A rally spreads awareness against tobacco use on Thursday. (Express Photo by Arul Horizon)
For World No Tobacco Day 2018, WHO has joined hands with the World Heart Federation to highlight the link between tobacco and cardiovascular diseases (CVDs) — the world’s leading cause of death, responsible for 44 per cent of all NCD (non-communicable diseases) deaths, or 17.9 million deaths annually. An official statement issued on Thursday said that according to a new WHO report tobacco use had declined since 2000, but the reduction was insufficient to meet globally agreed targets aimed at protecting people from death, cardiovascular diseases and other NCDs.
Tobacco use and second-hand smoke exposure are major causes of cardiovascular diseases, including heart attacks and stroke, contributing to approximately 3 million deaths per year. But evidence reveals a serious lack of knowledge of the multiple health risks associated with tobacco. Tobacco kills over seven million people each year, despite the steady reduction in its use globally, as shown in WHO’s new ‘Global Report on Trends in Prevalence of Tobacco Smoking 2000-2025. The report shows that worldwide, 27 per cent smoked tobacco in 2000 compared to 20 per cent in 2016.
While many people are aware tobacco use increases the risk of cancer, there are alarming gaps in knowledge of the cardiovascular risks of tobacco use. In many countries, this low awareness is substantial; for example, in China, over 60 per cent of the population is unaware smoking can cause heart attacks, according to the Global Adult Tobacco Survey (GATS). In India and Indonesia, more than half of adults do not know smoking can cause stroke. Other main findings from the new report include — there are 1.1 billion adult smokers in the world today, and at least 367 million smokeless tobacco users. The number of smokers in the world has barely changed this century: it was also 1.1 billion in 2000. This is due to population growth, even as prevalence rates decline. For males aged 15 and over, 43 per cent smoked tobacco in 2000 compared to 34 per cent in 2015. For women, 11 per cent smoked in 2000, compared to 6 per cent in 2015.
Smokeless tobacco: around 6.5 per cent of the global population aged 15 and over use smokeless tobacco (8.4 per cent males and 4.6 per cent females). Over half of all WHO member states have reduced demand for tobacco, and almost one in eight are likely to meet the 30 per cent reduction target by 2025. But countries must do more to monitor tobacco use in all its forms – not only tobacco smoking. Currently, one in four countries have insufficient data to monitor their tobacco epidemic.
Worldwide, about 7 per cent, or just over 24 million children aged 13–15, smoke cigarettes (17 million boys and 7 million girls). About 4 per cent of children aged 13–15 years (13 million) use smokeless tobacco products. Over 80 per cent of tobacco smokers live in low- and middle-income countries (LMICS). Prevalence of smoking is decreasing more slowly in LMICs than in high-income countries, and the number of smokers is on the increase in low-income countries. Dr Pankaj Chaturvedi, Professor, Surgical Oncology, from Tata Memorial Hospital, said, “Tobacco is the singlemost known and preventable cause of cardiovascular death and disability in the world. Chemicals like nicotine are constrictive in nature leading to coronary problems. It is commonly known that smoking increases the risk of heart disease but the fact is that smokeless forms of tobacco are equally harmful.”
As per GATS-2 2016-17, in India consumption of smokeless tobacco is far more than smoked tobacco. The data shows that 42.4 per cent of men, 14.2 per cent of women and 28.6 per cent of all adults currently either smoke and or use smokeless tobacco. As per data, 19 per cent of men, 2 per cent of women and 10.7 per cent of all adults currently smoke tobacco, while 29.6 per cent of men, 12.8 per cent of women and 21.4 per cent of all adults currently use smokeless tobacco. Smokeless tobacco users at 19.9 crore are far more than 10 crore smokers, whether cigarettes or bidis.
In Maharashtra, as per GATS-2, 35.5 per cent of men, 17 per cent of women and 26.6 per cent of all adults currently either smoke and or use smokeless tobacco. As per data, 6 per cent of men, 1.4 per cent of women and 3.8 per cent of all adults currently smoke tobacco, while 31.7 per cent of men, 16.6 per cent of women and 24.4 per cent of all adults currently use smokeless tobacco.
Sanjay Seth, trustee, Sambandh Health Foundation, said that tobacco use was estimated to cause nearly 10 per cent of all cardiovascular diseases. Given the large burden of such diseases in India, the impact is huge. He added that while governments are budgeting large outlays for setting up healthcare facilities there should be greater focus on prevention strategies, chief among them being reduction of tobacco usage.