Mid-January, Union Health Minister Ghulam Nabi Azad made a statement that is likely to have a huge impact on the health of the nation, particularly, on those who use chewable, smokeless forms of tobacco.

According to reports on the Medindia website, Mr. Azad said that while the government hitherto focussed on smoke-forms such as cigarettes and beedis, clearly the number of people chewing tobacco had increased. This had forced it to come up with a policy specific to chewing tobacco.

Those working in the anti-tobacco movement have reason to rejoice over this, especially in Tamil Nadu. “It is a great move. If we finally have a policy against chewable tobacco too, it would have an impact on its usage for sure,” says J.John Kennedy, project co-ordinator, Smoke-free Chennai Project.

“About 40 per cent of tobacco use in Tamil Nadu is the smokeless forms. These are primarily gutka, pan masala and raw tobacco,” Mr. Kennedy says. Chewable tobacco is a major reason for oral cancer, which causes both disfigurement and functional problems. Swallowing, and articulation become very difficult with oral cancer. If untreated on time, it is fatal.

India is the number one country in the world for oral cancer, explains Arvind Krishnamoorthy, surgical oncologist specialising in head and neck cancers at Adyar Cancer Institute. Smokeless tobacco contributes to much of this. The cancers are being found in the same sites that the users habitually place the wad of tobacco or the pan masala particles, he explains.

Welcome policy

While, as an oncologist, his recommendation is for a complete ban on chewable forms of tobacco, Dr. Arvind is clear that a policy focussing on this form of tobacco is welcome. “Most people think that chewable tobacco is not harmful, compared to cigarettes or beedis. They don't know it is carginogenic too. We need to build knowledge about the harmful effects of chewing tobacco products.” Mr. Kennedy says children as young as 13 years take up the habit, believing it to be harmless.

A recent High Court order banning the use of plastic sachets to sell gutka and pan masala is an unexpected shot in the arm for the anti-tobacco lobby, according to E. Vidhubala of the Tobacco Cessation Centre, Adyar Cancer Institute. “The long term storage, display, and distribution of such products will certainly be affected,” she says.

The key, Dr. Arvind, says is primordial and primary prevention. For this, it is essential to catch them young, and disseminate messages related to the ills of chewing tobacco, perhaps in as graphic a manner as possible.