A cigarette to smoke but no bread to eat ........ Bobby Ramakant

What a paradox has confronted Kenya, that neither there is any readily available land nor farmers are willing to grow food crops! As a result of which the market is struck with severe crisis of foodgrains but tobacco overfloods their markets and is the largest foreign exchange earner. Just think the plight of Kenyans that these tobacco farmers have bundles of money, but the markets have no bread to sell!

Overwhelming majority of it’s agricultural land, has swinging tobacco crops all the year round. Most of it’s farmers have stopped growing food crops and switched over to tobacco cultivation. Due to acute shortage of food grains, Kenya was left with no other option but to import them in 1997, and then every year thereafter.

The ‘takeover’ of agriculture by tobacco is not an age-old story rather began when British American Tobacco Company (BAT) entered into Kenya in 1907.

Tobacco cultivation has radically changed the agricultural equations in Kenya. Besides the biodiversity of Kenyan agriculture, is at stake too. Because the food grain cultivation is rapidly shrinking, so are reducing those available agricultural lands where food grains can be grown. On the contrary, not only increasing number of farmers are switching to tobacco cultivation and abandoning food grain agriculture, but also the agricultural land available for tobacco cultivation is fast expanding. Another stump to Kenyan food cycle is the fact that the availability of potential seeds of food grains, is a scarcity because of diminishing demands over a number of years, the seeds stored for future, have lost their germination potential.

Now, in Kenya, the largest agro-based company is British American Tobacco company! BAT contracts 17,500 small-scale farmers to cultivate tobacco over an estimated 15,000 hectares of fertile agricultural land.

Is it not paradoxical that despite of tobacco money, cases of malnutrition are high, and the common man is not even getting the basic amenities of life. A survey report by United Nations Children’s Fund verifies that "... 52% of children in Kenya, either suffer from Chronic or acute under nutrition or are under-weight".

In a 1994 study conducted by John Nkuchia for the University of Michigan, School of Public Health, (presented at 9th World Conference on Tobacco or Health in Paris, France), established that food production in Kenya has suffered a major jolt as farmers have drifted from food crops to tobacco!

Using figures extracted from the Kenyan Central Bureau of Statistics and the Industries annual report, John Nkuchia estimated that "... the number of farmers growing tobacco will nearly double by 2010". And that he rightly feared will also double the area of the agricultural land used for tobacco cultivation at the expense of food crop. Kenyan government literature discussing the problem of under-nutrition in Migori District admits that people in the district have ‘insufficient powers to purchase right food’. However Keli Kiilu, a BAT company spokesman says that increased tobacco production has generated ancillary employment in distribution, marketing and retailing. BAT cigarettes are sold through 49 distributors, 1000 stockists or wholesalers and atleast 40,000 notified retailers. More than a million Kenyan families depend on BAT for their livelihood, and there are about 5-6 families in Kenya in total! Such is the dependence of Kenyan economy on tobacco.

And this revenue from tobacco accounts for about 29% of Gross Domestic Product in Kenya. Tobacco is Kenya’s major foreign exchange earner. In 1997, BAT alone cornered a record 906 million shiilings ($15.4 million) as foreign exchange!

Although tobacco is a cash crop and tobacco tycoons are one of the richest businessmen, yet the plight of tobacco farmer remains pitiable. Some farmers in Migori District of Western Kenya, were surveyed as a part of a study done by Jane Kariuki which was published as "Tobacco Cultivation threatens food security in Kenya". This study reported that some farmers in Migori District of Kenya have abandoned tobacco cultivation for Maize. But their annual income has not sunken deep rather contrary to about 8,000 shillings (133$) which they were getting from a single tobacco crop per capita, it has swollen to 60,000 shillings (1000$) from 2 maize harvests per year per capita.

This study reports that tobacco cultivation is much more time consuming than food crop agriculture. And the profits which tobacco industry incur, are not able to trickle down to the farmer. The tobacco farmer’s year begins with the preparation of seed-beds around February. British American Tobacco company hands out the seeds free as an incentive, but most farm inputs like chemicals and fertilizers come as loans.

Constant watering, weeding, and ridging is followed by harvesting in July. And that too, is not the end of it-because curing takes more time. Farmers then have to manually inspect leaf by leaf before hauling it all off for weighing.

Tobacco cultivation is so strenuous and needs manpower to an extent that the children of these farmers have to skip schools from January to August to assist in this work. The problem which Kenya is persistently struck with is that most of the farmers of food crop too are shuttling between food crops and tobacco. From January to August they grow tobacco for BAT, and after that switch over to Maize cultivation. As and when this dual farming habit has spread over, the crisis for food crops in Kenyan markets became more and more critical. And since 1997, it had to resort to import of food crops to feed it’s population of 30 million.

As per the reports, Kenya needs atleast 2 harvests of food crops in a year to feed it’s population.But as the farmers prefer to grow both - tobacco and maize, this food crisis is bound to intensify.

It is indeed thought-provoking to witness a place where people have tobacco to chew, tobacco to smoke, and tobacco to sell, but they don’t have food to eat and are yearning for the basic needs of life. Immediate lobbying for withdrawal of multinational BAT from Kenya should be done as now it is not only a danger to the health of Kenyans but also has threatened the food cycle of Kenya. Unless radical measures to curb the growing menace of tobacco are undertaken, life itself is at stake!

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Rights of a smoker --- Virtual or Real ........  Prof. Ramakant

It is indeed appalling to note that on February 20 when tobacco control advocates once again will be observing Non-Smokers’ Right Day, the very existence of such rights in practice remains vestigial.

Travelling in buses with ‘No Smoking’ signboard over my head and smoke belching out from neighbourhood smoker all around, is perhaps a truly cosmopolitan scene - atleast in Indian perspective. Be it Tamil Nadu, or Jammu & Kashmir, Gujarat or Meghalaya, the plight of of non-smokers is indeed distressing! Distressing because, they have to quietly suffer or lock horns with adamant smokers and indulge in a free-for-all outburst of chosen expletives.

There are legal impositions and sign-boards of NO SMOKING displayed all over, but in practice these have negligible impact and rights of Non-Smokers go on being trampled. Therefore organizations like NOSA (Non Smokers Association) who are dedicatedly working to safeguard the rights of non-smokers, should broaden their reach and workforce to educate the masses as HOW to SAFEGUARD their rights as a non-smoker.

And even before that, a relocation of position is also needed. Presently smokers exert themselves on non-smokers that ‘they have a right to smoke’. What is needed is that Non-Smokers must begin to make their say "You cannot smoke everywhere".

This change of attitude is significantly crucial because it is for this aggressive outlook of smokers and their misconception that they can perhaps smoke everywhere and anywhere even right under a no-smoking sign-board which deter many non-smokers to lodge their protest.

This radical change of concept is utterly needed since tobacco advertisements and social acceptance of tobacco products has transformed the reality into virtuality and made us to believe that virtuality is reality.

Instead of non-smoker being aggressive to a smoker, the things are usually exactly the reverse. Smokers vehemently protest and safeguard their right to smoke, whereas non-smokers quietly let their rights be taken away and themselves jeopardise their health.

It is indeed very saddening that out of the perview of law, smokers within the family ravage a slow but steady assault on health of non-smokers in family. And by the time tobacco-related hazards especially those associated with passive smoking surface up, it is usually quite late for any remedial action. Even quitting at such a late stage will not undo the deadly tobacco-related cancers. And more disturbing is the fact that usually these are fathers, elder brothers and family peers who unknowingly jeopardise the health of their loved ones including their children and wives. Perhaps otherwise they might be willing to sacrifice their life for the welfare of their loved family members but under the spell of tobacco addiction they continue to ravage the health of their near and dear ones.

Maybe many of us non-smokers don’t realise the magnitude of damage we incurr on our health by forbearing our smoking companion. It can cost our lives.

World Health Organization estimates that around 700 million ( 70 crores) children in world are involuntarily exposed to tobacco smoke in places where they live, learn and play. There is robust and consistent evidence on the basis of hundreds of studies conducted all over the world that Environmental Tobacco Smoke (ETS) causes illness in children. Parental smoking is an important cause of lower respiratory tract illness (ex. Croup, bronchitis, bronchiolitis, pneumonia) during the early years of a child’s life. Considering the widespread tobacco usage within households, it is hardly a matter of surprise that lower respiratory tract infection is a common cause of childhood morbidity (or disability). The large population impacts of passive smoking coupled with rising incidence of Asthma, makes the point more crucial that passive smoking AGGRAVATES Asthma and is known to cause several other chronic respiratoy ailments like wheeze, cough, breathlessness and phlegm.

Tobacco smoke exacerbates cases of asthma in children, is in itself a ‘black gift’ of smokers in family of the child, and obviously a ‘lethal fruit’ of violation of non-smokers’ right.

Maternal smoking during pregnancy causes adverse effects on neonatal lung mechanics. And above all, incidence of middle ear disease is rising in people, whether adults or children, who live in smoke-ridden homes or workplaces. Postnatal ETS increases the risk of middle ear diseases. Foetal growth is also adversely affected by maternal smoking with neonates born with lower birth weight, intra-uterine growth retardation and higher risks of developing tobacco-related cancers later in life. Not only this, exposure to tobacco smoke during pregnancy is a known factor to cause a marked increase in Sudden Infant Death Syndrome (SIDS).

How can a father or better, would-be-father justify his ‘love’ and ‘concern’ when his tobacco smoke is threatening the very survival of his born or yet-to-born child? Rights to good health of a non-smoker child or yet-to-born child must be safeguarded to ensure healthy progeny.

Violation of child’s right by smokers, is the most sensitive angle of this whole issue. Under Provisions in 1989 United Nations Convention on the Rights of the Child, all signatory governments are obliged to guarantee children’s right to life, to create an environment that maximises the survival and development of children and to implement measures ensuring and recognising children’s right to the highest attainable standard of health.

These children who are exposed to tobacco smoke in their childhood, are reported to be more prone to initiate tobacco usage, and further risking their health.

It is also a question of ethics of relationships. A smoker father, peer or mother, ravishing the health of their own children! How brute! Where have we gone wrong?

Unless tobacco usage looses social acceptance, and NON-SMOKING STATUS becomes a more respectable and enviable position, safeguarding the rights of non-smokers will lure us for long. Besides the indifference of non-smokers manytimes become a root cause for their exploitation. Apathy is dangerous particularly when it is the question of life itself. Educating the masses of misleading tobacco advertisements, letting them know the magnitude of the tobacco epidemic, and ‘training’ young children HOW TO SAY "NO" to peers or friends inviting them to smoke, are some of the potential weapons which can make the ‘big’ difference in tobacco control.

Moreover ‘training’ of people in negotiating aggressive tobacco users and making them extinguish burning cigarettes, is also a herculean task to be done. On this year’s NON-SMOKERS" RIGHT DAY, let us resolve to start safeguarding our own rights, for our own health and welfare.

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Non-Somker's Rights Day --- February 20, 2000 ........ Office of ICAT (Bobby Ramakant)

Sunday, February 20, 2000 is being observed as Non-Smokers’ Rights Day by all member-organizations of International Coalition Against Tobacco (ICAT). In Lucknow, Indian Society Against Smoking (ISAS) had organized 2 days long workshops on tobacco control for Classes 9th and 11th at TD Inter College on Friday and Saturday on "How to negotiate a smoker into stopping smoking near you?". These workshops were conducted by Vasushena Mishra and Bobby Ramakant.

On Sunday, Indian Cancer Society had organized a guest lecture for medical professionals in Rae Bareilli where Prof.Rama Kant spoke on Tobacco & Cancer.

Prof.Rama Kant of Department of Surgery, King George’s Medical College, Lucknow who is also the President of Indian Society Against Smoking, and Chairman of International Coalition Against Tobacco (ICAT), states that the Carbon Mono-oxide level in the blood of pregnant mother is very high if her husband is a smoker. As a result of which the blood vessels constrict, increasing the pulse rate and blood pressure and ultimately culminating in severe toxemia during pregnancy.

Such a man is also increasing the risk of spontaneous abortion, foetal death or even the chances of delivering ‘blue baby’ for his wife. Datas have proved that the weight of the child of a passive smoker is usually lesser by over 170 gm than the child of a non-smoking couple.

The newborn baby also suffers in a number of ways, thanks to his father being a smoker.

Passive smoking is when you yourself do not smoke, but inhale the smoke released by other smokers around you. Those women who have been passive smokers during pregnancy, develop a deficiency of vitamin C in their milk.

Cases where the husband has been a heavy smoker, the nicotine finds it’s way to the lactating glands of his wife. As a result the mother’s milk has nicotine. Reports say that 0.5 mg of nicotine has been found in one litre of such mother’s milk.

Prof.Rama Kant adds that in 1981, Trichopoulas and Hirayama were the first to reveal the potential carcinogenicity of tobacco smoke released into the air. They showed an increased risk of lung cancer in non-smoking women married to smoking men. Hazards of passive smoking, have been surfacing since then. The most horrifying fact is Side Stream Smoke (SSS) that is the smoke which comes out by itself from the burning cigarette ends, is far more dangerous than the Main Stream Smoke (MSS). MSS is the smoke which smoker himself exhales out. SSS plus MSS constitutes E.T.S. (Environmental Tobacco Smoke).

It may be shocking to know that SSS contains five times more CO, three times more tar and six times more nicotine and ammonia than the smoke which the smoker himself inhales.

Children of such parents are often weak and lean. They are born susceptible to various respiratory ailments including severe bronchitis, pneumonia, tracheaitis, chronic cough, asthama, laryngitis, and middle ear infections.

When this unfortunate child grows up, instead of fetching laurels at his level, he gets stuck with mental retardation, abnormal behaviour or even reduced fertility. These are the crutches which a child of smoker parents inherit.

The delusion that most women have about the connection between smoking and manliness is absurd. All such publicity stunts to delude innocent youth on the road to ‘travails of smoking’, must immediately be stopped.

Even the recent Bulletin of Tobacco Prevention Division of W.H.O. (May 1998 issue) contained the following fact that passive smokers account for one-third of lung cancer cases.

It is high time such men realized it is worth stubbing out this habit than stubbing out those around him - most of them are his near and dear ones. Several programmes to educate smokers should be launched to create awareness in society and make an emotional appeal to ‘quit smoking for those you love’.

The recent slogan where a smoker asks his partner ‘Mind if I smoke?’ and in reply is told ‘Care if I die?’, should be taken rather seriously by all smokers.

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European Union adapts a landmark directive on tobacco advertising ........ Bobby Ramakant

Although Tobacco Prevention Division of World Health Organization has been making frantic efforts to impose a blanket ban on tobacco publicity, promotion and sponsorship, yet nothing much could happen until 1989, when the European Union proposed a historic move to contemplate a ban on tobacco promotion.

However this proposal was defeated badly with hardly any nation taking a stand in favour of it. It was not until 1992, when European Union Parliament approved this proposal. But again, it was blocked by the triad alliance of Germany, U.K. and Netherlands.

World Health Organization, International Union Against Tuberculosis and Lung Disease (IUATLD), International Union of Cancer Congress (IUCC), International Non-Governmental Coalition Against Tobacco (INGCAT) and several other International anti-tobacco advocates made all-out endeavour to initiate a hectic lobbying process in favour of this proposal. Their efforts bore fruits and in 1997, this proposal was finally approved by the Health Council of European Parliament, despite of a dramatic struggle with Austria and Germany voting against the nation, Denmark and Spain abstaining themselves from voting, and 11 nations voting in favour of this motion.

This was indeed a historic move in the entire history of tobacco control and received overwhelming support from tobacco control advocates the World over.

After the approval of this proposal by Health Council, it was forwarded to Environmental Committee of European Parliament, which outrightly supported it with the following remark :

Since then, promotion of tobacco through publicity, advertisement or sponsorship, has been severely curtailed in the European Union Nations. And after 2006 A.D., all such vicious instruments of tobacco promotion will come to an end. This is the most laudable development in tobacco control in World, and definitely indicates the possibility of our future where World may be tobacco-free.

The final meeting of European Union Parliament is going to take place on May 12-13, 1999 where the guidelines of an effective programme to implement the said proposal shall be laid out. This meeting shall be held in Brussels. The policy makers of European Parliament are also going to set a full-fledged time-table for the phase-out operation of tobacco promotion by 2006 A.D.

This is indeed a remarkable achievement since prior to this nothing major could be done in this regard. This fact becomes all-the-more significant because tobacco prevention division of W.H.O. had carried out a World-wide survey to evaluate the link between tobacco sponsorships of sport-events and initiation of tobacco usage by children in age-groups 13-17 years. In India, this survey was carried out by Chairman of National Organization of Tobacco Eradication (N.O.T.E. India UP) and Founder-President of Indian Society Against Smoking- Prof.Rama Kant of King George’s Medical College Lucknow. Prof.Rama Kant’s team had conducted this survey on 9004 students of 130 schools in 10 cities of India, in age-group (13-17 years) to establish the link between tobacco sponsorship of sport events and initiation of tobacco usage by children. The results of this survey, were published by W.H.O. in May 1998 issue of their World No Tobacco Kit, and the findings were as follows :

* Class 9 students are most prone to tobacco usage after seeing tobacco-sponsored sport events.

AFTER seeing WILLS World Cup Cricket Series,

* 13% felt "a desire to smoke"

* 4.7% felt "no harm trying"

* 4.6% felt "it was worth a try"

* 2.6% felt like "enjoying a cigarette"

* 1.1% felt like "smoking a cigarette"

* 1.4% felt like "buying a cigarette"

* 5.4% students had smoked WILLS

* 16% had smoked some other brand.

Therefore it is indeed a positive development that European Union is all-set to establish a historic precedence and going to take a lead in tobacco control. India’s tobacco control programme like the ban imposed on smoking in public places in Delhi, fail at implementation level. Much more serious efforts should be made to culminate this growing menace of tobacco and a Worldwide phase-out drive be initiated to eventually decimate the tobacco sponsorship, promotion and misleading publicity stunts.

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Tobacco vs. Oral Health ........ Shivani Sharma

It is indeed surprising that people are so much concerned about their looks, the way they dress, the way they walk, the food they eat, their entire lifestyle is monitored by so many accustomed norms, but oral hygiene and health hardly figures in their list, except for some trendy toothpaste which they may be using every morning.

Tobacco, a product whose health hazards are no doubt gory, has it’s manifestations in oral health too. Now the researchers have proven beyond doubt, that tobacco whether used for smoking, chewing or as a dentifrice, has a direct relationship with the development of oral cancer.

Tobacco Vs. Smoking

* Cigarette smoking : Cigarette smoking affects the oral cavity as a whole, particularly the cheeks, lips and palate. Those who smoke cigarette upto the butt ends, produce lesions on the lips.

* Bidi Smoking : This is much prevelant in Lower and Lower-middle socio-economic sector of our population. In Bidi Smoking, the lesions are made on the angle of mouth. This is primarily caused by the secondary smoke that oozes out from the angle of mouth as the bidi is held between the teeth. In these cases of bidi-smoking-related health hazards, serious manifestations are found in soft and hard palate of mouth.

* pipe or cigar smoking : Not only pipe or cigar smoking identifies you with a well-established social sector, the hazards of cigar or pipe smoking on oral health, are also typical. The lesions caused by cigar or pipe smoking, form a pattern identified as "Smoker’s Palate". As the Pipe-smokers will recount, that pipe is held at a specific site over the teeth and the jet of smoke strikes the palate, thereby forming specific lesions which over a period of time, takes the shape of "Smoker’s Palate". However, at many grimmer instances of life, you will agree that it is quite true : "God Allows U-Turns". And those people who take these U-Turns by stopping tobacco usage when early stages of primary lesions appear, have far better chances that their "Smoker’s Palate" will revert to normalcy.

* Reverse Smoking : Our Telugu brethren will recollect the typical smoking pattern prevelant in fisherwomen of coastal Andhra Pradesh. And oncologists the World over, identify these tobacco-related cancers as Chutka cancers. In this particular type of style of smoking, the burning end of cigarette is kept inside the mouth, and the lesions are produced due to the combined effect of smoke, heat and ash.

* Julku smoking : It is a clay pipe, popular in Goa region. This pipe is held in the lips and thus the lesions are produced on the lips.

CHEWING TOBACCO Vs Oral Health

With the advent of GUTKHA CULTURE, chewing tobacco-related health hazards are certain to assume tyrranical proportions. Tobacco Quid, where tobacco mixed with lime, or kept in the beetle leaf ("Tambaku wala pan") is held within the mouth in the vestibular region producing lesions at that site. These are related to cancers no doubt, but their hazards are far more gory than what is documented in medical science, because the ingredients of Gutkha or pan masala, are of extremely poor quality and hazardous to health. For instance, the local pan masala manufacturers in Kanpur, discovered a cheap extract of a stone in Pilibhit district, which is much cheaper to "Kaththa", without realising it’s implications on health of it’s chewers. And it is indeed very saddening, that this culture of gutkha-chewing has assumed unimaginable proportions in our population.

DENTIFRICE Vs Oral health

A famous advertisement of yesteryears where a wrestler rubs burnt tobacco in the morning, and his sister rebukes him that ‘body is so strong and teeth so weak!’ is worth mentioning here. This custom of applying dentifrice on teeth like burnt tobacco, was much prevelant before. But whether these dentifrice cleanses the teeth or not, one fact is certain, that the person gets addicted to tobacco in it while rubbing it over the teeth and gums, thereby producing lesions on the gums and staining the teeth.

Dental health care and hygiene is infact, jeopardized by tobacco usage. And without teeth, or teeth with stains, hardly look impressive. And if some serious tobacco-related cancer like oral cancer, grips you, then the plight is pitiable. Doubtlessly, quitting tobacco is the only sensible option in such modern times where logic prevails over desires.

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Love or Smoke ?? Choice is Yours ........ Pooja Ramakant

Countless number of times people have rebuked me that ‘awareness is impotent, it is not going to accomplish any worthwhile mission,...’, but the glimpses of my childhood memories re-affirmed my faith and made me recollect the times when my father had undauntedly and stringently traversed on the path of anti-tobacco crusade spreading awareness about hazards and mobilizing thoughts in a direction where the smoker may by his free will, quit tobacco usage. ‘By force’, he says, ‘you can only accomplish short-lived temporary goals’.

And it is true. That is what happened in 1997 where Government enforced a prohibition on smoking in public places in Delhi. And today, for all practical considerations, this prohibition is non-existent. What to talk of common man, you can find policemen smoking, presspeople smoking, doctors smoking, in public places in Delhi, in broad day-light. And the "law" moans.

However, the path of awareness is no doubt tough, rough, and seemingly lack lustre. But goals accomplished on it, are ‘long-lived and relatively permanent’. Say for example, when our present-executive committee member, Shri PN Sharma had quit tobacco years before. He did this on his free will, needed counselling, and was ready to take it. And he did quit tobacco because he realized "He had no choice".

This year, on World No-Tobacco Day, we have made our best possible effort in bringing out this bulletin, with just one intention: to let the people listen the sordid saga of the

travails of tobacco. We leave the choice on the smokers. We feel that tobacco consumers will realize that tobacco is not only hazardous to health, but using it is also irresponsible, insensible and dangerous, not only to them, but also to their family, loved ones, and society too.

Repeating the slogan which was much-popularized by my father Prof.Rama Kant in 1994, and which also became the title of such similar bulletin published in 1993-94, with the hope that our efforts, no matter how small they may be, will not go in vain. 

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Tobacco - Deadly is the way ........ Prof. Ramakant

Tobacco is probably the single largest cause of non-communicable disease and is likely to produce World pandemic unless urgent preventive action is taken. Every year, fresh hazards of smoking are demonstrated. New research is helping to define the risks of passive smoking. Death rates from lung cancer are already falling in some western countries but in China, Eastern Europe, parts of Russia, Indian Sub-continent, they are fast rising and there is likely to be a major epidemic in these parts of the World in the early years of next century, far exceeding any previous outbreak of cancer. Smoking related cardio-vascular and Chronic Obstructive Lung Diseases(COLD) will be an additional burden. Government action to curb the activity of tobacco companies must be the first priority, particularly in developing countries.

When this century is winding to a close, we can predict logically that in coming 21st century, cancers of lung and COLD (Chronic Obstructive Lung Disease) will be the main cigarette-related disease in many third-world countries. However cardio-vascular diseases are likely to remain the most important tobacco-health-hazard in few developed nations.

TOLL OF DEATH

Nearly one-fifth of all deaths have been attributed to cigarette smoking in western countries. In India it is estimated that

between 5 to 10 lakhs premature deaths occur each year from tobacco use. The total World mortality from tobacco use must amount to several millions each year.

LUNG CANCER

A threefold increase in the duration of regular cigarette smoking from 15 to 45 years can raise the annual incidence of lung cancer. Where teenage smoking is increasing as in many developing countries, an epidemic of lung and other cancers is almost inevitable. Even in present times, Lung Cancer is overtaking breast as the commonest malignancy of women in parts of USA and Scotland which is suggestive of rising trend of tobacco usage in women.

Other Cancers

In many Asian countries, cancers of mouth, larynx, and pharynx, are major tobacco-related malignancies. Cigarette smoking doubles the risk of bladder cancer in man and also increases prevalence of pancreatic cancer. Although pipe and cigar smokers, have much lower risk of lung cancer than cigarette smokers, yet their risk of developing oral, laryngeal and oesophageal cancer is as great as for cigarette smokers. If both tobacco and alcohol are used, the risk of suffering from one of these cancer becomes even higher.

Cardiovascular deaths accounted for about a half of the mortality from cigarette smoking and most were due to coronary

heart disease. In men, under 45 years of age, at least 80 percent of coronary deaths can be attributed to smoking. Cigarette smoking significantly increases the risk of sudden deaths.

Other Vascular Diseases

Peripheral vascular diseases and abdominal aneurysms have been found to be even more closely related to cigarette smoking than is coronary heart disease. About 95 percent of patients with intermittent claudication or gangrene of the legs are smokers. Stopping smoking is usually the most effective treatment and if achieved early in the course of disease, can prevent the need for amputation. Renal artery stenosis leading to hypertension has relationship with smoking.

There is increased risk of sub-arachnoid hemorrhage in smokers in women on oral contraceptive pills.

COLD (Chronic Obstructive Lung Disease)

Cigarette is by far the most important cause of this disease, especially in people exposed to atmospheric pollution or a dusty work environment. This is a highly significant cause of mortality related to smoking.

Women who smoke during the pregnancy increase the risk of still births and neonatal mortality, and their children are liable to suffer delay in physical and intellectual development upto the age of 11 years. Smoking also reduces fertility.

PASSIVE SMOKING

It is now accepted that there are risks to non-smokers who inhale other people’s smoke. The smoke from burning end of the cigarette contains considerably more toxic substances than the smoke breathed out by the smokers. Children of smokers have more cough and are more likely to have bronchitis and pneumonia than children of non-smokers.

It may sound unbelievable but it is true that about a third of cases of lung cancer occur in non-smokers who live with smokers, and a quarter of cases of lung cancer in non-smokers actually may be attributed to passive smoking.

Tobacco companies are estimated to spend US$ 2 billion yearly to advertise their products and to counteract the growing public awareness of the dangers of smoking. Since tobacco advertising tends to neutralize the health education, especially among young people, all such advertising and sport sponsorship by tobacco companies should be banned.

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Tobacco Control in India - How farce ? How true ? ........ Prof. Ramakant

It is established beyond doubt that tobacco in any form, smoking, chewing, eating or applying it in any part of body, causes widespread pathological effects. It is indeed shocking to reveal that nearly 8,00,000 deaths occur in our country every year from tobacco usage, which may be a population of a city and still, there is no hue and cry.

The percentage and extent of tobacco consumption in India has reached to a saturation point and their extremely valuable customers (chain smokers or chewers) die in large numbers every year and the new entrants are unable to increase the sale. Thus they target their sale on children and women. As a result of which, the third world countries are becoming potential major markets of America to sell their cigarettes with total thrust on school-going children and women.

One will be surprised to know that America is the largest producer of cigarettes but has one of the lowest smoking rates 25.5% of it’s population.

American tobacco companies spend more than quarter billion dollars every year, giving free supplies of cigarettes to these countries. This is basically made available to adolescents and teenagers.

These companies spend billion of dollars on advertisements especially in sponsoring sport events. Practically all-important ministries are hand-in-glove with these tycoons viz. Ministry of Commerce, Finance, Agriculture, Social Welfare, Law, Revenue, Labour, Land reforms, Human Resource Development, Forests, etc. Their high officials are ‘looked after and gifted well’ by these tobacco doyens.

A report published on Tobacco Control by W.H.O. in 1994, reveals that about 5.83 billion dollars were paid to the Indian Government for permitting to name cricket match as "Wills Trophy". Such instances are shameful to our society. Each finance minister (evidently right from India to UK or US) talks of revenue collection from tobacco industry and also the employment to lakhs of people. But statistics have proved that the money earned through revenue from tobacco sales is grossly less in comparison to money spent by Government on the treatment of tobacco-related diseases and cancers.

The policy of Government and laws are paradoxical and ridiculous. Let’s consider some:

* Exemption of tobacco industry from Central Excise and Tariff Act 1944.

* Incentives are given to grow more tobacco.

* Promotion of tobacco industries by sponsoring, assisting, co-ordinating, and encouraging scientific, technological and economic research, says Section 8(2).

* Subsidy of Rs.100 crores being given to the tobacco-farmers indirectly by the commerce ministry.

* Besides there are large number of benefits extended to tobacco growers.

* The youth is attacked and targetted from all sides to be lured for joining tobacco users caravan. Newspapers, glossy magazines, airports, railway stations, roads, restaurants, and no matter where he goes, he sees that the most attractive, expensive, stylish boards, display some of their favourite hero exclaiming LIVE LIFE KING SIZE with some brand of cigarettes. Government policy of "... no such sign-boards or shop within a kilometre of a school" is openly flouted.

A young mind is attracted towards experimentation and when there is an offer of free cigarettes too, the experience happens easily. This is how new generation indulges in this addiction and firmly believes that those who smoke are symbols of success and supremacy in life.

While the cruel irony is that those who are successful, dynamic, powerful, they usually DO NOT SMOKE!

The vehement opposition enforced to such public figures for advertising the cigarettes, falls on deaf ears because they are very highly paid.

Most of the tobacco companies, claim that they advertise for change of brand to a smoker and not for encouraging new people to start smoking. Such gimmicks sound ridiculous and fail to explain the misleading publicity stunts used in tobacco advertisements.

Introduction of small pack or pouches, has caused a furore. This is one of the greatest sin ever done by the politicians because the sale of tobacco has boomeranged. Even economically-weaker people have no hesitation in buying a "chota gutka".

Racket of increasing excise tax to satisfy anti-tobacco activists has also been exposed. Government has increased the excise duty on certain lengths of cigarettes (70, 80, 85, 90 mm) but just after announcements, the companies have reduced the size by 2mm (65-68mm) and they escaped through the net of raised taxes.

A survey conducted on about 900 students in Lucknow city involving class IX students on the effect of watching WILLS TROPHY cricket matches, has proved beyond doubt that nearly 4.5% new students were initiated to start smoking after getting stimulated by these tobacco-sponsored matches. 84% students believed that Sunil Gavaskar, Kapil Dev, Sachin Tendulkar, smoked, and thus played well. Truth is, none of them is a smoker. This nation-wide survey had similar inferences, and established that tobacco-sponsorship of popular events (sport, musical nights etc.) encourages children (especially Class IX) to start tobacco usage.

We have to realise the dilemma which our children face today, that if cigarette is bad for health, then why would our Government manufacture them, why their elders (we) smoke, why their screen-heroes smoke-on-screen and perform heroic stunts-on-screen?

We have to counter this dilemma and play a role-model for the benefit of our own progeny. After working with youth for over 33 years, I can express with confidence that they are most vulnerable, adaptable, and correctable, provided you understand them and treat them as friends. Long live youth!

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