This document summarizes the health hazards of tobacco use. It notes that tobacco kills around 800,000 Indians per year. Tobacco use is linked to various cancers as well as cardiovascular and lung diseases. Tobacco use also increases risks during pregnancy like miscarriage, preterm delivery, and low birthweight babies. India has a high burden of tobacco-related diseases but tobacco cultivation and consumption continue to rise due to misleading advertising and gaps in tobacco control programs. Comprehensive tobacco control policies are needed in India to reduce both direct and indirect costs of tobacco on health and the economy.

1. TOBACCO: Health hazards
Dr. Srabana Misra Bhagabaty: In-Charge,
Department of preventive oncology, Dr. B. Borooah Cancer Institute

2. Dr. Srabana M
Bhagabaty

3. Dr. Srabana M

4. • Gutka, a combination of arecanut, slaked lime,
paraffin and katechu along with tobacco, is
virtually poison. Promoted as a mouth
freshener, this mixture is a combination of
4,000 chemicals of which at least 48 are
carcinogenic compounds.

5. Around the world, nearly 5.4 million people
every year die from tobacco related diseases.
If current trends continue tobacco will account
for 13% of all deaths by 2020
Reference :Review Article Tobacco Control in India – Where are we now?
Sonali Jhanjee National Drug Dependence Treatment Centre, All India Institute of Medical Sciences,
New Delhi-110029 unit
Dr. Srabana M

6. Global Deaths
4.9
10
0
1
2
3
4
5
6
7
8
2000 2030
millionsofdeaths
Developed Countries
Developing Countries
Dr. Srabana M
2.8 2.1 3
7

7. Tobacco
abuse
AIDS +
Alcohol abuse +
Other drug use +
Homicide +
Suicide +
Motor vehicle
accidents +
Fires combined
(CDC) Dr. Srabana M

8. The slow poisoning of India
Tobacco kills:
•800,000 Indians in a year
•2200 in a day
•90 people per hour
India is the second largest consumer and third
largest producer of tobacco
Dr. Srabana M

9. PHYSICAL ill effects of tobacco
: CANCER :
40% of all cancers,50% cancers in males 25%
cancers in
Females are tobacco related.
90% of the oral cancers are tobacco related
India reports the highest
number of oral cancer in
the world
Dr. Srabana M

10. TOBACCO RELATED CANCERS ACCORDING TO who guidelines
2004 are
Cancers of
Lip,
Tongue,
Mouth,
Pharynx,
Oesophagus,
Larynx,
Lung,
Urinary bladder,
Stomach,
Colo-rectal, pancreas,
Paranasal sinuses,
kidney,
Acute myeloblastic leukaemia and
Cervical cancer
Dr. Srabana M

11. Male :
1,57,461 newly detected TRCs ( AAR: 24.3)
Females :
56,767 newly detected TRCs (AAR: 9.3)
Globocon 2012 estimates for India
Tobacco Related Cancers(TRCs)
Dr. Srabana M

12. NORTH EAST PBCR AAR REPORTS 2009-11
PBCRS MALE FEMALE
MEGHALAYA
103 36
KAMRUP
URBAN
92.3 45.3
MIZORAM 79 45
CACHAR 60.2 23.9
DIBRUGARH 54.6 20.5
TRIPURA 45.4 12
NAGALAND 44.2 11.65
MANIPUR 29.1 17.4
SIKKIM 27.6 21.8
Dr. Srabana M

13. WHAT OUR GUWAHATY HOSPITAL
BASED CANCER REGISTRY AT BBCI SAYS
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14. Tobacco Related Cancer (2013-14)
TRC
67%
Others
33%
Male
TRC
46%
Others
54%
Female
Dr. Srabana MMale :Female=1:1.45

15. 0
500
1000
1500
2000
2500
3000
3500
4000
2010:2540
2011:2637
2012: 2916
2013: 3374 2014: 3517
Dr. Srabana M

16. LEUKOPLAKIA ERYTHROPLAKIA
Sub mucosal fibrosis
Precancerous lesions often encountered during screening at BBCI
OPD
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17. OTHER HEALTH HAZARDS

18. • Cardiovascular diseases
• Lung diseases
• Peripheral vascular diseases
• Effects on reproductive health
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19. DAMAGING EFFECT ON REPRODUCTIVE
HEALTH
INCREASED RISK OF MISCARRIAGE
PRE TERM DELIVERY
STILLBIRTH
INFANT DEATH
LOW BIRTH WEIGHT BABY
TOBACCO & WOMEN
Dr. Srabana M

20. MAKING THE NEXT GENERATION
UNWELL!
Dr. Srabana M

21. Mental issues related
Nicotine is a potent
parasympathomimetic
alkaloid
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22. NICOTINE ADDICTION
• A psychoactive drug affecting mood and
performance
• Nicotine is:-
- 1000 times more potent than alcohol
- 10 – 100 times more potent than barbiturates
- 5 – 10 times more potent than cocaine or morphine
•Within 10 seconds reaches brain.
Dr. Srabana M

23. Stimulates release of two chemicals
Nicotine reaches
brain
Dopamine
‘Good’ feeling
Nicotine is highly addictive
with its
The Vicious Cycle of ADDICTION
A tobacco user
takes tobacco Noradrenaline
Alertness & energy

24. Social issues
The total social costs of tobacco products exceed
the direct outlay on them, owing to morbidity, mortality
and negative externalities associated with the
consumption of tobacco products.
Tobacco cultivation has sustained despite social
approval and domestic demand (beedi tobacco)
and the international market
Culturally accepted, named as habit not an abuse

25. Economic impact :
Where we are
India earns Rs 18,000 crores revenue per year
from tobacco
India spent Rs 16,800 crore in 2011 to treat
tobacco-related diseases
overall economic burden ( 16%direct treatment
cost and 84% indirect cost) due to tobacco was Rs
1,04,500 crore. This was 1.6 per cent of the
country's gross domestic product. It was 12 per
cent more than the combined states' and Central
government's expenditure on health.

26. CHANGING TRENDS IN DEVELOPED
COUNTRIES
Realization of health hazards of tobacco by the
Government
Planning
Massive public awareness efforts and stringent policy
implementation
resulting in
Persistent decline in the
prevalence of tobacco in these countries
Dr. Srabana M

27. WHY SO….
UNFORTUNATELY…….
…. In developing countries like India prevalence
of tobacco in various forms is increasing

28. Because of
Misleading advertising by tobacco companies
Poor awareness among general public
 Gaps in effective implementation of tobacco
control programs and laws
Gaps in inte-rsecroral co-ordination
Absence of sufficient no of tobacco de-addiction
centers for those who wish to quit their habit

29. Indicates the need for a more
comprehensive approach to tobacco
control within the country in terms of
taxation trade economic policy and
enforcement policy
Inter-sectorial co-ordination is
mandatory

30. In a survey conducted by the Preventive Oncology Department, BBCI to
perceive the effect of Gutkha ban randomly selecting 400 pan shops of the
metro in later part of this year, it was observed that 10% of the tobacco
vendors were minors and were using pan masala with added tobacco
pouch into it which we named
INDIRECT SALE OF GUTKHA and AVAILABILITY
IN 96% OF PAN SHOPS WE OBSERVED INDIRECT SALE OF GUTKHA
Minors selling Gutkha in the city (Parents/Guardians counseled)
Birubari Noonmati SilpukhuriHatigaon
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31. Dr. Srabana M

32. THANK YOU
Dr. Srabana M