Curbing Tobacco Usage: Call of the hour

Pritha Roy Choudhury, CNS Correspondent, India
A narrow lane leads us to a poorly lit small dingy room of a four storied building in the suburbs of Delhi. Veer Prakash is lying in a cot, coughing on and off. His wife Lila Devi dusts two small stools in a corner and arranges them for us to sit. “His cough has aggravated with time, the medicines are costly.

It is difficult to hospitalise him even though it is very much necessary, but where will the money come from,” laments his wife Lila Devi, who somehow manages to feed the family of five by doing odd jobs after she is through with her household chores. Veer Prakash’s cough has become chronic. He is a chain smoker of bidis— a form of locally produced cheap cigarette, which is made by rolling tendu/temburni leaf with tobacco inside (the plant is native to Asia only). He is also an alcoholic. During previous visit to the doctors, he had been warned against smoking. But every time his addiction wins over his will power to quit smoking. Persistent cough and poor health have confined his movements inside the four walls of his house and, at the most, to the nearby lanes sometimes. He has become incapable of earning a single penny. The irony of the situation is that while the effect of his smoking is directly visible on Veer Prakash, passive smoking (or second hand smoke) is silently jeopardising the health of the other family members for no fault of theirs.

The sufferings of Veer Prakash and his family is just a single example. There are many who undergo similar shattering life because of tobacco consumption or inhalation. According to data shared by Dr Tara Singh Bam of the International Union Against Tuberculosis and Lung Disease (the Union), during a webinar organised by Citizens News Service, about 800 million men and 200 million women smoke cigarettes worldwide—world cigarette consumption in 2009 was 5.9 trillion. Dr Bam said that tobacco consumption poses the biggest threat to public health in the world today. It is a risk factor for 6 of the world’s 8 leading causes of death and kills more than 5 million people each year. Despite the arresting statistics on the harms of tobacco, smokers are often unaware of the specific harms caused by tobacco use and underestimate risks to themselves and others. With the tobacco consumption contributing significantly to the deteriorating global health scenario, the World Health Organisation (WHO) came up with the first international treaty – Framework  Convention on Tobacco Control (WHO-FCTC) on 21st May 2003, which came into force by 27th February 2005. Since then it has become one of the widely embraced treaties in the history of the United Nations.

While the guidelines according to the treaty are in place, the commitments are also there, but the action at countries’ level is slow, which is adding to the concerns. India ranks second amongst the tobacco consuming countries in the world—the first being China. Tobacco is used in various forms in India— either as bidis or cigarettes or in hookahs a traditional way of smoking; or as chewing tobacco in the form of gutkha, khaini, zarda and pan masala. The youth, including teenagers, are catching up fast with such unhealthy eating habits. Though a number of measures have been taken by the Indian government to curb tobacco use in accordance with FCTC, including pictorial health warnings on tobacco packets, a lot more still needs to be done. Pictorial health warnings (that now occupy 85% of the total pack area in India) can educate people on dangers of tobacco use; motivate smokers/tobacco users to quit; and convince youth not to start smoking/tobacco use.

“Yes, I do see the warnings on the cigarette packs that I buy. They are disturbing, but I am unable to give up smoking,” says Ashish, a 30 year old software developer. The people of North-east India consume tobacco in a very peculiar way. They either chew the tobacco leaf with another kind of leaf, locally called paan, and betel nut with slaked lime; or else they just fold the tobacco leaf and keep it in their mouth for long hours to derive a high. WHO has recently came up with the idea favouring plain packaging of tobacco products, with only pictorial and text health warnings and no mention of any brand name. This has already been tried in Australia with very good results, and prompted many other countries to follow suit. UK, France, Ireland, While there is a need to curb the easy and abundant availability of tobacco and tobacco products in the market, there is also a need to raise awareness on this issue among the smokers and young adolescents so that they stay away from such products which are detrimental not only for their health but also of their family members and friends (due to second hand smoke).

Pritha Roy Choudhury, Citizen News Service - CNS
June 7, 2016