Directors of 17 regional cancer treatment centres in India, including the Tata Memorial Centre (TMC), have recently written letters to Prime Minister Manmohan Singh to ban smokeless tobacco products like gutkha.
India has the highest number of oral cancer patients in the world with 75, 000 to 80,000 cases reported every year. Chewing tobacco and guthka is responsible for 90% of oral cancer cases in the country, doctors have said.
Easy availability of gutka - a mixture of areca nut (supari), slaked lime and certain food additives - in small and affordable pouches in every nook and corner of the country has become a serious health hazard. “We have learned many lessons through our failures as well as our successes on how to fight tobacco. The most recent one being the ban on plastic gutka pouches by the supreme court. We have learned that use of tobacco can be and should be regulated not only from public health perspective, but also from environment and other perspectives,” said Dr Rajan Badve, director, Tata Memorial Hospital.
He added, “If we ban tobacco once, there will be a 50% fall in the number of cancer cases immediately. Though we have also raised our voice against cigarette smoking, but gutkha should be banned first.”
The letter says, “The tobacco industry has been targeting youth and children by selling tobacco products outside schools and colleges, distributing free samples and getting film stars to endorse these killer products through attractive advertisements on TV, radio, newspapers, billboards and buses.”
According to the Global Adult Tobacco Survey (GATS 2010) released in Oct 2010, nearly one third of Indian population is addicted to smokeless tobacco. A large number of children and youth in India are addicted to smokeless tobacco. Depending upon the geographical areas, different names with different combinations of smokeless tobacco are marketed, such as Mawa, Khaini, Gudakhu, panni etc. All these preparations essentially have tobacco with our without supari and are well proven to be harmful for health.
The letter adds that, smokeless tobacco contains nicotine, which is highly addictive. There are 3095 chemical components in tobacco and among them, 28 are proven carcinogens or cancer causing. The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids. The nitrosamine level is directly related to the risk of cancer.
