Tobacco is deadly in any form or disguise. Scientific evidence has unequivocally established that exposure to tobacco smoke causes disease, disability and death. According to the International Agency for Research on Cancer (IARC) monograph, there is sufficient evidence in humans that tobacco smoking causes cancer of the lung, oral cavity, naso-, oro- and hypo-pharynx, nasal cavity and paranasal sinuses, larynx, oesophagus, stomach, pancreas, liver, kidney (body and pelvis), ureter, urinary bladder, uterine cervix and bone marrow (myeloid leukemia).
Ninety per cent of all lung cancer deaths in men and 80 per cent in women are caused by smoking. Studies on bidi smoking, the most common form of tobacco smoking in India, provide evidence toward causality of it as a carcinogenic substance.
Case-control studies demonstrate a strong association of bidi smoking with cancers at various sites such as oral cavity, pharynx, larynx, oesophagus, lung and stomach. Almost all studies show significant trends with duration of bidi smoking and number of bidis smoked.
Forty per cent of the tuberculosis burden in India may be attributed to smoking. The risk of tuberculosis deaths among bidi smokers was 2.60 times higher than non-smokers in India. Workers engaged in tobacco cultivation suffer from an occupational illness known as green tobacco sickness (GTS), an acute form of nicotine toxicity resulting from absorption of nicotine through the skin.
City-based pulmonologist Anil Kancherla said there were several new developments in the efforts to help people get over their addiction to tobacco. The chemical that makes people become tobacco addicts is nicotine.
Pulmonologists, in a joint effort with general physicians and psychiatrists/psychologists, were trying to help nicotine addicts to break the habit. This was done by administering nicotine or nicotine-replacement drugs in a controlled manner, Dr Anil said. The other name for this is Nicotine Replacement Therapy (NRT).
Will power needed
NRT is a way of getting nicotine into the bloodstream without smoking or through other harmful ways like gutka. This was done using nicotine chewing gum, patches, inhalers, tablets, lozenges and sprays. NRT stops or reduces the symptoms of nicotine withdrawal, but it does not make people stop smoking. Will power and determination were needed to breaking the smoking habit.
Dr. Anil said that tobacco addicts should not try NRT on their own and without the guidance of a doctor or a psychiatrist. There have been cases when the addiction increased with the patients continuing to smoke and using the nicotine replacement products. The need for a counsellor is also important because de-addiction can best be achieved with motivation and will power.
