A two-day National Consultation on Smokeless Tobacco is being organized by the Ministry of Health & Family Welfare in collaboration with Pubic Health Foundation of India (PHFI) and World Health Organization (WHO) on April 4-5, 2011 at Vigyan Bhawan, New Delhi. The primary objective is to highlight current pattern and the burden smokeless tobacco use globally, regionally and particularly in India, with a view to learn from global best practices and find local solutions for regulation.
As per the reports submitted by Parties to the World Health Organization Framework Convention on Tobacco Control (FCTC), smokeless tobacco use is a widespread and growing problem globally, with males consumption average from 1% for the Region of the Americas to 33% for the South-East Asia Region. For females it is as low as 2% for the European Region to a high of 10% for the South-East Asia and the Western Pacific Regions.
As per the recent Global Adult Tobacco Survey (GATS) India Report, 2010, the current use of smokeless tobacco among adult males in India is as high as 32.9% and for females it is 18.4%. Overall, 26% of the adult population consumes smokeless type of tobacco.
Youth is also a vulnerable group to smokeless tobacco use. Global Youth Tobacco Survey (GYTS)-India, 2009, revealed that 12.5% (Boy = 16.2%, Girl = 7.2%) youth used tobacco products other than cigarettes. The situation is alarming when the report says, school going children aged 13-15 years, across 132 countries, were more likely to report using non-cigarette tobacco products, than to report smoking cigarettes.
Globally, the highest smokeless tobacco prevalence rate of 53.1% among male consumers has been observed in Yemen, and in Bangladesh, the prevalence of smokeless tobacco use among females (27.9%) exceeds that of males (26.4%).
As per GATS India Report, Khaini is the most common smokeless tobacco product in use in India and also the most common smokeless tobacco in use by men. This is followed by Gutkha. The use of smokeless tobacco in India is peculiar as there are large no. of smokeless tobacco products in use e.g. paan with tobacco, paan masala with tobacco, Gul, Mawa, Mishri, Bajjar, Gudakhu etc, which are used as dentrifice i.e. for application on teeth or gums.
Prevalence of Smokeless tobacco use is high in North East region and states like Bihar, Jharkhand, Orissa etc.
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As per available evidence, smokeless tobacco contains more than 3000 chemical compounds, and 29 of these are proven carcinogens i.e cancer causing substances.
As per ICMR, 50% of cancers among men and 25% among women in India are related to tobacco use. 90% of oral cancers are related to use of chewing tobacco.
States with high prevalence of smokeless tobacco also face the challenge of high burden of oral cancer. Besides oral cancer, smokeless tobacco use is also associated with cancers of food pipe, pancreas, kidney throat and stomach. There is also increased risk of death from cardiovascular diseases among smokeless tobacco users. Some neurological and metabolic disorders have also found to be related to use of smokeless tobacco. The use of smokeless tobacco during pregnancy is known to be associated with increased incidence of birth complications, anemia, fetal loss, preterm babies and low birth weight babies. Thus smokeless tobacco use also leads to huge health cost burden to the country.
In view of huge health and health cost burden, some states in India tried to ban use of Gutkha in the respective states. However the matter was taken to the Supreme Court of India and in one of the judgments, the Central Government was directed to take call in the matter as COTPA, 2003 (Cigarettes and other tobacco products regulation act) is a central act.
Over the years, Tobacco industry has come out with various flavoured smokeless tobacco products to popularize the same. The extremely low cost of smokeless tobacco products bring them within the reach of low socioeconomic class and especially youth. The weak implementation of provisions under COTPA at state and sub state level has failed to regulate use of smokeless tobacco in the country.
Given this scenario, prominent national and international experts have been invited to deliberate on the scientific evidences, while identifying the gaps in policy and capacity for effective prevention and control of smokeless tobacco products both globally and in India.
Sh. K. Chandramouli, Secretary, Ministry of H&FW would be the Chief Guest for the occasion, Dr. R K Srivastava, DGHS would be Guest of Honor and Dr. Poonam Khetrapal Singh, Deputy Regional Director, WHO, SEARO, would be special invitee for the inaugural function.
The two day consultation with relevant stakeholders is expected to bring out recommendation aiming at strategies to regulate use of smokeless tobacco in India and south east Asia region.
Following is the State-wise consumption of smokeless tobacco: