Time to ban pseudo ads - On World No Tobacco Day 2022 experts have this request and a warning for govt

New Delhi, May 31, 2022:

In India, tobacco is known to be a major cause of various chronic diseases, such as cardiovascular disease, lung and oral cancer, etc. According to a report released by the Indian Council of Medical Research, as much as a third of the cancer cases reported in India are linked to tobacco use. Moreover, the number of people diagnosed with cancer is expected to increase to almost 30 million by 2025.

A study published in the National Library of Medicine revealed that 11 percent of women and 57 percent of men between the age of 15 and 49 years use tobacco products. In addition to cigarettes, other forms of smokeless tobacco like betel quid and zarda are also widely available in various parts of the country.

The report released by the GLOBOCAN 2012 states that India ranked fourth among the different types of cancer in men, while sixth among the cancers in females. Among males, lung cancer was the leading cause of cancer mortality at 48,697, while the incidence rate for women was 15,062. India is also the second country having the highest number of oral cancer cases and contributes almost one-third to the total global burden.

On the World No-Tobacco Day, Financial Express Online talked to Dr. Prashant Pawar, Head and Neck Surgical Oncologist, HCG Cancer Center, Mumbai and Dr. Sachin Kumar, Senior Consultant – Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru to know about the incidence of tobacco-related cancer in India, signs to look out for, and the social awareness required to encourage people to quit consuming tobacco products.

On the incidence of lung cancer in India

“Lung cancer is the most often diagnosed cancer and the leading cause of cancer-related deaths worldwide. In India, lung cancer accounts for 5.9% of all cancers and 8.1% of all cancer-related deaths. The prevalence of smoking in patients with lung cancer is nearly 80%” informed Dr. Prashant Pawar.

“Among Indian males, lung cancer was the most common cause of cancer mortality at 48,697; the estimated lung cancer mortality among Indian females was 15,062. Various reports have noted that the smoker: nonsmoker ratio is high at 20:1” he added.

On pandemic affecting lung cancer diagnosis and treatment

“In India, cancer services such as new patient registrations, outpatient services, hospital admissions and major surgeries had dropped between March and May 2020, compared to the same period in 2019” Dr Sachin Kumar said citing a May 2021 Lancet study.

“These disruptions could lead to 83,600-111,500 patients requiring cancer services for more advanced diseases over the next two years, it found. Excess cancer-related deaths in the next five years could be 98,650-1,31,500,” he added.

Dr Prashant Pawar shared that due to Covid-19 becoming a primary health concern in 2020 there was the scarcity of personnel in hospitals due to infection, quarantine or as a conscious staff-sparing strategy. “There was also scarcity of blood available for various procedures due to reduced number of blood donation camps. Even patients who were already diagnosed with cancer had to endure delay in treatment both due to prevailing situations in hospitals and secondly if they were diagnosed to have COVID 19.” he said.

On how smoking causes cancer

Smoke consists of atleast 4000 various chemical compounds out of which atleast 40 are known carcinogens. Some of them are Carbon monoxide , Ammoniac, Formaldehyde , Hydrogen Cyanide, Vinyl Chloride , DDT, Acetone , Methanol, Arsenic, Napthalene, Nicotine Cadmium, etc., informed Dr Prashant Pawar.

Exposure to smoking and its associated carcinogens results in DNA damage and leading to formation of mutations and other changes in DNA. These changes lead to uncontrolled growth of cells resulting in formation of a cancer, h esaid.

Dr Sachin Kumar informed that chemicals also damage the parts of DNA that protect us from cancer. It’s the build-up of DNA damage in the same cell over time that leads to cancer. “Roughly 1-in-7 current smokers will get lung cancer in their lifetime. The risk of cancer increases with the number of cigarettes smoked per day.” he added.

On concerns of light, occasional or passive smokers

Secondhand smoke or passive smoking at home or work increases risk of developing lung cancer by 20 to 30 percent, said Dr Prashant. Secondhand Smoking causes more than 7000 lung cancer deaths among US non smokers each year, he informed citing a study. “Environmental tobacco smoke exposure during childhood is strongly associated with the risk of developing lung cancer.” he further added.

De Sachin Kumar shared that Passive smoking is more dangerous because thesmoke that we inhale from a second-hand smoke has no filter and we unknowingly inhale all the harmful chemicals that the cigarette contains. Nonsmokers who are exposed to secondhand smoke or passive smoking at home or at work increase their risk of developing lung cancer by 20–30%.” he added.

On symptoms to look out for lung and oral cancer

“Smoking increases your risk of developing more than 50 serious health conditions. It causes numerous forms of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.” informed Dr Sachin Kumar

Dr Prashant Pawar shared all the signs that leads to early diagnosis of lung and oral cancer mentioned below.

Lung Cancer : Most common symptoms are Cough (often with blood), chest pain, wheezing and weight loss etc. These symptoms often don’t appear until the cancer is advanced.

People may also experience pain in back , cough that can be chronic, dry, with phlegm, or with blood, frequent respiratory infections, shortness of breath, or wheezing, generalized weakness , fatigue or loss of appetite, weight loss .

Oral Cavity Cancer : Oral cancer is a major public health problem in the India and is the most common cancer among indian males .The oral cavity includes the lips, buccal mucosa, teeth, gingiva, anterior two-third of tongue, floor of the mouth and hard palate.

The most common risk factors for oral cancer are tobacco consumption (either in the form of chewing tobacco or in the form of smoking), areca nut (supari) consumption and alcohol consumption. Especially chewing tobacco in rampant in India and it is therefore that we have a much higher incidence of oral cancer.

The most common symptoms of oral cancer are – a nonhealing ulcer or growth in the tongue or cheeks for more than 3 to 4 weeks , associated with bleeding and which does not heal despite taking medications. Pain in the oral cavity, Change in voice, loosening of teeth, difficulty in swallowing are other common symptoms. Some patients develop white or red patches in oral cavity which are precancerous lesions.

On measures that the government should take to generate awareness

The generation of awareness among the masses, especially tier- 2 cities has not happened in a full-fledged manner, shared Dr Sachin Kumar. “Active participation of government, as well as media and other industries, are required to promote awareness and make it more accessible to help quit smoking,” he said.

Dr. Kumar further advised on negative publicity, social media and workplace education, and any type of negative feedback or de- incentive for someone who uses tobacco or smokes to encourage people on quitting tobacco consumption.

Dr. Prashant Pawar opined that there is a storm of ‘pseudo advertising of tobacco and related products’ that encourages the young generation to pick up the habit of tobacco. “There should be an effort to educate children from a young age about the harmful effects of tobacco. There should also be more strict implementation of existing tobacco control policies like the COTPA (Cigarettes and Other Tobacco Products Act, 2003) act” he advised.

Dr Pawar also appealed to the government to initiate tobacco cessation clinics across all public hospitals to encourage and support smokers who are willing to quit. FInancial Express