Post on 08-Apr-2018
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TOBACCO-A GLOBAL EPIDEMIC
Dr. Hardik Thakker.
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TOBACCO--???
Tobacco is an agricultural product processed from
the leaves of plants in the genus Nicotiana.
There are more than 70 species of tobacco in the
plant genus Nicotiana The word nicotiana (as well as nicotine) is in
honor ofJean Nicot, French ambassador to
Portugal
It is well known that tobacco is, by nature, anAmerican plant, the use of which, when
discovered by the Europeans, was rapidly spread
across the globe.
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HISTORY OF TOBACCO IN INDIA
First brought to India by Portuguese Sailors
Used as a commodity for barter against Indian
Textiles
With the increase in demand and establishmentof British East India company, Tobacco wasstarted to be grown in India as a Cash Crop
Leaves were exported to America and wereimported back in the form of cigarettes
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CONTD
In the late nineteenth century, the beedi industry began to grow
in India.
The price differential from cigarettes favored the use ofbeedis by
the working classes and this domestic product soon supplantedcigarettes as the major form of tobacco consumption.
Tobacco chewing was practised for many centuries, commercial
production and marketing have been markedly upscaled recently,
with the introduction of the gutka
Consumption of gutka has overtaken that of smoking forms of
tobacco
New and broader front in the battle between commercial tobacco
and public health in India.
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TOBACCO IS CONSUMED AS
Smokeless Tobacco quid with tobacco Pan Masala Tobacco areca nut and
slaked lime preparation
Mainpuri tobacco Mawa Tobacco and slaked lime
(khaini) Chewing tobacco Suns
Mishri Gul Bajjar Gudhaku Creamy snuff Tobacco Water
Smoked Tobacco Beedis Cigarettes Cigars
Cheroots Chuttas Reverse chutta
smoking Dhumti Reverse dhumti
smoking Pipe Hooklis Chillum Hookah
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Man !!!! I Could Just Burn A Human
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IMMEDIATE AND RAPID EFFECTS ON THE
BRAIN - PART OF THE ADDICTIVE POWER OF NICOTINE COMES FROM ITS DIRECT EFFECT ON THE
BRAIN. IN ADDITION TO THE WELL-UNDERSTOOD CHEMICAL DEPENDENCY, CIGARETTE SMOKERSALSO SHOW
EVIDENCE OF AHIGHER RATE OF BEHAVIORAL PROBLEMSAND SUFFER THE FOLLOWING IMMEDIATE
EFFECTS:
Increases stress
Alters Brain Chemistry
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IMMEDIATE AND RAPID EFFECTS ON THE
RESPIRATORY SYSTEM
Bronchospasm. This term refers to airway irritability orthe abnormal tightening of the airways of the lungs.
Increases phlegm production. The lungs producemucus to trap chemical and toxic substances.
Persistent cough. Coughing is the bodys natural responseto clear irritants from the lungs. Without the help of cilia (above),
a smoker is faced with the difficult task of clearing increased
amounts of phlegm with cough alone.
Decreases physical performance
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IMMEDIATE AND RAPID EFFECTS ON THE
CARDIOVASCULAR SYSTEM
Adverse lipid profile- Nicotine increases the amount ofbad fats (LDL, triglycerides, cholesterol) circulating in the bloodvessels and decreases the amount of good fat (HDL) available.
Atherosclerosis.Atherosclerosis is a process in which fatand cholesterol form "plaques" and stick to the walls of an artery
Thrombosis. Thrombosis is a process that results in theformation of a clot inside a blood vessel.
Constricts blood vessels. It has been shown thatsmoking, even light smoking, causes the bodys blood vessels toconstrict (vasoconstriction). Decreased secretion of NO2 whichdilates the vessels
Increases heart rate. Heart rate is a measure of howfast your heart is pumping blood around your body. Young adultsmokers have a resting heart rate of two to three beats perminute faster than the resting heart rate of young adultnonsmokers.
Increases Blood pressure
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SMOKING WOMEN
Greater Risk ofHeart Attacks Elevated Blood
Pressure- Due to Interaction with Oral
contraceptives
Menstrual abnormalities
Increased Risk of Pelvic Inflammatory diseases
Early Menopause
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SMOKING WOMENPREGNANCY
Mothers who smoke during pregnancy are known
to have low birth-weight babies
Women smokers have around 72 percent of thefertility of nonsmokers.
Pregnancy to be difficult to achieve.
Infants and children exposed to Environmental
Tobacco Smoke (ETS) are at increased risk for
death and disease
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ADVERSE EFFECTS ON ORAL TISSUES
Periodontal disease
Staining of Teeth and Gums
Pigmentation
Halitosis
Precancerious Lesions
Oral cancer
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TOBACCO & PRECANCEROUS LESIONS
Oral Leukoplakia
Erythroplakia
Oral Submucous Fibrosis - OSMF
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ORAL LEUCOPLAKIA
It is characterized by white patch on the buccal
mucosa or any place in the mouth and is adjacent
to the place where the tobacco quid is kept. The
less likely place is floor of the mouth and tongue
although 93% of leucoplakia at this sites turn
malignant.
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ERYTHROPLAKIA
This is characterized by red velvety patch which
is not associated with any trauma or
inflammation. It may present with or without
leucoplakia. This lesion is easily missed out but
is considered to have great malignancy potential
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ORAL SUB MUCOUS FIBROSIS
This condition is characterized by limited
opening of mouth and burning sensation on
eating of spicy food. This is a progressive lesion
in which the opening of the mouth becomes
progressively limited, and later on even normal
eating becomes difficult.
It occurs almost exclusively in Indians and
Indian communities living abroad.
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Ifyoucant stop smoking, cancer will.
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COMMON SITES FOR ORAL CANCER
The most common sites of the oral cancer is the
tongue and the floor of the mouth. The other
common sites are buccal vestibule, buccal
mucosa, gingiva and rarely hard and soft palate.
Cancer of bucco-pharyngeal mucosa is common in
smokers
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DIAGNOSIS
Initially oral cancer may be asymptomatic but acheck up of a small ulcerative lesion from aprofessional is recommended. But patients normallypresents when pain and discomfort is predominant
and then the prognosis becomes poor. Diagnosis is established by many ways like
applying dyes like toluidine blue which may givefalse positive results in inflammatory lesion butnever false negative, using X rays and scans to see
the extension of the lesion and the bonyinvolvement and the most confirmatory test isbiopsy of the lesion and its histo-pathologicalexamination
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SQUAMOUS CELL CARCINOMAOF TONGUE
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CARCINOMAOF FLOOR OF MOUTH &
TONGUETheimage cannotbedisplayed. Your computer may nothave enough memory toopen theimage,or theimagemay havebeen corrupted.Restartyour computer,and then open thefileagain. Ifthe red x stillappears, you may havetod eletetheimage and then insertit again.
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CARCINOMAOF CHEEK
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CARCINOMAOF GUMS
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CARCINOMAOF UPPER JAW
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WHEN YOU SMOKE, YOU ARE NOT COOL. IN THE END,HOWEVER, YOU ARE EXTINCT
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PREVALENCE OF TOBACCO USAGE IN
INDIA
According to the Global Youth Tobacco Survey
2006, a total of 36.9% children in India initiate
smoking before the age of 10.
4.2 % students currently smoke cigarettes withrate for boys significantly higher than girls.
11.9% students currently use other tobacco
products.
Cigarette smoking among youth is higher in
central, southern and north-eastern regions
(12%).
Exposure to second-hand smoke (SHS) in public
places is as high as 40%.
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DEATH TOLL IN INDIADUE TO TOBACCO
USE
India has the highest number of oral cancers inthe world and 90% of these are tobacco-related.Also, 40% of all cancers are tobacco-related.
By 2010, tobacco use will cause 10 lakh deathseach year in India.
More than 2,200 Indians die each day from a
tobacco-related disease.
Every day, 55,000 Indian youth start tobaccouse.
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FREQUENTLYASKED QUESTION
How do I prevent oral cancer ?
Why is that not all people consuming tobacco have oral cancer ?
Who is more susceptible to oral cancer ?
I have a precancerous lesion in my mouth, would I get cancer ?
How is the diagnosis established ?
I Occasionally chew tobacco/smoke, and keep tobacco only for very shorttime. Am I susceptible for cancer ?
My friend has been told that he has oral cancer, but he does not believe it.what to do?
My dentist has recommended the biopsy of the premalignant lesion. Whatshould I do?
I have oral cancer and I am taking ayurvedic medicine. Will that help?
My Friend had cancer after tooth extraction. Was the doctor negligent?
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If God had wanted us to smoke, hewould have given us a separate hole forit.
Thank You