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Category Archives: Scientific Information

Voices of Victims – 17th March, 2011

Voices of Victims – 17th March, 2011

Action Council Against Tobacco (ACT India), Healis-Sekhsaria Institute for Public Health, Salaam Bombay Foundation and Voluntary Health Association of India (VHAI), joined hands with Tata Memorial, Mumbai to organize a  second Voice of Victims event in Delhi on 17 March 2011. This event was organised on the request of the leader of Opposition in the Lok Sabha (lower house of Indian Parliament), Ms Sushma Swaraj, who wanted the victims voices to reach the ears of her fellow parliamentarians. Ms Swaraj, personally invited all the parliamentarians and brought along over 40 of them to hear out the victims.

Testimonies from cancer victims ranged from their battles with oral cancer to living with half a jaw to talking through a voice box while those from their families were on the challenges in coping with the expenses of treatment to depleting resources to support household expenses, children’s education and daughters’ marriage. These experiences overwhelmed the audience and resulted in many wet eyes and choked throats. Both the victims and their families appealed to the audience to “let not what has happened to them, happen to any more people” and urged the government to take stringent actions against gutka and other forms of smokeless tobacco and expressed their solidarity in the fight to save others from the menace of gutka.

The highlight of this event was the presentation of a Charter of the demands by the victims to Ms Sushma Swaraj and other parliamentarians that called for banning gutka, increasing taxation on all tobacco products and implementing policies and programmes that reflect the demands of the victims of chewing tobacco. The victims also got the all the parliamentarians at the event, to sign a pledge assuring their commitment to support all tobacco control initiatives for a healthier India.

The events were well attended and covered by the media and generated extensive coverage in the print and TV channels

In keeping with her promise (to the victims in her first interaction with them in Feb 2011) to raise the tobacco control issues in the Parliament, Ms Sushma Swaraj, did so in her speech in the lower house on 15 March:     .
Madam Speaker, many thanks to you. With your kind permission I wish to raise an important matter in the Parliament regarding public health. Whenever introspection is done on the negative factors which have direct bearing on public health, the one which stands out is – usage of tobacco products.
Madam you know that tobacco is consumed in two ways – cigarette, bidi smoking and gutka, pan masala, zarda, khaini chewing. Madam Speaker, you will be surprised to know that eight to nine lakh people are dying annually due to tobacco products. This figure has been provided by the government and it is recent.
This disease not only kills, it damages a victim physically and materially. Patients bear on their bodies while the family suffers financially and mentally. When one sees any of our loved ones going through the pain of it, then family even prefer to sell their utensils for treatment. Families and families are devastated by it. I want to say that only to address this issue a report was tabled which mentions that 35% of the adult population of India is consuming tobacco. Therefore, it is must that the government forms a firm policy towards this issue. When I was the health minister in 2003, I was instrumental in passing a bill in this House which is known as COTPA in English. It talked about ban on advertisements of tobacco products, no sale within 100 yards of an institution, no sale to a minor and pictorial warning on packaging of tobacco products. After 2003 in 2008 this government started doing something on warnings, but the Rules formed were only to be delayed till 2009. Rules said it has to be harsher every year. A stronger warning was again expected in 2010 but government postponed it by six months to 1/12/2010, then I wrote to the Health Minister and said that the proposed warning on tobacco products which you have chosen is appropriate but implementation is getting delayed. Now as the government has decided that it will be implemented on 31st Dec, therefore I request you not to delay it but implement it this time, as it will prove to be an effective step towards improving public health. But I am disheartened to say that I got a response on 27th January after government decided to postpone it till 2011. Therefore, I wish to raise this issue with your kind permission. A few days back, people suffering from usage of tobacco products, who have cancer of mouth, throat, tongue came to see me. These 8-9 lakh people are dying from cancer. On one hand government is spending 100 crores in 100 districts to prevent cancer but on the other hand 8-9 lakh people are dying only because we are not able to ban tobacco products or implement strong warnings. These victims are coming to Delhi on 17th and they want to sensitize the MP’s, but I am surprised to say that whenever I try to raise this issue then disturbances are created. I want to say that if you will permit me I will bring the victims to you. Their scary faces, lack of confidence and no charm to live really tells their agony. I will make them meet you. Doctors of Tata Cancer hospital have initiated it and taking the victims to places. I want to say through you that it is imperative to ban tobacco products, but if not possible then please make sure that at least stronger pictorial warning, which shows a gory picture on the packaging of tobacco products, should be implemented. I request you to please instruct the government that it is implemented on 31st Dec 2011 and not to delay it any further. This is my earnest request.

Ms Swaraj also expressed her solidarity to the issue through her tweets on the same day:

I raised the issue of adverse effect of tobacco on the health of our people in Lok Sabha today.
As many as 8 Lakh people are dying of cancer caused by tobacco products in India every year.
I stand for complete ban on all tobacco products.
If the Government is not ready to ban them immdtly, we must ensure tht pictorial warnings r more prominent and strict compliance is ensured

For Pictures of the event click
Links to some news stories –
Printed coverage
Online Coverage –
Media Coverage 01

Media Coverage 02

Media Coverage 03

to access the photographs:

To See Event Pictures

Pledeges Signed by the Members of Parliament

 

 

Press Release

Sushma Swaraj Leads Parliamentarians & Cancer Patients in an Appeal to Ban Gutka/Pan Masala Products

New Delhi, 17th March 2011: Steadfast in her commitment to fight the tobacco menace, Sushma Swaraj, Leader of the Opposition, Lok Sabha, Members of Parliament and Public Health experts met  cancer patients in the Voices of Victims(VoV) programme.  Victims of oral cancer urged Smt. Swaraj and MPs present to take urgent steps to ensure a ban on  sale of Gutka and Pan Masala products in the country. This comes close on the heels of Smt. Sushma Swaraj raising the issue , in Lok Sabha on March 15th.  where she spoke  of the adverse effect of tobacco on the health of our people.

Tobacco control  is definitely close to the heart of the leader of the Opposition as is apparent from her Updates on the popular social networking forum, Twitter. “As many as 8 Lakh people are dying of cancer caused by tobacco products in India every year.” “I raised the issue of the adverse effect of tobacco on the health of our people in Lok Sabha today” reads Sushma ji’s update on Twitter, on March 15th.

According to the Global Adult Tobacco Survey (GATS 2010) released in 2010 reveals that nearly one third of Indian population use smokeless tobacco.

India has the highest number of oral cancer in the world with 75, 000 to 80, 000 new cases of oral cancers a year. Gutka and other forms of chewing tobacco sold in small pouches across the country has become a very serious health hazard. Since Gutka and Pan Masala are marketed as mouth fresheners, its habit starts at a very young age. Due to its flavoured taste, easy availability and low price, it is popular among children, youth and women. Gutkha use is becoming an alternative choice in India as our social mores do not permit children or women to smoke cigarettes.

A recent report by experts of National Institute of Health and Family Welfare (NIHFW) on  the harmful effects of gutka informs that the number of Oral Cancer cases in India alone is 86 per cent of the oral cancer figures across the world. What is more shocking, is that the chewing tobacco and gutka contribute to 90 per cent of oral cancer cases in the country.

Chewing tobacco is wrongly considered to be safer than smoking. Smokeless tobacco comes in various forms like gutka, khaini, zarda, mishri, mawa, pan masala and is sold cheaply in small  sachets. All these products contain poisonous and carcinogenic substances and are known to cause oral and pancreatic cancer, increased blood pressure and heart rate and adverse reproductive outcomes. Taking this chance gutka manufacturing companies market it as breath fresheners.

MPs both from the Opposition and the ruling party coming together to hear the Voices of the Victims clearly indicates that that there are voices in the corridors of power who have the greater health interest of 1 billion Indians at heart and are ready to campaign till the government responds.

The VoV is a national campaign to advocate against chewing tobacco and other smokeless forms.  It has been conceptualized and initiated  by oral cancer victims who have come together to promote greater awareness about the harmful effects of tobacco use and for  appealing  for stronger enforcement of tobacco control laws and the complete ban of chewing tobacco in the country.

The victims and their families from across the length and breadth of the country have presented  a Charter of their demands to Smt. Sushma Swaraj and other Members of Parliament, requesting them to show their commitment to a healthier India by banning gutka, increasing taxation on all tobacco products and implementing policies and programmes that reflect the demands of the victims of chewing tobacco.

In order to strengthen the national campaign, and to emphasize the menace of tobacco use to unwary users, specially the youth, The Chew On This website is also being launched with the objective of  disseminating messages amongst youth.

SMS messages will be sent to millions of mobile phone users across the country. Mobile phone users will be encouraged to visit the website and see for themselves the truth about smokeless tobacco. Incentives will be provided in the form of free ringtone downloads
.
The campaign is seen as a world first for India to combine messages on smokeless tobacco in many languages, through a wide range of media including: television, radio, outdoor media and social networks such as the internet and mobile phone SMS. The Website in question can be accessed at the following address

Voices of Victims’
Charter of Demands
We represent those Indians who have suffered from cancers of the mouth, throat, lung and oesophagus; or heart diseases or the many other problems caused by chewing tobacco, especially, gutka.
We urge you, our Leaders and Representatives to take the following steps to secure the lives and futures of us Indians:

Show your commitment to a healthier India by:

1)    Banning gutka
2)    Implementing stringent pictorial warnings on chewing tobacco products
3)    Increasing taxes on chewing tobacco products
4)    Putting an end to indirect advertising of chewing tobacco products
5)    Stopping sale of chewing tobacco products near educational Institutes
6)    Determining strong policies and programs for tobacco control in consultation with victims of chewing tobacco

Learn About Tobacco Hazard

International Classification of Diseases (ICD-10) has notified tobacco dependence as a disease.  The International Agency for Research on Cancer of the World Health Organization has categorized tobacco as a category I carcinogen (confirmed human carcinogen). Tobacco usage is strongly associated with several lethal diseases and numerous chronic disabilities. Tobacco, as per an ICMR study conducted in 1996, was responsible for 42 lakh cases of coronary artery disease and 37 lakh cases of chronic obstructive lung disease as well as about 1.5 lakh new cancers! Most Indians use smokeless tobacco therefore we are furnishing the information here.
To know about various tobacco products in India – http://www.aftcindia.org/tob_pro_india.htm
Smokeless Tobacco  –
Predominant form of Smokeless tobacco in India is Gutka, Pan Masala and other such products that are posing serious health problems in India. While Pan Masala is a predominantly Areca Nut (Supari) product, Gutka is a combination of the Smokeless tobacco and Areca nut (Supari).Both Pan Masala and Gutka contain several other additives such as menthol, perfume, spices, sugar, preservatives etc to package it into a mouth freshening product.
Analysis of various market preparations of Gutka and Pan masala in India have shown very high levels of heavy metals viz. Lead, Cadmium, Chromium, Arsenic, Copper and Nickel in such products. These heavy metals are capable of causing serious human disease, as they are toxic even at ultra small levels. FDAs in several states have raided and seized several gutka products in the past especially in Maharashtra and Gujarat due to very high levels of Magnesium Carbonate.
Summary of health effects of the Smokeless tobacco are as follows–
•         Highly addictive with dismal Quit rates of 5%.
•          International Agency for research on Cancer, World Health Organization has classified  Smokeless tobacco as confirmed cancer causing substances.
•         Contains 3095 chemicals and 28 well proven carcinogens
•         Causes severe impairment of the oral and dental health
•         Strongly associated with precancerous lesions and cancer of mouth that is a leading cancer in India.
•         Apart from mouth cancers, smokeless tobacco usage is associated with cancers of  oesophagus, stomach, pancreas, larynx, pharynx and lung.
•         It is associated with hypertension and Ischemic heart disease.
•         It’s use is associated with increased risk of Stroke.
•         It adversely affects reproductive health in women and also seriously affects the fetus.

 

To know more about disease related to tobacco

 

Latest News on Tobacco

 

Centers for Disease Control and Prevention

Learn About Arecanut Hazard

Supari has been declared as a cancer causing substance by International Agency for Research On Cancer, World Health Organization. Supari is one of the main ingredient of Gutka and Pan Masala that are posing serious health problems in India. While Pan Masala is a predominantly Areca Nut (Supari) product, Gutka is a combination of the Smokeless tobacco and Areca nut (Supari). Both Pan Masala and Gutka contain several other additives such as menthol, perfume, spices, sugar, preservatives etc to package it into a mouth freshening product. Aanalysis of various market preparations of Gutka and Pan masala in India have shown very high levels of heavy metals viz. Lead, Cadmium, Chromium, Arsenic, Copper and Nickel in such products. These heavy metals are capable of causing serious human disease, as they are toxic even at ultra small levels. FDAs in several states have raided and seized several gutka products in the past especially in Maharashtra and Gujarat due to very high levels of Magnesium Carbonate.
Summary of Health Effect of the Areca Nut  or Supari

  • Highly addictive
  • Usually taken along with smokeless tobacco
  • International Agency for research on Cancer, World Health Organization has classified Areca Nut as confirmed cancer causing substances.
  • It contains several polyphenols and nitrosamines that are confirmed carcinogenic.
  • It causes impairment of oral and dental health.
  • It’s usage is strongly associated with precancerous lesions and cancer of mouth that is a leading cancer in India.
  • Studies have shown association between Supari chewing and cancers of the Liver, oesophagus,  stomach and lung.
  • Supari use is associated with hypertension and ischemic heart disease.
  • Usage of Supari adversely affects reproductive health in women and also affects fetus.
  • Supari chewing is associated with diabetes, obesity and several metabolic disorders.
  • Supari chewing is associated with causation of certain psychological disorders.

For more information on Areca Nut or Supari

Tobacco Menace in India

India has the dubious distinction of harboring the world’s largest number of oral cancer patients with an annual age standardized incidence of 12.5 per 100,000, and oral cancer amounts to 9.4 percent of all cancers in India. Historically, this has been attributed to widespread usage of smokeless tobacco, and for this reason a great emphasis is being laid by the government and nongovernment organizations towards effective tobacco control. Over last several decades, billions of rupees have been spent for this purpose. Despite all efforts of tobacco control, oral cancer that is an uncommon disease in the west continues to be the major cause of cancer related death in India. The main form of smokeless tobacco which is sold in India is ‘gutka’ and ‘pan masala’ with tobacco. Gutka is a preparation of crushed areca nut, tobacco, catechu, paraffin, lime and sweet or savory flavorings. Some manufacturers also make gutka without tobacco and market them as pan masala or even mouth freshener. Tobaco and areca nut which are critical ingredients of gutka and pan masala are classified as Group 1 human carcinogens by the World Health Organization and International Agency for Research on Cancer. Thus it is well established that gutka and pana masala , are carcinogenic to human beings. According to recent Global Adult Tobacco Survey, about 275 million people in India are addicted to tobacco, and one third of them use it in smokeless form. India is the greatest producer of Areca nut, producing about 3, 30,000 million tons a year (nearly half of global Areca nut production), and most of them are consumed within the country. The gutka industry in India has grown from small beginnings forty years ago to a multi-billion rupee industry with nearly 375 brands, of which, nearly 100 of them are located in Mumbai. It is estimated that, gutka and paan masala worth around Rs10,000 crore is sold in the country annually. Due to low cost, easy availability, attractive packaging, aggressive marketing, innocent adolescents and youths are becoming addicted to them. In India, over 5 million children under 15 are addicted to gutka.

Statistics on Tobacco Use in India

Facts about Gutka

Tobacco Consumption in India

India has alarmingly high rates of tobacco consumption. Almost 275 million Indian adults i.e. one-third of the population consume some form of tobacco, including 47.9% of adult males. Tobacco use kills about 1 million Indians per year.

According to Global Adult Tobacco Survey (GATS 2010) released by the Ministry of Health and Family Welfare:

• India has one of the highest rates of smokeless tobacco usage in the world.
• More Indians ( 75 %) use smokeless tobacco than cigarettes or bidis combined
• Betel quid with tobacco, khaini and gutkha are among the most common forms of smokeless tobacco consumed in India
• Gutka is the second most commonly consumed smokeless tobacco product
• 8 percent of all adults in the country chew gutka
• 91% of female tobacco users use smokeless products; betel quid with tobacco is used the most, followed by gutkha and khaini
• Gutka consumption decreases with an increase in education

Health harms of Smokeless Tobacco use:

• Consumption of smokeless tobacco causes oral cancer, pancreatic cancer, increased blood pressure and heart rate and adverse reproductive outcomes
• Regular usage of gutka leads to Oral Submucous Fibrosis (OSF), oral cancer, heart disease
• Consumption of gutka during pregnancy decreases gestational age at birth and decreases birth weight and also lead to still birth

Phone No.:
+91-22-2757 5487
Correspondence Address:

Sambandh Health Foundation, 1st Floor, Polyclinic, Near Rishi Public School, Sector 31, Gurugram 122001