World No Tobacco Day: India stands at 4th in world tobacco use rankings


NEW DELHI, May 31, 2018: Tobacco is one of the most common and preferred forms of addiction. Even though scientific evidences have revealed its harmful health effects, the use of tobacco in different forms has seen a dramatic increase, especially in the developing countries.

This potentially lethal substance is responsible for more than 1 in 10 fatalities globally, with India featuring among the top four users of tobacco. About 11.2 percent smokers worldwide are Indian.

Despite decades of research and strong initiatives for controlling diabetes carried out globally, the number of tobacco users in the world has not seen a declining trend.

Besides cancer, the use of tobacco in any form is also a leading cause of Type-2 diabetes, the most common type of the disease as seen in adults. Research shows that smokers are 30 percent to 40 percent more likely to develop diabetes as compared to non-smokers. This risk doubled with the number of packs of cigarettes smoked per day.

"Naturally occurring tobacco does not have much sugar, the processed forms have added sugars in high amounts. Hence, tobacco raises blood sugar levels and makes it more difficult to manage diabetes. This was not the only problem. While nicotine may seem harmless, it plays havoc on your body by changing the natural cell processes, thus affecting insulin response leading to a condition called insulin resistance. People with insulin resistance need larger and more frequent doses of insulin to control the blood sugar levels in their body," said Sujata Sharma, Diabetes Educator, BeatO.

"Thus, smokers with diabetes are at a higher risk of developing serious complications such as heart disease, neuropathy or nerve damage in extremities and poor blood circulation to limbs and genitalia leading to gangrene, infections and possible disability and infertility. Retinopathy leading to blindness is another common complication associated with diabetic tobacco users," added Sharma.

A Global Adult Tobacco Survey (GATS-2) report shows that India is the second largest consumer of tobacco products with 28.6 percent of the population addicted to it in any form. Of this, 10.7 percent smoke, and 21.4 percent use SLT. Of the 346?million global SLT consumers, India alone has 152.4?million consumers with a substantial increase across all age groups.

"Many smokers tend to use Smokeless Tobacco when quitting cigarette addiction. Vaping, as the use of e-cigarettes is called, is also considered as an alternative and at only 10 percent of nicotine compared to a cigarette, it may seem relatively less harmful. But this is not so. Smokeless tobacco poses just as many health risks," said Dr Ramananda Srikantiah Nadig, Head of the Clinical Advisory Board, healthi.

Snuff and chewing tobacco also contain nicotine, which is responsible for tobacco addiction. Though it is absorbed at a slower pace than that from cigarettes, the absorbed amount is three to four times and remains in the bloodstream longer.

"Due to the presence of nicotine and other chemicals, prolonged use of SLT causes serious health issues such as cancer and heart disease. It also increases the risk of oral and oropharyngeal cancer. Sometimes, there may be white patches on the gums, tongue, or lining of the mouth called leukoplakia. Though this is noncancerous, it could evolve into a fully blown cancer of the mouth.

"Lung, stomach, bladder, pancreatic and oesophageal cancer are some of the other cancers associated with smokeless tobacco addiction," added Dr Nadig.

Another form of tobacco, called smokeless tobacco and sheesha, release high levels of carbon monoxide. By reducing the amount of oxygen circulating in the blood, these raise a person's heart rate and blood pressure putting undue stress on the cardiovascular system.

"Apart from this, frequent tobacco users also stand the risk of cardiac arrests, elevated blood pressure levels, strokes, hemorrhages, blood clots, and other heart-related ailments. It is imperative for people who are at risk or those with a history of cardiac ailments to discontinue using snuff or other smokeless tobacco products after an attack, failing which it can become life threatening," said Dr Rajiv Agarwal, Cardiologist, Lybrate.

Quitting tobacco/smoking can be a great challenge and often requires professional help and rehabilitation. Once on track, your body will definitely experience better overall health. It is possible to overcome tobacco addiction through support systems, programmes, and prescription medications.

Products such as the following can help wean the addict from SLT.
• Nicotine gum
• Nicotine patches
• Lozenges

Prescription medicines such as bupropion SR and varenicline tartrate can be used under physician's guidance to quit nicotine addiction.


Image Courtesy: The Indian Express