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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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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Tobacco Use is High Among Boys in Much of Asia

Source: https://www.researchgate.net/publication/12476172_World's_best_practice_in_tobacco_control

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