിട്ടു ലഭിക്കും എന്നതാണ് ഇതിന്‍റെ പ്രത്യേകത. 

പുകവലിക്കുന്നവരും പുകയില ഉത്പന്നങ്ങള്‍ ഉപയോഗിക്കുന്നവരും ക്വിറ്റ് ലൈന്‍ നമ്പര്‍ ഡയല്‍ ചെയ്താല്‍ മറുവശത്ത് പരിശീലനം ലഭിച്ച കൗണ്‍സിലര്‍മാര്‍  നിശ്ചിത സമയപരിധിക്കുള്ളില്‍ ഈ ദു:ശീലം ഉപേക്ഷിക്കുന്നതിനുള്ള ഉചിതമായ പരിഹാരങ്ങളും വഴികളും  ഉപദേശിക്കുകയും ചെയ്യും.

ഇന്ത്യന്‍ മെഡിക്കല്‍ അസോസിയേഷന്‍ (ഐഎംഎ) കേരള അദ്ധ്യക്ഷന്‍ ഡോ. ഇ.കെ. ഉമ്മര്‍ കേന്ദ്ര സര്‍ക്കാര്‍  നടപടിയെ സ്വാഗതം ചെയ്തു. എല്ലാ പുകയില ഉല്‍പന്ന പായ്ക്കുകളിലും ക്വിറ്റ് ലൈന്‍ നമ്പര്‍ ഉള്‍പ്പെടുത്തുന്നതിലൂടെ പുകയില ഉത്പന്നങ്ങള്‍ ഉപയോഗിക്കുന്നവര്‍ക്കും അല്ലാത്തവര്‍ക്കും ഈ നമ്പര്‍ കൂടുതല്‍ പരിചിതമാകുമെന്നും സ്വമേധയാ ഈ ദുശീലം ഉപേക്ഷിക്കാന്‍ ഇത് കൂടുതല്‍ ആളുകളെ പ്രേരിപ്പിക്കുമെന്നും അദ്ദേഹം അഭിപ്രായപ്പെട്ടു.    

വായിലെ കാന്‍സറിന്‍റെ രൂക്ഷത പ്രകടിപ്പിക്കുന്ന ചിത്രങ്ങള്‍ ഒരു ഡോക്ടര്‍ ആയ തന്നില്‍പോലും വേദനയുളവാക്കുന്നു. ഇത്തരം ചിത്രങ്ങള്‍ കാണുകയും പുകവലിയുടെ ദോഷങ്ങള്‍ മനസിലാക്കുകയും ചെയ്യുന്നവര്‍ തീര്‍ച്ചയായും ഈ ദുശീലം ഉപേക്ഷിക്കുന്നതിന് ക്വിറ്റ്ലൈനിനെ ആശ്രയിക്കുമെന്ന് അദ്ദേഹം പറഞ്ഞു.  

ദീര്‍ഘകാലമായി ആഗോളതലത്തില്‍വരെ പുകയില മോചന പ്രചാരണ പ്രവര്‍ത്തനത്തിനായി പ്രവര്‍ത്തിക്കുന്ന അച്യുത മേനോന്‍ സെന്‍റര്‍ ഫോര്‍ ഹെല്‍ത്ത് സയന്‍സ് സ്റ്റഡീസിലെ എമിരിറ്റസ് പ്രൊഫസര്‍ ഡോ. തങ്കപ്പന്‍,  ഇംഗ്ലീഷ് ഹിന്ദി ഭാഷകളില്‍ മാത്രമല്ല, ഇന്ത്യയിലെ എല്ലാ പ്രമുഖ ഭാഷകളിലേക്കും ഈ സേവനം വ്യാപിപ്പിക്കണമെന്ന് അഭിപ്രായപ്പെട്ടു. ഇന്ത്യയില്‍ പുകയില ഉപയോഗം അവസാനിപ്പിക്കുന്നവര്‍  23 ശതമാനത്തില്‍ താഴെയാണ്. ഇത് പുകയില ഉല്‍പന്നങ്ങളുടെ തീക്ഷ്ണമായ  ആസക്തി സ്വഭാവമാണ് ചൂണ്‍ണ്ടിക്കാട്ടുന്നത്. ഈ സ്വഭാവത്തില്‍നിന്ന് മോചനം നേടാന്‍ ക്വിറ്റ്ലൈന്‍ പ്രയോജനപ്പെടുമെന്ന് അദ്ദേഹം ചൂണ്ടിക്കാട്ടി.

വിവിധ തരത്തിലുള്ള പുകയില ഉത്പന്നങ്ങളുടെ ഉപയോഗം നിര്‍ത്താന്‍ ആത്മാര്‍ത്ഥമായി ആഗ്രഹിക്കുന്ന എല്ലാവര്‍ക്കും ക്വിറ്റ്ലൈന്‍ വളരെ ഉപകാര പ്രദമായിരിക്കുമെന്ന് പതിനേഴാം  വയസ്സില്‍ ഈ ശീലത്തിന് തുടക്കമിട്ട് 35 വയസ്സുള്ളപ്പോള്‍ ഉപേക്ഷിച്ച സുരേഷ് കെ.സി അഭിപ്രായപ്പെട്ടു. മലബാര്‍ കാന്‍സര്‍ സെന്‍റര്‍ പുകയില ഉത്പന്നങ്ങള്‍ ഉപേക്ഷിച്ചവരുടെ കൂട്ടായ്മയായി രൂപം നല്‍കിയ  'മുന്നേറ്റം' എന്ന സംഘടനയുടെ സെക്രട്ടറിയാണ് സുരേഷ്.  മുന്നേറ്റത്തിന്‍റെ ശ്രമഫലമായി ഇതുവരെ 160 പേര്‍ പുകയില എന്ന ദുശീലം ഉപേക്ഷിച്ചിട്ടുണ്ടെന്നും അദ്ദേഹം കൂട്ടിച്ചേര്‍ത്തു.

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Total ban on smokeless tobacco may soon be a reality in India

On the 26th April, Dr Balram Bhargava, the newly appointed director general of Indian Council of Medical Research (ICMR), the apex body for medical research in India, said that the government must take steps to contain the growing consumption of tobacco through measures as aggressive as those used to fight tuberculosis in the country. He also suggested that all medical colleges must have tobacco cessation clinics – small set up with doctors from surgery, cardiology, psychiatry and dentistry – and those which don't have such clinics, must be de-recognised and higher taxation should be imposed on tobacco, along with sugar and trans fats. He also highlighted the burden of the problem in India and neighbouring countries in South East Asia such as Bangladesh, Myanmar, Sri Lanka and others.

“I am planning to raise these issues with the prime minister, I have sought an appointment with him. I will probably be meeting him next week,” Dr Bhargava said, speaking at the National Institute of Cancer Prevention and Research (NICPR) for the release of a report brought out by the WHO Framework Convention for Tobacco Control and NICPR, recommending the ban on manufacturing, selling and importing smokeless tobacco products which include pan masala, gutka, and khaini. The report also throws light on the global progress made in implementing smokeless tobacco control policies as these products have posed a grave challenge to public health in the country.

Dr Bhargava, a former professor of cardiology at AIIMS, said that heart attacks have hit those in their early 40s too, "even when there is no history of diabetes or hypertension, and it is all because of tobacco use.” Dr Ravi Mehrotra, director, NICPR, spoke about the opening of India’s first tobacco testing laboratory next month. The laboratory will be the first-of-its-kind set up which will be equipped to detect and quantify tobacco content in products sold in the market, he said. Other such laboratories are in Netherlands and in Atlanta. NICPR is also now a global hub for smokeless tobacco research.

According to the latest Global Adult Tobacco Survey India Report 2016-17 (GATS), which is a global standard for systematically monitoring adult tobacco use (smoking and smokeless) and tracking key tobacco control indicators, 199.4 million of all adults currently use smokeless tobacco in India and 49.6 per cent of current smokeless tobacco users are planning or thinking of quitting smokeless tobacco use. A 2010 study estimated that more than 36,800 deaths were attributable to smokeless tobacco use in the country. To address the issue, the government has joined hands with WHO-FCTC Secretariat and set up a global knowledge hub on Smokeless Tobacco (KH-SLT) at the ICMR-NICPR, Noida.

Source: The Week

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Health Ministry Notifies New Pictorial Health Warnings on Tobacco Products: Quitline Number to be introduced First Time on Tobacco Products in India

Replacing the existing images on tobacco products, the Health Ministry has now released a new set of 85 percent pictorial health warnings for mandatory display on both sides of the packets of cigarettes, bidis, and chewing tobacco with effect from September 1, 2018. Government of India for the first time introduced Quitline number to be printed on all tobacco products.

As per the notification, two images of specified health warnings as notified in the schedule shall be displayed on all tobacco product packages and each of the images shall appear consecutively on the package with an interregnum period of 12 months.

During the rotation period, there shall be two images of specified health warning which shall appear consecutively on the package with an interregnum period of twelve months.

Textual Health Warning. – For smoking and smokeless forms of tobacco products, the word “TOBACCO CAUSES CANCER” and the word “TOBACCO CAUSES PAINFUL DEATH” shall appear in white font colour on a red background and the words “QUIT TODAY CALL 1800-11-2356” shall appear in white font colour on a black background.

The Health Ministry has implemented, from April 2016, large pictorial health warnings occupying 85 per cent on both sides of all tobacco packages of cigarettes, bidis and all forms of chewing tobacco products and have been in effect for almost 2 years.

India’s current international ranking for package warnings is no. 3rd in the world, as outlined in the October 2016 Canadian Cancer Society Report, Cigarette Package Health Warning International Status Report that ranked 205 countries worldwide. The entire world applauded this progressive step taken by India in tobacco control and saving human lives. Implementing 85 percent pictorial warnings was a landmark step taken by the Government of India.  Shri J.P. Nadda was awarded by the World Health Organization for this major reform in public health.

The recently released Global Adult Tobacco Survey (GATS) 2016-17 by Union Ministry of Health and Family Welfare (MoHFW) had put to rest all apprehensions about the effectiveness of the warnings, since 62% of cigarette smokers and 54% of bidi smokers shared that they had thought of quitting because of the 85 percent pictorial warnings on the packets. And 46% of smokeless tobacco users thought of quitting because of the warnings on smokeless tobacco products.  

Pictorial health warnings on tobacco products are the most cost-effective tool for educating on the health risks of tobacco use. In a country like India, where people use several languages and dialects, the pictorial warning transcends the language and in many cases also the illiteracy barrier.

The 85 percent pictorial warnings on all cigarettes, bidis and chewing tobacco packages manufactured and sold in India, have resulted in 92% of adults (surveyed under GATS 2016-2017) believing that smoking caused serious illness, and 96%  saying that use of smokeless tobacco causes serious illness. The findings also revealed that there has been a growing demand for cessation centres as 55% of smokers and 50% of smokeless tobacco users were planning or thinking of quitting tobacco use.

Courtesy:News Patrolling

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Tobacco products to carry new warnings, ‘Quitline’ number

Replacing the existing images on tobacco products, the Union Health Ministry has now released a new set of pictorial health warnings that are to be displayed on both sides of packets of cigarettes, bidis, and chewing tobacco with effect from September 1, 2018.

The ministry has also for the first time introduced a ‘Quitline’ number - QUIT TODAY CALL 1800-11-2356 - to be printed on all tobacco products.

A notification in this regard was issued on April 3. As per the notification, two images of specified health warnings, as notified in the schedule, should be displayed on all tobacco product packages. “During the rotation period, there shall be two images of specified health warning, which shall appear consecutively on the package with an interregnum period of twelve months,” the notification has stated.

Textual health warning

“For smoking and smokeless forms of tobacco products, the words TOBACCO CAUSES CANCER and the words TOBACCO CAUSES PAINFUL DEATH shall appear in white font on a red background, and the words QUIT TODAY CALL 1800-11-2356 shall appear in white font on a black background,” the notification said. From April 2016, the Health Ministry has implemented the rule of large pictorial health warnings occupying 85% of the space on both sides of all packages of cigarettes, bidis and all forms of chewing tobacco products, and has been in effect for almost two years.

India’s current international ranking for package warnings is 3, as outlined in the October 2016 Canadian Cancer Society Report, Cigarette Package Health Warning International Status Report that ranked 205 countries worldwide. The entire world applauded this progressive step taken by India in tobacco control and saving human lives.

The recently released Global Adult Tobacco Survey (GATS) 2016-2017 by the Union Ministry of Health and Family Welfare (MoHFW) revealed 62% of cigarette smokers and 54% of bidi smokers shared that they had considered quitting because of the 85% pictorial warnings on the packets. Moreover, 46% of smokeless tobacco users considered quitting because of the warnings on smokeless tobacco products.

Courtesy:The Hindu

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Tobacco use is barrier to sustainable development-WHO Director

Dr. Tedros Adhanom Ghebreyesus, WHO Director General, says tobacco use is a barrier to sustainable development on all fronts.

He made the remark in Cape Town, South Africa, March 7 during the 17th World Conference on Health or Tobacco, WCTOH. The event is placed under the theme: “Uniting the World for a Tobacco Free Generation.”

During the event, the WHO Director joined various speakers to appeal for a renewed focus on tobacco control policies to help users quit and to prevent non-users from becoming addicted.

Michael Bloomberg and Bloomberg Philanthropies, all  organisers of the event said, “international collaboration is vital for tracking tobacco use, which remains the world’s leading preventable cause of death, killing more than seven million people each year.”

They disclosed that global tobacco control measures have saved nearly 35 million lives around the world, even though; tobacco industry is pushing to find new users.

Various participants attended the event were of the opinion that the event will serve as avenue “to address this epidemic by working together to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure. Tobacco has no benefits to humanity whatsoever as the tobacco industry is poisoning people to death,”

Given that tobacco use kills more than seven million people worldwide each year, stakeholders at the event proposed that to save lives, governments across the globe must stand up to the tobacco industry and fully implement the proven strategies called for by the tobacco control treaty, the FCTC. These include significant tobacco tax increases, comprehensive smoke-free laws, advertising bans and large, graphic health warnings.

“Now is the time for leaders to implement strong policies proven to protect their citizens from tobacco,” he appealed.

Courtesy:Journal du Cameroun

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India home to a high proportion of young smokers

Data from the Global Tobacco Atlas released recently indicates that despite lowering tobacco use in recent years, India is home to an estimated 625,000 child smokers in the age group of 10 to 14 years. More than 932,600 Indian lives are lost to tobacco-related diseases every year. Further, the economic burden of smoking is very high in India and this includes both direct cost of healthcare and the indirect cost of lost productivity.

Use of tobacco is one of the leading causes of cardiovascular diseases, stroke, pulmonary diseases and certain types of cancers.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “One of the major causes for continued tobacco consumption in India is the fact that it is a part of the country’s social culture. Kids start smoking even before they’re old enough to think about the risks; after starting they rapidly become addicted to smoking and then regret it later. Smoking aggravates bone loss and is a risk factor for hip fracture. It is responsible for more than 10% of heart blockage diseases all over the world and 33% of all cardiac deaths. Any form of tobacco like snuff, chewing, and dipping varieties which are not burnt can be termed as smokeless, another variant that is harmful to health. Smokeless forms also contain sugar and prolonged usage can adversely affect control of blood sugar levels in patients with diabetes.”

It is a common practice in India to use SLT mixed with areca nut. Areca nut itself is classified as a class one carcinogenic and also causes other adverse health effects.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Quite often, we may rebuke a patient for failing in his efforts to quit smoking and say, ‘If you do not quit, you may die’. A statement worded as this may inadvertently sound discouraging to the patient. While it is important that people know the dangers of smoking or using tobacco products, a positive communication approach may have a more fruitful impact than a critical approach.”

HCFI tips to quit this habit.

· Try short-acting nicotine replacement therapies such as nicotine gum, lozenges, nasal sprays, or inhalers. These can help overcome intense cravings.

· Identify the trigger situation, which makes you smoke. Have a plan in place to avoid these or get through them alternatively.

· Chew on sugarless gum or hard candy, or munch raw carrots, celery, nuts or sunflower seeds instead of tobacco.

· Get physically active. Short bursts of physical activity such as running up and down the stairs a few times can make a tobacco craving go away.

One approach to smoking cessation is the five-step algorithm called the “5 A’s” (Ask, Advise, Assess, Assist, Arrange)

All smokers should be advised to quit smoking.

Even brief advice to quit has been shown to increase quit rates.

Smokers be managed with a combination of behavioral support and pharmacologic therapy

Combination therapy is superior to either behavioral intervention or pharmacologic therapy alone.

Courtesy:The Health Site

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Campaign launched to warn of dangerous link between tobacco and TB

The Ministry of Health and Family Welfare (MoHFW), during the End-TB Summit here, has re-launched 'Cough,' a national mass media campaign to warn citizens about the links between TB and tobacco use.

'Cough' shows that tobacco consumption and exposure to secondhand tobacco smoke increases the risk of TB and of dying from the disease. A key barrier to timely diagnosis and treatment among smokers is the assumption that a cough is related to their smoking. This campaign encourages smokers to visit their doctor to confirm whether a persistent cough is a sign of TB.

TB killed 432,000 Indians in 2016 - more than 1,183 every day. The government aims to eradicate TB from India by 2025, five years ahead of the global TB elimination target of 2030. The campaign, which is designed to create support for TB eradication, encourage smokers to quit, and increase timely diagnosis and treatment of TB, was developed and implemented with technical support from Vital Strategies.

"Most TB deaths in India occur among young, economically productive adults and the disease is one of the top five causes of death among people aged 30-69 years," said Jose Luis Castro, President and Chief Executive Officer, Vital Strategies.

"India's tobacco epidemic is contributing to this burden. 'Cough' will support progress towards the target of eliminating TB by 2025 by encouraging smokers to quit and ensuring that smokers and those exposed to secondhand smoke visit the doctor about a persistent cough. This is a life-saving message and we congratulate MoHFW on the re-launch of this important campaign," added Castro.

When 'Cough' first launched on World No Tobacco Day in 2017, India became the first country in the world to run a national tobacco control campaign that highlights the increased risk of TB and dying from TB linked to smoking tobacco (cigarettes or bidis) or exposure to second hand smoke.

The public service announcement (PSA) graphically shows that while a smoker's cough tells the smoker they have a health problem, a persistent cough over two weeks or more could indicate that problem is TB. The PSA shows a father smoking and coughing beside his daughter, noting that exposure to second-hand smoke brings the same risks. It ends with the stark warning that "Every bidi cigarette brings you and those around you closer to TB."

Courtesy :Deccan Chronicle

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Detrimental Tobacco

Let me start by saying that I don't want to sound like a fanatic, for I don't suggest anything that I can't do myself. I quit smoking recently. And that's no small feat. Tobacco is the most common form of addiction and one of the most harmful as well, much more than the dreaded cannabis or for that matter Ecstasy, let alone alcohol.

If, and I know it's a big if, alcohol is consumed in moderation at a decent pace, half an hour for a peg, it's actually medicinal. But there's no safe amount of consumption of tobacco products. And for a young country like India, where half of the population is below 25 years of age, tobacco is doom. The greatest challenge before India, as a nation, is to exploit the incredible demographic potential—and inculcating a sports culture is the most effective way of doing it. Tobacco is the surest and easiest way of squandering it.

Simply put, tobacco is a significant public health hazard, and something urgently needs to be done to discourage people from tobacco consumption. Just to give an idea of the enormity of the problem, globally, tobacco kills more people than tuberculosis, HIV/AIDS, and malaria combined. Remember, smoking a cigarette is just one of many ways of consuming tobacco. The consumption of smokeless tobacco in the form of snuff, chewing tobacco, tobacco leaf and gutkha is widespread amongst all age groups in India. There's no escape, every second Indian is hooked on to one or the other form of tobacco consumption, and more often than not, it contributes to oral submucosal fibrosis or OSF.

More Indians chew tobacco than they smoke cigarettes or beedis, the figures are 26 per cent and 14 per cent, respectively, according to the Indian government and the World Health Organisation's Global Adult Tobacco Survey of 2009-2010. Not surprisingly, nearly 80 per cent of oral cancer patients are tobacco users.

Recently, the Indian Journal of Medical of Pediatrics published a study by Gauravi Mishra, Sharmila A Pimple and Surendra S Shastri that pointed to the fact that India is the second-largest consumer of tobacco globally, and accounts for approximately one-sixth of the world's tobacco-related deaths. The Global Youth Tobacco Survey paints a grim picture of India. It was carried out amongst students of classes VIII, IX and X, or roughly of the 13-16 age group. It was found that 15 per cent of students used tobacco products, mostly chewing tobacco (nearly 80 per cent).

Despite this, not much has been done to curtail tobacco consumption. One of the main reasons is that the tobacco industry is fairly influential. It has been boasting about its contribution to the Indian economy at large by generating employment in the agriculture and manufacturing sectors along with revenues in the form of exports and taxes, as a justification to be allowed to play with the health of our country's people. But one doesn't need rocket science to understand that the public health hazard caused by tobacco outweighs all economic benefits many times over.

In the past, many states have tried to ban chewing tobacco but with little success. Take the case of gutka, a concoction of raw betel nut mixed with tobacco, which has been banned for some years now. To circumvent this, many tobacco companies started selling gutka discreetly, by selling pan masala paired with a separate sachet of tobacco. Though this may seem harmless, tobacco sold in small portions in a sachet actually facilitates its use primarily amongst teenagers. Many celebrities, from the film industry to sports, campaign for tobacco products, in spite of the repeated persuasion against doing so. Tobacco, sadly, has become an integral part of life in cities and villages.

I specialise in youth outreach programmes by the way of sports. And tobacco consumption is a great impediment to the objective of creating a healthy society that is committed to playing sports. Children and the unemployed youth are hard-pressed for money, and their consumption of tobacco products is highly susceptible to strong fiscal measures.The availability of tobacco products in smaller quantities, in sachets and cigarettes sold by individual sticks, make it accessible to all, even children. Ideally, the government should ban the consumption of tobacco. But, till the time it's done, at least the government should ensure two things. One, those that are 18 years and below are not to be sold any tobacco product. And two, the sale of tobacco products in small quantities, especially sachets which cost merely Rs 5 to 10, should be banned at the earliest. This will effectively curtail the access of tobacco products to sub-adults. No half measures will suffice in the fight against tobacco. Ban tobacco. 

Courtesy: Millennium Post

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WHO wants developing countries to hasten implementation of tobacco control conventions

The World Health Organisation has reiterated the need for countries to focus on accelerating implementation of the Framework Convention on Tobacco Control (FCTC), especially in developing countries.

The WHO FCTC remains one of the most swiftly embraced United Nations treaties, gaining 181 Parties in just over ten years.

These 181 countries are legally obliged to adopt and implement its evidence-based measures for reducing tobacco use.

Since it came into force in 2005 high impact policies have been increasingly introduced by some countries around the world.

But officials believe it is high time more countries especially developing countries to live up to their commitments by accelerating the implementation of the Convention.

For some countries, this means ensuring that they comply with their obligations, such as tightening existing laws to eliminate smoking rooms and point-of-sale advertising.

It has been identified that tobacco not only wrecks health and health systems it is also a drain on economies and the environment.

Every year, according to the WHO, tobacco use kills about 7 million people, and many more people develop serious illnesses such as cancers, chronic respiratory diseases and heart disease.

Tobacco costs the global economy more than 1 trillion US Dollars annually in health spending and lost productivity.

“This is unacceptable”, said the Director-General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus during his opening speech at the 17th World Conference on Tobacco or Health, in Cape Town, South Africa.

Raising Taxes

He is optimistic this cost can be offset if all governments raised excise taxes by about 80 U.S. cents per pack of cigarettes.

This, according to him, would increase revenues by 47 percent, or 140 billion US Dollars, which could provide much-needed funding for health systems.

It would also increase cigarette prices by an average of 42 percent leading to a 9 percent decline in smoking rates and at least 66 million fewer smokers.

Effects of tobacco production on the environment

In a report published in 2017, the WHO showed that tobacco production is extremely water-intensive.

Large amounts of water are used in areas where tobacco farms and factories are located, which can put severe stress on local water reserves.

In addition, countless trees must be cut down to cure tobacco leaves, and the waste from tobacco also contains over 7000 toxic chemicals, including some that cause cancer.

Emissions from tobacco products contribute thousands of tonnes of human carcinogens, toxicants and greenhouse gases to the environment.

“All of this can be prevented if countries take action to implement the convention. Our message is implement, implement, implement the Convention. It is comprehensive,” Dr Adhanom Ghebreyesus

Call to eliminate the illicit trade in tobacco products

The “legal” cigarette market is bad enough. But the illicit trade of tobacco products creates a shadowy market that not only destroys health, it fuels organised crime and deprives governments of tax revenues.

The Protocol to Eliminate the Illicit Trade of Tobacco Products will help countries put a stop to the situation.

To come into force, the WHO needs six more countries to ratify by July, 2, because so far, only 34 countries have ratified the protocol.

“I urge countries in this room that have not ratified the protocol to do so. I am writing to all Parties to the Convention, encouraging them to ratify the Protocol and bring it into force,” he pleaded.

It is therefore critical for countries to strengthen their efforts and scale up their actions while facing increasing interference from the tobacco industry.

Today, 6 in 10 people globally are protected by at least one of the six tobacco control best practices in the demand reduction tobacco control policies, collectively known as MPOWER.

That’s four times more people than in 2007 when WHO first introduced MPOWER to help countries implement the Convention.

Africa is at the heart of the Sustainable Development agenda but is also seen as a growth market for the tobacco industry.

Africa has made great strides on some health issues, such as HIV/AIDS, but the tobacco problem is in its early stages and is not being given sufficient attention.

But there are many reasons for hope since countries like Ghana, Ethiopia, Gabon, the Gambia have recently increased tobacco taxes.

Kenya is fighting the illicit tobacco trade through an advanced track and trace system;

Senegal implemented four tobacco control measures at the same time, including large graphic health warnings and a comprehensive ban on tobacco advertising, promotion and sponsorship.

Uganda has passed a comprehensive tobacco control law, and 13 of the 34 countries that have ratified the illicit trade protocol are in Africa.

But there is more work to be done.

"We need to ensure that developing countries, some of which have the highest rates of tobacco consumption, take steps to implement the WHO Framework Convention on Tobacco Control. We need more countries to increase tobacco taxes to drive down smoking rates and generate revenues to fund health systems. We need to stop the illicit trade in tobacco products by bringing the WHO FCTC Illicit Trade Protocol into force,” the WHO Director said.

Head of the Secretariat of the WHO FCTC, Dr Vera Luiza da Costa e Silva, told delegates that tobacco control was at the heart of the new Sustainable Development Agenda.

“By accelerating the implementation of the WHO FCTC, the global tobacco control treaty, and becoming Parties to the Protocol to Eliminate Illicit Trade in Tobacco Products, countries can facilitate the achievement of their goals by 2030 and save tens of millions of lives,” said da Costa e Silva.

Meanwhile, President of the 17th WCTOH, Dr Flavia Senkubunge, is optimistic the high quality of science being presented in Cape Town comes at a pivotal moment in tobacco control.

“This confirms that we know what works in tobacco control,” said Dr Flavia Senkubunge.
 

Courtesy: myjoyonline.com

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Sale Of Gutkha In Maharashtra Will Become A Non-Bailable Offence, Says Govt

The Maharashtra government on Wednesday told the Legislative Council that sale of gutka, banned in the state, would be made a non-bailable offence.

Punishment for the offence would be enhanced to three years in prison, the government said.

Leader of Opposition Dhananjay Munde alleged through a calling attention motion that though anti-gutka laws are in place, gutka -- a scented tobacco mix -- is smuggled from neighbouring states.

Smuggling happens with connivance of corrupt officials in the Food and Drug Administration (FDA), the NCP leader alleged, demanding an inquiry by the Criminal Investigation Department (CID).

In response, Minister of State for FDA Madan Yerawar said gutka is manufactured in other states where it is not banned, and the Maharashtra FDA, since 2012-13, has seized gutka worth Rs 114.2 crore.

Munde said Maharashtra has the highest number of youth falling prey to cancer due to chewing of gutka. He demanded inquiry into continuing sale of gutka despite the ban.

FDA minister Girish Bapat said that currently the sale of gutka is a bailable offence with a punishment of a maximum of six months in prison.

The government has held discussions with the Director General of Police and the Law and Judiciary Department, and will make the offence non-bailable, he said.

"The Centre has given us the permission to do so. Once the technicalities are sorted out (and the amendment made), those found guilty will have to face a rigorous imprisonment for three years," the senior minister said.


An inquiry by the vigilance squad of the FDA is underway into illegal sale of gutka, and the government will order a CID probe if the Leader of Opposition is still not satisfied with its report when it comes out, Bapat assured.

Courtesy:Outlook India

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9.9% school kids suffer from bronchial asthma

The students residing in rural area who are exposed to smoke along with a family history of bronchial asthma are at greater risk of getting the chronic inflammatory disease compared with those staying in urban area, shows a study conducted by Amrita Institute of Medical Sciences among the higher secondary school students in Ernakulam district.

A total of 629 students participated in this study and the prevalence of bronchial asthma was estimated to be 9.9%. Besides family history, one of the main causes for asthma as per the study is active and passive smoking. Almost 15.3 % of those who had asthma reported that their friends used to smoke in their presence, when compared to 8.6% of those who reported not being exposed to friend's smoke. In the study, 18.6% who had asthma reported a family history of asthma, as per the study published in the Journal of Family Medicine and Primary Care.

"One of the main cause of chronic respiratory disease is active and passive smoking, besides family history. This shows that despite the tobacco control programs in place, school students in Ernakulam reportedly smoke," one of the author of the study PS Rakesh, department of community medicine, AIMS.

The study shows that while 5.4% of those having bronchial asthma were told by a doctor that they had asthma, 4.1% were currently receiving treatment for asthma. Majority of those studied (56.1%) were males, with 54.8% residing at a rural location and 93.9% living in pucca houses. Incidentally, of those residing in rural area (12.2%) had asthma while it was 7.1% for those belonging to urban areas.

In India, there are currently more than 15 million people living with asthma. Kerala government that has implemented a pilot project of the World Health Organization (WHO) recommended practical approach to lung health strategy, with an intention to further strengthen the health system and to improve the quality of diagnosis, treatment and management of common chronic respiratory illnesses in primary healthcare settings.

The state government has a plan to scale up public health programmes for chronic respiratory disease management. As per the plan, they have started a programme to address the problem of asthma and chronic obstructive pulmonary disease, a major cause of morbidity and mortality in India, affecting nearly 9% of the population above 35 years.

Courtesy:Times of India

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Tobacco shops can't sell soft drink, snacks

Sale of soft drinks, chips, toffees and other eatables at tobacco and cigarette shops will be banned in Lucknow city.

The Lucknow Municipal Corporation has prepared a team in each zone to crack down on tobacco shops selling eatables and soft drinks. The decision came following the guidelines of the Cigarettes and Other Tobacco Products Act, 2003 (COTPA), which restricts selling of eatables at tobacco shops.

The municipal commissioner has issued orders to all eight zonal officials to survey all markets and residential areas in their zones and crack down on tobacco shops selling toffees and other eatables. The commissioner has written to the district administration to provide support to the drive.

A joint team of five departments-LMC, police, CMO, Food Safety and Drug Administration, state government and district administration-will raid these shops. While police have authority to impose a penalty of Rs 500-5,000 on tobacco shop owners selling eatables, FSDA department can even cancel licences of permanent shops.

LMC has the responsibility to remove shops running illegally on roadsides.

LMC's environment engineer Pankaj Bhushan said, "The drive is to prevent children from accessing tobacco shops. It is observed that while reaching out to these shops to buy chips, toffees and cold drinks, children also get access to tobacco products. To stop this and create awareness, LMC has launched the drive to remove eatables from these shops."

Courtesy:Times of India

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Holy smoke! Sale of tobacco products to kids continue unchecked

  

The sale of tobacco products to those under the age of 18 continues to burgeon in blatant disregard of the law making this illegal. Every vendor has the board put up claiming that sale to underage children is prohibited. However, the biggest customers for tobacco products remains school and college students!

The once in a blue moon raids carried out by excise sleuths or police results in big loads of pan and other products being confiscated. However, there is seldom any action other than detaining the peddlers and slapping them with a fine. Often there aren't any probe into the source and the channels of smuggling these products.

The punishment for transporting or selling tobacco products is only a fine, a mere slap on the wrist which enables those caught to continue doing the same things. Most of the people caught in such instances under police record are repeat offenders. These days, on top of tobacco products, even intoxicating sweets are being sold in shops near schools.

Earlier, routine health department checks used to take place under schemes like Healthy Kerala. This kept a check on the sale of such products. However, new steps taken by the health department, decreasing the regularity of checks has contributed to the upsurge in sales of these products.

In spite of the fact that parent bodies, teachers associations and school managements are all increasing their roles, in many cases, nobody comes forward to give an official complaint. The need of the hour is to stop letting off those involved with mere fines and instead trace out the source of the problem and bring them to public light.

Courtesy: Manoramaonline

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E-cigarette vapours laden with toxic metals, say experts

It has come to light that e-cigarette vapours contain a significant amount of toxic metals, which can be dangerous.

According to a study conducted by at Johns Hopkins Bloomberg School of Public Health, significant amounts of toxic metals, including lead, leak from some e-cigarette heating coils and are present in the aerosols inhaled by users.

 In the study, the scientists examined e-cigarette devices owned by a sample of 56 users. They found that significant numbers of the devices generated aerosols with potentially unsafe levels of lead, chromium, manganese and/or nickel.

Chronic inhalation of these metals has been linked to lung, liver, immune, cardiovascular and brain damage, and even cancers.

"It's important for the FDA, the e-cigarette companies, and vapers themselves to know that these heating coils, as currently made, seem to be leaking toxic metals--which then get into the aerosols that vapers inhale," said senior author, Ana María Rule.

Vaping, the practice of inhaling this aerosol as if it were cigarette smoke, is now popular especially among teens, young adults and former smokers.

Vaping is popular in part because it provides the nicotine "hit" and the look and feel of tobacco-smoking but without smoking's extreme health risks. Evidence that vaping isn't entirely safe continues to accumulate, however.

For the new study, Rule and her colleagues, including lead author Pablo Olmedo, recruited 56 daily e-cigarette users from vaping conventions and e-cigarette shops around Baltimore during the fall of 2015.

Working with participants' devices, which they brought to the researchers' lab at the Bloomberg School, the scientists tested for the presence of 15 metals in the e-liquids in the vapers' refilling dispensers, the e-liquids in their coil-containing e-cigarette tanks and in the generated aerosols.

Consistent with prior studies, they found minimal amounts of metals in the e-liquids within refilling dispensers, but much larger amounts of some metals in the e-liquids that had been exposed to the heating coils within e-cigarette tanks.

The difference indicated that the metals almost certainly had come from the coils. Most importantly, the scientists showed that the metal contamination carried over to the aerosols produced by heating the e-liquids.

Of the metals significantly present in the aerosols, lead, chromium, nickel and manganese were the ones of most concern, as all are toxic when inhaled.

Almost 50 per cent of aerosol samples had lead concentrations higher than health-based limits defined by the Environmental Protection Agency. Similarly, median aerosol concentrations of nickel, chromium and manganese approached or exceeded safe limits.

"These were median levels only," Rule said. "The actual levels of these metals varied greatly from sample to sample, and often were much higher than safe limits".

E-cigarette heating coils typically are made of nickel, chromium and a few other elements, making them the most obvious sources of metal contamination, although the source of the lead remains a mystery.

Precisely how metals get from the coil into the surrounding e-liquid is another mystery. "We don't know yet whether metals are chemically leaching from the coil or vaporizing when it's heated," Rule said.

The researchers did observe, however, that aerosol metal concentrations tended to be higher for e-cigarettes with more frequently changed coils--suggesting that fresher coils give off metals more readily.

The researchers also detected significant levels of arsenic, a metal-like element that can be highly toxic, in refill e-liquid and in the corresponding tank e-liquid and aerosol samples from 10 of the 56 vapers. How the arsenic got into these e-liquids is yet another mystery--and another potential focus for regulators.

The findings from the study are published online in Environmental Health Perspectives.

Courtesy Deccan Chronicle

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Tobacco Increases The Risk Of Cancer No Matter How It Is Used: Study

A recent study conducted by JAMA Internal Medicine revealed that cigarettes were not the only type of tobacco products that can lead to premature death or fatalities from smoking-related cancers. There is only one difference – the people who exclusively smoke cigarettes have twice the risk of premature death. But people who use cigars or pipes are not safe either, according to the study. The research team was headed by Carol Christensen, member of U.S. Food and Drug Administration’s Center for Tobacco Products.

“Combustible tobacco used in any form is a cancer risk, and pipe and cigar smokers cannot be given a pass,” said Dr Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City to Medical Express.

The research tracked the health and habits of more than 3,57,000 US citizens from 1985 to 2011. Among the people who were selected for the research, 57% (2,03,071) never used tobacco. 5,7,251 participants were daily cigarette smokers. 531 participants were cigar smokers and 1099 participants had a daily habit of using pipes.

“Cigar smokers had a 20 percent elevated odds of death from any cause and a 61 percent higher risk of death from tobacco-linked cancer,” the research stated. Compared to the never smokers, pipe smokers had a 58% higher risk of dying from tobacco-linked cancer during the research period.

“A full-size cigar can contain chemicals the equivalent of one pack of cigarettes, and individuals who switch from cigarettes to cigars frequently unintentionally inhale cigars the way they inhaled cigarettes—exposing them to large amounts of the hazardous substances in cigar smoke,” said Patricia Folan who directs the Centre for Tobacco Control at Northwell Health in Great, New York.

Tobacco consumption in India

The findings in the study have relevance in the Indian context as the country stands as the second largest consumer and producer of tobacco globally. China tops the list. India also accounts for one-sixth of the world’s tobacco-related deaths. Tobacco is available in the country in wide varieties of smoke and smokeless forms. Tobacco consumption is highest in the states like Mizoram, Meghalaya, Manipur, Nagaland, Tripura, and Assam, according to the data published by the National Family Health Survey.

Source: The Logical Indian

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