The first-ever report on the global use and public health impact of smokeless tobacco has found that more than 300 million people in at least 70 countries use the carcinogenic product. Eighty per cent of smokeless tobacco users in the world are in India and Bangladesh.
The report ‘Smokeless Tobacco and Public Health: A Global Perspective’ was released on Monday by the USA’s Center for Disease Control and Prevention (CDC) and the National Cancer Institute at Tata Memorial Hospital in Parel.
The report revealed that majority of smokeless tobacco users (89%) are in Southeast Asia, which also has the highest oral cancer rates in the world. Cancer prevalence among men using smokeless tobacco is high across the region, varying between 25% and 51% in five countries.
The prevalence is also high -- equivalent to that of cigarette usage -- among youth aged 13 to 15 years. The study has given no figure on cigarette usage.
“The incidence rate of cancer due to smokeless tobacco, as the statistics shows, is higher in India when compared to other countries. This is also an indication that the products being sold in the region are far more dangerous than the countries where the incidence rate is lower,” said Dr Mark Parascandola of National Cancer Institute, USA. “Moreover, the risk of oral cancer is five times higher among smokeless tobacco users than smokers,” added Dr Parascandola.
On the sidelines of the report’s release, the director of National Tobacco Control Programme (NTCP) said that the ministry of family health and welfare will come up with a dedicated toll-free 24x7 national helpline number for tobacco de-addiction and counselling.
“The helpline unit will be headquartered in Delhi. Initially, we will offer counselling in English and Hindi languages but we aim to include more regional languages over a period of time,” said Amal Pusp, director NTCP.
* Oral use of smokeless tobacco is widely prevalent in India. People chew tobacco or apply tobacco preparations to teeth and gums. According to the monograph developed by the International Agency for Research in Cancer (IARC) of the World Health Organisation, the three forms of smokeless tobacco which are commonly used orally are:
a) Tobacco (with aroma and flavours) – creamy or dry snuff, gudakhu, gul, mishri, red tooth powder
b) Tobacco with other components such as lime, sodium bicarbonate, ash – khaini, zarda, maras, naswar
c) Betel quid with tobacco (includes areca nut, slaked lime, catechu and tobacco with spices) – betel quid, gutkha, mawa
* There are 3,095 chemical components in smokeless tobacco products, including gutkha, among them 28 are proven carcinogen or those causing cancer.
* The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines (TSNA) and no safe level of this chemical has been ascribed so far.