Wednesday, 21 March 2018

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.

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Monday, 19 March 2018

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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Friday, 16 March 2018

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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Tuesday, 13 March 2018

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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Friday, 9 March 2018

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.
 
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Thursday, 8 March 2018

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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Tuesday, 6 March 2018

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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