THE TOBACCO EPIDEMIC 

World No Tobacco Day 2023. 

Written by: Sadiya Khan, Intern, Bangalore.

The consumption of tobacco is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year, including around 1.2 million deaths from exposure to second-hand smoke.

Tobacco is harmful in all forms – cigarette smoking, cigars, waterpipe tobacco, bidi, pipe tobacco, kreteks. Nearly 267 million adults (15 years and above) in India (29% of all adults) are users of tobacco, according to the Global Adult Tobacco Survey India, 2016-17. 

There is sufficient evidence that tobacco smoking causes cancer of the lung, oral cavity, naso-, oro- and hypo-pharynx, nasal cavity and paranasal sinuses, larynx, esophagus, stomach, pancreas, liver, kidney (body and pelvis), ureter, urinary bladder, uterine cervix and bone marrow (myeloid leukemia). 

Active smoking can also lead to adverse reproductive outcomes, chronic obstructive pulmonary disease and cardiovascular disease. Workers engaged in tobacco cultivation are at increased risk of an occupational illness known as green tobacco sickness (GTS), an acute form of nicotine toxicity resulting from absorption of nicotine through the skin. Symptoms include nausea, vomiting, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhea, weakness, breathlessness and more.  

Tobacco growing, manufacturing and use poison our water, soil, beaches and city streets with chemicals, toxic waste, cigarette butts, including microplastics, and e-cigarette waste. This leads to soil degradation and food scarcity at a large scale. Across the globe around 3.5 million hectares of land are converted for tobacco growing each year. Growing tobacco also contributes to deforestation of 200 000 hectares a year.

World No tobacco day is celebrated on May 31^st every year to raise awareness and educate people about its ill effects and to encourage people to stop its consumption. This year’s theme “We need food, not tobacco”  aims to raise awareness among farmers to reduce tobacco cultivation and suggest alternative sustainable and nutritious crop production. 

The campaign will also aim to raise awareness about the ways the tobacco industry interferes with attempts to substitute tobacco growing with sustainable crops. Farmers are usually under contractual agreements with the tobacco industry and are under vicious cycle of debt. In most countries, the tobacco industry provides farmers seeds and other materials needed to grow tobacco and then later removes the costs from the earnings, which makes moving away from tobacco very difficult from a farmer’s perspective. 

The campaign also aims to mobilise governments and policy makers to support farmers and help them make the switch by helping them pay off their loans and creating alternative marketing opportunities for them.

The WHO has also introduced the MPOWER measures to  implement strategies and monitor tobacco control which include 

• Monitor tobacco use and prevention policies
• Protect people from tobacco use
• Offer help to quit tobacco use
• Warn about the dangers of tobacco
• Enforce bans on tobacco advertising, promotion and sponsorship
• Raise taxes on tobacco.

It is our responsibility as future doctors and citizens of the world to implement the above measures to the best of our capacity to help curb this epidemic before it causes further destruction. 

References- 

1. Tobacco [Internet]. Who.int. [cited 2023 May 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
2. The Hindu Bureau. Two-pronged strategy suggested for World No Tobacco Day 2023 [Internet]. Thehindu.com. 2023. Available from: https://www.thehindu.com/news/national/karnataka/two-pronged-strategy-suggested-for-world-no-tobacco-day-2023/article66862150.ece
3. World No Tobacco Day 2023: We need food, not tobacco [Internet]. Who.int. [cited 2023 May 25]. Available from: https://www.who.int/europe/news-room/events/item/2023/05/31/default-calendar/world-no-tobacco-day-2023–we-need-food–not-tobacco
4. Pictures- Image by <a href=https://www.freepik.com/free-vector/hand-drawn-world-no-tobacco-day-illustration_13234009.htm#query=world%20no%20tobacco%20day&position=4&from_view=keyword&track=ais>Freepik</a>