Curb tobacco use to prevent millions of cancer deaths

New Delhi: As tobacco-induced cancer is emerging as a major public health threat in the country, top medical experts have suggested a three-pronged tobacco control strategy— public awareness, strengthening legislation and hiking taxes to make tobacco inaccessible to common man especially kids– to keep the deadly disease at bay.

Presently different kinds of cancer is taking into its grip around 14 lakh Indians, killing 8 lakh every year, as many as 27 per cent are attributed to tobacco use.

The health experts also felt that passage of the proposed amendments for a stricter tobacco-control law, COTPA, will help reduce the menace.
“Tobacco products are the major contributors for various cancers and other diseases. In India, tobacco-related cancers (TRCs) contribute nearly half of the total cancers in males and one-fifth in females,” Dr GK Rath, former Head, National Cancer Institute said during a webinar organised on the World Cancer Day.

Equating tobacco with poison, he said that it kills slowly given that tobacco consumption causes 17 types of cancer of which many are preventable. He also expressed displeasure that while tobacco firms were targeting through various marketing strategies to children as young as ten year old, some bollywood celebrities were engaged in surrogate advertisements of health hazardous items like gutka. “This is very unfortunate as they are impacting the impressionable minds of young children to take up this deadly habit,” he said at the event hosted by journalist Arun Anand.

It is important to note that in the last 15 years, cancer has become one of the top causes of mortality and morbidity in India. Tobacco-related cancers accounted for 27 per cent of the country’s cancer burden in 2020, according to the Indian Council of Medical Research (ICMR). This is likely to increase in India which is the second leading consumer of tobacco products. As India celebrates its 75th year of Independence as a year-long ‘Amrit Mahotsav’ it is time to work towards getting freedom from tobacco and free the citizens, especially youth, from these poisonous and cancer causing addictive products.

Dr Alok Thakar, Professor of head-neck surgery and otorhinolaryngology at the AIIMS, New Delhi flagged the concern at rising oral cancer cases due to unabated sale and consumption of tobacco products like cigarette, beedi, khaini, tambaku, gutka and zarda. “Since these are yet to be regulated in true sense and not many people are aware about its ill-effects, it will increase the country’s health burden dramatically.”

Dr Rahul Bhargava, leading hemato-oncologist from Gurugram-based Fortis Hospital echoed similar views and asserted that as long as tobacco products were easily available and affordable for poor and children, achieving ‘Tobacco Free India’ mission will remain a dream.

While dwelling in detail about the financial burden of the consumption of tobacco on national exchequer, he cited various reports and added that the burden from tobacco use amounted to Rs. 177,341 crores in 2017-18 which is 1% of India’s GDP. He also suggested that reforming tobacco taxes provides an easy way for the government to raise much needed revenue.

According to an ICMR report, tobacco contains at least 69 cancer-causing agents. Yet another report published by National Cancer Registry Programme (NCRP), the number of new cancer cases in India is likely to increase from 13.9 lakh in 2020 to 15.7 lakh by 2025, a rise of nearly 20%.
Dr Rambha Pandey, Additional Professor, radiation oncologist, AIIMS, New Delhi lamented that women are increasingly taking up tobacco consumption, viewing it as a ‘fashion symbol’. “This is a very disturbing trend. The habit of smoking and chewing start at the age of 10-12 years among kids and once they get into the habit it is difficult to shun.”

Dr Pandey hoped that the stringent COTPA amendments having provisions such as ban on designated smoking zones (DSA) will help in cutting down tobacco consumption among the public and thus suffering from cancer. People must be told that tobacco has no single benefit, she said.

“The link between tobacco consumption and cancer is very clear. There is a need to look into the financial toxicity caused by tobacco consumption resulting in cancer. A multi-pronged strategy focussing on awareness, higher taxes and stringent laws is needed to make these killer products unaffordable and inaccessible to make India healthy.” said Dr Rakesh Garg. Additional Professor of Anaesthesiology, Critical Care, Pain and Palliative Medicine, AIIMS, New Delhi.

According to the health experts, cancers caused by tobacco include lungs, mouth, pharynx (upper throat), nose and sinuses, larynx (voice box), oesophagus (food pipe), liver, pancreas, stomach, kidney, ovary, bladder, cervix, and some types of leukaemia. Smoking causes other diseases too, such as heart disease and various lung diseases.