Why World No-Tobacco Day is so critical for India's youth

Tobacco consumption remains a widespread issue. Not only is it a major contributor to a heath-crisis, but according to a report released by the World Health Organisation (WHO), tobacco growing and production exacerbates food insecurity. The report also suggests that the land used to cultivate tobacco can be more efficiently used to meet sustainable production goals. In lieu of this, World No to Tobacco Day is all the more crucial for Indian youth. Here's why.

According to the Global Youth Tobacco Survey (GYTS), nearly one-fifth of children aged 13-15 years are using tobacco products in India.

The survey revealed that 38 per cent of cigarettes, 47 per cent of bidi and 52 per cent of smokeless tobacco users have picked up the habit before their 10th birthday.

Bhavna B. Mukhopadhyay, chief executive, Voluntary Health Association of India, said: "The Global Adult Tobacco Survey 2016-2017 says about 27 crore people consume tobacco in our country and about 12 lakh people die every year due to tobacco-related illness. The average age of starting tobacco use in India is 18.7 years. Men start using tobacco at a younger age than women."

She further said that tobacco can cause 25 types of diseases and about 40 types of cancer, in which the major ones are mouth cancer, throat cancer, lung cancer, prostate cancer, stomach cancer and brain tumour.

Prof Surya Kant, head of the department of respiratory medicine, King George's Medical University, said: "Tobacco smoke emits harmful gases and chemical substances, in which nicotine and tar are prominent. In all, 70 chemical substances have been found to be carcinogenic but these facts are ignored by those consuming tobacco."

Dr Abhishek Shukla, secretary general, Association of International Doctors, said: "Smoking bidi is more harmful than cigarette. Due to the low amount of nicotine in bidi, nicotine addicts need it again and again. In our country, addiction to smoking is more in men as compared to women."

Dr Amita Shukla, senior gynaecologist, SC Trivedi Memorial Trust hospital, pointed out: "One reason for infertility among women is smoking which can also cause pre-mature delivery, in case a pregnant woman consumes tobacco during pregnancy."

When someone smokes, 30 per cent of the smoke of bidi or cigarette goes to the lungs of the smoker and 70 per cent remains in the surrounding environment, which affects passive smokers or those smoking indirectly, according to doctors.

Further, a survey by Vallabhbhai Patel Chest Institute in New Delhi has revealed that Class 10 pass students were the highest in numbers among the consumers of tobacco products.

The institute stated on Wednesday that it had received a total of 71,39,473 IVR calls this year until April 30, based on which this conclusion was reached.

On Wednesday, the institute observed World No Tobacco Day and presented this data.

"Out of the total number of IVR calls received by this center this year until April 30, 20,43,227 calls were counselled, including 9,96,302 inbound calls, 26,80,657 outbound calls, and 3,91,160 registered by the call center. A total of 1,56,644 individuals have successfully given up tobacco use," it said.

The institute further stated that the statistics revealed that most of these calls originated from Uttar Pradesh, with a total of 1,23,508 calls.

The data also indicates that males make up the highest percentage at 98 per cent, followed by transgender individuals at 5 per cent of the total population, while females comprise the lowest percentage.

Among the consumers of tobacco, the highest number is 1,74,097 individuals who have passed their Class 10 exam.

The National Tobacco Cessation Service (NTQLS) was initially established in a single room with sic counsellor stations, and it was expanded in 2020 by then Union Minister of State for Health, Ashwini Kumar Choubey.

Further, doctors on the eve of World No-Tobacco Day have expressed concerns over the endorsement by leading actors like Amitabh Bachchan, Shah Rukh Khan, Ranveer Singh, and Akshay Kumar of brands that also manufacture gutka — a generic name given to smokeless tobacco products, which cause severe harm to the human body through surrogate means.

They lament that even famous former cricketers like Sunil Gavaskar, Virender Sehwag, Kapil Dev and Chris Gayle have been roped in to promote these brands.

"Movies and cricket are widely followed in the Indian subcontinent. People of all ages are watching IPL matches, and movies of all languages, thanks to OTT platforms. If any of the movie stars or cricket players promote a product, naturally the impact will be there on adolescents and youth," said Dr Mahesh Gudelli, Consultant - Clinical and Interventional Pulmonologist, KIMS Hospitals.

"Gutka is a type of smokeless tobacco that is made in India and is widely used throughout Asia. It is a mixture of tobacco, crushed areca nut (also called betel nut), spices, and other ingredients. It is used like chewing tobacco and is placed in the mouth, usually between the gum and cheek. Gutka contains nicotine and many harmful, cancer-causing chemicals. Using it can lead to nicotine addiction and can cause cancers of the lip, mouth, tongue, throat, and esophagus. Nearly 4200 chemical constituents have been identified in gutka. The main carcinogens in gutkha are derived from its ingredients including tobacco, areca nut, lime, and catechu. Gutkha (pan masala with tobacco) has been proven to be a carcinogenic agent," the doctor explained.

He strongly recommends the stars not to endorse any of these products even for bulky remunerations. "We request all celebrities to take a step back and limit themselves from promoting such products even if they are promoted as generic brand names."

"Approximately 40 per cent of the total tobacco consumed in India is in smokeless form and gutka is the most important component in this. We have been seeing prominent film actors and now cricketers come together to promote brands which are associated with gutka production. Though the claim is that these celebrities are only promoting flavoured cardamom, the brands' association allegedly remains with harmful tobacco products. Despite a ban in 2012, gutka and other smokeless or chewable tobacco products are illegally marketed and consumed across many states in India. And endorsement of celebrities to brands which provide a recall to harmful tobacco products is highly unfortunate," feels Dr Anusha Kantheti - Consultant Pulmonology, SLG Hospitals.

Experts also recommend that individuals planning to get pregnant must foremost give up smoking.

"Best time to quit smoking is at least four months before pregnancy, that is, whenever you plan pregnancy," Dr Rajashri Tayshete Bhasale, Consultant Gynecologist, Laparoscopic Surgeon and Obstetrician at Wockhardt Hospitals, Mira Road, told IANS.

"Smoking can interfere with the normally functioning ovaries and reduce the number of mature eggs that can be fertilised by lowering the egg count," Dr Manju Gupta, Senior Consultant - Obstetrician & Gynaecologist, Motherhood Hospitals, Noida.

According to the health experts, exposure to even secondhand or passive smoking can harm biological processes during preconception, pregnancy, and post-delivery.

"Even during the nine months of pregnancy, a woman's susceptibility to secondhand smoke's effects might alter, reflecting various pathways of harm as the foetus develops and grows," Dr Gupta told IANS.

"Avoid any contact with direct smoke or smoking in the same room. It is seen that traces of smoke are found for hours after smoking, hence any kind of smoking should be avoided in the house and also house guests should be instructed the same way," Dr Bhasale said.

She explained that nicotine, present in tobacco, is a potent vasoconstrictor thus it can lead to abortion, ectopic pregnancy, Intrauterine growth restriction (IUGR) or birth defects in babies.

Women exposed to smoke "are more likely to develop hypertension in pregnancy and its complications. Studies have shown smoking is associated with birth defects like cleft lip, cleft palate, congenital diaphragmatic hernia, limb reduction defect, gastroschisis, hypospadias. More over exposure in later months of pregnancy have shown to cause preterm delivery, low birth weight baby, stillbirth, intrauterine foetal demise or even sudden infant death syndrome," Dr Bhasale told IANS.

Tobacco is a leading cause of preventable morbidity and mortality in the country. Smoking is a growing matter of concern in India. Tobacco consumption impacts all the organs of the body.

Smoking contains tobacco which causes lung cancer, asthma, and chronic obstructive pulmonary disease (COPD), which includes emphysema, and chronic bronchitis.

"Other problems due to tobacco are wheezing, chronic cough, increased mucus, and shortness of breath. Smoking declines lung function. Thus, it is the need of the hour to quit tobacco and lead a healthy life. All forms of tobacco are harmful. Moreover, there is no safe level of exposure to tobacco. It is better to quit it in all forms," Dr Samir Garde, Director of Dept of Pulmonology and Lung Transplant, Global Hospitals, Parel, told IANS.