By Nawaz Yasin Islam
From the implementation of the Inner Line Permit to curbing the practice of inter community marriages, from assuring employment to ensuring developmental practices, political parties have taken every possible route to lure voters into pressing the little ‘blue’ button in favour of the party, ‘formed to change the world’!
The most striking point that needs to be noted in all the picturesque promises that have been painted is the neglect shown towards the health sector. We are not talking about the sanction of rupees amounting crores for the construction of institutes or health centres but the inclusion of minor changes to tackle the ever rising rate of tobacco consumption and the likes.
As per the Global Adult Tobacco Survey (GATS), released by the Ministry of Health and Family Welfare (2010), the percentage of tobacco users in Meghalaya has been recorded at 55percent and was ranked as being the fourth highest in the country with Mizoram reigning at 67 percent. It is surprising that such staggering figures could fail to be wake up calls for the political parties here. It may be recalled here that the whole idea of banning smoking in public places turned into smoke too with no proper directives being issued in this regard.
Sale of tobacco products to minors is another area that has not been monitored by any. During these elections, not one political party is talking about saving the children of India who are consuming tobacco even from the age of 8 years. Every day in India, 5500 children start to use tobacco in some or the other form. Children are consuming tobacco instead of toffees and ice-cream. Is this not serious for the political party leaders? Tobacco industry is known to contribute heavily to political parties. Is this making the parties blind to the suffering of millions? With the highest being 40 percent, Meghalaya stands at 36 percent in terms of smokers aged 15 and above as per the GATS report.
Among all the regions, smoking is initiated at a much younger age in the Central region of India. It is at a comparatively older age in the South region. About 44 percent of daily smokers in the Central region start smoking before they turned 18 as against 29 percent from the South region. The mean age of initiation of smoking among smokers in the Central region is 17.1 years, almost two years lower than the corresponding mean age in the Southern region of India. Reports suggest that about 28 percent of daily smokers in Meghalaya have initiated this habit below the age of 15 whereas 24.2 percent between the age of 15 to 17 and 23.3 percent between the age group of 18 to 19.
Patrons of Voice of Tobacco Victims (a campaign by Healis – Sekhsaria Institute for Public Health) have urged upon political parties to include tobacco control in their manifesto considering its seriousness as the biggest public health problem in India. Such initiatives need recognition and support of the masses.
The graveness of the issue that is repeatedly ignored can be ascertained from the fact that in India, every year, around one million new cancer cases are diagnosed and around 600,000 to 700,000 people die from cancer. Around two-fifths (40%) of all cancers in India are attributable to tobacco use and the economic costs of illness and premature death due to tobacco consumption exceed combined government and state expenditure and state expenditure on medical and public health, water supply and sanitation. (Challenges to effective cancer control in China, India and Russia, April 2014 – The Lancet Oncology).
Smokeless tobacco contains nicotine, which is highly addictive. There are 3095 chemical components in tobacco, among them 28 are proven carcinogen. The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids. The nitrosamine level is directly related to the risk of cancer. Scientific evidence has established that tobacco chewing causes cancer of mouth, oesophagus (food pipe), larynx and pharynx (throat), pancreas, stomach, kidney and lung.
It can also cause high blood pressure and other life threatening cardiovascular conditions like myocardial ischemia, stroke etc. The use of smokeless tobacco during pregnancy can cause still birth, low birth weight, premature delivery, anaemia of mother and several complications during delivery.
The prevalence of smokeless tobacco use varies from a high of 38 percent in the Eastern region to the low of 7 percent in the Northern region. Regional pattern of prevalence of smokeless tobacco use is slightly different from that of the prevalence of smoking. It has been noted that in India as a whole the prevalence of smokeless tobacco is greater than that of smoking.
It is worth a mention that in Mizoram, Tripura, Meghalaya, Tamil Nadu and Puducherry, a higher proportion of females are consuming smokeless tobacco than males. The absence of a uniform ban on manufacture and sale of such products is marring the government’s efforts – sale of gutka and pan masala is banned in all states and union territories, except Meghalaya and Lakshadweep.
The Government of India enacted Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) to prohibit the consumption of cigarettes and other tobacco products which are injurious to health with a view to achieve improvement of public health in general and also to prohibit the advertisement of and provide for regulation of trade, commerce, production, supply and distribution of cigarettes and other tobacco products in the country but effective implementation is still a far fetched dream
Focused tobacco control initiatives targeting these areas, taking into consideration the existing socio-economic and cultural factors associated with tobacco use need to be implemented and at the end of the day, questions should be raised if another ineffective party gets to sit on the golden throne.