The Burden of Tobacco Addiction in India

India is home to one of the largest populations of tobacco users in the world. According to the Global Adult Tobacco Survey (GATS) 2016-17, about 28.6% of adults (15 years and older) in India use tobacco in some form, including smokeless tobacco, smoking, and dual use. This translates to approximately 267 million individuals. The prevalence of tobacco use is higher among males (42.4%) compared to females (14.2%).

The economic burden of tobacco use is substantial. The Ministry of Health and Family Welfare estimates that the economic costs attributable to tobacco use from all diseases in India in 2011 amounted to INR 1,04,500 crores. This includes direct healthcare costs and indirect costs related to lost productivity due to illness and premature death.

Health Effects of Tobacco Use

Tobacco use is a leading cause of morbidity and mortality in India, contributing to a range of serious health conditions:

Respiratory Diseases: Tobacco smoke contains numerous harmful chemicals that damage the respiratory system. Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are among the most severe consequences of smoking. Additionally, smokeless tobacco is linked to oral cancers and other respiratory issues.

Cardiovascular Diseases: Smoking is a major risk factor for cardiovascular diseases, including coronary artery disease, stroke, and peripheral vascular disease. It accelerates the atherosclerotic process, leading to increased risks of heart attacks and other cardiovascular events.

Cancers: Tobacco use is associated with various types of cancer, not just limited to the lungs. Oral, throat, esophageal, bladder, and pancreatic cancers are significantly linked to tobacco use. Smokeless tobacco also increases the risk of cancers of the oral cavity and esophagus.

Reproductive Health Issues: Tobacco use affects reproductive health, leading to complications such as reduced fertility, complications during pregnancy, and adverse birth outcomes like low birth weight and preterm births.

Other Health Effects: Beyond the major diseases, tobacco use contributes to a myriad of health problems including hypertension, diabetes complications, and impaired immune function.

Measures to Manage Tobacco Addiction

Addressing tobacco addiction requires a multi-faceted approach, incorporating policy interventions, community programs, and individual support. The following measures are crucial for managing tobacco addiction in India:

Legislative and Policy Measures:

Implementation of the Cigarettes and Other Tobacco Products Act (COTPA) 2003: This legislation regulates advertising, packaging, and sales of tobacco products. Strict enforcement of this act can significantly reduce tobacco consumption.

Taxation and Pricing Policies: Increasing taxes on tobacco products is one of the most effective ways to reduce tobacco use. Higher prices discourage initiation among young people and motivate existing users to quit.

Public Awareness and Education

Mass Media Campaigns: Educational campaigns highlighting the dangers of tobacco use and promoting cessation services can influence public attitudes and behaviours.

School-based Programs: Integrating tobacco education into school curricula can prevent initiation among young people.

Cessation Support Services

Quit-lines and Helplines: Providing access to quit-lines where trained counsellors can offer support and advice to individuals trying to quit tobacco.

Nicotine Replacement Therapy (NRT) and Medications: Making NRT and other cessation aids available and affordable can improve the success rates of individuals attempting to quit.

Community Engagement and Support

Community Health Programs: Engaging community health workers in tobacco rcessation programs can enhance outreach and support at the grassroots level.

Support Groups: Establishing support groups where individuals can share their experiences and strategies for quitting can provide the necessary social support.

Monitoring and Research

Surveillance and Data Collection: Regular surveys like GATS help in monitoring trends in tobacco use and evaluating the effectiveness of interventions.

Research on Cessation Strategies: Conducting research to identify the most effective cessation strategies tailored to the Indian context.

To sum it up, we need to have a no tobacco day every day that serves as a critical reminder of the ongoing battle against tobacco addiction in India. The country’s high prevalence of tobacco use underscores the urgent need for comprehensive strategies encompassing policy, education, support services, and research. By strengthening these efforts, India can significantly reduce the burden of tobacco-related diseases, improve public health, and save millions of lives.

 

By, Dr. Pavan Yadav, Lead Consultant – Interventional Pulmonology & Lung Transplantation, Aster RV Hospital