World No Tobacco Day is celebrated on 31st May every year. It was first celebrated in 1987 after a proposal from the World health assembly. It is celebrated to make aware people of the ill health effects of tobacco.

To read in Hindi click here

The Theme of World No Tobacco Day 2023

“We need food, not tobacco” is the theme for World No Tobacco Day 2023. Under this theme main emphasis is given to the tobacco farmers to shift to alternate nutritious and sustainable crops rather than growing tobacco.

Why the Theme “We need food, not tobacco”

it is time to shift to alternate nutritious food crops from growing tobacco due to various reasons listed below¹⁰:

• Around 3.5 million hectares of land are converted to tobacco growing every year around the world.
• It depletes the soil fertility for other crops on the same land.
• Tobacco growing requires heavy pesticides and fertilizers.
• Tobacco farmlands are more prone to desertification and this causes the deforestation for new land to cultivate tobacco on it.
• Tobacco farming is not sustainable and degrades our ecosystem and environment. It also poses the risk of food insecurity by:
  • degrading soil.
  • limiting land for crop production.
  • requiring a lot of labour and it takes around 9 months to mature, which makes farmers unable to grow food crops.

Tobacco Production in India

• In India, it is grown in an area of 0.45 Million hectares which accounts for 10% of the total cultivation area in the world³.
• 750 Million kg of tobacco leaf is produced every year in India which accounts for 9% of global production³.

Top 5 Countries in Growing Tobacco

Tobacco is cultivated in over 124 countries in the world. According to the FAO report of 2021¹, the top countries with the maximum area under tobacco cultivation are:

India along with China and Brazil accounts for around 55% of the global production of tobacco².

What is Tobacco?

Tobacco is a plant grown for its leaves. leave are cured (dried and fermented ) before being taken into use. Tobacco is used in many forms by users. The most common is the smoking of tobacco, others are: chewing and sniffing. Smoked tobacco products are cigarettes, bidi, cigars etc. Some smoke tobacco in pipes or Hukkas.

Why Tobacco is Consumed?

Tobacco is mainly consumed by people for various reasons like pleasure, stress relief and in some social conditions but later it becomes an addiction they become dependent and they keep on consuming it.

Chemicals Found in Tobacco

The most common form of consuming tobacco is smoking. A cigarette contains a mix of around 7000 Chemicals⁴ including around 70 chemicals that can cause Cancer. Others can cause severe diseases including Cardiovascular diseases, chronic obstructive pulmonary diseases (diseases of the lungs). 

How so many chemicals get into a cigarette:

1. Some chemicals are found in the tobacco plant leaves naturally like- cadmium, lead and nitrates.
   • Cadmium is a carcinogenic and toxic metal
   • Lead is also a toxic metal

They are absorbed by the tobacco plant from soil or fertilizers

2. Some are added during the processing and manufacturing process. Tobacco-specific nitrosamines (TSNAs) are formed on curing the tobacco leaves.
   • Ammonia is added to the tobacco for better absorption of nicotine.

3.  While some chemicals are produced by burning when a cigarette is lit (same for bidi and cigar) like sugars and flavours are added to reduce the harshness of smoke, they produce cancer-producing chemicals on burning.

Nicotine:

Nicotine is a chemical found naturally in the leaves of tobacco and therefore found in tobacco products. 

• It is not Nicotine that makes tobacco deadly or that harmful. Rather, Nicotine acts as a stimulant and releases a variety of neurotransmitters in the brain which can protect a person or enhance performance in various diseases like – Alzheimer’s disease, Parkinson’s disease, ulcerative colitis, tourettes disease and sleep apnoea⁵.
• But Nicotine causes addiction. Due to the addiction caused by nicotine, people keep on taking tobacco products and thus several chemicals along with it, which can make them sick, very sick indeed.

Hookah Smoking

Contain some of the same chemicals found in a cigarette. Hookah users are at risk of some of the same health effects as smokers. Due to hookah usually being consumed over long sessions, a person consumes more toxic chemicals than cigarette smoke. One hour of hookah smoke can produce an effect similar to several packs of cigarettes consumed together⁴.

Smokeless Tobacco

Smokeless tobacco in India is used as chewing tobacco, with or without lime. Gutkha, Khaini, Zarda etc. are all examples of such use. Snuff is an example of the nasally used form.

Although non-combustible, even it may contain up to 4000 chemicals and up to 30 cancer-causing chemicals. Patients are found to be diagnosed with oral cancer, oesophageal cancer and pancreatic cancer because of smokeless tobacco.

E-cigarettes

E-cigarettes are devices with a battery, a heating element and a tank to hold liquid containing nicotine. these devices produce aerosols from the liquid it contains and this aerosol is inhaled by the user into the lungs for absorption. E-cigarettes come in various shapes but are usually made to look like cigarettes.

Combustible Cigarettes Vs E-Cigarettes:

Although e-cigarettes are considered to be less harmful than combustible cigarettes,

• some chemicals found in combustible cigarettes like- formaldehyde, acrolein and acetaldehyde are also found in e-cigarette aerosols. These chemicals can cause irreversible lung damage above certain concentrations.
• E-cigarettes also contain flavouring like diacetyl and acetoin. Although these flavouring agents are found safe for ingestion, not evaluated for inhalation.
• It also contains nicotine. therefore, is addictive

E-cigarette is relatively new and hence more research is needed for E-cigarettes.

• In the interest of protecting the youth, India banned e-cigarettes in September 2019. [The prohibition of electronic cigarettes (production, manufacture, import, export, transport, sale, distribution, storage and advertisement) Act 2019]

Secondhand Smoking (SHS)

When a person breathes in the smoke of a burning cigarette or smoke breathed out by a smoker, it is called secondhand smoking.

• There is no safe level of exposure.
• Even brief exposure can cause serious health problems⁶
• SHS in adults those who don’t smoke can cause coronary heart disease, stroke, and lung cancer, as well as adverse reproductive health effects in women, including low birth weight⁶
• In infants and children, SHS can cause sudden infant death syndrome(SID), asthma, respiratory infections and ear infections.
• Secondhand smoke accounts for 9 Lakh deaths and 240 lakh disability-adjusted life years (DALYs) annually. Nearly 30% of adults in India are exposed to SHS⁷.

Impact of Tobacco on Health

• As we discussed earlier smoking tobacco can cause
  • Cancer
  • Heart disease
  • Stroke
  • Lung diseases
  • Diabetes
  • COPD

• it increases the risk of
  • Tuberculosis
  • Eye disease and
  • Problems with the immune system and related diseases (like Rheumatoid arthritis)

Tobacco Consumption in India

• India is the third-largest tobacco-producing nation and the second-largest consumer of tobacco worldwide.
• According to the Global Adult Tobacco Survey 2016-17, there were around 28.6% of people above 15 years of age use tobacco.
• Mortality due to tobacco in India is estimated at upwards of 1.3 million. Out of these, one million are attributed to tobacco smoking and the rest to smokeless tobacco use.

Tobacco Use in School Children

According to the Global Youth Tobacco Survey (GYTS-4) 2019, published on 10 August 2021 by the Press Information Bureau, Govt of India:

• 14.6% of children in India aged between 13-16 use tobacco in any form
• The current use of tobacco among students across the States/ UTs ranged from the highest in Arunachal Pradesh and Mizoram (58% each) to the Lowest in Himachal Pradesh (1.1%) and Karnataka (1.2%)⁹.
• Use of any form of Tobacco was higher among boys than girls
• More than 29% of students were exposed to second-hand smoke
• 85% of school heads were aware of COTPA, 2003 and 83% of schools were aware of the policy to display a ‘tobacco-free school’ board

Govt of India Initiatives to Curb Smoking and Tobacco Consumption

• India enacted ‘The Cigarettes and Other Tobacco Products Act 2003 (COTPA 2003)’ This Act
  • prohibit smoking in public places (fine penalties for violaters Rs 200, Rs1000 in Jharkhand state)
  • prohibit the advertisement of cigarettes and other tobacco products
  • prohibit the sale of cigarettes or other tobacco products to anyone below the age of 18 years and in a particular area (like within a radius of 100 yards of educational institutes)
  • Mandatory depiction of specified pictorial health warnings on all tobacco product packs
• Govt of India launched the National tobacco control program in 2007-2008, currently running in all 28 states and 8 union territories.
  • training of health and social workers, NGOs, school teachers, and enforcement officers
  • Information, education, and communication (IEC) activities
  • School programmes
  • Monitoring of tobacco control laws
  • Coordination with Panchayati Raj Institutions for village-level activities
  • Setting up and strengthening cessation facilities including the provision of pharmacological treatment facilities at the district level

• Food Safety and Standards (Prohibition and Restrictions on Sales) Regulations, 2011 dated 1st August 2011, lays down that tobacco and nicotine shall not be used as ingredients in any food products and as such Gutkha is banned
• Juvenile Justice (Care and Protection of Children) Act, 2015, whoever gives, or causes to be given, to any child any intoxicating liquor or any narcotic drug or tobacco products or psychotropic substance, except on the order of a duly qualified medical practitioner, shall be punishable with rigorous imprisonment for a term which may extend to seven years and shall also be liable to a fine which may extend up to one lakh rupees
• The Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Act, 2019: bans the e-cigarette in India

Quit smoking

• Quitting smoking is not easy. It requires strong willpower and self-motivation as Quitting smoking may require multiple attempts.  proper counselling and social support also play a vital role.  
• Nicotine replacement therapies can double the chances of quitting and are available over the counter but it is best to talk to your doctor as there may be the side-effects of NRTs as well.

• The Government of India has established a National level tobacco cessation Quitline in Vallabhbhai Patel Chest Institute (VPCI), New Delhi with a toll-free number (1800-112-356)

• One may approach Tobacco cessation centres (TCC). Every state in India has TCCs, in Himachal Pradesh there are 14 TCCs consisting of All Districts Hospitals & and 2 Medical College (in addition to De-addiction facilities)
• Research has clearly shown that definite health benefits, apart from socio-economic benefits, are associated with quitting tobacco use

Download the Poster on World No Tobacco Day 2023

to read this post in Hindi click here