It was almost like one of the rites of passage to manhood. The first smoke and the first
peg. But research reveals that a smoke is far more dangerous to the well being
of an individual. The government and several private bodies have been working
very hard to curb smoking. In Goa, a state dominated by the tourism industry,
visitors come from all over the world. Which also means there are visitors with
different attitudes to smoking. However, the determination of associations like
National Organisation for Tobacco Eradication (NOTE) is paying off.
Among all states and two union
territories, according to the Global Adult Tobacco Survey, Goa reported the
lowest prevalence of tobacco use. There was a 0.6% decrease in the consumption
of tobacco in the state. Dr Shekhar Salkar, Consultant, Surgical Oncology,
Cancer Care, who has been involved with NOTE in Goa, says “The road ahead is
long, smoking has reduced but chewing tobacco has increased in rural areas. In
1984, our study showed 52% males were smoking and 10% were chewing and by 1998
that had dropped to 35%. By 2002 it came down to 22% and is now at 15%.”
He states that oral cancer in Goa is much lower when compared to
other states. It is around 25% in Goa as compared to 45% in the northern
states. He adds that this has been achieved by controlling the consumption of
tobacco.
Khaini is the most commonly used tobacco.
The battle is along various fronts. NOTE is also focussing very
aggressively on educating the youth on the dangers of smoking. The doctor
conducts awareness lectures in school and also helps those who want to quit. To
increase the task force, he conducted a training of councillors at the primary
health centre. Dr Salkar is also part of the North Goa task force.
When one considers the overall picture, the situation is quite
daunting. India is the third largest tobacco producing nation and second
largest consumer of tobacco, worldwide. Mortality due to tobacco in India is
estimated at upwards of 1.3 million. Out of these, one million are attributed
to tobacco smoking and the rest to smokeless tobacco use. One feature of
tobacco related mortality in India is the high incidence of oral cancer,
exceeding even that of lung cancer and accounting for almost half of all oral
cancers in the world. India has the highest burden of both, tuberculosis (TB)
and Multi Drug Resistant (MDR) TB based on estimates reported in Global TB
Report 2016. Smoking increases the risk of TB by more than two-and-a-half
times.
A new battle is now being fought by the doctor. The tobacco
industry came up with the E cigarettes. They are battery-operated devices.
E-cigarettes contain harmful substances. But the types or concentrations of
toxins vary by brand, type of device and how it is used.
While many people may turn to e-cigarettes as a way to try to
stop smoking, the research available has not shown that they are helpful for
quitting. As such, the FDA has not approved e-cigarettes as a way to quit
smoking. In India this year, 12 states banned e-cigarettes. Goa has not as yet.
As
technology evolves, the platforms of delivery get more sophisticated and those
fighting the good fight have to evolve and tackle it. The future of a
generation is at stake.
