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.
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