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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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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How Smoking and Tobacco Changes Your Body and Mind

It is far too common these days to see someone lighting up a cigarette and puffing it in public. While many are very much addicted to this vice, others take it at certain times for a little feel good feeling. Whichever the reason, smoking is dangerous to both smokers and none smokers. The probability of death by tobacco for a long term smoker is strikingly high. Smoking without a doubt is dangerous to health and life.

While the media portrays smoking in a glamorous light, in reality it is far from that. According to the World Health Organization(WHO), 25 major life threatening diseases are linked to smoking. Smoking plays a big role in the cause of lung cancer, heart attack, stroke and so forth. It causes stinking breath, skin problems, impotence in men and even makes the teeth brownish.

Asides harming the smoker, smoking also harm those around the smoker. Children who are constantly near smokers are at a risk of having pneumonia and other chest problems. Smoking is also dangerous to pregnant women.Dangerous substance in the cigarette smoke can enter into the pregnant woman’s body and then enter the child. This could harm the baby, in some cases lead to stillbirth, abortion and even death.

Tobacco vs Cigarette
In a bid to convince people to keep up the habit of smoking, the tobacco industry brought out low tar and nicotine cigarettes. This however seems to be worse as those who made the switch craves as much dose of nicotine as they had when something taking cigarettes.Yet those that simply switch are still at risk of health problems.

There is the powdered tobacco called snuff and the chewing tobacco which is chewed.

Cigars and pipes are also not any different. They still have as much negative effects. There is even an increased risk of developing cancer of the mouth or lip.

Whichever the case, snuff and chewing tobacco both are causes of cancer, cause bad breath, stained teeth. So sucking or chewing tobacco is by no means a wise alternative to smoking it.

Benefits of Quitting
    Low risk of lung cancer
    Better breath and smell
    Freedom from nicotine
    Decrease in coughing and other chest complications.
    Feelings of accomplishment

Many smoke addicts who do want to quit smoking has found it difficult to do, due to the large amount of nicotine which is a highly addictive substances. Nicotine, is a substance which is more active than heroin and cocaine. This is one reason why quitting is hard. Another reason is that smoking has been interwoven into our daily routine. The media and many in the society views it as normal, without really paying attention to the effect it will have on the long run.

By all means, the Pros outweigh the Cons. Smoking is a terrible habit, one that easily ruin a person as well a be harmful to loved around him. It is more than a pleasurable past time. It is dangerous.

Article by Paul Becker in Times Lifestyle

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One cigarette a day 'increases heart disease and stroke risk'

Smokers need to quit cigarettes rather than cut back on them to significantly lower their risk of heart disease and stroke, a large BMJ study suggests.

People who smoked even one cigarette a day were still about 50% more likely to develop heart disease and 30% more likely to have a stroke than people who had never smoked, researchers said.

They said it showed there was no safe level of smoking for such diseases.

But an expert said people who cut down were more likely to stop.

• Why young people are now less likely to smoke
• Quit smoking campaign backs e-cigs
• 'One smoke leads to daily habit for most'

'Stop completely'
Cardiovascular disease, not cancer, is the greatest mortality risk for smoking, causing about 48% of smoking-related premature deaths.

While the percentage of adults in the UK who smoked had been falling, the proportion of people who smoked one to five cigarettes a day had been rising steadily, researchers said.

Their analysis of 141 studies, published in the BMJ, indicates a 20-a-day habit would cause seven heart attacks or strokes in a group of 100 middle-aged people.

But if they drastically cut back to one a day it would still cause three heart attacks, the research suggests.

The researchers said men who smoked one cigarette a day had about a 48% higher risk of developing coronary heart disease and were 25% more likely to have a stroke than those who had never smoked.

For women, it was higher - 57% for heart disease and 31% for stroke.

Prof Allan Hackshaw at the UCL Cancer Institute at University College London, who led the study, told the BBC: "There's been a trend in quite a few countries for heavy smokers to cut down, thinking that's perfectly fine, which is the case for things like cancer.

"But for these two common disorders, which they're probably more likely to get than cancer, it's not the case. They've got to stop completely."

The researchers said it might be expected that smoking fewer cigarettes would reduce harm in a proportionate way as had been shown in some studies with lung cancer.

However, they found that men who smoked one cigarette per day had 46% of the excess risk of heart disease and 41% for stroke compared with those who smoked 20 cigarettes per day.

For women it was 31% of the excess risk of heart disease and 34% for stroke.

Prof Hackshaw said the increased risks of cardiovascular illness were over the course of a lifetime but damage could be done in just a few years of smoking.

But he said the good news was that those who quit smoking could also quickly reduce their risk of cardiovascular disease.

Cutting down not 'useless'
Paul Aveyard, professor of behavioural medicine at the University of Oxford, said the "well conducted" study confirmed what epidemiologists had suspected - that light smoking created a "substantial risk for heart disease and stroke".

But he said it was wrong to conclude cutting down smoking was useless.

"Those who try to cut down with the aid of nicotine, whether from nicotine replacement treatment or an e-cigarette, are more likely to stop eventually and thus really reduce their risks from smoking," he said.

Martin Dockrell, tobacco lead at Public Health England, said: "This study adds to the growing body of evidence which tells us that cutting down to just one cigarette a day still leaves a substantial risk of heart attack and stroke. The best and safest thing you can do is to quit completely for good."

Deborah Arnott, chief executive of health charity ASH, said: "It's addiction to nicotine that keeps people smoking but it's the tar in cigarette smoke that does the serious damage.

"Vaping is much less harmful, but only if you quit smoking altogether."

Simon Clark, director of the smokers' group Forest, said discouraging people from cutting down smoking could be "counter-productive".

Source: BBC

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Tobacco may cause irreversible blindness: AIIMS docs

Tobacco not only causes cancer, its prolonged consumption also may also lead to blindness, and often such cases are irreversible, doctors at AIIMS said.

They also said studies have shown that those who smoke tobacco, significantly increase their risk of developing cataract compared to non-smokers.

Smoking or chewing tobacco over five to 10 years affects the optic nerve which may lead to visual loss, the doctors said.

"Often such cases of blindness are irreversible. People know that smoking and chewing of tobacco causes heart disease and cancer, but vision loss and other eye problems due to tobacco are not widely known," said Dr Atul Kumar, Chief of Dr R P Centre for Ophthalmic Sciences in AIIMS.

He said of the total number of blindness cases reported at the centre annually, around five per cent of those are due to tobacco consumption.

Diabetic retinopathy can get worse in smokers due to decrease of oxyhaemoglobin. The only remedy is stopping tobacco consumption, Dr Kumar said.

He also said long-term indiscriminate use of steroidal eyedrops, commonly applied in case of eye allergies, can result in glaucoma and lead to irreversible blindness.

Dr Kumar said the AIIMS, in collaboration with the Union Health Ministry, is conducting a National Blindness survey to collect data about visual impairment and blindness in the country.

According Professor Praveen Vashist, the in-charge of community ophthalmology, out of 30 districts selected for the survey, data collection has been completed in 19 districts across 17 states.

The survey is expected to be completed by June next year, he said, adding, "As of now, cataract has been found to be main cause of blindness."

According to the World Health Organisations (WHO) 2010 data, India accounts for 20 per cent of the global blindness burden.

Source: India Today

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Impose stricter controls and regulation of bidis: Lancet study

At a time when the Union Health Ministry has called for taxing bidis at 28 per cent along with the highest cess under the new GST regime, a recent Lancet study recommends stricter controls and regulation to combat the health burden caused by this small, but lethal, tobacco product.

Higher levels of severe respiratory impairment, significant cardio-respiratory conditions and follow-up mortality were found among bidi smokers as against cigarette smokers and non-smokers, reports the study in the respected Lancet Global Health journal.

The largest-ever prospective international community-based cohort study of its kind covered as many as 14,919 men across five centres in India, including Thiruvananthapuram besides a centre each in Bangladesh and Pakistan. The other Indian centres covered in this sub-study of Prospective Urban Rural Epidemiology (PURE) were Chennai, Bengaluru, Chandigarh and Jaipur.

Households with at least one member aged 35-70 years were approached for the study, which was coordinated by the Population Health Research Institute in Canada. Baseline data was collected from January 1, 2003, to December 30, 2009, and follow-up data collection took place from January 1, 2008, to December 30, 2013.

Trained personnel administered standardised interview-based questionnaires that surveyed and accounted for demographic, household, behavioural and medical information, including risk factors, symptoms and the occurrence of any multiple disorders. 

Dr Sanjeev Nair, from the Department of Pulmonary Medicine, Thiruvananthapuram Medical College, is one of the co-authors of the study. “The health and economic burden caused from bidi smoking is tremendous, leading to the recommendation of stricter controls and regulation on this product. High levels of taxation to dissuade consumption would be a welcome policy initiative,” he said.

“Collective efforts should be made to provide alternative livelihoods to workers involved in bidi manufacturing in cottage industries that escape other prevailing tobacco regulations and taxes. Such a measure would be in the interest of the health of bidi workers as well. As the Kerala Government is striving hard to achieve the Sustainable Development Goals, tobacco control also has a key role in reducing mortality from cardiovascular diseases, COPD, and cancers, for which all stakeholders must come together,” Dr Nair added.

Another co-author, Dr K. Vijayakumar, Secretary, Health Action by People said, “The study has shown conclusively that there is no safe threshold from the harmful effects of tobacco smoking and even low-intensity, clinically-trivial smoking is associated with respiratory impairment. Our way forward should be to create 100 per cent tobacco smoke-free environments that would benefit the poor and the young significantly.”

Reaffirming existing information on the enormous impact of bidi smoking on the poor, the study has found that heavy bidi smokers were more likely to come from rural communities and from lower socio-economic sections.

Further, in what should be a worrying trend with a fast-aging population, the study pointed to a marked rise in decreased lung function among older bidi smokers.

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The War Is Far From Over-Smoking Causes 1 in 10 Deaths Worldwide

A new study finds smoking continues to be a challenging public health threat. Nearly one billion people worldwide smoked daily in 2015—one in four men and 1 in 20 women. Of course, this is despite decades of tobacco control policies and more than half a century of unequivocal evidence of the harmful effects of tobacco on health.

Smoking’s impact worldwide

In 2015, smoking was the second leading risk factor for early death and disability worldwide. This addictive habit causes one in 10 deaths throughout the globe, and half of them are in just four countries: China, India, Russia and the United States. Since 1990, smoking has claimed more than 5 million lives each year. In lower income countries, its contribution to disease is growing as the tobacco industry’s pursuit of new smokers is complicated by rapidly evolving social, demographic and economic markets. The tobacco industry is always seeking new customers, and they are now aggressively targeting consumers in these areas of the world.

Results from the study

This study relied on a systematic analysis from the Global Burden of Diseases, Injuries, and Risk Factors 2013 Study (GBD 2013) from 1990 to 2013 of 188 countries where researchers collated diverse data sources and synthesized them to come up with comprehensive, comparable estimates of daily smoking prevalence by sex and age group.

Findings from the study showed that worldwide the prevalence of daily smoking among men was 25 percent and 5.4 percent among women. This means that smoking rates have decreased: In 1990, 28.4 percent of men and 34.4 percent of women were daily smokers. Most countries experienced decline in smoking prevalence from 1990 to 2005 and only four countries had significant increases in smoking prevalence between 2005 to 2015—Congo and Azerbaijan for men and Kuwait and Timor-Leste for women. In 2015, 11.5 percent of deaths worldwide were attributed to smoking and 52.2 percent of took place in China, India, the U.S. and Russia. Smoking was ranked among the five leading risk factors for mortality in 109 countries and territories in 2015, up from 88 countries in 1990.

The number of women who smoke continues to lag behind significantly in comparison to men—roughly only one in every 20 smokers are women.

Challenges faced by continued use of tobacco products

Even though impressive strides have been made over the years in the fight to reduce the number of smokers, there are still challenges, especially in regards to demographic forces poised to heighten smoking’s global toll. It’s important to continue to push for continued progress in preventing people lighting up to begin with and to promote cessation among those who already have.

Smoking is widely recognized as a risk factor for premature morbidity and mortality. It increases risk for numerous health conditions, including lung cancer, coronary heart disease, stroke, high blood pressure, emphysema, chronic obstructive pulmonary disease and chronic bronchitis.

The staggering negative effects of smoking extend well beyond the health of individuals and a country’s population as a whole. The more people there are who smoke in a region of the world, the greater the rise in billions of dollars attributable to lost productivity and the greater the threat on already resource-constrained health care costs.

Getting a handle on snuffing out smoking

Over the past ten years, there has been substantial expansion of tobacco control initiatives that have strategized on using a wide range of effective policies to address the smoking epidemic. Some of the most successful strategies have been the following:

Increased taxation on tobacco products

Banning smoking in public places

Instituting smoke-free zones

Restrictions on marketing and promoting cigarettes

Community-wide and nation-wide smoking cessation interventions

Including both text and pictorial warning labels on tobacco products

To substantially loosen the hold of the global tobacco industry’s grip, there needs to be continued and sustained focus on comprehensive tobacco control policies around the world. To keep smoking prevalence rates low in areas of the that haven’t experienced a smoking epidemic yet, intensified efforts will be required to effectively and aggressively enforce policies and laws. Even though the war against tobacco is far from over, success is possible. We owe it to our children and future generations who have not yet started to smoke and hopefully never will.

Source: Observer

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Study links oral clefts to maternal passive smoking

Use of tobacco - one of the leading causes of preventable death - - can affect pregnant women even if they aren't active users. Scientists say women exposed to secondhand smoking during pregnancy are more likely to give birth to children with cleft lip or palate -- a non-fatal congenital deformity.

A study of 100 children -- 50 of them with cleft lip or palate -- in three citybased government hospitals found that although not many mothers were regular users of cigarettes or other tobacco products, several of them were exposed to second-hand smoking. The study found that 48% of mothers of children with oral cleft were exposed to second-hand smoking compared to 24% of mothers of normal children.

Although consanguinity and positive family history are among the commonly discussed causes in India, researchers said they were 'uncertain' if genes had any role in triggering the birth defect among the local population. "The study has brought forth the role of passive smoking in the development of oral clefts thereby warranting an effective public health policy to tackle the same," said Dr Mohammed Junaid of the department of Public Health Dentistry , Meenakshi Ammal Dental College and Hospital.

Although oral clefts and tobacco are public health problems, they aren't considered synonymous. In India, although the prevalence of oral cleft is high, there have not been enough studies on its association with tobacco abuse, the authors of the study said.

In India, almost 28,600 infants are born every year with cleft lip and palate. The deformity is classified syndromic, which occurs due to chromosomal aberrations caused by mutation of a gene, or non-syndromic, caused by the interaction between genetic and environmental factors. In India, doctors say, the deformity in 80% of children has been found to be nonsyndromic in nature. Commonly associated risk factors for the deformity are age during conception, obstetric history, environmental pollutants, consanguinity, positive family history, infections, maternal obesity, drugs that affect fetal growth, alcohol use, tobacco use or exposure, and deficiency of folic acid in diet. During the study published in Clinical Oral Investigations, doctors wanted to determine the association between maternal tobacco use or exposure and presence of a gene variant called transform ing growth factor alpha (TGFA) in the occurrence of oral clefts.

More than 85% of mothers of children with cleft lip were exposed to second-hand smoke. Among these, almost all said they were exposed to smoke from 1-10 cigarettes daily for a duration of less than 30 minutes. Paternal use of tobacco did not show any significant difference between either the case or the control of fathers although the mawa (27.5%) and gutkha (27.5%) forms of smokeless tobacco were predominantly used by the fathers of children with the deformity.

Data from the first phase of the National Family Health Survey released by the Union health ministry shows a dip in the use of all forms of tobacco, among men and women, in the past decade. However, men continue to dominate use of tobacco products.

The survey found 6.8% of women and 45% of men used tobacco in 2015-16. Although Tamil Nadu stands below the national average with 2.2% of women and 31.7% of men using tobacco, the public health impact remains high.

Source: Times of India

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Why smoking is still so widespread

MORE than 50 years after it became clear that smoking kills, the habit remains the leading preventable cause of death, with an annual toll of nearly 6m lives. A study published this week in the Lancet, a medical journal, helps to explain why it is so enduring.

The study examined the link between smoking prevalence and measures to curb it in 126 countries. The authors considered five measures: taxation to raise cigarette prices, smoke-free places, cessation programmes, warning labels on cigarette packs and bans on tobacco advertising. 

They took stock of the countries which, between 2007 and 2014, had introduced these measures at the level of stringency recommended by the World Health Organisation (WHO). It advises, for example, that taxes comprise at least 75% of the retail price of the most popular brands of cigarettes, and that countries ban all forms of advertising, including billboards, promotional discounts and sponsorship of events by tobacco companies.

Countries that introduced more measures had greater declines in smoking between 2005 and 2015. In a country that introduced three such measures, for example, the number of smokers shrunk on average by about a fifth. 

But the vast majority of countries have a long way to go. During the ten years the study considered, the average country saw only a modest reduction in smoking prevalence, from 25% to 22%. In 2014 each measure was in place in its strictest form in only about a quarter of countries or fewer. Turkey was the sole country to have followed the WHO's recommendations on all five measures. A policy of high taxation, the most effective way to reduce smoking quickly (especially in poor countries), is mostly limited to Europe. Few countries in Africa and the Middle East have instituted any of the five measures with the strictness demanded by the WHO. These two regions are home to 22 of the 24 countries in the study where smoking is on the rise.

The battle against smoking is far from being won. The Lancet study makes it clear that the governments of countries where smoking is still popular largely have themselves to blame.

Source: Economist.com 

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Create 100 per cent tobacco smoke-free environments to end TB, say experts

As the world 'unites to end TB' on World TB Day, March 24, like-minded bodies in Kerala have come together to strongly pitch for 100 percent tobacco smoke-free public places.

The Indian Chest Society, South Zone; TB Association of Kerala and Tobacco Free Kerala call for both individual and collective tobacco control measures to wipe out drug-resistant tuberculosis.

The WHO attributes 40 per cent of the TB burden in India to smoking.  Studies have also shown that people who smoke have approximately twice the risk of tuberculosis and thrice the risk of tuberculosis infection.  

Dr. DJ Christopher, Chairperson, Southern Region, Indian Chest Society is vocal in calling for coordinated efforts to achieve 100 per cent tobacco smoke-free public places to protect lung health. 

“Over the years, Kerala has made great strides in curtailing smoking in public places. The next step forward is to work towards public places that are 100 per cent smoke-free as mandated by the WHO. Such a measure would greatly contribute to overcoming the scourge of TB in Kerala. Kerala with is high literacy rate is in the best position to show the way for the rest of the country,” 

“It is not very widely known that tobacco smoking increases risk of developing TB disease and smokers has worse disease and lung damage and respond to treatment poorly when compared to non-smokers. Even after successfully being cured from TB, the risk of the disease recurring in twice as high. It is important to understand and propagate the message about this lethal effect of tobacco as we observe the world TB day,” Dr Christopher, also the Prof & Head, Pulmonary Medicine, Christian Medical College, Vellore said.

“Studies have also shown that second hand smoke may increase susceptibility to the conditions such as cancers and chronic obstructive pulmonary disease (COPD). Children are particularly vulnerable and become more prone to respiratory infections and wheezing,” Dr Christopher added.  

Dr M Sunil Kumar, Honorary Secretary, TB Association of Kerala said, “General symptoms of TB include fever, cough with sputum or blood stained, loss of weight and evening rise of temperature. It goes beyond doubt that smoking aggravates TB symptoms and hence a patient should not smoke. At the individual level, every possible effort should be made to stop smoking to protect oneself from TB.”

According to the latest published figures of the Government of India’s Revised National Tuberculosis Control Programme, as many as 14,147 persons in Kerala were diagnosed with TB, and 22,785 patients registered for treatment in 2015.

Dr AS Pradeep Kumar, former Addl Director of Health Services and Advisor, Tobacco Free Kerala, citing a study conducted in Chennai said, “50 percent of deaths among male TB patients in India were among smokers.”

Explaining the concept of 100 per cent tobacco smoke-free, Dr Pradeep Kumar said, “It involves creating an environment where tobacco smoke cannot be seen, smelled, sensed, or measured. Presence of cigarette/bidi butts or ash would also not make an area 100 per cent smoke-free.”

Smoking aids such as ashtrays, matchboxes or lighters in the public place are in violation of Section 4 of Indian tobacco control law COTPA, 2003. Warning signages prohibiting smoking in a public place should be put up in accordance with size and colour dimensions prescribed by the Act, Dr Pradeep Kumar pointed out. 

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Tobacco use triggers multimorbidity among the elderly, says a study

Tobacco use is responsible for causing more than one health condition or multimorbidity among the elderly, thereby accentuating the burden by non-communicable diseases in Kerala, a new study reveals.
The seven-state study, published in a recent edition of BMJ Open (a leading online, open access journal on medical research), has brought out that Kerala has the highest prevalence of high blood pressure, diabetes and heart disease. 

A high 45.5 per cent of 9,852 adults aged 60 or more were found to be an ‘ever tobacco user’ or those who had used tobacco at least once in their lifetime, found the study conducted using data collected by the United Nations Population Fund.

Hospitalisations within one year due to chronic non-communicable diseases (NCDs) were higher among ever tobacco users as against non-users, the study points out.

The study considered 12 NCDs such as arthritis, high-blood pressure, cataract, diabetes, lung disease, heart disease, paralysis, depression, Alzheimer’s disease, stroke, dementia and cancer.  The study defines multimorbidity as the co-existence of at least two of these 12 selected NCDs in the same person.

Researchers attached to Achutha Menon Centre for Health Science Studies of Sree Chitra Institute of Medical Sciences and Technology here and Centre for Public Health, Amrita Institute of Medical Sciences, Kochi carried out the study. 

Titled ‘Pattern, correlates and implications of non-communicable disease multi-morbidity among older adults in selected Indian states: a cross-sectional study’, its aim was to estimate the proportion of older adults with multi-morbidity, its correlates and implications.

Dr KR Thankappan, Principal investigator of the study and Professor and Head of Achutha Menon Centre, said, “Tobacco-induced morbidity and multimorbidity is preventable through adequate tobacco control interventions. Through tobacco control, the physical and financial burden caused by non-communicable diseases in Kerala can be brought down to a large extent.” 

Citing an earlier study, Dr Thankappan, who is also the Vice Chairman of Tobacco Free Kerala, said, “The economic burden on tobacco-induced diseases is Rs 1514 crore a year in Kerala; this is massive draining away of productive resources. Mainstreaming supply and demand reduction of tobacco in policy discourse and heightened enforcement to prevent youth initiation has become highly imperative.”

Dr GK Mini, Assistant Professor, Centre for Public Health, Amrita Institute, and principal author of the study, said, “Tobacco being a highly addictive substance, the key is to prevent initiation. Our educational institutions have to be made tobacco-free, both in letter and spirit.”

Other than Kerala, Tamil Nadu, Punjab, Himachal Pradesh, Maharasthra, Odisha and West Bengal were included in the study. From each state, 1,280 households with older adults were selected. The sample covered 47 per cent men with a mean age of 68 years. 

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Smoking and atherosclerosis

The image shows how smoking can affect arteries in the heart and legs. Figure A shows the location of coronary heart disease and peripheral artery disease. Figure B shows a details view of a leg artery with atherosclerosis - plaque buildup that's partially blocking blood flow. Figure C shows a detailed view of a coronary (heart) artery with atherosclerosis. 

Source: https://www.nhlbi.nih.gov/health/health-topics/topics/smo

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Nicotine exposure may cause hearing problems in kids: study

The research from Freie Universitat Berlin in Germany found, for the first time, that the auditory brainstem, an area of the brain which plays a role in analysing sound patterns, may develop abnormally in offspring when pregnant mothers are exposed to nicotine before and after giving birth.

Children with impaired auditory brainstem function are likely to have learning difficulties and problems with language development.

The researchers added nicotine to the drinking water of pregnant mice to reach blood nicotine levels similar to heavy human smokers.

The offspring of the mice were exposed to nicotine before birth and via the mothers milk until they were three weeks old - an age that is approximately equivalent to primary school children.

The scientists then analysed the brains of the offspring mice by measuring the firing properties and signalling abilities of their neurons.

These results were compared to a control group of offspring from pregnant mice with no nicotine exposure.

Neurons that get input from the cochlea (sensory organ in the ear) were less effective at transmitting signals to other auditory brainstem neurons in mice exposed to nicotine. Moreover, these signals were transmitted with less precision, which deteriorates the coding of sound patterns.

These could be part of the underlying causes for auditory processing difficulties in children of heavy smoking mothers.

"We do not know how many other parts of the auditory system are affected by nicotine exposure," said Ursula Koch, professor at the Freie Universitat Berlin.

"More research is needed about the cumulative effect of nicotine exposure and the molecular mechanisms of how nicotine influences the development of neurons in the auditory brainstem," said Koch.

"If mothers smoke during pregnancy and their children show learning difficulties at school, they should be tested for auditory processing deficits," she said.

The study was published in The Journal of Physiology.

Source: India Today

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Third-hand smoke may affect growth of baby

Exposure to the sticky residue of tobacco smoke -- or third-hand smoke -- left behind on the furniture and walls of your home may significantly affect your baby's growth and immunity system, researchers have found.

The findings showed that the residue of the smoke puts babies and toddlers at much greater risk because they come into contact with contaminated surfaces while crawling or teething during their critical period of immune system development.

"We suspected the young are most vulnerable because of their immature immune systems, but we didn't have a lot of hard evidence to show that before," said lead author Bo Hang, scientist at Lawrence Berkeley National Laboratory (Berkeley Lab) in California, US.

Further, the dangers associated with smoking continues for a long time, even after the cigarette is snuffed out, the researchers said.

For the study, appearing in the journal Scientific Reports, the team studied the changes to body weight and the hematopoietic system after three weeks of exposure for two age groups of mice: birth to 3 weeks (neonatal) and 12-15 weeks (young adult). 

They were compared to a control group of mice that were not exposed to smoke.

The results revealed newborn mice exposed to smoke weighed significantly less than mice born in a control group. 

In addition, newborn and adult mice exposed to third-hand smoke showed persistent changes in blood cell counts. 

There were lower levels of platelets and specific types of white blood cells -- associated with inflammation and allergic reactions -- in the smoke-exposed mice. 

"The effects on blood cell count persisted even after exposure ended. Changes remained at least 14 weeks after exposure ended for the neonatal group and two weeks after it ended for the adults," Hang said.

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