Bengaluru: Enough scientific evidence for tobacco not to exist, says NIMHANS director

In pre-Covid times, the ‘tobacco quitline’ at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru used to receive 5,27,287 calls yearly, which came down to 3.6 lakh last year.

Dr Pratima Murthy, director of NIMHANS told The Indian Express that though the number of calls has come down, there has been a gradual increase in the number of people who want to quit smoking. “We have a center for addiction medicine and a quitline helpline to which people can call and get online counseling and telephonic counseling to quit tobacco. The government is aware that we need a public health approach to help people quit tobacco,” she said.

Speaking at a panel discussion ‘Eliminating the cigarette and bidi butts by amending COTPA’, she said: “There have been some small measures in terms of a seven per cent reduction in tobacco use between the global tobacco survey 1 and 2. The best advocates to tell people to quit smoking are those who have themselves quit smoking. Though the success we have garnered is small, it is good to see that in public places smoking has come down due to regulations. However, public engagement is important. There is enough scientific evidence for tobacco not to exist. Often people do not know alternative ways to deal with stress and emotional difficulties and they resort to tobacco use.”

Murthy stated that the clarion call for India’s independence was ‘Quit India’, likewise the call today should be ‘Quit Tobacco India’. “For the non-communicable and communicable diseases, risk factors include tobacco and alcohol,” she said.

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In a bid to expose rampant smoking in public places, thousands of cigarette and bidi butts were collected by National Service Scheme (NSS) volunteers, citizens and civil society organizations in the past three weeks across Bengaluru. All the collected butts were displayed at NIMHANS urging political representatives from Karnataka and the Union Health Ministry to get the principal tobacco control law COTPA (Cigarette and Other Tobacco Products Act) amended and make public places 100 per cent smoke-free.

The COTPA is the principal law that governs tobacco control in India that prohibits – smoking in public places, direct and indirect tobacco advertising, sale of cigarettes or other tobacco products to persons below the age of 18 years and sale within 100 yards of any educational institution .

“We find that COTPA is not strong and comprehensive to cover all the issues related to tobacco control. Through this campaign we want to appeal to all the members of Parliament from Karnataka, and the Union health ministry to amend COTPA and strengthen it to curb the gross violations. Designated Smoking Areas (DSA) at public places like hotels, restaurants, bars, pubs and airports have to be removed as they are posing threat to the health of non-smokers. We need 100 per cent smoke-free public places” said Dr Ramesh Bilimagga, an oncologist and the president of the NGO, Consortium for Tobacco Free Karnataka.

Dr Vishwanath V Bellad, pulmonologist at BGS Gleneagles Global Hospital said: “In our clinical practice, we are seeing a large number of relatively younger adults coming with chronic obstructive pulmonary diseases, hypertension, heart attack, cancers and stroke. On diligent audit of these cases, one of the most common causes is tobacco smoking or use of smokeless tobacco, that too initiated in adolescence. Considering the enormous health complications associated with tobacco use and its economic burden on health care and economics, it is of utmost importance to understanding the factors influencing its use and to plan strategies to reduce its intake. In India, despite the awareness programme, the recognition of harmful consequences of its usage is not demonstrable.”

“Many people are unaware of the health consequences of tobacco use. Added to this, a wrong belief is being spread throughout the country that beedis are less harmful than cigarettes. Thus, in a country like India, widespread community awareness programs on the hazards of local and cheaper tobacco products like beedis and gutka are more essential than a few school-based programmes,” he added.

Pointing out the violation of laws, Bellad elaborated: “India has passed the Tobacco Products Bill 2001, which prohibits the advertisement of all tobacco products, smoking in public places and selling tobacco to persons under 18 years of age. It also directs the manufacturers of tobacco products to indicate the nicotine and tar contents and warnings of adverse health effects of tobacco products on packages in both English and regional languages. In addition, the bill places a total ban on sponsorship of any sport or cultural events by tobacco companies. During the last five years, the State Governments have also passed relevant orders for smoking bans in public places. One such order prohibits the sale of tobacco products within 100 meters of schools. Enforcements of laws have often been a problem in India. For example, although non-smoking zones exist at important public places, especially in the large cities, there is an utter disregard for them.”

Sharing her experience Dr Shalini Joshi, senior consultant, internal medicine, Fortis Hospitals, said: “I have worked at Fortis’ Tobacco Cessation Clinic for a couple of years now and I have met young adults who have developed a habit of smoking cigarettes since their college days, resulting in significant reliance. The majority of smokers I counsel want to quit, but they haven’t been able to do so in the past. A young newlywed couple came in, with the husband needing bypass surgery at the age of 35. Since he had been smoking for the previous 14 years, the risk of having a heart attack was significantly high necessitating an open-heart surgery just 6 months post their marriage, impacting not just the individual but also their loved ones.”

“India has one of the highest rates of SLT (smokeless tobacco) use in the world, as does the number of head and neck cancers. One such case included a middle-aged woman who used SLT and was diagnosed with tongue cancer. She was operating on at the right moment, preventing the disease from spreading throughout her body, and she is doing well after the major surgery,” she added.


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