Tobacco and health
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![Page 1: Tobacco and health](https://reader035.fdocuments.in/reader035/viewer/2022070521/58ef1f1d1a28ab9a208b45df/html5/thumbnails/1.jpg)
TOBACCO: Health hazards
Dr. Srabana Misra Bhagabaty: In-Charge, Department of preventive oncology, Dr. B. Borooah Cancer Institute
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Dr. Srabana M Bhagabaty
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Dr. Srabana M Bhagabaty
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• Gutka, a combination of arecanut, slaked lime, paraffin and katechu along with tobacco, is virtually poison. Promoted as a mouth freshener, this mixture is a combination of 4,000 chemicals of which at least 48 are carcinogenic compounds.
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Around the world, nearly 5.4 million people every year die from tobacco related diseases.
If current trends continue tobacco will account for 13% of all deaths by 2020
Reference :Review Article Tobacco Control in India – Where are we now? Sonali Jhanjee National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi-110029 unit Dr. Srabana M
Bhagabaty
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Global Deaths
4.9
10
0
1
2
3
4
5
6
7
8
2000 2030
mill
ions
of d
eath
s
Developed CountriesDeveloping Countries
Dr. Srabana M Bhagabaty
2.8 2.1 3
7
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Tobacco abuse
AIDS +Alcohol abuse
+Other drug use
+Homicide +Suicide +Motor vehicle accidents +Fires combined
(CDC) Dr. Srabana M Bhagabaty
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The slow poisoning of IndiaTobacco kills:•800,000 Indians in a year•2200 in a day •90 people per hour
India is the second largest consumer and third largest producer of tobacco
Dr. Srabana M Bhagabaty
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PHYSICAL ill effects of tobacco
: CANCER :
40% of all cancers,50% cancers in males 25% cancers in
Females are tobacco related. 90% of the oral cancers are tobacco related
India reports the highest number of oral cancer in
the world
Dr. Srabana M Bhagabaty
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TOBACCO RELATED CANCERS ACCORDING TO who guidelines2004 are
Cancers of Lip, Tongue,Mouth,Pharynx,Oesophagus,Larynx,Lung,Urinary bladder, Stomach, Colo-rectal, pancreas, Paranasal sinuses, kidney, Acute myeloblastic leukaemia and Cervical cancer
Dr. Srabana M Bhagabaty
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Male : 1,57,461 newly detected TRCs ( AAR: 24.3)
Females : 56,767 newly detected TRCs (AAR: 9.3)
Globocon 2012 estimates for IndiaTobacco Related Cancers(TRCs)
Dr. Srabana M Bhagabaty
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NORTH EAST PBCR AAR REPORTS 2009-11PBCRS MALE FEMALEMEGHALAYA 103 36
KAMRUP URBAN
92.3 45.3MIZORAM 79 45
CACHAR 60.2 23.9
DIBRUGARH 54.6 20.5
TRIPURA 45.4 12
NAGALAND 44.2 11.65
MANIPUR 29.1 17.4
SIKKIM 27.6 21.8
Dr. Srabana M Bhagabaty
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WHAT OUR GUWAHATY HOSPITAL BASED CANCER REGISTRY AT BBCI SAYS
Dr. Srabana M Bhagabaty
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Tobacco Related Cancer (2013-14)
TRC67%
Others33%
MaleTRC46%
Others54%
Female
Dr. Srabana M Bhagabaty
Male :Female=1:1.45
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0
500
1000
1500
2000
2500
3000
3500
4000
2010:25402011:2637
2012: 2916
2013: 3374 2014: 3517
Dr. Srabana M Bhagabaty
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LEUKOPLAKIA ERYTHROPLAKIASub mucosal fibrosis
Precancerous lesions often encountered during screening at BBCI OPD
Dr. Srabana M Bhagabaty
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OTHER HEALTH HAZARDS
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• Cardiovascular diseases• Lung diseases• Peripheral vascular diseases• Effects on reproductive health
Dr. Srabana M Bhagabaty
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DAMAGING EFFECT ON REPRODUCTIVE HEALTH
INCREASED RISK OF MISCARRIAGE
PRE TERM DELIVERY
STILLBIRTH
INFANT DEATH
LOW BIRTH WEIGHT BABY
TOBACCO & WOMEN
Dr. Srabana M Bhagabaty
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MAKING THE NEXT GENERATION UNWELL!
Dr. Srabana M Bhagabaty
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Mental issues related
Nicotine is a potent parasympathomimetic alkaloid
Dr. Srabana M Bhagabaty
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NICOTINE ADDICTION• A psychoactive drug affecting mood and
performance • Nicotine is:- - 1000 times more potent than alcohol - 10 – 100 times more potent than barbiturates - 5 – 10 times more potent than cocaine or
morphine•Within 10 seconds reaches brain.
Dr. Srabana M Bhagabaty
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Stimulates release of two chemicals
Nicotine reaches brain
Dopamine ‘Good’ feeling
Nicotine is highly addictive
with its
The Vicious Cycle of ADDICTION
A tobacco user
takes tobacco NoradrenalineAlertness & energy
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Social issues
The total social costs of tobacco products exceed the direct outlay on them, owing to morbidity, mortality and negative externalities associated with the consumption of tobacco products.
Tobacco cultivation has sustained despite social approval and domestic demand (beedi tobacco) and the international market
Culturally accepted, named as habit not an abuse
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Economic impact : Where we are
India earns Rs 18,000 crores revenue per year from tobacco
India spent Rs 16,800 crore in 2011 to treat tobacco-related diseases
overall economic burden ( 16%direct treatment cost and 84% indirect cost) due to tobacco was Rs 1,04,500 crore. This was 1.6 per cent of the country's gross domestic product. It was 12 per cent more than the combined states' and Central government's expenditure on health.
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CHANGING TRENDS IN DEVELOPED COUNTRIES
Realization of health hazards of tobacco by theGovernment
Planning
Massive public awareness efforts and stringent policy implementation
resulting in
Persistent decline in the prevalence of tobacco in these countries
Dr. Srabana M Bhagabaty
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WHY SO….
UNFORTUNATELY…….
…. In developing countries like India prevalence of tobacco in various forms is increasing
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Because ofMisleading advertising by tobacco companiesPoor awareness among general public Gaps in effective implementation of tobacco
control programs and lawsGaps in inte-rsecroral co-ordinationAbsence of sufficient no of tobacco de-addiction
centers for those who wish to quit their habit
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Indicates the need for a more comprehensive approach to tobacco control within the country in terms of taxation trade economic policy and enforcement policy
Inter-sectorial co-ordination is mandatory
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In a survey conducted by the Preventive Oncology Department, BBCI to perceive the effect of Gutkha ban randomly selecting 400 pan shops of
the metro in later part of this year, it was observed that 10% of the tobacco vendors were minors and were using pan masala with added
tobacco pouch into it which we namedINDIRECT SALE OF GUTKHA and AVAILABILITY
IN 96% OF PAN SHOPS WE OBSERVED INDIRECT SALE OF GUTKHA
Minors selling Gutkha in the city (Parents/Guardians counseled)
Birubari Noonmati Silpukhuri Hatigaon
Dr. Srabana M Bhagabaty
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Dr. Srabana M Bhagabaty