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Smokeless Tobacco: Challenges and Threats for India

Smokeless Tobacco: Challenges and Threats for India

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Published by Hemant Goswami
Article by Hemant Goswami :: Smokeless Tobacco: Challenges and Threats for India

Smokeless tobacco is no Less harmful than its smoked variant Like cigarettes. In many cases it is even more harmful with a smaller gestation period for the onset of health effects and the consequential fatality. However many myths about the false concept
about its safety are being spread by the tobacco industry to confuse the public and even governments
Article by Hemant Goswami :: Smokeless Tobacco: Challenges and Threats for India

Smokeless tobacco is no Less harmful than its smoked variant Like cigarettes. In many cases it is even more harmful with a smaller gestation period for the onset of health effects and the consequential fatality. However many myths about the false concept
about its safety are being spread by the tobacco industry to confuse the public and even governments

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Published by: Hemant Goswami on Jul 09, 2010
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SmokelessTobacco:ChallengesandThreatsforIndia
HemantGoswami
Indiansalwayshadapenchantforthe"imported"tagonallproducts.IfeelthatitwouldhavebeenbetterifthisfadfortheforeignstuffdominatedtheIndianmentalityincaseoftobaccotoo.Ifitwasso,thenwewouldn'thavebeenhavingthemassivechallengewearenowfacingonaccountofourown homegrown'Bidi'and"Smokeless'tobaccoproducts. Whilethecommonmandidn'tgetinfatuatedexclusivelybytheforeignversionoftobacco;the policymakers,alltheseyears,lookedonlytowards thewestforcontrollingtobacco.Unfortunatelythe sectionofIndianpolicymakerswhoshouldnothaveimportedtheirunderstandingabouttheproblem-in- handactuallyfounditeasytoimportthe'statistics' ontobaccousageandproblem.Asaresult;allour tobaccocontroleffortsgotconcentratedaroundthe 'WhiteCigarettes'(whicharearound15%ofthe totalconsumption)andweignoredthechallengesposedbythedomesticbrowncigarettes,popularlyknownas'Bidi'andalsothevariedformsof'Smokeless'tobacco.Itisindeedshamefulthatthegovernmentdoesnotevenhavecompletestatisticsontheseproducts.Littleisclearlyknownabout theconsumptionpatterns,useoftobaccoother thancigarettes,healtheffectsofotherformsof tobacco,etc.Mostofthestatisticsquotedbythe governmentbodieseithercomefromtheindustry itself,ormajorityofstatisticalunderstandingand datacomesfromforeignpapersorfundedresearch (mostlyfocussingoncigarettes)orfromsmallsamplesurveysabout'self-declaredtobaccouse'conductedbyWHOandsomeothersuchbodies.Asaresult,organisationsandpolicymakersgropeindarkandhavetoworkonlywiththebestavailableguessestimates.Notagoodscenarioforacountrywhichhastodealwithoveramilliontobaccorelateddeathseveryyear.Asonewouldlogicallyconclude,allthishasnowprovedtobeoneofthebiggestmistakesinIndiantobaccocontrolscenario.Somerealisationhasnowdawned-uponaboutthehealtheffectsanddeathtollduetoconsumptionofotherformsoftobacco; whichhasbeenexponentiallyrising,eventhoughstill littleattentionisbeingpaidtotheissue.Amongallforms,theriseofthesmokelessformoftobaccois particularlyalarming.
Whatissmokelesstobacco?
Formostpartsofthewest,smokelesstobaccoisa newthing;atleastasacommercialproductmarketed withcompetitivemarketingstrategies.Howeverin India,wehaveallpossiblevariantsoftobacco.Any tobaccoproductwhichisconsumedwithoutitbeing burntandinhaledcomesinthecategoryofsmokelesstobaccoproduct.Someofthemorepopularand commerciallymarketedformsare;
Chewingtobacco-raw-
Chewingtobaccoconsistsofsmallpiecesofraw finelycuttobacco. Mostofthetimesitisunlabelledcomingfromsmallcottageindustriesbutthere arealotofsmalltimecommercialbrandstoo available.
PaanMasala-Tobacco
PaanMasalaisacommercialconcoctioncontainingarecanut, slakedlime,catechu,condimentsalongwith
II
9
 
powderedtobacco.PaanMasaLacontainsaLmost aLLtheingredientsthatgointothemakingofapaan,butaredehydratedsothatthefinaLproductisnotperishabLe.PaanMasaLaismorepopuLarinurbanareas.ThemarketforPaanMasalahasgrownmanyfoldsoverthelast10years.
Gutka-
ItisapreparationofcrushedbeteLnut,tobacco,catechu,LimeandsweetoraLittlesavoryflavourings.Itismostly soLdacrosssmaLLsachetsatahighlyeconomicalpriceofRs.1to8.Itis chewingtobacco.
Paan(BetelQuid)
withTobacco-Paanwithtobaccoconsistsof;betelleaf,arecanut, slakedLime,catechuandtobacco.BetelleavescontainvoLatileoi~suchaseugenoLandterpenes,nitrates andsmallquantitiesof sugar,starch,tanninand severalothersubstances.ManyCondimentsandsweeteningagentsmayaLsobeaddedasperregionalpracticesandindividualpreferences.EachPaanistailormadeand specificingredientsareaddedalongwithtobacco accordingtotheinstructionsofthechewer.One canfindPaanshopsineventhesmaLLestviLLages ofIndia.
KhainiandZarda
Anothervariantof chewingtobaccowhich consistsofrawtobacco mixedwithfragrances andspicesforachieving desiredflavors.WhileZardarepresentstobacco thatisLatermixedwith limebytheuser,Khainiisaconsideredastep aheadandprovidesthefinalmixtureinasingle package.Khainiiswidelyusedforitswiderrange offragrancesandflavoursandisalittlecostlierthanZardabecauseofitsuser-friendlynature.
Naswar-
Naswarissunandheat-driedtobacco leavesmixedwithslakedlimeandashfromtree bark,flavoringandcoLoringagents.Wateris
addedandthe
mixture
mayalsoberolledintoballs.ItisheLdinthemouthfor10to15minutes.Ifitischeweditproducesabadtasteinthemouth.PeoplewhoareaddictedmayconsumeitonanhourLybasis.BesidesIndia(amongpeopLetracingtheirorigintoPashtunethnicgroups)itismorecommonlyusedinCentralAsia,Iran,Afghanistan, Pakistan,Tajikistan,etc.
Snus-.
Snusisamoistpowdertobaccoproductoriginatedfromavariantofdrysnuff,intheearly19thcenturyinSweden,consumedbypLacingitunderthelipforextendedperiodsoftime.ItisavailabLeinteabagLikepouches.Snushasitsuniquenessinthefactthatitissteam-curedratherthanfire-cured.Itissaidtobenotfermented containingnoaddedsugar,unlikemanychewingtobaccovariantsavailableinIndia.
Snuff-
SnuffisgroundorpuLverizedtobacco,whichisgenerallyinsufflatedor"snuffed" throughthenose.There areseveraltypesofsnuff,buttraditionallyitmeansnasalsnuff.Itisalsooftenflavouredandtypicalflavorsarefloral,mentholated,fruit,andspice,eitherpureorinbLends."Snuff"can alsorefertodippingtobacco,whichisappLiedto thegumsratherthaninhaled.Anothercommon variantofthisis'Bajjar'inIndia.Bajjarisdry snuff(akaTapkeer)appliedcommonlybywomen inGujaratontheteethandgums.
Otherforms-
Besidestheabovementioned,there arenumerousothervariantsofliquid,chewing andnasaltobaccolikeTuibur,Mishri,Mawa,GuL, Gudhaku,Plug,etc.,inuseinmanyregionsand partsofIndia.
PromotionStrategyoftheIndustry
Toattractnewusersandhighlightthefeaturesof itssmokeLesstobacco,thewebsiteofoneofsmokeless
I
10
IIIIIIIIIIiIIi_F_eb_ru_a~__-_Ma_rC_h_a_nd_A_p_ril_-_Ma_~~2_0_10
~=-
~==~_=~_
 
tobaccomanufacturersspellstheadvantagesofitsproductsasreproducedhereunder;LessharmfuLthancigarettes.NoexternaLeffectssuchasthosefrompassivesmoking.Canbeusedin"No-Smoking"areasLikeairports,airpLanes
&
otherpubLicpLaces.UnLikecigarettes,handsremainfreesincethereisnoneedtohoLdtheproductduringconsumption.AseasytouseaschewinggumwithaUse
&
ThrowmethodLikethatofchewinggumItisanextremeLyLow-pricedproductThemanufacturespromotionaLstatementabovehighLightstheexactstrategicapproachofthesmokeLesstobaccoindustry.Fromtheabove,itisclearthatthetobaccoindustryistryingtobuiLdupontherestrictionsonsmokingandtakeadvantageofthetobaccocontroLmomentum.TheindustryisaLsostrategisingtogainfromthecessationeffortsofaLargenumberofpeopLetryingtoquitsmoking.OneofthemostdangerousfaLsestatementsmadeaboveareclaimsstating,"LessharmfuLthancigarettes."SimilarmisconceptionandfaLsenotionsaboutsafetyareaLsobeingpushedbySwedish'Snus.
HealthEffects
SmokeLesstobaccoisnoLessharmfuLthanitssmokedvariantLikecigarettes.InmanycasesitisevenmoreharmfuLwithasmallergestationperiodfortheonsetofheaLtheffectsandtheconsequentiaLfataLity.Howevermanymythsaboutthefalseconcept aboutitssafetyarebeingspreadbythetobaccoindustrytoconfusethepubLicandevengovernments
Tobaccocausesmouthcancer
aroundtheworLd.InsomecasesitisalsobeingwrongLypushedasarepLacementtocigarettesorevendeceitfullypushedasanaLternateformofnicotineusefuLinquittingtobacco.ALLuchclaimsarenotonLyfaLseandincorrectbutratherhavethepotentiaLtocausefurthermiseriesandcompLicateandaggravatetheheaLthconditionofexistingsmokers.TheentryofbigpLayershasresuLtedinthesegiantspressurisingthegovernmentsandheaLthauthoritiestodeclarethatsmokeLesstobaccoisLessharmfuLandLikeLytoofferheaLthbenefits.ThisisdonesoLeLytogiveafaLsenotionofsafetytopeopLe.SmokelesstobaccoisaLsoa'classKcarcinogenandcontainsover25cancercausingagents.ItisweLLknownthatoraLandspittobaccoincreasestheriskforleukoplakia.aprecursortooraLcancer.Chewingtobaccohasbeenknowntocausecancer, particuLarLyofthepancreatic,oesophagus,mouthand throat.Thereisnowclearevidencethatincreasing trendof
'qutka
consumptioniscausinganepidemicof'oralsubmucousfibrosis'andisLeadingtoanincreasedincidenceoforaLcancerevenamongyoung persons.SmokeLesstobaccouse,whichhasnowbecomemorecommonamongwomeninIndia,hasbeenfoundtocauseadversereproductiveoutcomesintheformofLowbirthweight(Lowerbyanaverageof105g),Lower gestationperiod(anaverageof6days)andhigher stillbirthrates.OneoftheLateststudiesbyPrakashGupta(inAhmedabad)showsthathowthereisanexponentiaLgrowthofcasesinmouthcancerwith increaseinconsumptionpatternsofchewingtobacco,especiallyGutka.Thestudyshowsthatbetween1985and2006,theincidentsofmouthcancerhavebecomenearLy300percentmoreprevaLentamongyoungstersintheagegroupof35to44yearsofageandhasseenoverfourfoLdincreaseamongthe25-34agegroup(seeFig.1).ThisisindeedaLarming.
Fig.1
India,Ahmedabad(MouthCancer)MaLe
50.046.1 45.040.035.030.025.020.015.010.05.0L~IIIIiiii~~D:=-~_
0.5
-1985
32.3
-1995-200615-2424-3435-4445-5455-6465-74
11

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