A 30-year-old man, working in a software company, was diagnosed with tongue cancer owing to tobacco consumption. The diagnosis of cancer came in as a shock to his family and his wife whom he was married to for a year. The patient was diagnosed at such an advance stage that despite chemotherapy and radiotherapy the tumour could not be controlled. Towards the end, the tumour had spread to the neck and started to show on his skin over the neck. He bled to death in the hospital room on one fateful day. This was the story of one of the million bread winners.
Cancer has become a common word, with almost every family having experienced a near one or friend go through this devastating illness. If that’s not enough, what’s worse is that we are seeing these cancers more in the younger age group of 20s and 30s as compared to late ‘50s. Twenty nine per cent of Karnataka’s adult population consumes tobacco (nearly 1.3 crore) and the age of initiation of these habits is presently 10 years and up. This is one of the main reasons we are seeing more cancers and other tobacco illnesses. It is estimated that one third of these consumers will die a premature death (nearly 40 lakh individuals).
IT’S A DISEASE
Tobacco use is not just a habit. The International Classification of Diseases (ICD-10) has now notified ‘tobacco dependence’ as a disease. Tobacco is the only legally available consumer product in the world that kills even when used as per the manufacturer’s specifications.
No less than 4,000 irritating, suffocating, dissolving, inflammable, toxic, poisonous, carcinogenic gases and substances and even radioactive compounds (nickel, polonium, plutonium, etc.) have been identified in tobacco. Of these the World Health Organisation has shown that at least 60 have been proven to be cancerous to humans. Nicotine is a powerful insecticide and is poisonous for the nervous systems. It reaches the brain in just 7 seconds and blocks brain impulses.
NO ESCAPE
Tobacco affects every cell of the body. The three main illness caused by tobacco consumption are heart diseases, lung disorders and cancer. Tobacco consumption also makes you vulnerable to other illness such as cataracts, Alzheimer’s, stomach ulcers, loss of memory, skin problems such as wrinkles, psoriasis and many more. In short, tobacco gains entry into every cell of the body thus making every organ vulnerable to various illness.
It is not only the patient who undergoes the treatment but also his entire family which bears the brunt, both emotionally and financially. Furthermore, many patients do not have access to health care in villages and hence need to move to cities for better facilities. Annually, India registers 1 lakh new cases of cancer and tobacco consumption is implicated in almost 50 per cent of these cancers. Cancers of the head and neck include areas of the body such as mouth, throat, voice box or food pipe which take care of vital functions such as speech, swallowing, breathing and also maintain cosmesis. Hence cancer afflicting these areas kills the very life force of existence.
CAUSE AND EFFECT
Despite advances in technology, science has not been able to significantly improve the cure rates or add years to life, in these cancers caused by tobacco. Some may ponder, why so? Well, expecting any technological advancement to improve outcomes is like letting a man consume poison and then looking for a new antidote. Isn’t this imprudent? Precisely, that is we have been witnessing all these years. Trying to find a new antidote - rather than quitting the poison. We were always taught to practice a simple principle in medicine, “Treat the cause and not only the effect”. Similarly, treatment for these cancers, whatever is the modality; surgery, chemotherapy or radiotherapy, aim at treating the effect- cancer after the cause has played its role. That is why the scientific world has moved from - trying to improve survival to improving quality of life for these patients. However, what could yield more gratifying results is “preventing cancers”. Similarly why not look at the lakhs of heart diseases, lung disorders or several such diseases caused by tobacco and develop the same preventive outlook. Rather than treat these diseases by medications, surgery or other treatments, let us say no to tobacco and embrace life!
Not so pretty through the smoke
Many often wonder if there is truth to the belief that health risks are higher or different for women who smoke. There is.
In India, till recently, tobacco use among women was not very common. Though, rural women do consume tobacco, in various parts of India, the sight of a woman lighting up a cigarette was uncommon and not socially acceptable. Smoking was seen as an act of rebellion usually linked to notions of freedom and equality.
Now, in urban India, smoking is picking up with women. It has been predicted that as greater financial independence is gained, socio-cultural and religious taboos on smoking by women, living in developing countries, weaken. Ironically, smoking among women in many developed countries is on the decline. Among Indian women, 2.9 per cent women smoke and 18.4 per cent chew tobacco. Most figures come from north India, east India, north-east India and Andhra Pradesh.
Since smoking by women does turn heads, other forms of tobacco consumption such as hookah, tobacco water have become the trend.
There’s also smokeless tobacco which is seen as a convenient option for women since it can be easily concealed and does not attract the same social attention as smoking does.
The major concern with this is that smokeless tobacco is shown to contain 3,095 chemicals of which 28 are potential carcinogens cancer causing agents). India presently has the largest number of oral cancer patients in the world and smokeless tobacco users have a high risk of developing oral precancer and cancer. In the case of smoked tobacco there are more than 4,000 chemicals, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
Passive is harmful
Inhaling second-hand smoke(SHS) is equally harmful. Women exposed to second-hand smoke are equally vulnerable to the various illness caused by its direct consumption. SHS causes lung cancer, coronary heart disease, increases the chances of still births and many others. In children, SHS causes sudden infant death syndrome (SIDS) and many other diseases, primarily related to the respiratory tract. Other than tobacco consumption, in smoked or smokeless forms, even the chemicals used in tobacco farming have hazardous effects on maternal and fetal health.
women at risk
Few of the reasons for the unique relationship between smoking and women are as follows. Research findings reveal that female smokers derive greater subjective pleasure from nicotine than their male counterparts.
Also weight control and reduction of appetite are important aspects of the appeal of smoking for many women and girls. Studies do suggest that cessation may be more difficult for women than for men; one of the reasons could be weight gain or the fear of weight gain.
Other than the gender neutral effects of smoking such as lung and heart diseases, strokes, cancers etc., women are at an increased risk for female reproductive issues, including painful, irregular periods; earlier menopause; increased risk for cervical cancers and human papilloma virus (HPV), breast cancers and increased risks among those who use certain birth-control methods.
How to curb
As tobacco industries target gender-specific consumption, an effort has to be made to develop gender-specific prevention strategies as well. Women who are very conscious of their looks should not fall prey to such lame excuses of reduction in appetite for weight control as they could end up with much more disfiguring consequences. A change in perspectives is required to consider tobacco use as ‘uncool’ and not a normal behaviour.
Gender specific tobacco control activities should also take into consideration the millions of women involved in tobacco farming and production who tirelessly roll lakhs of beedis to earn meagre amounts.
World Health Organisation and its partners have recently been focusing on issue of women and tobacco to help them make well informed choices about their health and life.