Tobacco smoking and surgical healing

[drmithila]

A ban on gutkha, the popular chewing tobacco held responsible for the high incidence of oral cancer in India, is spreading across the populous country. Numerous courts are now supporting the movement.
Tobacco has been chewed in India for centuries and in the past decade, gutkha has emerged as the chewing tobacco of choice.
Ready-packaged in small sachets, gutkha is a commercially produced mixture of crushed areca nut, tobacco, lime, paraffin and other “secret” ingredients. Some brands also contain lead, arsenic, chromium, nickel and cadmium.
Because of its sweet or chocolate-like flavor and dirt-cheap prices – as low as 2 euro cents per sachet – gutkha has become increasingly popular among children who chew and even eat it.
More chew than smoke
In fact, five million Indian children are already addicted to gutkha, with another 5,000 joining their ranks everyday, according to an Indian Health Ministry report. Many try it for the first time as early as age five.
Gutkha is cheap, as little as two euro cents
Overall, more tobacco is chewed than smoked in India. Last year, the Global Adult Tobacco Survey (GATS) reported that 26 percent of adult Indians were tobacco chewers while 14 percents were smokers. One-third of Indian men and one-fifth of women users were addicted to chewing tobacco, most of them to gutkha, according to survey.
To make its shelf-life longer, some producers add magnesium carbonate, which is used in fire extinguishers and is also a known carcinogen.
Among more than 3,000 chemical components found in the tobacco products, including gutkha, at least 28 were proved to be carcinogenic, according to oncologist Sharadwat Mukherjee.
A cause of cancer and other diseases
“Every year, more than 80,000 cases of oral cancer are reported in India and rising use of gutkha is the key reason behind the spurt of the disease,” Mukherjee told DW. “More than 90 percent of oral cancer cases are directly associated with the use of tobacco and India has the highest prevalence of oral cancer globally – even 12 to 13-year-old children are getting pre-cancerous growths in their mouth after two or three years of chewing it.”
Five million Indian children are already addicted to gutkha
Mukherjee added that gutkha was also triggering a host of other cardiovascular, gastrointestinal and even psychological diseases.
When the chewing tobacco was introduced to the market in the 1990s, its producers said it was a palate cleanser or mouth freshener. The product was also identified as a foodstuff.
In August 2011, India’s Food Safety and Standard Authority issued a regulation banning nicotine or tobacco in foodstuffs, including gutkha.
Several medical experts and non-government organizations have mounted a country-wide campaign lobbying for a blanket ban on the manufacture and sale of gutkha across the country.
Calls for nation-wide ban
In April 2011 Madhya Pradesh became the first Indian state to ban gutkha. With the states of Andhra Pradesh and Odisha joining the ban earlier this month, the manufacture and sale of the chewing tobacco has now been prohibited in 17 of India’s 28 states and three of the seven union territories (UTs), including New Delhi.
Anti-gutkha activist dentist Debjit Ray told DW that although the tobacco product was banned in Bihar, Jharkhand and Odisha, it was still being sold secretly in all three states. He said the product was smuggled from the adjacent West Bengal state, where it was still legal.
“A ban in only part of the country is of no help at all; all states and UTs where gutkha is not yet banned should cooperate and ban it immediately,” said Ray, who is based in Kolkata, the capital of West Bengal. “Gutkha chewers spit just everywhere and spread many infectious diseases. Gutkha stains make public places look awfully ugly.”
Gutkha is mix of tobacco and a handful of unhealthy substances
Anti-gutkha activists in West Bengal have long demanded a ban on the chewing tobacco but the state government has yet to act. Earlier this month, they took their demand to the High Court in Kolkata, which last week criticized the West Bengal government for not banning the product.
Money talks
The state, according to the court, is more eager in generating revenue from the sale of gutkha than in ending the health risks it causes thousands of people.
“We hope the court will order the government to immediately ban gutkha in the state at the hearing next month,” said Ray.
Although gutkha sachets display a warning that the product causes cancer, most people ignore the health risks, according to the dentist. “Unless gutkha is banned and actually made unavailable in the market across the whole country,” he said, “you cannot stop people from chewing it.”