World No Tobacco Day 2016: India cannot afford preventable burden of killer tobacco

Dr Raghav Gattani, CNS Medical Correspondent
Prof Rama Kant, WHO DG's Awardee 2005
[हिंदी] India's health systems are already significantly overburdened with tobacco-related diseases such as cardiovascular diseases (heart disease and stroke), a range of cancers, respiratory illnesses, diabetes, asthma, tuberculosis (TB) among others. "Tobacco diseases are preventable, avoidable, and evidence-based measures are already known to avert this public health disaster. Why are we failing to save lives? Tobacco-related diseases and premature deaths can be prevented. Tobacco kills. Why is the sense of urgency not driving our public health programmes?" said Prof Rama Kant, WHO Director-General's Awardee and former President of Association of Surgeons of India.

Tobacco use is no.2 leading cause of cardio-vascular diseases

Prof Rishi Sethi, Cardiologist, KGMU
Tobacco use is the second leading cause of cardio-vascular diseases (such as heart disease and stroke), after high blood pressure. “Tobacco use is estimated to cause nearly 10 per cent of cardiovascular diseases (CVDs). Nearly 60 lakh people die from tobacco use or exposure to secondhand smoke, accounting for 6 per cent of female and 12 per cent of male deaths worldwide, every year” said Professor (Dr) Rishi Sethi of Department of Cardiology, King George’s Medical University (KGMU).

"Tobacco use, whether by smoking or chewing, damages blood vessels, temporarily raises blood pressure and lowers exercise tolerance. Moreover, tobacco decreases the amount of oxygen that the blood can carry and increases the tendency for blood to clot. Blood clots can form in arteries causing a range of heart diseases that ultimately result in a stroke or sudden death. Also we need to understand that there is no risk-free level of exposure to secondhand tobacco smoke. Non-smokers who breathe secondhand smoke have between a 25 – 30 per cent increase in the risk of developing a CVD" said Prof Rishi Sethi, National Convenor of Cardiological Society of India's STEMI.

In states like UP heart disease rates have shot up along with rising tobacco use. The Intervention cardiology data compilation done by Prof Rishi Sethi revealed that over 4500 lifesaving angioplasty procedures and almost 2000 lifesaving pacemaker implantations have been performed in 2011-2012 in the state of UP. The number of these procedures has increased by almost 30% over previous year.

90% lung cancer deaths due to tobacco

Shobha Shukla,Executive Director,CNS
"Tobacco smoking is the top risk factor for lung cancer, with 90 percent of cases attributed to tobacco use. People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. A U.S. Surgeon General’s Report in 2014 stated that women smokers were 25.7 times more likely than women who never smoked to develop lung cancer – for male smokers, it was 25 times the risk of men who never smoked" said Shobha Shukla, Executive Director of CNS who edited 3 editions of scientific updates on lung cancer in Asia Pacific in May 2016.

Dr Tara Singh Bam
The Union
Deadly links: Diabetes, TB, HIV, tobacco use

"Recent studies have shown that 16% - 46% of the people living with TB also have diabetes, and many are unaware of it. Scientific evidence shows that tobacco smoking is one of the significant risk factors for TB as well as for diabetes. If we really want to eliminate TB, we will have to eliminate tobacco and control diabetes" said Dr Tara Singh Bam, Technical Advisor (Tobacco Control) of the International Union Against Tuberculosis and Lung Disease (The Union).

"Quitting tobacco use reduces the risk of an individual to fall prey to major life threatening non-communicable diseases (NCDs) such as heart disease, stroke, cancers, diabetes, respiratory illnesses among others. Similarly improving implementation of tobacco control laws will help save preventable burden of diseases, disabilities and deaths. Government can easily control major and common risk factor for deadly diseases: Tobacco - but why we do not see action which we should with so much of alarming disease and death burden associated with tobacco?" asks Rahul Dwivedi, Director, Vote For Health campaign.

Rahul Dwivedi, Director
Vote For Health campaign
Tobacco use doubles the risk of death in people living with HIV. People living with HIV can live normally if they are on antiretroviral therapy (ART) but at risk of HIV related and non-related illnesses, said Rahul Dwivedi.

Ban on tobacco use, alcohol and other addictions

"Tobacco farmers should shift to food grain and other crop cultivation - and government must ensure that minimum support price is being given to all farmers in India Those who use tobacco or alcohol or other addictions must refrain from self-harm and rather invest their hard-earned money into activities that are beneficial for their own self, families and societies at large" said Dr Sandeep Pandey, Magsaysay Awardee and Vice President, Socialist Party (India).

Tobacco control is not enough, endgame of tobacco is a social justice imperative
"Tobacco control is not enough. If we keep doing business as usual then tobacco 'business' will keep flourishing and people dieing of needless and preventable causes prematurely. We need to accelerate progress towards ending game of tobacco - and choosing health and life over misery and death" appealed Rahul Dwivedi.

(About the author: Dr Raghav Gattani, MBBS, Junior Consultant at Avadh Hospital and Heart Center is also the honorary Medical Correspondent for CNS - Citizen News Service)
30 May 2016