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Tobacco use in India: An evil with many faces
Deaths in India Due to Tobacco Use
Tobacco use one of the major reasons for death in India. Here are some facts about Tobacco use in India and its effect:
What is secondhand smoke?
Secondhand smoke (SHS) is also known as environmental tobacco smoke (ETS). SHS is a mixture of 2 forms of smoke that come from burning tobacco:
Sidestream smoke – smoke from the lighted end of a cigarette, pipe, or cigar
Mainstream smoke – the smoke exhaled by a smoker
Even though we think of these as the same, they aren’t. Sidestream smoke has higher concentrations of cancer-causing agents (carcinogens) than mainstream smoke. And, it has smaller particles than mainstream smoke, which make their way into the lungs and the body’s cells more easily.
When non-smokers are exposed to SHS it is called involuntary smoking or passive smoking. Non-smokers who breathe in SHS take in nicotine and toxic chemicals by the same route smokers do. The more SHS you breathe, the higher the level of these harmful chemicals in your body.
Why is secondhand smoke a problem?
Secondhand smoke causes cancer
Tobacco smoke contains more than 7,000 chemical compounds. More than 250 of these chemicals are known to be harmful, and at least 69 are known to cause cancer.
SHS has been linked to lung cancer. There is also some evidence suggesting it may be linked with childhood leukemia and cancers of the larynx (voice box), pharynx (throat), brain, bladder, rectum, stomach, and breast.
IARC reported in 2009 that parents who smoked before and during pregnancy were more likely to have a child with hepatoblastoma. This rare cancer is thought to start while the child is still in the uterus. Compared with non-smoking parents, the risk was about twice as high if only one parent smoked, but nearly 5 times higher when both parents smoked.
Secondhand smoke and breast cancer
Whether SHS increases the risk of breast cancer is an issue that’s still being studied. Both mainstream and SHS have about 20 chemicals that, in high concentrations, cause breast cancer in rodents. And we know that in humans, chemicals from tobacco smoke reach breast tissue and are found in breast milk.
One reason the link between SHS and breast cancer risk in human studies is uncertain is because breast cancer risk has not been shown to be increased in active smokers. One possible explanation for this is that tobacco smoke might have different effects on breast cancer risk in smokers and in those who are exposed to SHS.
Where is secondhand smoke a problem?
You should be especially concerned about exposure to secondhand smoke in these 4 places:
The workplace is a major source of SHS exposure for many adults.
SHS in the workplace has been linked to an increased risk for heart disease and lung cancer among adult non-smokers. The Surgeon General has said that smoke-free workplace policies are the only way to do away with SHS exposure at work. Separating smokers from non-smokers, cleaning the air, and ventilating the building cannot prevent exposure if people still smoke inside the building. An extra bonus other than protecting non-smokers is that workplace smoking restrictions may also encourage smokers to smoke less, or even quit.
In public places
Everyone can be exposed to SHS in public places, such as restaurants, shopping centers, public transportation, schools, and daycare centers. The Surgeon General has suggested people choose restaurants and other businesses that are smoke-free, and let owners of businesses that are not smoke-free know that SHS is harmful to your family’s health.
Some businesses seem to be afraid to ban smoking, but there’s no proof that going smoke-free is bad for business. Public places where children go are a special area of concern. Make sure that your children’s day care center or school is smoke-free.
Making your home smoke-free may be one of the most important things you can do for the health of your family. Any family member can develop health problems related to SHS.
Children’s growing bodies are especially sensitive to the poisons in SHS. Asthma, lung infections, and ear infections are more common in children who are around smokers. Some of these problems can be serious and even life-threatening. Others may seem like small problems, but they add up quickly — the expenses, time for doctor visits, medicines, lost school time, and often lost work time for the parent who must stay home with a sick child.
Think about it: we spend more time at home than anywhere else. A smoke-free home protects your family, your guests, and even your pets.
In the car
Most of the people spend a great deal of time in cars, and if someone smokes there, the poisons can build up quickly. Again, this can be especially harmful to children.
What can be done about secondhand smoke?
Local, state, and federal authorities can enact public policies to protect people from SHS and protect children from tobacco-caused diseases and addiction. Because there are no safe levels of SHS, it’s important that any such policies be as strong as possible, and that they do not prevent action at other levels of government.
Smokeless Tobacco use
Smokeless tobacco is very common in India. Tobacco or tobacco-containing products are chewed or sucked as a quid, or applied to gums, or inhaled.
The route is different, but the nicotine addiction is the same. Nicotine in smokeless tobacco products absorbs from the mouth or nose along with other compounds in the tobacco. Cigarettes, pipes, and cigars burn the tobacco, and the nicotine from the smoke gets into the body through the mouth, nose, and lungs along with other particles generated by combustion. Burning tobacco sends out secondhand smoke, which other people and the smoker breathe in as it lingers in the air and settles on surfaces.
All forms of tobacco and nicotine can harm or kill children and pets if accidentally or otherwise ingested.
What kinds of illness are caused by oral or smokeless tobacco
Harmful health effects of smokeless tobacco include:
Mouth, tongue, and throat cancer
Cancer in the esophagus (the swallowing tube that goes from your mouth to your stomach)
Possible increase in risk of heart disease, heart attacks, and stroke
Addiction to nicotine
Leukoplakia (white sores in the mouth that can become cancer)
Receding gums (gums slowly shrink from around the teeth)
Bone loss around the roots of the teeth
Abrasion (scratching and wearing down) of teeth
Stained and discolored teeth
Leukoplakia is a white patch in the mouth that can become cancer. These are sometimes called sores but they are usually painless. Many studies have shown high rates of leukoplakia at the place in the mouth where users place their chew or dip. One study found that nearly 3 of 4 of daily users of moist snuff and chewing tobacco had non-cancerous or pre-cancerous lesions (sores) in the mouth. The longer a person uses oral tobacco, the more likely they are to have leukoplakia.
Tobacco can irritate or destroy gum tissue. Many regular smokeless tobacco users have receding gums, gum disease, tooth decay (from the high sugar content in the tobacco), and bone loss around the teeth. The surface of the tooth root may be exposed where gums have shrunken. All this can cause teeth to loosen and fall out.
Smokeless tobacco may also play a role in heart disease and high blood pressure. A study showed that men who switched from cigarettes to snuff or chewing tobacco had higher death rates from heart disease stroke, cancer of the mouth and lung, and all causes of death combined than former smokers who stopped using all tobacco products. It’s unclear whether the heart disease was caused by the smokeless tobacco products in this study.
The snuff and chewing tobacco products most widely used in India have very high levels of cancer-causing agents (carcinogens) called tobacco-specific nitrosamines. There are other kinds of cancer-causing agents in smokeless tobacco, too, such as benzo[a]pyrene and other polycyclic aromatic carcinogens. These carcinogens may be why several types of cancer are linked to use of smokeless tobacco.
How do the risks of using smokeless tobacco compare with cigarette smoking?
Smokeless tobacco products are less lethal than cigarettes: on average, they kill fewer people than cigarettes. But smokeless tobacco hurts and kills people all the same. Even though they are marketed as a less harmful alternative to smoking, smokeless products can be deadly. And they have not been proven to help smokers quit.
Smokers who delay quitting by using smokeless products between cigarettes greatly increase their risk of lung cancer. They also set themselves up for new health problems caused by smokeless tobacco.