India is facing a triple challenge: Fighting the Covid-19 pandemic, while keeping sight of the tobacco menace and the cancer burden.
The link between tobacco use and severity of Covid-19 must be highlighted in order to galvanise public health measures for tobacco control and bring them under a broader Covid-19 prevention strategy.
Indians use various smokeless forms of tobacco, leading to one of the highest rates of oral cancer in the world — an annual incidence of 10 per 100,000. All tobacco products contain carcinogens and toxins as well as the addictive nicotine. All these substances damage the DNA, which can mutate into cancerous tumours.
Smokeless tobacco products contain more than 28 carcinogens. Tobacco use among adolescents in India is a worrying trend, at nearly 11 per cent in 2016 (Global Adult Tobacco Survey). Data also shows that those between 15 and 24 years started smoking at an early age. This can lead to lifelong tobacco addiction and increase the risk of lung cancer, among other diseases.
As a cancer surgeon, I see several such cancer cases every year that cost people their lives and livelihoods. For the tobacco industry, India’s youth has become a lucrative market. An estimated 5-25 per cent of Indian adolescents currently use or have used tobacco.
Tobacco and supari — a common ingredient in gutka, pan masala, khaini, and mawaas — are a deadly combination. The addictive and cancer-causing substances are falsely marketed as mouth fresheners. The sale of loose cigarettes also makes them easily available to young people.
It is tragic that, as a society, we have let our children become targets and are only now beginning to address the issue. Age-specific interventions to control the tobacco epidemic among adolescents are essential.
We must not overlook the fight against the tobacco epidemic and the associated disease burden amidst our war against Covid-19. Tobacco-related diseases are entirely preventable. As the pandemic has highlighted the need to take preventive health measures, we have a unique opportunity to stem the tobacco menace.
The writer is Professor, head and neck surgeon, and deputy director, Centre for Cancer Epidemiology, Tata Memorial Centre. Views are personal