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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Just 3 per cent of cigarette trade in India illicit: Study differs from industry claims

Industry estimates of the illegal cigarette trade in India could be vastly overrated, suggests a study published in BMJ Tobacco Control that found that less than 3% cigarettes sold in the market have travelled through illegal channels. Industry estimates, which come out routinely every time taxes on tobacco products are increased, put the figure at 20-25%.

The study collected 11,063 empty cigarette packs from 1,727 retailers across the country and found varying proportions of illicit products across the country. A cigarette pack was classified as illicit if it had a duty-free sign, no graphic health warnings, no textual health warnings or no mention of “price inclusive of all taxes” or similar text.

Empty packs generated by one day’s single-cigarette sales were collected directly from vendors in four large and four small cities covering the length and breadth of India. Ten areas were randomly selected in each city/town, and all shops selling cigarettes within 1 km of the central point were surveyed.

The study concluded: “Our estimate of the illicit cigarette market share of 2.73% casts serious doubt on the tobacco industry estimate of 20% and Euromonitor’s estimate of 21.3%.” The estimates varied substantially across locations, with the highest prevalence of illicit packs in the Mizoram capital of Aizawl (35.87%) near the Bangladesh and Myanmar borders. The share of illicit cigarettes was found to be much higher (13.77%) among the cheapest cigarette brands.

Conducted by researchers from the Centre for Public Policy Research, Kochi, and the School of Economics, University of Cape Town, the study is the first independent estimate of illicit cigarette trade in India. It is significant because raising tobacco taxes are a crucial public health intervention to reduce health effects of tobacco products and because every time this is done, the tobacco industry cries foul and presents its own estimates of illicit trade to highlight how much revenue the government is losing out on.

For example the Tobacco Institute of India, which describes itself as a “representative body of farmers, manufacturers, exporters and ancillaries of the cigarettes’ segment of the tobacco industry in India, whose members account for more than 98% of the country’s domestic sales of duty paid cigarettes”, puts the share of illicit cigarettes at a quarter of the market. “Illegal cigarette trade comprising international smuggled and locally manufactured tax-evaded cigarettes accounts for as much as 1/4th of the cigarette industry in India. Based on the current tax rates on cigarettes, it is estimated that the government loses Rs. 13,000 crore per annum on account of illegal cigarette trade,” states the TII handbook on illicit cigarette trade.

“Tobacco industry always makes tall claims about how huge the illicit tobacco problem in India is and they have been saying that it has been increasing over the years,” Dr Rijo John, senior fellow at the Centre for Public Policy Research, Kochi, and one of the authors of the study, told The Indian Express. “In several countries that claim has worked as a deterrent for the government in taxation. But in India there are no independent studies to validate those claims.”

The study also comes in the backdrop of a Karnataka High Court order that ruled that 40% and not 85% should be the size of the pack warnings. The Supreme Court, which later stayed the Karnataka High Court order, will hear the matter in the coming days.

Dr Pankaj Chaturvedi, oncologist at the Tata Memorial Hospital, Mumbai said: “This article published yesterday is a big blow to the falsehood being promoted by cigarette lobby regarding magnitude of illicit cigarette business in India. For decades they have misled policy makers with fabricated statistics to garner sympathy and derail efforts for higher taxation and pack warning. This proves that statistics forwarded by tobacco lobby should never be relied upon.”

Source: The Indian Express

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