Your SlideShare is downloading. ×
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Smokeless Tobacco
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Smokeless Tobacco

5,132

Published on

Published in: Health & Medicine
2 Comments
0 Likes
Statistics
Notes
  • So true!, the word cigarette companies should be replaced with ITC. due to bad government policy, in india, cigarette industry is monopoly market which itself is illegal!
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • i am completely agree with your presentation STA India on Smokeless tobacco .
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

No Downloads
Views
Total Views
5,132
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
89
Comments
2
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Good..! Let their focusJARDA / KHAINI TOBACCO be only on prevalence 52% adults exposed to passive smoking at home Ban Smokeless Plastic Tobacco Ban They are Ignoring harm caused by smoking. Is it because we are SWADESHIStrong Industry? in India LegalHealthWarning Cases Jarda / Khaini Tobacco Industry
  • 2. Will you support this? To increase sales of Videshi products, If Swadeshi products are banned? If you do not support this, then please read this booklet to understand how Swadeshi Smokeless Tobacco Industry is being targeted for the benefit of Videshi Smoking Industry VIDESHI Cigarette Industry cheers 1• High potential from women users and switch from non-cigarettes to cigarettes will aid cigarettes companies 2• Government goes soft on statutory warnings for cigarette packs• Rollback of blanket ban on depiction of smoking in films3 SWADESHI Chewing Tobacco Industry cries 4• Health Ministry is formulating a smokeless tobacco specific policy 5• Separate harsher pictorial warnings have been designed for smokeless tobacco products 6• National Consultation for Smokeless Tobacco recommends ban on smokeless tobacco products 7• Despite Food Safety and Standards Act (FSSA) excludes Tobacco from its purview , 8 some states are trying to cover Jarda / Khaini under prohibitory order , thus imposing unjustified ban. 2
  • 3. Brief FactsSmokeless tobacco is tobacco consumed without burning. It is 989 to 99%10 safer than cigarettes. In India,various types of smokeless tobacco products are used like Chewing tobacco, Jarda, Khaini, Spit Tobacco.These are manufactured by Swadeshi Industry since centuries providing livelihood to millions. Unfortunately,livelihood in this industry is in danger due to dual approach. Most harmful tobacco i.e. cigarettes are favouredand least harmful tobacco like smokeless tobacco is treated harshly. In setting policies, all tobacco productsconsumed without burning are combined into one category called Smokeless Tobacco. Even products likeGutkha / Pan Masala are wrongly perceived as Smokeless Tobacco products. Actually, these areprimarily an Areca Nut based products11 because their principal ingredient (> 80%) is Areca Nut.The scientific basis of tobacco product regulation: report of a WHO study group clearly says -The differences in risks associated with use of different smokeless tobacco products meanthat it would be scientifically inappropriate to consider smokeless tobacco as a singleproduct for the purposes of estimating risk or setting policies12. However, this aspect is completely ignored by policy makers. 13Lie - Smokeless Tobacco contains 28 carcinogenic chemicals -Advocates of Tobacco Control often say this giving reference of InternationalAgency for Research on Cancer (IARC). However, Table given by IARCMonograph on Smokeless Tobacco clearly shows that there are only 11chemical agents in Chewing Tobacco (not 28), for 6 chemicals there isinsufficient evidence available and for 5 chemicals, no evidence is available asregards carcinogenicity in humans14. Reality - As per IARC itself, no chemicalagent present in chewing tobacco is found to be carcinogenic in humans. Lie - Almost 2 in 5 deaths among adults in India are caused due to smokeless tobacco15 - News in a prominent daily said this giving reference of WHO Global Report - Mortality Attributable to Tobacco. The said report however does not mention this anywhere, and this news is completely misleading. 2 in 5 means 40%, whereas title of the news itself says Smokeless tobacco claims lives of 17% of 30 plus adults. Further, even 17% is incorrect. Reality - Page 182 of this report16 clearly says that proportion of deaths attributable to tobacco is 7%. Here tobacco means smoking as well as smokeless tobacco. This booklet will explain further how smoking related deaths are more than 95% of tobacco related deaths in India.Lie - Deaths due to tobacco are equivalent to 10 packed jumbo jetscrashing every day or 10 Tsunamis hitting Indian shores every year17 -Advocates of tobacco control describe tobacco related deaths in India as 20jumbo jets crashing every day. This figure is derived assuming 10 lac deaths inIndia due to tobacco and dividing 10 lac by 365 days. However GATS (GlobalAdult Tobacco Survey India) report has mentioned that smoking causes 9.30lac adult deaths in India18.Reality - This means 93% of tobacco related deaths in India are due tosmoking. This booklet will explain further how smoking related deaths aremuch more than 9.30 lacs. 3
  • 4. Smokeless Tobacco is less harmful Because it is not burnt Extracts from ORAL AND MAXILLOFACIAL PATHOLOGY written by - Dr. Robert E. Marx 19 (DDS) & Dr. Diane Stern (DDS) University of Miami, School of Medicine, Miami, Florida"In order for electrophilic intermediates that damage DNA or becomebound to DNA to be generated from tobacco products, the tobacco mustbe combusted (smoked). Thus, these epoxides of tobacco tars, notnicotine, are the actual DNA-damaging agents (i.e. carcinogens)""Nicotine is the addictive agent and is not by itself carcinogenic.Therefore, because these epoxides are not formed in "smokeless"tobacco, such tobacco products are not significantlycarcinogenic and, despite the claims of several organizations, do notproduce a higher incidence of oral squamous cell carcinoma than thatwhich spontaneously occurs in the nonsmoking, nonusers ofsmokeless tobacco population""However, 9% of all squamous cell carcinomas in our major cancercenter occurred in individuals with no direct tobacco history, indicatingthat "smokeless tobacco" history is coincidental rather thancausative" But based on high prevalence, smokeless tobacco is regulated...Tobacco control policies in India are framed considering prevalence4 and ignoring which type oftobacco is causing real harm. In their appeal, advocates of tobacco control mention combined harmcaused by all types of tobacco (smoking as well as smokeless). However their appeal is restricted to 20ban on smokeless tobacco . As per GATS India 2009-2010 report 18 9.30 lac Smoking related deaths in India 21 Smokeless tobacco is more prevalent than smoking in India What should be banned? More harmful smoking or More prevalent smokeless Is it not injustice to focus on prevalence instead of harm? 4
  • 5. Prevalence of smokeless tobacco is more... but can you ignore passive smoking ? 22 Second hand smoke is four times more toxic than mainstream cigarette smoke 50.00%Percentage of Adults in India 40.00% 30.00% Passive Smoking Passive Smoking 20.00% Passive Smoking 10.00% Smoking Passive Smoking Passive Smoking Passive 0.00% Smokeless 24 Health 23 24 Public Public Restaurants Government Tobacco Smokers Home Care 23 Places24 Transport 24 Buildings 24 24 users Facility 25.90% 14% 52.30% 29% 17.50% 11.30% 6.60% 5.40% Exposed to second hand smoke at various places Only 14% adults smoke in India23 but second hand smoke affects larger population24 Please refer page 7 for harmful effects of passive smoking Unfortunately those affected include innocent children 5
  • 6. Chronic Obstructive Pulmonary Disease (COPD) epidemic in India Emphysema 25 COPD Currently, India has close to 2.40 crore ( 1 in 50 people) COPD cases Chronic Bronchitis Asthma 26 It is One of the main causes of death in India (more than 5.50 lakh p.a.) 27 Cigarette smoking is the most important risk factor for COPD 28 Passive smoking doubles kids risk of developing COPD as adults Lack of awareness on this disease in health care providers and policy 26 makers has led to the increase in prevalence rate of lung diseases Not only COPD, Leading site of cancer is Lung Cancer, not Mouth Cancer As per Page 111 of National Health Profile 2010 29 [Published by Central Bureau of Health Intelligence - Government of India ]Lung cancer is the leading cancer site among males in 7 Population Based Cancer Registries (PBCRs). Mouth cancer is not leading site of cancer in any of the 16 PBCRs. MALE FEMALE At Rank 1 At Rank 2 At Rank 1 At Rank 2 29 29 29 29 7 PBCRs 4 PBCRs Lung Cancer 2 PBCRs 3 PBCRs - 2 PBCRs 29 Mouth Cancer - - 6
  • 7. Not only COPD & Cancer... Cigarettes are harmful in many ways! 30 - As per Report of U.S. Department of Health and Human Service Harmful effects of SMOKING As per W.H.O. 40% of Tuberculosis Burden in India is attributable to 31 smoking Harmful effects of PASSIVE SMOKING 52% adults in India are exposed to passive smoking 32 at home World over these harmful effects of cigarettes are shown in Pictorial Warnings 7
  • 8. 33 Harsh Pictorial Warnings on cigarettes Worldwide showing various harmful effectsMalaysia European Union Australia BrazilBrunei America Malaysia European Union Singapore Singapore Singapore SMOKING CAUSES SMOKING CAUSES 92% of ORAL CANCERS NECK CANCER QUIT: 1800-438-2000 QUIT 1800-438-200 Hong Kong New Zealand 8
  • 9. USA has proposed 9 harsh pictorial warnings for cigarettes 34 but only 4 text warnings on smokeless tobacco products TYPE 34 35 Cigarette Packages Smokeless Tobacco Products Warning area 50% of front and rear panel 30% of 2 principal sides Type 9 different Harsh & Gory Pictures Only 4 Text warnings No pictures Harmful Addiction, Harm to Children, Fatal Lung Disease Addiction, Mouth Cancer, effects (Smokers as well as non smokers), Cancer, Strokes Gum disease and tooth loss covered and Heart Disease, Harm to baby during pregnancy, Death, Serious risk to health Difference in Cigarettes cause cancer This product can cause Wordings mouth cancer USA has mild warnings for smokeless tobacco products 9
  • 10. But in India, cigarettes are favoured Mild Pictorial Warnings on cigarettes in India 3 similar and animated pictures, is this a "Find the difference" contest? 36 Pictorial Warnings on Cigarettes are not noticed because In India 70% of sales are in Loose Sticks37 So 70% cigarette customers do not see the warning. In many countries law does not allow such loose stick sale. WHO Framework Convention on Tobacco Control (FCTC) also says "Each party shall endeavour to prohibit the sale of cigarettes 38 individually or in small packets". In India pictorial warnings on cigarettes show only lung and mouth cancer! What about other harmful effects about which there is no awareness at all? As explained in Lies Vs Reality on page no. 3, as per IARC itself, no chemical agent present in chewing tobacco is found to be carcinogenic in humans.Despite of this, only in India warnings on smokeless tobacco products are harsher than cigarettes. Comparison of employment Smokeless Tobacco Industry Smokeless tobacco industry (27.59 lacs) 75% 3 times more employment 39 than cigarette industry, but favour is given to cigarettes Cigarette Industry (9.43 lacs) 25% 10
  • 11. Smoking kills more than 10 lac adults every year Smokeless Tobacco & Passive Smoking (1 lac) 40 No. of Deaths 9% Smoking (10 lacs)41 91% Ban smokeless tobacco - deaths will increase to 35.78 lacsDr. Brad Rodu, Prof. of Medicine, Tobacco Harm Reduction Research University of Louisville (U.S.A.) estimatedthat if all 46 million smokers used smokeless tobacco, United States would see, at worst, 6,000 deaths from oral 42cancer, versus current 419,000 deaths from smoking-related cancers, heart problems & lung disease.Had Dr. Rodu seen situation in India, he would have suggested The Harm Reduction theory (THR) of switchingto smokeless tobacco from smoking. Unfortunately National Consultation on Smokeless Tobacco has 6recommended ban on only smokeless tobacco products . This recommendation if accepted, then present 2116.37 crore users of only smokeless tobacco may switch to smoking to satisfy crave for nicotine. In thisscenario present 11 lac tobacco related deaths40,41 will increase multi-fold to 35.78 lacs.43 If The Harm Reductiontheory (THR) as stated above is followed, then present 11 lac tobacco related deaths40,41 can be reduced to57,000, if smoking is banned.44 (Assuming that present 6.89 crore21 users of only smoking switch to smokelesstobacco) 35 lacs DANGER AHEAD 30 lacs National Consultation on25 lacs Smokeless tobacco recommended ban on 620 lacs smokeless tobacco products which may lead to this scenario15 lacs10 lacs 5 lacs A) Currently (10 Lac due to B) Ban on smokeless C) Ban on smoking tobacco 41 smoking & additional 1 Lac tobacco (35.78 lac deaths (57,000 deaths due to smokeless 45 43 44 (60,000 passive smoking + due to smoking) tobacco) 46 40,000 smokeless tobacco ). 11
  • 12. Lowest deaths in India from tobacco related cancers per 1 lac population30.0025.0020.0015.0010.00 5.00 0.00 United United New Kingdom Japan China Bhutan Australia Canada States of Bangladesh INDIA Zealand America 27.82 20.27 20.09 16.74 14.88 14.54 13.67 13.26 12.71 11.93 47 If we compare no. of estimated deaths for the year 2008 (As per report of WHO ) dueto Mouth, Oropharynx, Oesophagus and Bladder cancers (which are considered asTobacco Related Cancers apart from Lung Cancer), then India is the lowest, despite ofalleged prevalence of smokeless tobacco to be the highest. In Bhutan, such no. of deathsare more despite of ban on tobacco. Secondly while reporting tobacco related cancers, sites associated with the use of 48tobacco are reported by Population Based Cancer Registries (PBCRs) , without verifyingwhether these cancer patients are users of tobacco or not. This means even cancer patients who do not use tobacco are counted inreports of tobacco related cancer (TRC) figures. Please ask age-wise break-up ofTRC to any PBCR and you will find some patients in the age group of 0-4 also. Is it possible that an infant uses tobacco? nd 49 India is 2 highest tobacco producing country in World But TRCs (excl. lung cancer) deaths in India are lowest in these 10 countries This must be because use of tobacco in smokeless 9 form than smoking (which is 98% safer than smoking ) This is what The Harm Reduction Theory (THR) is advocating. This theory says that, if it is not possible for a smoker to quit smoking, then smoker should switch to less harmful products like smokeless tobacco. 12
  • 13. American President Obama advised to switch to smokeless tobacco Jeff Stier of American Council on Science and Health (ACSH) advises US President Obama how he can quit smoking by switching to smokeless. He says :- "Surprisingly, the risk of oral cancer from smokeless tobacco is low--far lower than the oral cancer risk from smoking cigarettes. And switching from cigarettes to snus eliminates the risk of heart disease, lung cancer and50the other systemic diseases related to smoking--not to mention secondhand smoke"Dr. Gilbert Ross of American Council on Science and Health (ACSH)"The simple truth, however, is that for those smokers who are trying to quit and have beenunsuccessful with current FDA-approved cessation methods-as is the case in the large majority- 51smokeless tobacco is an excellent alternative and has a great track record, especially in Sweden" What are the advocates of The Harm Reduction theory (THR) saying? Some Extracts from Tobacco Harm Reduction 2010 - a yearbook of recent research and analysis Edited by - Dr. Carl V. Phillips & Paul L. Bergen 52a Cancer risk from a lifetime of smoking compared to a lifetime of smokeless tobacco use. Best case: Worst case: Current case: If all smokers If all tobacco users (1,04,999) were smokeless were smokers tobacco users (1,35,542) (1,103) Based on American estimates of 7 cancer mortalities for 35+ males (re Lee & Hamling, 2009)v The evidence shows that the risk for any life-threatening disease from Smokeless Tobacco use is so low 52b that it cannot be reliably measured or even definitively established.v There is evidence of American men switching to ST as a method for quitting smoking (Dr.Rodu & Dr.Phillips 2008), and THR is increasingly being discussed in the scientific literature, and is gaining acceptance in the medical community (Dr.Nitzkin & Dr.Rodu 2008) 52Cv In their response to the EU Green Paper Consultation on Public Smoking, the Swedish Ministry of Health and Social Affairs drew attention to the need to take account of the Swedish experience with the use of snus as an alternative to cigarettes. 52dv Thus, discouraging a smoker, even one who would have quit entirely, from switching to a low-risk 52e alternative is almost certainly more likely to kill him than it is to save him.v I believe that FDA regulation of tobacco products will be effective and beneficial for public health if it incorporates tobacco harm reduction, which involves the substitution of alternative sources of nicotine, including smokeless tobacco products, for cigarettes by smokers who are unwilling or unable to abstain altogether from nicotine and tobacco.52f 13
  • 14. Smokers in USA have already started believing in The Harm Reduction Theory (THR)…. 53 FTC Reports Indicate Smokers Finally Getting The Right Message Two encouraging reports released Saturday by the FTC may indicate that U.S. tobacco users aregetting the message that smokeless tobacco products are up to 99% safer than smoking. According to the reports, smokeless tobacco consumption has increased 3.6% from 2006 to 2008 andsmokeless tobacco advertising spending increased 55% during the same period. Additionally, nationwidecigarette advertising and promotional expenditures declined 20% from 2006 to 2008 and cigarette consumptiondeclined by 8%. “For over a decade, smokers have been given the scientifically untrue message that smokelessproducts are just as dangerous as smoking, because tobacco manufacturers are prohibited by law to tell thewhole truth,” said Elaine Keller, CASAAs vice president. “They are required to place warnings on theirpackaging that the products are not a safe alternative to smoking. While this is technically true, most peoplewould consider a less than 1% health risk as quite safe compared to the smoking risks. Worldwide Cigarette companies are focusing more on smokeless tobacco, but in India scenario is opposite Tobacco companies are shifting their advertising dollars from high-risk cigarettes to these low-risk smokeless alternatives53 14
  • 15. Smokeless Tobacco is not so harmful... 19 As a explained on page no. 4, smokeless tobacco is not burnt and hence less harmful. This is not just a theory but can be proven with following example.... Deaths from Tobacco Related Cancers (excl. Lung Cancer) POLAND Only 1% male & 20.83 per 1 lac Less smokeless 0.1% females use population 47 54 but more cancers smokeless tobacco INDIA 33% male & 11.93 per 1 lac 47 More smokeless 18% females use population 55 but less cancers smokeless tobacco Definitely, it is not smokeless tobacco alone, but other factors also responsible for these cancers. Otherwise how is it possible that, a country like Poland (very less prevalence of smokeless) has more cancers than India (prevalence of smokeless tobacco 33 times more in males).India - Lowest consumption of cigarettes, hence great potential for smoking. Hence smoking tobacco companies trying to eliminate smokeless tobacco? 56 Number of cigarettes per adult per year250020001500 Refer page 10 which shows1000 danger ahead (35.78 lac deaths 500 due to smoking in India) 0 United New Bangla Russia Japan China United Australia Canada Kingdom Zealand desh India States 2319 2028 1648 1196 1130 897 790 565 172 99 15
  • 16. Why blame chewing tobacco alone? Main causes of oral cancer :1. “According to the WHO, chewing supari leads to cancer of the mouth even if tobacco is not added to it. In countries where betel nut is consumed extensively, there is a much higher level of oral cancer. There is a dire need to initiate a drive against this sweet poison. To save our oral and general health, children you need to be aware of the harmful effects of these easily available packets of sweet supari and gutka”572. In countries around the world, smoking is public healths enemy No 1. But there are unique and vexing problems everywhere. In Taiwan, for example, theres a major push to convince people to eschew the addictive areca, or betel nut, because chewing it is a major cause of Hence Taiwan (Chinese Taipei) is No.1 in Oral Cancer cancer. The areca nut causes 90 per cent of oral cancers in Taiwan, the worlds second 58 leading producer of the crop behind India.3. Gutka is primarily an areca nut based product. It has been conclusively proven that OSF Occurs because of areca nut consumption and is not associated with tobacco. 11 - Dr. Ajay Nayak, Yogesh Chhaparwal, Keerthilatha M.Pai (Manipal College of Dental Sciences) in OOOOE Journal 4. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Page 225 The 2004 Surgeon Generals report, The Health Consequences of Smoking: A Report of the Smoking Surgeon General (U.S. Department of Health and Human Services [USDHHS] 2004), concluded that the evidence is sufficient to infer a causal relationship between smoking and cancers of the lung, larynx, oral cavity, pharynx, esophagus, pancreas, bladder, kidney, cervix, and stomach, and acute myeloid leukemia59.5. An article published in “Journal of Cancer Research and Therapeutics” Apr-Jun 2009, Volume 5, Issue 2. Article written by Dr. Pankaj Chaturvedi, Department of Head and Neck, Tata Mem. Hospital, Mumbai “There has been a rising international recognition of the role of HPV as an etiologic agent in a subset of oral cancers. The HPV detection rate of 20%-50% in oral carcinomas is among the highest of any extragenital human malignancy. Given this high rate of positivity HPV may be recognized as a tumorigenic factor for development of head and neck cancers.”60 6. “The evidence for carcinogenic effects of alcoholic beverage consumption on the risk for cancers of the oral cavity and pharynx in humans was considered to be sufficient by a previous IARC Working Group (IARC, 1988)”617. Oral cancer - Other Risk Factors 62a. History of Oral Precancer Lesions 63b. Family history of cancerc. Age > 35 years, Chronic irritation of the mouth, Diet low in vegetables and fruits, Male gender, Poor oral hygiene, Sun exposure64 It will be an injustice to blame chewing tobacco alone for oral cancers Unfortunately only in India there are Mild health warnings on smoking products No awareness about HPV No health warnings on alcohol & many areca nut products But chewing tobacco products have strong health warnings 16
  • 17. India is not the oral cancer capital of the world, but Taiwan is with 20.9 incidences per 1 lac population 22 As per data from WHO Top 20 countries in crude rate of 20.9 Lip-oral cavity cancers per 1 lac population65 20 18 Incidence Crude rate per 1 lac 16 14.9 India is not in Mortality 14 Top 20 list* 12.1 11.6 12 11.4 10 9.9 9.8 9.6 9.4 9.4 9.2 9.1 9 8.7 8.7 8.6 8.4 8.4 8.1 8.3 8 7.7 7.9 8 6 5.4 5.1 4.4 4.5 4 3.2 3.6 2.8 3 3.2 2.9 2.9 2.8 2.4 2.3 2 1.9 1.8 1 0 o a A nka M lia po ia Be a A ia on nia R ba n on m Po es Sl n) k g G y i i (m Cr l gr ne i pe xe ne a ai ur ew gar ar t ak n iu v a a u ug ni oa to a Sp di ne lit ui i Lu Bru tr a m ,L C bo lg Ta ov lb eu un iL rt Es al us te en m se H Sr ro D a ne M et N hi a ce C pu an ce Pa an Fr Fr *Crude Rate of incidence in India is 5.9 per 1 lac population (almost 1/4 of Taiwan) Lip-Oral Cavity Lung Cancers What about health problems in India which are 55,540 more serious than mouth cancer?30 lacs25 lacs20 lacs15 lacs10 lacs 5 lacs 0 Tuberculosis, Mouth Cardio- Respiratory Maternal & STDs Road Other Diarrhoeal Digestive Diabetes and vascular Infections & Perinetal & Traffic reasons diseases Diseases mellitus oropharynx diseases Respiratory Conditions HIV Accidents Diseases cancersIf we compare various reasons of death from the data of World Health Foundation - Global Burden Disease DeathEstimates 200866, then it can be seen that there are other serious health problems than mouth cancer. 17
  • 18. Curing of smoking tobacco causes destruction of Forests As per a study by the Indian Institute of Forest Management, Bhopal, the use offuelwood between 1962 and 2002 for tobacco curing and production of cigarettes and othersmoking consumables has destroyed and degraded 680 sq. km of scrub forests, or nearly 868 67million tonnes of wood, through successive extraction. There is a global evidence of deforestation linked to tobacco production. An average of 687.8 kg of wood is needed to cure 1 kg of tobacco. India - Second largest producer of tobacco in the world. Output of approx. 600 M.Kgs 69(dry weight) of which Flue Cured Virginia (FCV) tobacco accounts for 185 M.Kgs. 70 This means 1443 million Kg of wood is needed to cure 185 M.Kgs. of FCV tobacco. 71However, smokeless tobacco is Sun-Dried. It does not require wood for curing.Thus it does not cause harm to the forests and environment. 72 Smoking causes deaths due to fire accidents...Smoking causes deaths due to fire accidents. More people die in fires caused by smoking than in fires 73caused by anything else. According to a report in 1998 due to fires caused by smoking, worldwidethere was a destruction of property to the tune of 2700 crore dollars 74 (1,21,500 crore rupees)Smokers turned off detectors at AMRI hospital. The 93 persons who suffocated to death in theblaze at Kolkatas AMRI hospital on Friday may well have been saved if insensitive smokers, 75including doctors and staffers, had not turned off the smoke alarms before puffing away 18
  • 19. Comparison at Glance SMOKING TOBACCO SMOKELESS TOBACCO 21 HARM 21No. of users 6.89 crores , no. of 100 No. of users 16.37 crores , no. ofdeaths 10 Lacs41. Deaths due to deaths 40,00046. So no. of deaths SMOKING 80passive smoking 60,00045. So no. 60 per 1 lac user = 24.of deaths per 1 lac user = 1538 40 This is 1.56% as compared to64 times more harmful than 20 smoking, means 98% safe. SMOKELESSsmokeless tobacco products. 0As per WHO, 40% of Tuberculosis Not responsible for TuberculosisBurden in India is attributable to burden in India 31smokingHarms to non smokers due to Does no harm to non userssecond hand and third hand smoke.As per GATS India survey, morethan 52% adults are exposed to 32passive smoking at home.Cigarette filters are made from Plastic ban for Chewing tobacco 78cellulose acetate and are resistant 76 products is being enforced . Butto degradation. Duration of the use of plastic by cigarette industrydegradation process is cited as is still continued in the form of filterstaking as little as 1 month to 76 77 3 (made of cellulose acetate ) and 76years to as long as 10–15 years .It is estimated that 4.5 trillion cigarette pack wrapped incigarette butts become litter every cellophane. 76year (9 lac tonnes, worldwide)Close to 4000 chemicals are Nearly 3000 chemicals identified in 79present in tobacco smoke, many of smokeless tobacco .But tobacco must 79them harmful. Among more than be burnt for these chemicals to be4000 constituents of tobacco harmful19. As explained in Lies Vssmoke, over 60 are known or Reality (page no. 3), as per IARC itself, 80 no chemical agent in chewing tobaccosuspected carcinogens is found to be carcinogenic in humans. 39Dir./Indirect employment 9.42 lac Dir./Indirect employment 27.58 lac39 EMPLOYMENTProfits taken away in foreigncountries through dividends &royalties. Major harm to Indians & Profits are retained in India.profits taken out of India ? There will be lot of news in the media about Smokeless Tobacco (other than Gutkha / Pan masala). We sincerely request you to Analyze the truth before believing... 19
  • 20. References1. High potential from women users and switch from non-Cig to Cig will aid ITC (Cig account for 15% of total tobacco usage) as the duplication is high in these categories which will enhance tobacco users upgrade to cigarettes —As per post dated 21 August 2012 on equitybulls.com. http://www.equitybulls.com/admin/news2006/news_det.asp?id=1096152. Government has watered down the pictorial warnings to be printed on cigarette packets depicting the health risks of smoking - News dated 31 May 2011 in Mumbai Mirror. http://www.mumbaimirror.com/article/15/2011053120110531033122548ed6c363a/Govt-goes-soft-onstatutory-warnings-for- cigarette-packs.html3. The Union health ministry has rolled back its original call for a blanket ban on the depiction of smoking in films - News dated 10 August 2012 in The Times of India. http://articles.timesofindia.indiatimes.com/2012-08-10/india/33136438_1_tobacco-use-occurrences-i-b-ministry-foreign- films4. Noting that 26 per cent of the total population is chewing cancer-causing tobacco, the Centre on Monday said it was formulating a smokeless tobacco specific policy - News dated 17 January 2011 in Jagran Post. http://post.jagran.com/centre-to-frame-smokeless-tobacco-specific-policy-azad-12952729765. For the first time that separate harsher pictorial warnings have been designated for smokeless tobacco - News dated 28 May 2011 in The Times of India http://articles.timesofindia.indiatimes.com/2011-05-28/india/29594315_1_pictorial-warnings-smokeless-tobacco-tobacco- products6. A progressive ban on smokeless tobacco products in the country was one strong recommendation that delegates of a National Consultation agreed upon and urged the Government to move in that direction. —Press Release published on 5 April 2011 by Centre for Tobacco Control and Health Promotion. http://www.ctchp.org/index.php?option=com_content&view=article&id=161:national-consultation-forsmokeless-tobacco- ban-is-an-instrument-need-more-actions-under-12th-five-yearplan&catid=16&Itemid=1127. According to the FSSAI CEO, Dr V N Gaur , ”At present, the Act clearly says tobacco is not a food item.” —News dated 26 March 2011 —FSSAI news archive. http://fssai.gov.in/Daily_News_Archive/March.aspx8. Chewable tobacco products such as gutkha and khaini may soon be banned in Delhi. —News dated 23 August 2012 in Hindustan Times. http://www.hindustantimes.com/India-news/NewDelhi/Chew-on-this-Delhi-set-to-ban-gutkha/Article1-917951.aspx9. Use of smokeless tobacco is 98% safer than smoking. http://www.smokersonly.org/10. Smokeless tobacco products are up to 99% safer than smoking. http://www.onlineprnews.com/news/158413-1312221121-ftc-reports-indicate-smokers-finally-getting-the-right- message.html11. http://www.ooooe.net/article/S1079-2104(10)00488-9/fulltext12. Page 9 of The scientific basis of tobacco product regulation: second report of a WHO study group (WHO technical report series ; no. 951). http://www.who.int/entity/tobacco/global_interaction/tobreg/publications/9789241209519.pdf13. Union health minister Ghulam Nabi Azad had informed Lok Sabha on March 11, 2011 that there are more than 3,000 chemical ingredients in chewing tobacco products. Out of these, 28 chemical ingredients are proven carcinogens. http://www.downtoearth.org.in/content/kerala-becomes-second-state-ban-chewing-tobacco14. Table 3. Chemical agents identified in smokeless tobacco products (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans - VOLUME 89 - Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines) http://monographs.iarc.fr/ENG/Monographs/vol89/mono89.pdf15. News dated 16 February 2012 in The Times of India. http://articles.timesofindia.indiatimes.com/2012-02-16/india/31066047_1_smokeless-tobacco-harsher-pictorial-warnings- tobacco-report16. Page 182 of WHO global report: mortality attributable to tobacco. http://whqlibdoc.who.int/publications/2012/9789241564434_eng.pdf17. Deaths due to tobacco are equivalent to 10 packed jumbo jets crashing every day or 10 Tsunamis hitting our shores every year - News dated 27 July 2012 in kanglaonline.com. http://kanglaonline.com/2012/07/manipur-has-the-highest-tobacco-consumption-in-india/18. It has been estimated that in 2010 smoking will cause about 930,000 adult deaths in India; and about 70 percent of them will be between the age 30—years : Page No. 5 of The Global Adult Tobacco Survey India, 2009-2010 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf19. Page 286, ORAL AND MAXILLOFACIAL PATHOLOGY written by professors of , University of Miami, School of Medicine, Miami, Florida —Dr. Robert E. Marx (DDS, Professor of Surgery and Chief Division of Oral and Maxillofacial Surgery) Dr. Diane Stern (DDS, Clinical Professor of Surgery, Division of Oral and Maxillofacial Surgery)20. Billboards in India: Ban Smokeless Tobacco (This billboard displayed in front of Honble Supreme Court mentions 10 lac deaths per year, but appeals to ban only smokeless tobacco. Surprisingly, it is displayed by World Lung Foundation which should speak more against smoking than smokeless tobacco. http://worldlungfoundation.org/ht/d/ViewBloggerThread/i/1565521. The estimated number of tobacco users in India is 274.9 million, with 163.7 million users of only smokeless tobacco, 68.9 million only smokers, and 42.3 million users of both smoking and smokeless tobacco. - Page xxxv of Global Adult Tobacco Survey India 2009-2010 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf 20
  • 21. 22. Philip Morris toxico logical experiments with fresh side stream smoke : more toxic than main stream smoke - S Schick, S Glants http://tobaccocontrol.bmj.com/content/14/6/39623. Table 4.36 (Smokeless tobacco) and Table 4.14(Smokers) : From Page 72 & Page 43 resp. from Global Adult Tobacco Survey India 2009-10 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf24. Graph prepared on the basis of Page No. 129 & 133 of Global Adult Tobacco Survey India 2009-10 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf25. Currently, India has close to 24 million (1 in 50 people) COPD cases which are expected to increase by 34 per cent to 32 million by 2020 http://health.india.com/news/1-out-of-50-indians-will-have-copd-by-2012/26. Although COPD is one of the main causes of death in India — more than 5.50 lakh people every year — lack of awareness on this disease in health care providers and policy makers has led to the increase in prevalence rate of lung diseases http://www.dnaindia.com/health/report_never-smokers-more-vulnerable-to-copd_146785427. Cigarette smoking is the most important risk factor for COPD. It is estimated that 80% of COPD patients have significant exposure to tobacco smoke http://www.ijpbs.com/data/OCT-DEC2011/447-456.pdf28. Exposure to passive smoking doubles kids risk of developing chronic obstructive pulmonary disease (COPD) as adults http://www.medindia.net/news/exposure-to-secondhand-smoke-raises-copd-risk-in-kids-99016-1.htm29. Page 111 of National Health Profile 2010, Published by Central Bureau of Health Intelligence - Government of India http://cbhidghs.nic.in/writereaddata/mainlinkFile/File1012.pdf30. Figure 1.1 The health consequences causally linked to smoking and exposure to secondhand smoke —Page 4 of How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Dept. of Health and Human Services, Public Health Service, Office of Surgeon General, 2010. http://www.surgeongeneral.gov/library/reports/tobaccosmoke/full_report.pdf31. Page 1 of FACT SHEET ON TUBERCULOSIS AND TOBACCO (Sept. 2009) Published by World Health Organisation (WHO) http://www.who.int/tobacco/resources/publications/factsheet_tub_tob.pdf32. 52.3% adults exposed to second-hand smoke at home – Pg.129-Global Adult Tobacco Survey India 2009-10 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf33. http://www.tobaccolabels.ca/healthwarningimages34. http://www.fda.gov/downloads/TobaccoProducts/Labeling/UCM259401.pdf On the top 50 percent of both the front and rear panels of each cigarette package. http://www.fda.gov/TobaccoProducts/Labeling/ucm259214.htm#Placement_of_New_Warnings_on_Cigarette_Packages_a nd_Advertisements35. For smokeless tobacco packaging, the warning must be located on the two principal sides of the package and cover at least 30 percent of each side. http://www.fda.gov/TobaccoProducts/Labeling/Labeling/SmokelessLabels/default.htm36. http://www.tobaccolabels.ca/healthwarningimages/country/india37. According to appellants 70% of sales by the retailers are in the form of loose sticks and only 30% of sales are in packages [1998 (104) E.L.T. 151 (Tribunal) I.T.C. Ltd. Versus C.C.E. Bangalore]38. WHO Framework Convention on tobacco control (FCTC) - Article 16: Sales to and by minors - Each Party shall endeavour to prohibit the sale of cigarettes individually or in small packets which increase the affordability of such products to minors. http://www.who.int/tobacco/framework/final_text/en/index6.html39. Impact of Anti-Tobacco Legislation (including a ban on advertising) on direct employment in the Tobacco Sector Report prepared for Government of India (UNION MINISTRY OF LABOUR) : Dr. P. Pullarao.40. In addition, there are excess deaths due to smokeless tobacco use, which is common among men as well as women and also deaths due to exposure to second-hand smoke. These deaths have not been quantified, but it appears reasonable to assume that these will add at least another 100,000 deaths.- Page 89 of Report on Tobacco Control in India - Published by Ministry of Health and Family Welfare, Government of India. http://mohfw.nic.in/WriteReadData/l892s/911379183TobaccocontroinIndia_10Dec04.pdf41. Tobacco use has assumed the dimension of an epidemic resulting in enormous disability, disease and death with 17% of the smokers of the world living in India. It is estimated that in 2010 smoking will cause about one million adult deaths in India, annually. - Letter dt. 12 Feb 2010 written by Advocacy Forum for Tobacco Control (AFTC) to Dr. Manmohan Singh, Honourable Prime Minister of India. This letter is signed by 5 prominent personalities working in the field of tobacco control i.e. Dr. K. Srinath Reddy, Dr. Prakash C. Gupta, Dr. Mira B. Aghi, Shri. Alok Mukhopadhyay, Ms. Monika Arora). http://www.aftcindia.org/pdf/Letter%20to%20PM.pdf42. Table 1 showing comparison of deaths in equal no. of smokers and smokeless tobacco users. www.smokersonly.org/our_harm/scientific_rationale.html43. Present 6.89 core users of smoking21 + 16.37 crore users of only smokeless tobacco21 may switch to smoking. Hence total smokers will be 23.26 crore. Presently there are 10 lac deaths due to smoking41 and 60,000 deaths due to passive smoking 45. Hence no. of deaths in 23.26 crore smokers will be 35.78 lacs (10.60 Lacs x 23.26 crore / 6.89 crore)44. Present 6.89 core users of smoking21 + 16.37 crore users of only smokeless tobacco21 may switch to smokeless. Hence total smokeless tobacco users will be 23.26 crore. Presently there are 40,000 deaths due to smokeless tobacco46. Hence no. of deaths in 23.26 crore users of smokeless tobacco will be 57,000 (40,000 x 23.26 crore / 16.37 crore = 56,836 say 57,000)45. As per http://www.smokersonly.org/our_harm/scientific_rationale.html there are 40,000 passive smoking deaths in America due to 4.60 crore smokers. In India, as per page xxxv of Global Adult Tobacco Survey India 2009-2010, there are 6.89 crore only smokers21. Hence, in India, passive smoking deaths are assumed at 60,000 (40000 x 6.89 / 4.60 = 59,913, say 60,000).46. As per page 89 of Report on Tobacco Control in India - Published by Ministry of Health and Family Welfare, Government of India, there are 1 lac deaths due to smokeless tobacco and passive smoking40. Hence if we deduct 60,000 passive smoking deaths45 as calculated above, smokeless tobacco related deaths can be assumed at 40,000.47. As per data from, World Health Organisation Burden Disease Death Estimates for the year 2008, estimated deaths from mouth, oropharynx, oesophagus and bladder cancers (which are considered as Tobacco Related Cancers by Population 21
  • 22. Based Cancer Registries in India) calculated per 1 lac population.48. Table 3.2 on Page 61-62 of Three year Report of Population Based Cancer Registries 2006-2008 reports no. of tobacco related cancers (TRCs) in different PBCRs & related sites. These sites of cancer considered in calculating TRCs are Lip, Tongue, Mouth, Oropharynx, Hypopharynx, Pharynx Unsp., Oesophagus, Larynx, Lung & Bladder. If individual report of each PBCR is verified, then these figures will exactly match with total no. for each such site. This means, sites associated with the use of tobacco are considered in calculation of TRCs without verifying whether these patients are users of tobacco or not.49. Tobacco is an extremely important commercial crop in India. It is the worlds second largest producer of tobacco. http://www.tobaccoasia.net/features/389-tobacco-consumption-in-india-an-overview.html50. http://www.acsh.org/healthissues/newsID.1871/healthissue_detail.asp51. http://www.acsh.org/factsfears/newsid.2875/news_detail.asp52. Tobacco Harm Reduction 2010 - a yearbook of recent research and analysis edited by Carl V. Phillips & Paul L. Bergen http://tobaccoharmreduction.org/thr2010yearbook.htm a) Page 217 b) Page 17 c) Page 26 d) Page 46 e) Page 113 f) Page 15053. http://www.onlineprnews.com/news/158413-1312221121-ftc-reports-indicate-smokers-finally-getting-the-right- message.html54. Prevalence of smokeless tobacco in Poland : World Health Organisation http://www.who.int/entity/tobacco/surveillance/en_tfi_gats_poland_2010.pdf55. The extent of use of smokeless tobacco products among males (33%) is higher than among females (18%) - As per page xxxv of Global Adult Tobacco Survey India 2009-2010 (GATS Report) http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_India.pdf56. Graph prepared for 10 countries from List of countries by cigarette consumption per capita http://en.wikipedia.org/wiki/List_of_countries_by_cigarette_consumption_per_capita57. http://www.dawn.com/2011/09/10/health-sweet-poison.html58. http://www.canada.com/story_print.html?id=d1fb2308-1705-4342-8059-b2328a4b41bd&sponsor=59. http://www.surgeongeneral.gov/library/tobaccosmoke/report/full_report.pdf60. http://www.cancerjournal.net/temp/JCanResTher5271-3358555_091945.pdf61. As per Page 237 of IARC Monographs on the Evaluation of Carcinogenic Risks to Humans - VOLUME 96 - Alcohol Consumption and Ethyl Carbamate http://monographs.iarc.fr/ENG/Monographs/vol96/mono96.pdf62. http://sites.google.com/site/quitnut/arecapedia/arecancer/oral-cancer/risk-factors63. http://my.clevelandclinic.org/disorders/oral_cancer/hic_oral_cancer.aspx64. http://www.bettermedicine.com/article/oral-cancer-1/causes65. Graph available on web site of IARC-Globocan http://globocan.iarc.fr/bar_site.asp?selection=12010&title=Lip%2C+oral+cavity&sex=0&statistic=1&populations=5&window =1&grid=1&info=1&orientation=1&color1=20&color1e=&color2=30&color2e=&submit=%A0Execute%A066. As per data from, World Health Organisation Burden Disease Death Estimates for the year 2008, estimated deaths are calculated per 1 lac population for various reasons http://www.who.int/entity/gho/mortality_burden_disease/global_burden_disease_death_estimates_sex_age_2008.xls67. http://www.gobartimes.org/content/smoking-reality68. http://articles.timesofindia.indiatimes.com/2012-03-29/india/31254073_1_tobacco-production-world-lung-foundation- cigarette-production69. http://commerce.nic.in/psft/fs_tobacco.htm70. An average of 7.8 kg of wood is needed to cure 1 kg of tobacco. 3 Output of Flue Cured Virginia (FCV) tobacco accounts for 185 M.Kgs70. 4 Hence wood needed = 185 million kgs. X 7.8 = 1443 million kgs.71. Khaini is made from sun-dried or fermented coarsely cut tobacco leaves. Page 51 - IARC MONOGRAPHS VOLUME 89 http://monographs.iarc.fr/ENG/Monographs/vol89/mono89-6A.pdf72. http://theblacklisters.com/wp-content/themes/theblacklist/images/facts-deforestation-aboutit.jpg73. http://www.direct.gov.uk/en/HomeAndCommunity/InYourHome/FireSafety/DG_07169374. Smoking is a leading cause of fires and death from fires globally, resulting in an estimated cost of nearly $7 billion in the United States and $27.2 billion worldwide in 1998. http://www.sciencedaily.com/releases/2000/08/000807064005.htm75. http://www.hindustantimes.com/India-news/Kolkata/Smokers-turned-off-detectors-at-AMRI-hospital/Article1-781134.aspx76. http://en.wikipedia.org/wiki/Cigarette#Cigarette_litter77. Our filter tips are biodegradable over a period of between a month and three years http://www.bat.com/group/sites/UK__3MNFEN.nsf/vwPagesWebLive/4572237B0C2D456CC1257314004EF66778. India bans plastic tobacco pouches http://www.bbc.co.uk/news/world-south-asia-1193993379. Page 76 of Report on Tobacco Control in India Published by Ministry of Health and Family Welfare, Government of India. http://mohfw.nic.in/WriteReadData/l892s/911379183TobaccocontroinIndia_10Dec04.pdf80. Page 290 of Report on Tobacco Control in India Published by Ministry of Health and Family Welfare, Government of India. http://mohfw.nic.in/WriteReadData/l892s/911379183TobaccocontroinIndia_10Dec04.pdf Disclaimer External web site links are subject to change. Operation of these web sites is not in our control. 22
  • 23. On screen smoking targets youth and women... 3 ...but there is rollback of blanket ban on smoking in films You do not censor on screen smoking... 6...and least harmful tobacco (smokeless) is recommended complete ban? 23
  • 24. Humble Appeal1. Smokeless tobacco is tobacco consumed without burning. It is 98-99% safer than smoking.2. As per WHO - It would be scientifically inappropriate to consider smokeless tobacco as a single product for estimating risk or setting policies3. As per IARC - No chemical agent present in chewing tobacco is found to be carcinogenic in humans4. It is a complete lie to say that almost 2 in 5 adult deaths in India are caused due to smokeless tobacco.5. Smoking causes 1538 deaths in its one lac users whereas smokeless tobacco causes 24 deaths in its one lac users. This means Smokeless tobacco is 98% safer than smoking.6. Smoking kills 10 lac adult Indians every year. In addition, there are deaths due to passive smoking. More than 52% adults in India are exposed to passive at home. Despite of this, pictorial warnings in India are harsher on smokeless tobacco products than cigarettes.7. If smokeless tobacco products are banned, people will switch to smoking & it will cause more than 35 lac deaths.8. There are various reasons for oral cancer. Smokeless tobacco alone cannot be blamed for it.9. As per National Health Profile – 2010, Lung cancer is the leading cancer site among males in 7 Population Based Cancer Registries (PBCRs). Mouth cancer is not leading site of cancer in any of the 16 PBCRs.10. India is not the oral cancer capital of the world as accused always. It is Taiwan (Chinese Taipei) with 20.9 incidences per 1 lac population. Crude incidence rate in India is 5.9 per 1 lac population. There will be lot of news in the media about smokeless tobacco. We sincerely request you to analyze the truth before believing. Please Please Save SaveMillions of Millions of JOBS LIVES Vidarbha Tambakhu Kamgar Sanghatna, Lal Bavta Kamgar Union (Affiliated with Bhartiya Majdur Sangha) Jaysingpur - 416101 Kostipura, Nagpur- 8 Tal. Shirol, Dist Kolhapur Shramik Sangha Maharashtra Chewing Tobacco Workers Federation (Affiliated with Bhartiya Majdur Sangha) Lal Tara (Lal Bavta), Amalner, Dist- Jalgaon Sangamner, Dist.- Ahmednagar

×