SAY GOOD BY TO TOBACCO Sreeraj.V.T Jr.Health Inspector PHC Udayagiri What is Tobacco? Tobacco is a plant that has been known to release dangerous chemicals when burnt. Tobacco comes in various methods such as: – – – – Chewing Tobacco Smoking (cigarettes) Pipes Cigars ALL OF THESE METHODS ARE DEADLY!!!! If you smoke cigarettes, you are not only effecting yourself, but people around you as well, by second-hand smoke. The Methods Cigarette Cigarette is made from dried up tobacco chopped up and rolled in a piece of paper. When Cigarette is burnt, it releases dangerous chemical gases such as carbon monoxide, and hydrogen cyanide. Chewing Tobacco Cigars A dried up roll of tobacco that is much more dangerous than a Cigarette. A cigar has no filter like a cigarette, so the poisonous gases does for damage to your lungs, etc. Chewing Tobacco is also made from chopped up tobacco. It is placed between the gum and Pipe teeth. The tobacco is crushed by the teeth to Pipe is a tool for smoking. Tobacco is placed in the chamber and burnt. The release the nicotine. smoke then gets inhaled into the lung through the stem and mouthpiece. Cigarette Smoking is the principle cause of Premature Death WHAT IS AT STAKE? 1 tobacco related death every 6 seconds = 10 million annual deaths by 2030 1 Billion deaths in 21st Century Tobacco Is Now the World’s Leading Single Agent of Death Global Deaths per Year (millions) 6 5.4 5 4.0 4 3 2.1 2 1.9 1.6 1.2 1 0.9 0.6 0 Tobacco Lower Resp Infect AIDS Diarrheal Disease TB Traffic Injuries Malaria Measles Unless urgent action is taken, tobacco will kill 1 billion people this century World Health Organization Prevalence of Tobacco use in India Below 35% : 2 states Punjab and Goa Between 35 - 50% : 8 states Andhra Pradesh, Tamilnadu, Karnataka, Kerala, Maharashtra, Haryana, Himachal Pradesh and Delhi Between 50 – 65% : 8 states Gujarat, Rajasthan, Jammu&Kashmir, Uttarakhand, Uttar Pradesh, Jarkhand, Sikkim, Arunachal Pradesh Above 65% : 11states Madhya Pradesh, Bihar, Chattisgarh, Orissa, West Bengal, Assam, Meghalaya, Manipur, Tripura, Mizoram, Nagaland TOBACCO & MEN 61 57 50 13 11 7 Urban Rural Women Total Men • Any Tobacco Use – Prevelance: 57% • Currently smoke Cigarette or Bidi: 32.7% • Currently chews pan masala, ghutkas or other tobacco: 36.5% • About 7% of male aged 13-15 yrs smoke cigarettes in India CIGARETTE SMOKE CONTAINS 4000 POISONS More than 4,000 substances have been identified in cigarette smoke Nicotine increases systolic and diastolic blood pressure Cigarette smoking antigenic, cytotoxic, mutagenic, carcinogenic Normal lung and Smokers lung Cardiovascular Diseases Cancer Respiratory Diseases Pregnancy related complications Gastrointestinal disorders Depression CLINICAL AFFECTS TOBACCO AND CANCERS Lung Mouth (oral) Throat (Pharynx & Larynx) Food Pipe (Oesophagus) Urinary Bladder Other Sites OTHER DISEASES Chronic Bronchitis Emphysema Asthma Cataract Tuberculosis Diabetes Still Birth and Low Birth Weight > 25 Diseases CARDIOVASCULAR RISKS OF SMOKING 100% Increase in Risk Stroke; CHD; Impotence 300% Increase in Risk Death from undiagnosed CHD > 300 % Increase in Risk Peripheral Arterial Disease 400 % Increase in Risk Aortic Aneurysm CLOGGING OF CORONARY ARTERIES Emphysema Lung ACTIVE SMOKING PASSIVE SMOKING What is Second Hand Smoke Second-hand smoke: that is inhaled involuntarily or passively by someone who is not smoking. Second-hand smoke is also called involuntary smoking or passive smoking Second hand smoke causes serious Health Hazards – Lung cancer -risk up 24% – Heart diseases -risk up 25% – Asthma attacks – Sudden Infant Death Syndrome (cot death) – Childhood respiratory diseases – Chronic cough, phlegm, and wheezing – Chest discomfort – Lowered lung function PASSIVE SMOKING (ETS) Second Hand Smoke increase risk of – Cancer by 30% – Heart attack by 25% in spouse of the smoker Increased risk of asthma and lung disease in children TOBACCO & WOMEN Main cause of oral cancer is chewing of Tobacco ECONOMIC COSTS OF TOBACCO Health Care: Just for 3 diseases (Coronary Heart Disease; Cancer; Chronic Lung Disease) Health Care cost in 2002 – 2003 was Rs. 308.33 Billion (USD 7.2 Billion) Tobacco also has: Environmental costs & Social costs Pictorial Health Warnings (Globally) More Pictorial Health Warnings from Thailand Pictorial Health Warnings from Brazil Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) Section 4: Ban on Smoking in Public Places Secondhand smoke (passive smoking) of smoke causes many diseases like lung cancer, respiratory diseases, heart disease, breast cancer, asthma, bronchitis. In some cases, it can trigger severe, even life-threatening reactions in individuals. Children are the worst affected. It causes sudden infant death syndrome. People working, especially in the food service industry are affected. Ban on smoking in public places would prevent damage to the health of non smokers and smokers Section 5: Ban on Advertisements of Tobacco Products In India children and the youth have been greatly influenced by tobacco advertisements, especially those for cigarettes and gutka which definitely harms their health. Advertisements and placing of the product at a low height and next to candies at points of sale is a strategy they use to give undesirable exposure and access to children. A study found that children who had seen sports events being sponsored by a tobacco company were more likely to start smoking. This was during the period when a cigarette company sponsored cricket matches. Many tobacco industries are promoting tobacco products to target women. This provision would prevent women and children from being influenced by glamorized advertisements of tobacco products. Section 6: Prohibition of Sale of Tobacco Products to and by Minors . 18 വയസ്സില് താഴെ പ്രായമുള്ളവര്ക്ക് രുകയില ഉല്പന്നങ്ങള് വില്കുന്നത് ശിക്ഷാര്ക്ഹമാണ്. വിദ്യാലയങ്ങളുഴെ 400 മീറ്റര്ക് ദ്ൂര രരിധിയില് രുകയില ഉത്രന്നങ്ങള് വില്കുവാന് രാെിലല. Section 7: Specified Health Warning Labels on all Tobacco Products Images help smokers visualize the nature of tobacco-related diseases and convey health messages in a clearer way. Pictorial health warnings are intended to serve as visual cues to prompt smokers to take action to quit. They are designed to shock people into realizing that smoking kills and causes serious illness. Pictorial warnings also make the health warnings accessible to those who are illiterate. They are effective tool in conveying health risks to the tobacco users. It also has an impact on intention and ability to quit. In countries like Brazil, Canada and Thailand many pictorial warnings have helped in decreasing consumption of tobacco products Section 7(5): Every tobacco package to have nicotine and tar contents along with the maximum permissible limits Nicotine and tar are carcinogens Nicotine and tar contents along with permissible limits should mentioned on the packages Having them on the package would help people making an informed choice Increasing Tax and Price of Tobacco Products Price and tax measures are an effective and important means of reducing tobacco consumption by various segments of the population, in particular young persons. Implementing tax policies and price policies, on tobacco products would contribute to the health objectives aimed at reducing tobacco consumption. This measure acts as a demand reduction measure for tobacco products. Tobacco thrills , but it kills.