New Delhi : India has the dubious distinction of having largest amount of chewing tobacco consumption in the world. It is a cheap and easily available addiction and its growing consumption in the last two decades has contributed to alarming rise in oral cancer.
Every year nearly 10 lakh people in India are diagnosed with oral cancer and half of them die within a year of diagnosis. The main cause of the deaths and disabilities due to oral cancer is known in medical term as Head Neck Squamous Cell Carcinoma (HNSCC). As per GATS -2 (2017) survey, almost 96% of the youth of India agree on the fact that chewable tobacco is the major reason for serious diseases (cancer).
The World Head & Neck Cancer Day (WHNCD) is observed on July 27 this year. Government of India has taken landmark decisions such as Gutka ban, flavoured, packaged chewing tobacco. In fact, as per the Supreme Court’s order on 23rd September 2016 smokeless tobacco products were banned in India. Implementation in India remains a big challenge.
Dr. Harit Chaturvedi, cancer surgeon, Chairman Max Oncology and Voice of Tobacco Victims (VoTV) patron Said that according to GATS – 2, 19.9 crore people (age 15+) use chewing tobacco products. Due to the 85% pictorial pack warnings on chewing tobacco products, 46.7% people have thought about quitting these.
He further added that a large number of people across India fall prey to oral cancer owing to a combination of factors including late detection of the decease, inadequate treatment and unsuitable rehabilitation. People mainly in the age group of 60-70 years used to be prone to oral and throat cancer till as late as 30 years age. Now people as young as 30 to 40 years are being diagnosed for oral cancer.”
Blaming growing influence of western life style in the young generation, Dr Chaturvedi says even youth in the 20-25 years age group have become vulnerable to oral cancer due to smoking, which many of them mistakenly consider a style statement.
The Indian Council of Medical Research (ICMR) in a report in 2008 observed that in 90% of the head and neck cancer cases that were diagnosed consumption of alcohol, Gutka, tobacco and betel nut emerged as the root cause of the cancer which is preventable. The ICMR report also revealed that tobacco consumption was diagnosed as reason of cancer among 50 % male and 25% female victims. Nearly 90% of these victims (male and female) suffered due to oral cancer. The report pointed out that smokeless tobacco products such as chewing tobacco, Khaini, Gutka contain 3000 chemical compounds and 29 of them could be potential cause for oral cancer. India has the largest population of oral cancer patients in the world, making it the oral cancer capital of the world.
According to Dr. Harit, head and neck cancer cases are proving an additional burden on not only the national healthcare services but also on the affected communities, families and individuals.
Most of the head and neck cancer cases are treatable and preventable, if detected in early stage. But millions succumb to the disease due to late detection, inadequate treatment and rehabilitation, he adds.
Tata Memorial Hospital, Professor and Cancer Surgeon Dr. Pankaj Chaturvedi, who is heading campaign against head and neck cancer globally, stresses the need for multi-pronged and coordinated efforts by governments, voluntary organizations, health workers, educational institutes and industries to check cases of Neck Squamous Cell Carcinoma (HNSCC). It was with the aim to draw the world’s attention to the HNSCC cases that the World Head and Neck Cancer Day (WHNCD) is observed on July 27. Its observance was proposed by International Federation of Head and Neck Ontological Societies (IFHNOS). The Federation has support from several Government and non government organizations, 55 head and neck cancer institutions and 51 nations.
A comparative chart below, published in the Asia Pacific Journal of Cancer Prevention illustrates an alarming growth of cancer of all types in male and female between 2001 and 2016 in India.
Sambandh Health Foundation Trustee & Head of Tobacco Control, Sanjay Seth, says the sustained campaign by VoTV has resulted in ban on Gutka and other smokeless tobacco products in most parts of India. As Supreme Court banned
flavoured/manufactured tobacco products apart from Gutkha. Noted oncologists and cancer specialists have also associated themselves with this campaign against tobacco.
As an impact of the chewing tobacco products (Gutka and Pan Masala) ban, the Euromonitor International report shows tremendous decline in overall smokeless volume. It is in 2011 : 2% ; 2012: 26% ; 2013: 80% . It is predicted that the smokeless volume would have declined in 2016 to 30% and 2018 to 25% in consumption.