Once upon a time during a de-addiction programme, a gentleman sitting in the audience cracked a joke, hearing which everyone laughed heartily. After some time, he repeated the joke; now a less number of people laughed. Later, he kept telling the same joke again and again, until no one could laugh any longer. Then he smiled and said, “You can't enjoy the same joke again and again, then why do you keep craving for the same tobacco again and again?”

It is surprising that in spite of the constant alarm sounded by governments, health organisations, educational and awareness programmes and warning signs on the packs of tobacco products, people still chew tobacco!

Every year, a huge number of people die from oral cancer (6.4 lakh new cases a year, according to the recent world statistical data). India ranks first in oral cancer. It is often seen that those who smoke cigarettes turn to smokeless tobacco in places where smoking is not allowed. Of all cancers, 75% are caused only by tobacco. There is no safe level for tobacco as any tobacco product, in any form, can cause cancer, and several non-cancerous oral conditions and can lead to nicotine dependence and addiction.

In tobacco chewers, nicotine is absorbed through the oral tissues and it gets into the blood reaching the brain. Even after spitting, nicotine still remains in the blood stream (for a longer duration in chewers than in smokers) making it difficult to quit chewing compared to smoking.

Tobacco contains 28 cancer causing agents, Nitrosamines, polonium- 210 and polynuclear aromatic hydrocarbons being few of them. Smokeless tobacco causes oral cancer, esophageal cancer, pancreatic cancer, also cancer of the lips, tongue, cheek, gums, throat, floor of the mouth, oral precancerous lesions and conditions like leukoplakia, erythroplakia and oral submucous fibrosis ( OSF- which causes a burning sensation in the mouth, a wet leathery feeling, reduced mouth opening, trismus, referred pain in the ear/deafness, difficulty in deglutition, depapillation of the tongue and its restrictive movements and nasal intonation of voice). Also, it can lead to bleeding gums, periodontal problems and mobility of teeth.

Nicotine produces physical and mood altering effects in the brain that are temporarily pleasing; also it may increase temptation to try other substances like marijuana and narcotics, while withdrawal symptoms include irritability and anxiety.

The best way is to encourage the person to quit tobacco by adapting a healthy lifestyle, eating plenty of fruits and raw vegetables, exercising, breathing techniques, yoga and meditation, increasing will-power and controlling the cravings, a positive attitude towards life, happy environment and family life (cracking jokes and laughing, possibly at the same joke again and again)

(The writer is a dental surgeon. Email: littlesmiles@ovi.com)

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