A pandemic-based approach to tobacco control

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As India fights the pandemic with its back to the wall, medical experts have signaled the need to strengthen the tobacco control movement across the country. Speaking to experts from across the country on Sunday at an event hosted by the Postgraduate Institute of Medical Education and Research in Chandigarh, health expert Dr Rana J Singh noted that with about 267 million tobacco users in India, the time had come to ‘help users quit and put in place bans that would hinder initiation into smoking, especially among young people’.

About 70 participants, including those from Odisha, Telangana, Meghalaya and Pondicherry, called for a complete ban on menthol tobacco products, in line with the e-cigarette ban declared in 2019.

Public health expert Dr Sonu Goel explained that menthol, in addition to adding flavor, desensitizes receptors that create irritating sensations when exposed to nicotine, making the experience toxic less harsh smoking and helps maintain the deadly habit in users. He said a menthol ban would prevent smoking initiation and go a long way in ensuring a tobacco-free India.

“A menthol ban is a powerful and crucial step towards preventing premature Indian deaths from tobacco-related illnesses,” he said. Experts also pledged to prevent the tobacco industry from interfering with the health of their respective states, by marketing tobacco products to vulnerable segments of society, including children.

The request coincides with the U.S. Food and Drug Administration’s decision to ban menthol cigarettes in that country in response to a citizen petition from nineteen public health organizations. An FDA committee report concluded that had menthol cigarettes been taken off the market in 2010, around 17,000 premature deaths would have been prevented over the next decade, and around 2.3 million people would not have started smoking.

Earlier this year, researchers at PGIMER’s Oral Health Sciences Center published a peer-reviewed study on the online availability of herbal cigarettes and bidis in India. One of the pioneering research studies on herbal smoking products has shown their growing popularity, especially among young people. “These products are marketed as health promotion products, which is of great concern,” said Professor Krishan Gauba, director of the center.

Researchers have found that cheap herbal cigarettes and bidis are widely available online and are often marketed as a ‘safer’ and ‘healthier’ alternative to cigarettes, in addition to various other claims. unverified. “The point is that although these products do not contain tobacco or nicotine, they do contain other potentially harmful substances and can serve as a crossover to the use of conventional tobacco products,” said Dr. Arpit Gupta, member. of the faculty of the institute. He called for urgent regulation on the sale and marketing of these products.

The team’s analysis of 73 retail websites found that almost two-thirds sold herbal cigarettes, 12% sold herbal bidis, and 26% sold herbal shisha or hookahs. . To the researchers’ surprise, most of these products were sold under the “health care” category.

PGIMER’s Professor Ashima Goyal said it was unfortunate that these products were being sold online as a “ safer ” alternative to smoking without any age restrictions or verification under the pretext that they are nicotine-free. The study points out that herbal cigarettes, bidis, and hookah still contain potentially harmful chemicals, and the exhaled carbon monoxide can affect people in the immediate vicinity.

The study points out that public health policy in India has so far neglected herbal products.

On hookah bars and their popularity with young people, Chandigarh Health Services Director Dr Amandeep Kang said it is well known that tobacco and nicotine cause blood vessels to constrict, affecting all organs from head to toe. “The health risks of smoking through a hookah include exposure to toxic chemicals that are not filtered by the water, and the risk of infectious diseases, including tuberculosis and the recent corona infection, because smoking hookah is a social activity, ”she said.

A one-hour hookah session can be as harmful as smoking 100 cigarettes, said Dr Pankaj Chaturvedi of the Tata Memorial Center in Mumbai. He said that according to the World Health Organization, even tobacco-free or flavored hookah can be harmful to health because the smoke is filled with carbon monoxide and other harmful carcinogens.

“Hookah bars are marketed as a ‘hangout’ for young people although they serve deadly products,” said Dr Rakesh Gupta, an oncologist representing the Rajasthan Cancer Foundation. “They also serve alcohol, food and have live music etc. Many types of flavors are added to appeal to young people. A survey carried out in 2013-2014 found that 79% of young people between the ages of 12 and 17 smoked hookah because of the flavors, ”he said.

Judge Iqbal Ansari of the Punjab State Human Rights Commission said that in February the commission emphasized the human rights dimension of tobacco control. Calling for the development of strict laws to eradicate smoking, he said it was necessary to understand the perception of law enforcement agencies on human rights violations perpetrated by the tobacco industry. tobacco and tobacco users. “We need two types of support – legal support and judicial support. Legal support comes in the light of legal support. If you do not have the provision of the law – to make smoking a crime – then justice cannot stop it, ”he stressed.

“The WHO reports that smoking and exposure to second-hand smoke kills more than seven million people each year. In seeking to combat the tobacco epidemic, the WHO Framework Convention on Tobacco Control is not only a tool to combat the adverse effects of tobacco on the right to health, but also to protect the right to health. very human life, ”said Dr. Sonu Goel in his address.

Behavioral scientist Dr Mira Aghi has insisted on the tobacco industry’s violation of women’s human rights, saying women are poorly informed about the health implications of smoking and often ignore the fact that smoking affects their reproductive system. [Research also shows smoking damages men’s reproductive health including damaged DNA, sperm quality and hormonal disorders.]

Dr Aghi said tobacco advertising and tobacco industry actions prevent women from enjoying the best possible health. Second-hand smoke also has a significant impact on the health of women, especially those of childbearing age.

“We need to explain to stakeholders the link between fundamental human rights violations caused by tobacco use and the right to tobacco control. States and citizens must be equipped with the knowledge, resources and capacity to claim their rights and resist the tobacco industry’s ‘corporate social responsibility’, ‘corporate social investment’ or outright corruption that can prevent the realization of these rights, ”said Dr Rana J Singh.

“Therefore, a human rights-based approach to tobacco control is perhaps an important strategy in current circumstances and in times to come.”



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