This document discusses the dangers of tobacco use and provides information about World No Tobacco Day on May 31st. It notes that tobacco is the single largest preventable cause of death and disability globally. The document then provides details on the history and spread of tobacco use, the various forms of smoking and smokeless tobacco products consumed in India, health effects of tobacco including increased cancer and heart disease risks, and statistics on tobacco use and related deaths in India.

1. World No Tobacco Day- 31-05-2015
Chikkodi: “STOP ILLICIT TRADE OF TOBACCO”
Dr.Jagadish
Nuchin .MD, MBA.
District
Surveillance
Officer,
Belagavi
1
SHIVA

2. World No Tobacco Day is
observed annually on 31 May
to raise awareness around the
world about the dangers of
tobacco products, the single
largest preventable cause of
disability and death.
2

3. Introduction
Tobacco plant is native to North
and South American continents
and they knew its cultivation
8000 years ago.
It was Christopher Columbus
who landed in America in the
year 1492 who brought this
plant to European countries.
.
Portuguese traders brought
tobacco plants to India during
1600 through Goa and Indians
started cultivating it. 3
Deadly
Plant

4. Thus, the tobacco use spread
from Americas to rest of the
world.
In India, earlier it was
restricted to Royal people but
later in 17th century even
common people started using
it.
Gradually tobacco got
assimilated into the cultural
rituals and social fabric due to
presumed medicinal and
actually addictive properties
attributed to it.
4

5. Tobacco in India
• British East India company grew
tobacco in India as cash crop and its
use became widespread wherever
British ruled.
Cultivated tobacco in India
Exported to Britain
Re-imported cigarettes to India to
earn revenue
5

6. Tobacco can be consumed in the forms of smoking, chewing,
dipping or sniffing.

7. Smoking tobacco
and
Smokeless
tobacco
7

8. Smoking tobacco -- use in India
 Smoked forms
of tobacco use
- Bidis
- Cigarette
- Cigars
- Cheroots
- Chuttas
- Dhumti
- Pipe
- Hooklis
- Chillum
- Hookah.
8

9. Smokeless tobacco
• Known as spit tobacco,
chew, snuff, and dip, is
a form of tobacco that
has become popular,
especially with
athletes .
• Chewing on an
average-size piece of
chewing tobacco for
30 minutes can deliver
as much nicotine as
smoking three
cigarettes. 9

10. Smokeless forms of tobacco use- in India
- Pan (betel quid)
with tobacco,
Pan Masala
with tobacco
- Tobacco, areca
nut and slaked
lime
preparations,
Manipuri
tobacco,
Mawa, Khaini,
chewing
tobacco, snus,
gutkha
10

11. Smokeless forms of tobacco use
• Tobacco
products for
application:
Nicotine patch,
Mishri, Gul,
Bajjar, Lal
dantmanjan,
Gudhaku,
Creamy snuff,
Tobacco water,
Nicotine
chewing gum. 11

12. 12

13. World Tobacco Facts
130 Crore people worldwide smoke.
6,00,000 Crore cigarette sticks are
smoked worldwide every year.
Tobacco kills up to half of its users.
Half the people that smoke today – that is about 65
Crore people will eventually be killed by tobacco.
Tobacco kills nearly 60 Lakh people each year.
More than 54 lakh of those deaths are the result of
direct tobacco use, while more than 6 lakh are the
result of non-smokers being exposed to second-
hand smoke.
13

14. • Unless urgent action is taken, the annual death toll
could rise to more than one Crore by 2020 and 1.6
Crore by 2025.
• Nearly 80% of the world's 130 Crore smokers live in
low- and middle-income countries.
• Tobacco is the second major cause of death in the
world.
• Approximately one person dies every six seconds
and 10 per minute
due to tobacco, accounting
for one in 10 adult deaths.
14

15. • Children who are engaged
in tobacco related works
are especially vulnerable to
"green tobacco sickness",
which is caused by the
continuous absorption of
nicotine through the skin
from the handling of wet
tobacco leaves.
15

16. • Tobacco caused 10 Crore deaths in the 20th
century. If current trends continue, it may cause 100
Crore deaths in the 21st century.
• Tobacco use is linked to a large number of diseases
and is the single most preventable cause of death in
the world, according to the World Health
Organization.
• Smoking kills more people
each year than AIDS, fires,
car accidents, murders,
suicides, alcohol and
other drugs combined.
16

17. • Tobacco is responsible for one in four deaths in the
United States.
• In some countries, it is even more — in Turkey,
nearly 40% of deaths among males are related to
tobacco.
• The prevalence is decreasing in developed
countries but increasing in developing
countries.
• Developed countries have reduced smoking
by 10% while developing countries have
increased by 60% after 1970.
17

18. Smoking is increasing in the
developing world
Male adult prevalence, 1995
US 28 % (was 61% in 1939)
East Asia 61 %
Europe, Central Asia 57 %
Latin America, Caribb 40 %
South Asia 41 % (cigs + bidis)
Sub-Saharan Africa29 %

19. USA
18 and over
UK
16 and over
Japan
15 and over
81%
1960
78%
1970
70%
0198
61%
1990 54%
2000
61%
1960
55%
1970
42%
1980
31%
1990 28%
1998
52%
1965
44%
1970 38%
1979
28%
1990 26%
1999
Physicians who smoke
Smoking prevalence among
physicians
2000or latest available
data selected countries
percentages
women
1
3
men
Australi
a
Banglades
h
Bosniaand
Herzegovina
Chil
e
Chin
a
Colombi
a
Denmar
k
Icelan
d
Indi
a
Morocc
o
Republicof
Korea
Russian
Federation
Saudi
Arabia
Spai
n
Swede
n
SyrianArab
Republic
U
K
50
55
24
40
12
61
22
21
20
29
0
3
2
4
1
8
0
18
Indonesi
a
14
1
LaoPeople’sDemocratic
Republic
1
43
5
30
41
16
38
32
37
6
6
2
4
6
8
0
28
Smoking trends
percentage of male smokers
1960–2000 selected
countries
Smoking among males aged 15 and
over
latest available data
40% – 49%
Top
tenhighest overall smoking
ratesof men and women
combined
60% and above 30% –
39%
50% – 59%
20% –
29%
below 20%
no data
Smoking prevalence for men
50
%
49
%
47
%
44
%
48
%
54
%
47
%
52% GUINEA
45
%
44
%
SAN CROATIA B-H YUGOSLAVIA
ITALY SLOVENIA
REP.
MOLDOVA
UKRAIN
E
ESTONI
A
LATVIA
LITHUANIA
ALBANIA
AUSTRIA
FYR MACEDONIA
HUNGAR
Y
BULGARIA
ROMANI
A
GREEC
E
POLAN
D
BELARU
S
RUSSIA
N
FED.UNITED
KINGDOM
TUNISI
A
TUNISI
A
LIBYANARAB
JAMAHIRIYA
IRELAN
D
DENMAR
K
FRANC
E
SPAI
NPORTUGAL
GERMANY
CZECH
SWITZ
.
NET
H.
BELGIUM
LUX
.
MOROCC
O
ALGERI
A
ICELAN
D
NORWA
Y
FINLAN
D
SWEDE
N
REPUBLIC SLOVAKIA
MALTA
MARINO
ANDORR
A
A U S T R A L I A
REP.
KORE
A
BARBADOS
TRINIDAD &
TOBAGO
PALAU
NAURU
TUVALU
TONGA
STVINCENT&
GRENADINES
NICARAGUA
BAHAMA
S
ZIMBABW
E
UGAND
A
TURKME
N
UZBEKISTA
N
KYRGYZST
ANGE
O AZE
R
Hong
KongSA
R
SRILANKA
CUBA DOMINICA
NREPUBLIC
PUERTORICO
BRUNEI
DAR.
M A L A Y S I A
SAUDI
ARABIA
C H I N A
MONGOLI
A
PDR VIETNAM
CAMBODI
A
LAO
THAILAN
D
I N D I A
BANGLADE
SH
ISL.
REP.
IRAN
PAKISTA
N
TURKEY
SYRIAN
ARAB
REPUBLIC
IRA
Q
CYPRUS
LEBAN
ON
ISRAELWEST
BANK
& GAZA
JO
R
BAHRAI
N
QATA
R
UA
E OMA
N
KUWAI
T
YEME
N
NEPA
L
K A Z A K H S T A
N
U N I T E D ST ATES
OF A M E R I C A
C A N A D A
ALGERI
A
CHA
D
S U D A N
NIGERI
A
DEM.
REP.
CONGO
E GY P T
MOROCC
O
SENEGA
L
GAMBI
A
CÔTE
D’IVOIR
E
GHAN
A
NAMIBI
A
SOUT
H
AFRIC
A
MALA
WIZAMBI
A
UNITED
REP.
TANZANIA
KENY
A
DJIBOU
TI
S
L
GUATEMALA
ELSALVADOR
MEXIC
O
HAITI
BOLIVI
A
B R A Z I L
VENEZUEL
A
COLOMBI
A
HONDURAS
COSTA RICA
PANAMA
ECUADOR
PER
U
ARGENTIN
A
URUGUA
Y
CHIL
E
PHILIPPINE
S
NE
WZEALAN
D
PAPU
A
NEW
GUIN
EA
I N D O N E S I
A
JAPA
N
R U S S I A N F E DE R A T I ON
GREENLAN
D
MAURITIUS
SEYCHELLES
SINGAPO
RE
MYANMA
R
KIRIBATI
TOKELAU
SAMOA
NIUE
COOK
FIJI
VANUATU
RWAND
A
MALDIVES
SAOTOME
& PRINCIPE
2524
feature on the
landscape.”
Male Smoking global
scenario
19

20. Ranking Country No. of
Cigarettes per
adult per year
1 Greece 2,924
2 Serbia 2,822
3 Bulgaria 2,786
4 Russia 2,479
5 Moldova 2,401
6 Ukraine 2,360
7 Slovenia 2,278
8 Bosnia 2,266
9 Belarus 2,157
10 Montenegro 2,139
11 Lebanon 2,125
12 Czech 2,125
13 South Korea 1,958
14 Kazakhstan 1,934
15 Japan 1,934
16 Kuwait 1800
17 Spain 1752
18 Switzerland 1743
19 China 1712
20 Austria 1650
51 USA 1028
99 Pakistan 468
158 India 98
164 Sudan 75
165 Somalia 67
170 Afghanistan 69
174 Ghana 44
178 Ethiopia 42
180 Uganda 24
184 Solomon Islands 18
185 Guinea 9 20

21. Indian Scenario
 700, 000 deaths per year due to smoking accounting
for nearly 2200 deaths every day and 3 people every 2 minutes.
 800, 000 to 900, 000 deaths per year due to all forms of tobacco
use/exposure
4 lakh cases of cancer, 13 lakh cases of heart ailments, 80 to 90% of
lung cancer cases due to smoking.
Single most preventable cause of premature
death
21

22.  Tobacco is used by the youth all over
India with a wide range of variation
among states.
 Two in every ten
boys and one
in every ten girls
use a tobacco
product.
 Initiation to
tobacco products
before the age
of 15 years is
increasing.
Tobacco Use Among Youth in India
22

23. There are currently about
24 Crore tobacco users
aged 15 years and above
(19.5 Crore male users and
4.5 Crore female users) in
India.
 India is the world’s third
largest producer of tobacco
(Next to China and Brazil) and also
the second largest
consumer of
unmanufactured tobacco.
It is a second largest
exporter of
unmanufactured tobacco. 23

24. Tobacco deaths are on the increase in India
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1985 1990 1995 2000 2005 2010 2015 2020
Year
Tobaccodeaths(inmillion)
Estimates by WHO 1996, 1999
Estimates by Gupta 1989
Estimates by ICMR 1985 24

25. Tobacco in India
• In late Nineteenth century
Beedi industry grew in India
• Oldest Beedi manufacturing
firm established in 1887
• Introduction of Gutkha
aggravated the problem
• Bihar, Jharkhand,
Chhattisgarh, Nagaland,
Orissa, Tripura and Mizoram
show more than 40% of the
prevalence where as
Karnataka 19%.
25

26. Pattern of Consumption in India
• 54% Bidis, 19% Cigarette and
27% Pan Masala, Snuff, Chewing tobacco
• 55,000 children start smoking in an year.
• Indians smoke 9000 Crore cigarettes an year.
• At an average Rs. 12 a cigarette, Rs. 1,08000 Crores goes
up in smoke.
26

27. According to Indian
Council of Medical
Research the cost of
treating tobacco
related diseases and
cancers was Rs.
27760 Crores.
Whereas the value of
tobacco products
sold nation wide is
about 24,400 Crores.
If this trend goes
unchecked 13% of all
deaths in India would
be solely due to
tobacco.
27

28. Nicotine is highly addictive
• Nicotine --> release of serotonin,
dopamine, norepinephrine
• Neuro-adaptation
 Each year, nearly
3.5 Crore people
make a concerted
effort to quit
smoking.
 < 7% stay smoke-
free for a year; most
start smoking again
within days.

29. Smoke-A DEADLY MIXTURE
 Cigarettes burn at 900 0 C – 10000 C
 Cigarette smoke contains over 4000
chemicals and 69 of these are known to
cause cancer.
 Even if you don't smoke you can still get
sick from these poisonous chemicals just by
breathing in other people's smoke.
The smoke contains:
 Tar, a black, sticky substance that contains
many poisonous chemical such
as: ammonia (found in floor and window
cleaner), toluene (found in industrial
solvents) and acetone (found in paint
stripper and nail polish remover)
 Nicotine, the addictive drug in tobacco
29

30.  carbon monoxide, a poisonous
gas that reduces the amount of
oxygen taken up by a person's
red blood cells
 hydrogen cyanide, the poison
used in gas chambers during
World War ll
 metals,
including lead, nickel, arsenic (
white ant poison)
and cadmium (used in car
batteries)
 pesticides such
as Methoprene (found in flea
powder). Other chemicals such
as Benzene (found in petrol)
and Naphthalene (found in
mothballs) are also in tobacco
smoke. 30

31. • And even including
radioactive polonium
210.
• These chemicals are
absorbed into the
blood, reaches every
organ system in the
body and are cancer
causing, mutagenic
and tumor causing.
31

32. Are some cigarettes better?
• No such thing as
a safe cigarette
• “light”, “low tar”
cigarettes are
deceptive –
- Manipulation by
maker
- Compensation by
smokers so actual
yields not = FTC
(machine) yield

33. 33

34. • A cigarette
contains 8 or 9
milligrams of
Nicotine
• A cigar contains
100-200mg of
Nicotine
• There is
enough
nicotine in 4 or
5 cigarettes to
kill an average
adult if
ingested whole 34

35. Illicit trade of tobacco products must be stopped
 The illicit cigarette trade is defined as “the
production, import, export, purchase, sale, or
possession of tobacco goods which fail to
comply with legislation” (FATF 2012).
Illicit cigarette trade activities fall under 3
categories:
 Contraband: Cigarettes smuggled from
abroad without domestic duty paid
 Counterfeit: Cigarettes manufactured
without authorization of the rightful owners,
with intent to deceive consumers and to
avoid paying duty
 Illicit whites: Brands manufactured
legitimately in one country, but smuggled
and sold in another without duties being
paid.
35

36. Illicit trade of tobacco products must be stopped
 It is estimated that
one in every 10
cigarettes and
tobacco products
consumed globally
are illicit.
 Illicit tobacco
products are
typically sold at
lower prices,
thereby increasing
consumption.
36

37. The illicit trade of tobacco products
poses major health, economic and
security concerns around the
world.
Eliminating illicit trade in tobacco
will reduce the harmful
consumption of tobacco by
restricting availability of cheap,
unregulated alternatives and
increasing overall tobacco prices.
Critically, this will reduce
premature deaths from tobacco
use and raise tax revenue for
governments 37

38. Raise the tax
Ban the
advertisements
Put the pictorial
health warnings on
the packets
Strict implementation
of COTPA-2003
38

39. Takes 10-25 years
to be discomposed
into the land
39

40. Health effects of
tobacco
40

41. Diseases caused by tobacco use
 Cancer- mouth, lips, tongue, gums, palate , larynx, the lung, pancreas, kidney,
Cervix
 COPD (emphysema, bronchitis, etc)
 Stroke (bleeding in the brain)
 Heart attack and heart disease
 Narrowing and clogging of arteries
 Peptic ulcers (stomach bleeding)
 Respiratory infections and compromise (cough, wheezing etc)
 Gum disease and tooth loss
 Low birth weight and SIDS
 Asthma
 Ear infections
 Compromised sexual performance
 Greater susceptibility to TB?
 Cataracts
 Age-related macular degeneration, a leading cause of blindness in older people
 Hearing loss
 Incontinence
41

42. 42

43. 43

44. 44

45. Smoking decreases the blood supply to your
brain, constricts the blood vessels and
causes ‘atherosclerosis’.
45

46. Smoking & chewing tobacco are the main cause of cancers of
the tongue, salivary gland, mouth, pharynx and for brown
teeth. 46

47. Cancer of the cheek with erosion of tissue
47

48. Smokers are ten times as likely to get lung cancer
and emphysema as non-smokers.
48

49. Nicotine causes the blood clots & development
of plaque which leads to Risk of heart attack.
49

50. Esophageal cancer in esophagus
happens due to smoking.
50

51. Tobacco smoking or chewing accelerate the
process of Stomach cancer.
51

52. Kidney cancer is more common and
aggressive among tobacco users.
52

53. Poor blood circulation damages the blood
vessel lead to death of body tissue which
increases risk of ‘Gangrene’.
53

54. Tobacco smokers suffer more fractures
due to higher rate of
Osteoporosis (Decreased bone
density).
54

55. Effects on Male Fertility and Erectile
Dysfunction
• Smoking can harm a man's sexuality and
fertility.
• erectile dysfunction because it decreases the
amount of blood flowing into the penis
• impairs sperm motility, reduces sperm
lifespan, and may cause genetic changes that
can affect a man's offspring.
55

56. Women who smoke during pregnancy are
more likely to have:
– LBW/Premature baby
– An ectopic pregnancy
– Spontaneous abortion/miscarriage
– Vaginal bleeding
– Placental abruption )placenta peels away, partially
or almost completely, from the uterine wall before
delivery)
– A stillbirth
56

57. 57
SMOKE
ZONE-
FREE
SMOKING

58. Second-hand smoke kills
• Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces
when people burn tobacco products such as cigarettes, bidis and water pipes. There are
more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful
and more than 50 are known to cause cancer.
• There is no safe level of exposure to second-hand tobacco smoke.
• In adults, second-hand smoke causes serious cardiovascular and respiratory diseases,
including coronary heart disease and lung cancer. In infants, it causes sudden death. In
pregnant women, it causes low birth weight.
• Almost half of children regularly breathe air polluted by tobacco smoke in public places.
• Over 40% of children have at least one smoking parent.
• Second-hand smoke causes more than 600 000 premature deaths per year.
• In 2004, children accounted for 28% of the deaths attributable to second-hand smoke.
• Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the
health of non-smokers, are popular, do not harm business and encourage smokers to quit.
• Over 1 billion people, or 16% of the world's population, are protected by comprehensive
national smoke-free laws.
58

59. 59

60. Strict warning
for tobacco
misuse was
also issued
in ancients
times.
60

61. • 1604 (England) – King James I pronounced in
his “counter blast to tobacco” that smoking
was “Loathsome to eyes, hateful to nose,
harmful to the brain and dangerous to the
Lungs”
• 1633 (Turkey) –
Death penalty for smoking
61

62. COTPA-2003
• The Government of India has passed an anti-
tobacco legislation.
• “The Cigarettes and Other Tobacco (Prohibition
of Advertisement and Regulation of Trade and
Commerce, Production, Supply and
Distribution) Products Act 2003”, which came
into force on May 1, 2004. This replaces the
Cigarette Act 1975.
• If this act is enforced fully, there can be a tobacco-
free India.
62

63. TOBACCO
CONTROL ACT,
2003
Cigarettes and Other
tobacco products
(Prohibition of
Advertisement and
Regulation of Trade
and Commerce,
Production, Supply and
Distribution) Act, 2003

64. SCOPE OF THE ACT
• The Act is applicable to all products
containing tobacco in any form i.e.
cigarettes, cigars, cheroots, bidis,
gutka, pan masala (containing
tobacco) khaini, mawa, mishri,
snuff etc. as detailed in the
schedule to the Act.
• The Act extends to whole of India.

65. 65

66. 66

67. 67