Tobacco is a leading cause of preventable death, and is estimated to kill more than five million people each year worldwide. The gap in deaths between the low and middle income countries and the high income countries, is expected to widen further over the next several decades if we do nothing. If the current trends persist, tobacco will kill more than eight million people worldwide each year by 2030, with 80% of these premature deaths in the low and middle income countries.
By the end of this century, tobacco may kill a billion people or more unless urgent action is taken. Within the next two years, around 10 lakh people will die of smoking in India, says one of the most comprehensive studies. India is on the threshold of a tobacco-unleashed epidemic. Smoking increases the level of poisonous carbon monoxide in the lungs. It gets quickly absorbed in the blood, affecting its capacity to carry oxygen. It strains the smoker even more as the heart has to work harder. High levels of carbon monoxide in the blood can impair vision, perception of time and coordination. Smokers are more likely to develop respiratory ailments, thickening of the arteries, blood clots, and cancers of the lung, cervix, larynx, mouth, oesophagus, bladder, pancreas and kidneys. It could also lead to impotence.
Environmental tobacco smoke (also called passive smoke or second-hand smoke) affects people who are frequently around smokers. Second-hand smoking can cause chronic respiratory conditions, cancer and heart disease. It is estimated that around 35,000 non-smokers die of heart diseases each year as a result of exposure to environmental tobacco smoke.
Tobacco consumption is a leading cause of death among Indians aged 30-69 and one million Indians die of smoking-related diseases each year; among all women, 11% (over 54 million women) use some form of tobacco; approximately one in 20 (or 90,000) deaths among women of 35-69 years can be attributed to smoking.
Tobacco products are the only legally available products that can kill up to one half of their regular users if consumed as recommended by the manufacturer.
People, non-governmental organisations and governments unite on World No Tobacco Day (May 31) to draw attention to the health problems that tobacco use can cause. The theme for this year is: “Ban tobacco advertising, promotion and sponsorship.”
The tobacco industry operates as a global force and uses a wide range of methods to buy influence and power, and penetrate markets. Such strategies include direct and indirect political lobbying and campaign contributions, financing of research, attempts to affect the course of the regulatory and policy machinery and engaging in social responsibility initiatives as part of public relations campaigns.
As more and more countries move to fully meet their obligations under the WHO Framework Convention on Tobacco Control (WHO FCTC), the industry’s attempts to undermine the treaty becomes more aggressive. These include weakening public health efforts to ban tobacco advertising, promotion and sponsorship.
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There should be an effective surveillance system which should collect information on the prevalence of tobacco use, tobacco-related morbidity and mortality, and policy and programme interventions. It will enhance government capacity to find out the relation between the tobacco and health status of the population. Hence, it will assist in setting public health priorities. There is an urgent need to strengthen research to deal with tobacco control.
( The writer is Medical Director & CEO, Kalra Hospital Sri Ram Cardio Thoracic Neurosciences Centre, New Delhi. Email: dr_rnk@hotmail.com )
