Dr. Caleb Harris M.Ch.(Surgical Oncology)
WORLD CANCER DAY Feb 4, 2019
Growing up in the pre-internet era, we did not have the luxury of iTunes and other online streaming services for accessing music. It was the humble audio cassette, which I don’t think many of today’s youngsters would have seen. Nor were there as many artistes as today, with fewer acts, and scarce availability of their music in India. He was popularly known as the ‘King of Pop’, and he was truly the king. Michael Jackson, though controversial, was known for his philanthropic efforts, especially for the children of Africa afflicted by wars and famines. He crooned,
‘Heal the world, make it a better place
For you and for me and the entire human race’
Now you might be wondering what is ailing the children of Meghalaya and what you can do to Heal their world.
World Cancer Day, observed on February 4 annually, is an initiative of the Union for International Cancer Control(UICC), based in Switzerland. 2019 marks the launch of the 3-year ‘I Am and I Will’ campaign, which is an empowering call-to-action urging for personal commitment and represents the power of individual action taken now to impact the future.
So what is this personal commitment?
Northeast India has a higher incidence of cancers as compared to the rest of the country, but most of these are preventable. More than half of these cancers are due to tobacco, which has no positive benefit to mankind, except, of course, the profits to the tobacco companies. While most people will blame the government for not banning this noxious substance, we need to understand that it is easier said than done. Banning has not been an effective solution to such problems and considering the strong tobacco lobby, it would be politically impossible to achieve this.
But it is really heartening to know that India has very good laws to curb the use of tobacco. Unfortunately, though, its implementation is rather poor. It is here that we as citizens can make a difference by enforcing some of these laws. The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 or COTPA, 2003 provides the legal basis for curbing the use of tobacco.
I was buying vegetables last month when a gentleman stood next to me, smoking a cigarette. The wind was blowing in my direction and the smoke was all over my face. I politely, but very firmly requested him to move away and not smoke there, and he complied. I am sure many of you would have travelled in a bus or a taxi wherein a co-passenger or the driver would be smoking. We need to take a stand and ask the person to stop smoking, and if the person refuses to comply, we can complain to the police. Under section 4 of COTPA, smoking in public places is banned, with a fine on the person who smokes. All owners of public places like restaurants, theatres, shopping centres, etc should display signs saying Smoking is prohibited and they are liable to be fined otherwise.
While the law respects the right of an individual to choose to smoke, he should not endanger others, who are likely to be exposed to the smoke he exhales (second hand smoke). This contains carcinogens (cancer causing toxins) and is also called passive smoking. Its important to understand that women and children are the ones who are at risk of disease due to passive smoking. This is something which we the public have to enforce, as it is not possible to expect police personnel at all public places.
Nicotine, which is found in tobacco, is considered the most addictive substance. Once a person uses tobacco, it is nicotine which causes the craving in him, thus thus enslaving him to tobacco. Once enslaved, tobacco hastens the death of the person, by causing cancer, respiratory disorders and other diseases. Since the lifespan of the tobacco user is reduced, the tobacco industry focuses on efforts to bring in new users every year. Their primary target is adolescents and youngsters, as they are in a susceptible frame of mind and they are bound to be slaves for life.
Many tobacco users feel that they can kick the habit at will, after they have tried it out, but learn it the hard way that they have been enslaved. Tobacco Cessation Clinics are specialised centres wherein doctors, psychologists and other experts offer special treatment to enable tobacco users get out of the habit, and tobacco users can seek help. Such a clinic is being run in NEIGRIHMS. However, even with professional help, only about 4% are able to get out of the habit.
Since quitting tobacco is difficult, we need to ensure that children and youngsters are prevented from getting into this harmful habit. Section 6 of COTPA says that sale of tobacco to minors(<18 years) is a punishable crime and that tobacco should not be sold within 100 yards of all educational institutions. This is all around the perimeter of the campus. Also, the heads of these institutions are expected to put up signages indicating the prohibition of tobacco sales. The onus of checking the age of the buyer is with the seller. Children should not be allowed to sell tobacco too. Many children start tobacco when they were sent to buy for their parents or other elders. Hence this should be strongly condemned. The Act also prohibits the advertisement of tobacco products, by both direct and indirect means.
Now, coming back to the personal commitment. Every individual can prevent smoking in public places and thereby make these places safer. John F. Kennedy said, “Children are the living messages we send to a time we will not see”. Children learn from what they see rather than what they are told. If a child sees her teacher use tobacco, she is likely to explore and experiment with it. Those of us who are parents and educators or others who are come in contact with children, should ensure that we are good examples. This is our responsibility toward the society.
The heads of schools, colleges and other educational institutions can take steps to declare their institutions as “Tobacco Free Educational Institutions”(TFEI). A sign needs to be displayed outside the institution indicating that the premises is a “No tobacco zone” and that sale of tobacco is prohibited within 100 yards of the perimeter. Most importantly, none of the staff of the institution should use tobacco inside the premises.
Shillong has a high density of educational institutions, and if each and every institution takes the initiative to make its premises free of tobacco, this will really Heal our World and reduce the risk of cancer to which these students are likely to be exposed. To quote the world cancer day website, ‘Whoever you are, you have the power to reduce the impact of cancer for yourself, the people you love and for the world. It’s time to make a personal commitment.’
P.S.: For more information on this and for assistance in declaring your institution as TFEI, the author may be contacted at [email protected]
(The writer is Associate Professor and i/c, Department of Surgical Oncology, NEIGRIHMS, Shillong)