Budget must increase taxes levied on tobacco
Whether it be the Commonwealth Heads of Government Meeting, the creation of yet more districts, or Universal Secondary Education, there seems no end to the many and varied demands being made on the Ugandan government’s limited revenue base. It takes a brave person to be Minister of Finance.
So, we take this opportunity, on the World Health Organisation’s “World No Tobacco Day”, to remind Mr Ezra Suruma that he can reduce the growing gap between government expenditure and government revenue by increasing excise duty on cigarettes, which would at the same time reduce smoking-related deaths and illnesses, thereby increasing Ugandan life expectancy.
This tax increase would indeed be a marriage made in heaven between the Ministries of Finance and Health. So, we wonder why Mr Suruma has taken so long to implement such an obviously welcome measure.
We trust that his forthcoming budget will make amends by including a substantial increase in tobacco excise duty. And he will have a very strong argument to make his case to the tobacco companies if one can recall that in last year’s budget, taxes were increased on mineral water but not on cigarettes. The contradiction therein is blatantly apparent.
That the forthcoming budget should be tough on tobacco receives added support from two quarters. Firstly, Vice President Bukenya, in a recent visit to West Nile, said that tobacco growing should be abandoned in favour of other cash crops, as tobacco had made the people poorer.
Secondly the Ugandan Cabinet has supported the WHO’s Framework Convention on Tobacco Control (FCTC), and the country’s formal ratification will take place very shortly. The FCTC is the world’s first global public health treaty.
It aims to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco through comprehensive tobacco advertising bans, price and tax increases, big graphic health warning labels on tobacco products, measures to protect people from secondhand smoke and alternative crops for tobacco farmers.
Kenya, long ago, and Tanzania, recently, have ratified the FCTC, so it is a straightforward matter for tax policies to be harmonised within the East African Community and achieve a goal of the FCTC – regular and substantial increases in tobacco taxation.
So, on budget day we shall be expecting to hear good news from Mr Suruma; we expect you to increase excise duty on cigarettes.
Online at: http://www.monitor.co.ug/oped/oped05311.php
Wednesday, May 30, 2007
Cracking on smoking in schools, colleges
Cracking on smoking in schools, colleges
As part of its efforts to deter students consuming tobacco products, Karnataka will appoint 130 officials from various departments to take action against students smoking or consuming tobacco products.
Tobacco is said to have been introduced in Bijapur in the Adil Shahi era. Indian farmers who grew tobacco later, probably had no inkling of the hazards of their crop and luckily also did not use phosphatic fertilisers in modern times. However, it was discovered in a US based research that tobacco roots may absorb radioactivity from the soil.
There has been considerable fluctuation in the production of tobacco during the last two decades, even thought the area under the crop showed only slight fluctuation as per data of the Directorate of Economics and Statistics, Government of India. Endowed with various agro-climatic zones, India grows all types of tobacco (except oriental), which are broadly classified as flue cured Virginia (cigarette tobacco) and non-Virginia types. Gujarat, Andhra Pradesh and Karnataka between them account for 82.4 per cent of the area under tobacco crop. However, the production of tobacco in the country has been stagnant at around 6 lakh tonnes during the last two decades.
The need for development of alternate use for tobacco arises because of compulsion generated mainly out of health risks of using tobacco for introducing tobacco control laws. Tobacco is a major revenue-generating commodity in many countries.
As part of its efforts to deter students consuming tobacco products, Karnataka will appoint 130 officials from various departments in the state as implementing officers. These officers would be empowered to take action against students smoking or consuming tobacco products, said S Prakash, joint director (medical), Directorate of Health and Family Welfare.
In 2004, the year that Karnataka set up a State Anti-Tobacco Cell, a number of officers were identified from various departments like BMP, education, health, at district and taluk levels, along with principals of educational institutions to take action against students smoking or consuming tobacco products. The Central National Rural Health Mission has embarked in the anti-tobacco pilot project that has so far included five states. Karnataka is to be included too, with Bangalore Medical College as the nodal centre for the District Tobacco Control Programme, as well as District Hospital, Gulbarga, according to Dr Prakash. The funds for these two districts is said to be Rs 13.43 lakh.
Effective treatment for tobacco dependence could significantly improve overall public health within only a few years.
By Shonali Misra
Online at: http://www.deccanherald.com/Content/May312007/panorama200705314746.asp
As part of its efforts to deter students consuming tobacco products, Karnataka will appoint 130 officials from various departments to take action against students smoking or consuming tobacco products.
Tobacco is said to have been introduced in Bijapur in the Adil Shahi era. Indian farmers who grew tobacco later, probably had no inkling of the hazards of their crop and luckily also did not use phosphatic fertilisers in modern times. However, it was discovered in a US based research that tobacco roots may absorb radioactivity from the soil.
There has been considerable fluctuation in the production of tobacco during the last two decades, even thought the area under the crop showed only slight fluctuation as per data of the Directorate of Economics and Statistics, Government of India. Endowed with various agro-climatic zones, India grows all types of tobacco (except oriental), which are broadly classified as flue cured Virginia (cigarette tobacco) and non-Virginia types. Gujarat, Andhra Pradesh and Karnataka between them account for 82.4 per cent of the area under tobacco crop. However, the production of tobacco in the country has been stagnant at around 6 lakh tonnes during the last two decades.
The need for development of alternate use for tobacco arises because of compulsion generated mainly out of health risks of using tobacco for introducing tobacco control laws. Tobacco is a major revenue-generating commodity in many countries.
As part of its efforts to deter students consuming tobacco products, Karnataka will appoint 130 officials from various departments in the state as implementing officers. These officers would be empowered to take action against students smoking or consuming tobacco products, said S Prakash, joint director (medical), Directorate of Health and Family Welfare.
In 2004, the year that Karnataka set up a State Anti-Tobacco Cell, a number of officers were identified from various departments like BMP, education, health, at district and taluk levels, along with principals of educational institutions to take action against students smoking or consuming tobacco products. The Central National Rural Health Mission has embarked in the anti-tobacco pilot project that has so far included five states. Karnataka is to be included too, with Bangalore Medical College as the nodal centre for the District Tobacco Control Programme, as well as District Hospital, Gulbarga, according to Dr Prakash. The funds for these two districts is said to be Rs 13.43 lakh.
Effective treatment for tobacco dependence could significantly improve overall public health within only a few years.
By Shonali Misra
Online at: http://www.deccanherald.com/Content/May312007/panorama200705314746.asp
Becoming tobacco-free
Becoming tobacco-free
Make a list of the reasons why you want to quit smoking. Keep the list on hand so you can look at it when you have a nicotine craving.
As many as 2,200 Indians stop smoking every day — by dying. According to statistics, tobacco is the second major cause of death in the world. Tobacco is addictive. It contains nicotine, a chemical that is addictive making it very hard to quit but it isn’t impossible. The smoking forms of tobacco are beedis, cigarettes, cigars etc; the smokeless forms include chewing paan with zarda (tobacco), gutka, pan masala and snuff.
One cigarette and one beedi contain approximately 4,000 chemicals while one packet of Pan Paraag, gutka, Khaini, and Hans contain about 3,000 chemicals. Forty per cent of cancers detected in India are because of tobacco use. One cigarette and one beedi reduce seven minutes of your life while one packet of Pan Paraag, or Hans reduce four minutes of your life.
It causes sexual impotency in men, miscarriage and infertility in women, wrinkled skin, stained teeth, bad odour, mouth ulceration and difficulty in swallowing. Every organ in the body is affected from head to toe, especially the brain, lungs and heart. There could be heart attacks, chronic cough and lung disease, worsened condition of diabetes, blood pressure and lower stamina.
Babies born to mothers who smoke can be sicker, die suddenly, or have more infections of the middle ear, coughing and wheezing.
Cause problems to family, friends and co-workers from the smoke from the cigarettes — exposing them to the same dangers. This is called second hand smoking
By stopping, a person will no longer be a bad influence on younger children in his or her family and in the society. The self-confidence, and self-image of the person improves, when he or she quits. No more looks of disapproval or feelings of guilt.
Saving of money is another advantage, expenditure on buying cigarettes, lighters, ashtrays, matches and so on can be saved. Quitting smoking reduces bad breath, yellowing of teeth or fingers. Overall performance of the person in physical activities will be remarkably improved after quitting the habit of smoking.
Pick a stop date. Choose a date one to two weeks away so you can get ready to quit. If possible, choose a time when things in your life will change. Or just pick a time when you don’t expect any extra stress at school, work or home. For example, quit after final exams or a project assignment, not during them. Make a list of the reasons why you want to quit. Keep the list on hand so you can look at it when you have a nicotine craving.
Keep track of where, when and why you smoke. You may want to make notes for a week or so to know ahead of time when and why you will crave for tobacco.
Plan what you’ll do instead of using tobacco. You may also want to plan what you’ll say to people who pressure you to smoke or chew.
Throw away all of your tobacco. Clean out your room if you have smoked there or left a tobacco packet lying around. Throw away your ashtrays, lighters, empty packets, anything that you connect with your tobacco habit.
Tell your friends that you’re quitting. Ask them not to pressure you. Find other things to do with them besides using tobacco.
Stop on the stiulated date and time. Plan little rewards for yourself for each tobacco-free day, week or month. For example, buy yourself a new shirt or ask a friend to see a movie with you.
Things to do instead of smoking or chewing: Chew sugarless gum, cardamom, a toffee, etc. Call a friend. Go to a place where you can’t smoke. Take a walk or work out. Remind yourself why you want to quit. Develop a healthy lifestyle.
(Inputs: Tobacco Cessasion Center, NIMHANS, Bangalore)
Online at : http://www.deccanherald.com/Content/May312007/panorama200705314743.asp
Make a list of the reasons why you want to quit smoking. Keep the list on hand so you can look at it when you have a nicotine craving.
As many as 2,200 Indians stop smoking every day — by dying. According to statistics, tobacco is the second major cause of death in the world. Tobacco is addictive. It contains nicotine, a chemical that is addictive making it very hard to quit but it isn’t impossible. The smoking forms of tobacco are beedis, cigarettes, cigars etc; the smokeless forms include chewing paan with zarda (tobacco), gutka, pan masala and snuff.
One cigarette and one beedi contain approximately 4,000 chemicals while one packet of Pan Paraag, gutka, Khaini, and Hans contain about 3,000 chemicals. Forty per cent of cancers detected in India are because of tobacco use. One cigarette and one beedi reduce seven minutes of your life while one packet of Pan Paraag, or Hans reduce four minutes of your life.
It causes sexual impotency in men, miscarriage and infertility in women, wrinkled skin, stained teeth, bad odour, mouth ulceration and difficulty in swallowing. Every organ in the body is affected from head to toe, especially the brain, lungs and heart. There could be heart attacks, chronic cough and lung disease, worsened condition of diabetes, blood pressure and lower stamina.
Babies born to mothers who smoke can be sicker, die suddenly, or have more infections of the middle ear, coughing and wheezing.
Cause problems to family, friends and co-workers from the smoke from the cigarettes — exposing them to the same dangers. This is called second hand smoking
By stopping, a person will no longer be a bad influence on younger children in his or her family and in the society. The self-confidence, and self-image of the person improves, when he or she quits. No more looks of disapproval or feelings of guilt.
Saving of money is another advantage, expenditure on buying cigarettes, lighters, ashtrays, matches and so on can be saved. Quitting smoking reduces bad breath, yellowing of teeth or fingers. Overall performance of the person in physical activities will be remarkably improved after quitting the habit of smoking.
Pick a stop date. Choose a date one to two weeks away so you can get ready to quit. If possible, choose a time when things in your life will change. Or just pick a time when you don’t expect any extra stress at school, work or home. For example, quit after final exams or a project assignment, not during them. Make a list of the reasons why you want to quit. Keep the list on hand so you can look at it when you have a nicotine craving.
Keep track of where, when and why you smoke. You may want to make notes for a week or so to know ahead of time when and why you will crave for tobacco.
Plan what you’ll do instead of using tobacco. You may also want to plan what you’ll say to people who pressure you to smoke or chew.
Throw away all of your tobacco. Clean out your room if you have smoked there or left a tobacco packet lying around. Throw away your ashtrays, lighters, empty packets, anything that you connect with your tobacco habit.
Tell your friends that you’re quitting. Ask them not to pressure you. Find other things to do with them besides using tobacco.
Stop on the stiulated date and time. Plan little rewards for yourself for each tobacco-free day, week or month. For example, buy yourself a new shirt or ask a friend to see a movie with you.
Things to do instead of smoking or chewing: Chew sugarless gum, cardamom, a toffee, etc. Call a friend. Go to a place where you can’t smoke. Take a walk or work out. Remind yourself why you want to quit. Develop a healthy lifestyle.
(Inputs: Tobacco Cessasion Center, NIMHANS, Bangalore)
Online at : http://www.deccanherald.com/Content/May312007/panorama200705314743.asp
Putting Out The Fire
Putting Out The Fire
Deccan Herald
Those who stop smoking experience positive health changes that are detectable within days, but it may take years for the medical risks in ex-smokers to drop to the levels enjoyed by those who have never smoked.
Smoking increases the risk of respiratory infections and chronic obstructive pulmonary disease. Smoking predisposes to oral, lung, and other cancers. Smokers are more likely to suffer from high blood pressure, and to experience a heart attack or stroke. Smokers are also at increased risk of disturbances ranging from dental caries to osteoporosis. Women smokers are more likely to have abortions. Their children are more likely to have behavioural disorders. Nonsmokers, who regularly inhale cigarette smoke also suffer higher medical risks.
A study of half a million Americans who were followed-up for an average of nine years showed that the risk of death was doubled in smokers. In contrast, those who stop smoking experience positive health changes that are detectable within days; but, it may take years for the heightened medical risks in ex-smokers to drop to the levels enjoyed by those who have never smoked. A message here is that one should not start smoking; but what can be done for those who already smoke and can’t stop?
Many medicines can help smokers drop their deadly habit. Smokers are addicted to the nicotine in cigarettes, but the chemicals in the tobacco tar are what especially harm health. So, nicotine replacement can help smokers quit cigarettes without suffering the symptoms of nicotine withdrawal. Nicotine replacement is available as a patch, gum, lozenge, inhaler, and spray. The patch is applied to the skin, the gum is chewed, the lozenges are sucked, the spray is sprayed into the mouth, and the inhaler is breathed in. Each method of delivery of nicotine has its advantages and disadvantages.
Bupropion is another effective treatment. Patients take this drug for about three weeks before attempting a clean break with smoking.
About half of treated patients successfully quit smoking within two months, but most gradually relapse during the rest of the year. It appears that, to remain tobacco-free, patients need to take bupropion for a year or longer; but stopping bupropion thereafter is again associated with relapse during the succeeding year. This tells us that smoking is a chronic disease for many; treatment merely keeps the disease at bay. A plus with bupropion is that it reduces the risk of weight gain and depression after successful withdrawal from tobacco.
Why does bupropion work? One reason is that it increases the availability of dopamine in the reward centres of the brain; dopamine is the reward chemical activated during smoking. Another reason is that the principal metabolite of bupropion blocks the receptors on which nicotine acts in the brain; this makes smoking less pleasurable.
Varenicline is the latest drug. It received approval in the USA in May 2006. It is the best treatment available to-date. Its efficacy was demonstrated in six trials in which 3,659 chronic smokers participated. Five of these studies were randomised controlled trials conducted on smokers who had previously averaged 21 cigarettes a day for about 25 years. In all five trials, varenicline outperformed placebo in smoking cessation rates. In two of the studies, varenicline was also superior to bupropion.
About 70 per cent of smokers can expect to remain tobacco-free if they take varenicline for six months; more than half of these smokers can expect to remain tobacco-free during the next six months even if they stop the treatment.
Varenicline produces nausea in about a third of patients but is otherwise well tolerated; few patients stop treatment because of side effects. Varenicline does not prevent weight gain associated with abstinence from smoking. Patients who successfully quit smoking during three months of treatment can extend treatment for a further three months to increase the chances of long-term abstinence. The drug weakly stimulates a part of the nicotine receptor in the brain. Thus, in a way it mimics nicotine replacement therapy. It also blocks the nicotine receptor, diminishing the effect of nicotine from cigarettes should smoking resume.
Clonidine and nortriptyline are older drugs with modest efficacy against smoking. Topiramate, which helps alcoholics kick their habit, may also reduce smoking in these patients. Rimonabant, an anti-obesity drug, modestly reduces smoking rates. A vaccine against nicotine is under development.
Merely providing a medicine is insufficient; smokers also need counselling on how to stay tobacco-free. This guidance is provided through cognitive behaviour therapy (CBT), a highly successful approach used to treat depression and other psychiatric disorders. Combinations of medicines may be more effective than one medicine alone.
It is unfortunate that, despite the terrible health price that smokers pay, few hospitals run special clinics for smokers. The National Institute of Mental Health and Neurosciences, Bangalore, is one centre with a tobacco cessation clinic.
By Chittaranjan Andrade
(The writer is a professor, NIMHANS, Bangalore)
Online at: http://www.deccanherald.com/Content/May312007/panorama200705314742.asp
Deccan Herald
Those who stop smoking experience positive health changes that are detectable within days, but it may take years for the medical risks in ex-smokers to drop to the levels enjoyed by those who have never smoked.
Smoking increases the risk of respiratory infections and chronic obstructive pulmonary disease. Smoking predisposes to oral, lung, and other cancers. Smokers are more likely to suffer from high blood pressure, and to experience a heart attack or stroke. Smokers are also at increased risk of disturbances ranging from dental caries to osteoporosis. Women smokers are more likely to have abortions. Their children are more likely to have behavioural disorders. Nonsmokers, who regularly inhale cigarette smoke also suffer higher medical risks.
A study of half a million Americans who were followed-up for an average of nine years showed that the risk of death was doubled in smokers. In contrast, those who stop smoking experience positive health changes that are detectable within days; but, it may take years for the heightened medical risks in ex-smokers to drop to the levels enjoyed by those who have never smoked. A message here is that one should not start smoking; but what can be done for those who already smoke and can’t stop?
Many medicines can help smokers drop their deadly habit. Smokers are addicted to the nicotine in cigarettes, but the chemicals in the tobacco tar are what especially harm health. So, nicotine replacement can help smokers quit cigarettes without suffering the symptoms of nicotine withdrawal. Nicotine replacement is available as a patch, gum, lozenge, inhaler, and spray. The patch is applied to the skin, the gum is chewed, the lozenges are sucked, the spray is sprayed into the mouth, and the inhaler is breathed in. Each method of delivery of nicotine has its advantages and disadvantages.
Bupropion is another effective treatment. Patients take this drug for about three weeks before attempting a clean break with smoking.
About half of treated patients successfully quit smoking within two months, but most gradually relapse during the rest of the year. It appears that, to remain tobacco-free, patients need to take bupropion for a year or longer; but stopping bupropion thereafter is again associated with relapse during the succeeding year. This tells us that smoking is a chronic disease for many; treatment merely keeps the disease at bay. A plus with bupropion is that it reduces the risk of weight gain and depression after successful withdrawal from tobacco.
Why does bupropion work? One reason is that it increases the availability of dopamine in the reward centres of the brain; dopamine is the reward chemical activated during smoking. Another reason is that the principal metabolite of bupropion blocks the receptors on which nicotine acts in the brain; this makes smoking less pleasurable.
Varenicline is the latest drug. It received approval in the USA in May 2006. It is the best treatment available to-date. Its efficacy was demonstrated in six trials in which 3,659 chronic smokers participated. Five of these studies were randomised controlled trials conducted on smokers who had previously averaged 21 cigarettes a day for about 25 years. In all five trials, varenicline outperformed placebo in smoking cessation rates. In two of the studies, varenicline was also superior to bupropion.
About 70 per cent of smokers can expect to remain tobacco-free if they take varenicline for six months; more than half of these smokers can expect to remain tobacco-free during the next six months even if they stop the treatment.
Varenicline produces nausea in about a third of patients but is otherwise well tolerated; few patients stop treatment because of side effects. Varenicline does not prevent weight gain associated with abstinence from smoking. Patients who successfully quit smoking during three months of treatment can extend treatment for a further three months to increase the chances of long-term abstinence. The drug weakly stimulates a part of the nicotine receptor in the brain. Thus, in a way it mimics nicotine replacement therapy. It also blocks the nicotine receptor, diminishing the effect of nicotine from cigarettes should smoking resume.
Clonidine and nortriptyline are older drugs with modest efficacy against smoking. Topiramate, which helps alcoholics kick their habit, may also reduce smoking in these patients. Rimonabant, an anti-obesity drug, modestly reduces smoking rates. A vaccine against nicotine is under development.
Merely providing a medicine is insufficient; smokers also need counselling on how to stay tobacco-free. This guidance is provided through cognitive behaviour therapy (CBT), a highly successful approach used to treat depression and other psychiatric disorders. Combinations of medicines may be more effective than one medicine alone.
It is unfortunate that, despite the terrible health price that smokers pay, few hospitals run special clinics for smokers. The National Institute of Mental Health and Neurosciences, Bangalore, is one centre with a tobacco cessation clinic.
By Chittaranjan Andrade
(The writer is a professor, NIMHANS, Bangalore)
Online at: http://www.deccanherald.com/Content/May312007/panorama200705314742.asp
Ban on tobacco advertising not enough
Deccan Herald
Ban on tobacco advertising not enough
The best policy for the government is to sufficiently alarm people, to launch massive awareness campaigns, and to put a disincentive to the tobacco industry.
One cannot help finding an ironical twist to the ritual fulminations against smoking every year on the World No Tobacco Day because the government in India can neither ban smoking nor promote it. Since Portuguese merchants first brought tobacco to India 400 years ago, the trade boomed and tobacco quickly established itself as the most important commodity passing through Goa in the 17th century, perfected after the British introduced modern commercially-produced cigarettes.
But smoking is essentially a lifestyle problem. While tobacco companies are the usual bete noire, credited with causing cancer, a deeper cause for many other diseases of industrial civilisation like lung cancer may lie in modern commercial processing and refining of foods. Three kinds of food processing that are said to adulterate our foods — refining, deep frying, and hydrogenation — are perhaps no less harmful than tobacco. Many are beginning to suggest that we should go after the food processing industries for selling us products that kill us from heart disease, arthritis, diabetes, and a host of other ailments that are unknown outside of modern industrial societies.
Can the government spare a thought on our lifestyles?
That’s why ban on tobacco advertising is simply not enough. Cigarettes still have a strong general appeal as a product, especially to young people, thanks to skillful marketing. The tobacco industry, for instance, had lobbied at the highest political level in Europe to try to prevent the EC passing a directive to ban tobacco advertising and sponsorship.
Tobacco kills — we all know that — but for the government tobacco is an extremely profitable means to kill. India produces about 0.64 million tonnes of tobacco per annum and is the second largest harvester of tobacco in the world after China. About 0.1013 million tonnes of tobacco are exported and the rest consumed within the country. India is the third largest consumer of tobacco in the world after China and the USA. Tobacco and tobacco products contribute over Rs 6,500 million in export earnings and over Rs 30,000 million to the excise of the country. But how to strike a balance between public welfare and revenue earning? According to an estimate, tobacco usage in India claims more than 8,00,000 lives annually.
Scholars on the subject argue that India is at the intersection of local and global forces fuelling a worldwide epidemic of smoking deaths.
Globally the number of smokers is expected to rise to 1.7 billion by 2020. The smoking epidemic that currently results in an estimated four million deaths annually is projected to rise to 10 million by 2030, 70 per cent of which will occur in developing countries. From the initial focus of men in high-income countries, the tobacco majors have turned to tap women both in developing and high-income countries, and more recently to men in low-income countries.
Ninety per cent of the smokers in the country start smoking before they are 24 years old, most of them experiencing their first puff before attaining the age of 18. Out of 1,000 teenagers who smoke, at least 500 have been found to die of tobacco-related diseases.
To go by a study of the Epidemiological Research Centre in Chennai, half the male tuberculosis deaths in India are caused by smoking. According to the World Health Organisation, if smoking is unchecked, by 2020, 1.5 million people in India will become regular smokers.
The rub is the volume of people making a living out the tobacco-related industries, which somehow feeds off the government policies and plays an important role in the Indian economy. The tobacco industry generates nearly five per cent of the budget revenue which is fairly substantial. About six million Indian farmers are engaged in growing tobacco. Another 20 million people work on tobacco farms, and a large percentage of the population is employed in the retail trade. Taking the employees’ families into account, the tobacco industry in India probably supports 100 million people.
Mind you, the worldwide trend is a downscale of smoking — even in high-smoking countries such as France, China and Japan. The 61st survey on household consumer expenditure by the National Sample Survey Organisation finds that smoking habit among Indians is on the decline as the percentage of rural and urban households having smokers has dropped sharply during the past 11 years.
But the freedom to slow-poison oneself without endangering others is also deemed a right in a fiercely independent country. So the best policy for the government is to sufficiently alarm people, to launch massive awareness campaigns, and to put a disincentive to the tobacco industry. In the USA, the drop in smoking has been attributed to a number of reasons — a growing awareness about the health-damaging effects of smoking, rising cigarette prices, rising cigarette taxes, aggressive anti-smoking campaigns and a decline in the social acceptability of smoking. India can take the cue.
Life after Quitting
* After two Weeks: Blood flow improves; nicotine has passed from the body
* Two weeks to three months: Circulation will improve, making walking and running easier; lung functioning increases up to 30 per cent
* After five Years : Risk of stroke will be substantially reduced; within five to 15 years after quitting, it becomes about the same as non-smokers
* After 10 years: Risk of dying from lung cancer will be about half of what it would have been if smoking is continued. Risk of cancer of the mouth, throat, Esophagus, bladder, kidney, and pancreas will also decrease
* After 15 years: Risk of dying from a heart attack is equal to a person who never smoked
Now A VACCINE
NicVAX is a vaccine against smoking which is presently under development. It produces antibodies against nicotine, the addictive substance in tobacco. If a vaccinated person smokes, the antibodies attach themselves to nicotine. The resultant nicotine-antibody complex is too large to cross the blood-brain barrier.
Consequently, the smoker does not experience the expected effect of smoking in his brain. Clinical trials on NicVAX have begun; the Food and Drug Administration in the USA has put this research on the fast track.
NicVAX could be useful for smokers who are trying to quit, and for abstinent smokers who wish to remain abstinent. NicVAX may also prevent smoking; for example, parents may vaccinate their children against the development of addiction. This then might be the first vaccine to prevent a behaviour rather than a disease!
Instead of smoking...
* Chew sugarless gum, cardamom, a toffee, etc
* Call a friend
* Go to a place where you can’t smoke
* Take a walk or work out
* Remind yourself why you want to quit
* Develop a healthy lifestyle
STEPS TO FOLLOW
* Stop on the stipulated date and time. lan little rewards for yourself for each tobacco-free day, week or month. Buy yourself a new shirt or ask a friend to see a movie with you.
* It is quite understandable if the person is not able to quit by himself, considering the addictive nature of tobacco. Help is available in the form of counselling and medication
* The Tobacco Cessation Clinic (TCC) a WHO and Ministry of Health, Government of India initiative, functions at the De-addiction Out Patient Department (OPD) of NIMHANS, Bangalore every Monday and Saturday from 9 am to 2 pm.
* You can call Sudha/Jerome at 080-26995311 (Tuesday-Friday, 9:30-4:40) or send a mail to tccbangalore@ gmail.com for further information.
By Prasenjit Chowdhury
Online at: http://www.deccanherald.com/Content/May312007/panorama200705304740.asp
===============================================
Ban on tobacco advertising not enough
The best policy for the government is to sufficiently alarm people, to launch massive awareness campaigns, and to put a disincentive to the tobacco industry.
One cannot help finding an ironical twist to the ritual fulminations against smoking every year on the World No Tobacco Day because the government in India can neither ban smoking nor promote it. Since Portuguese merchants first brought tobacco to India 400 years ago, the trade boomed and tobacco quickly established itself as the most important commodity passing through Goa in the 17th century, perfected after the British introduced modern commercially-produced cigarettes.
But smoking is essentially a lifestyle problem. While tobacco companies are the usual bete noire, credited with causing cancer, a deeper cause for many other diseases of industrial civilisation like lung cancer may lie in modern commercial processing and refining of foods. Three kinds of food processing that are said to adulterate our foods — refining, deep frying, and hydrogenation — are perhaps no less harmful than tobacco. Many are beginning to suggest that we should go after the food processing industries for selling us products that kill us from heart disease, arthritis, diabetes, and a host of other ailments that are unknown outside of modern industrial societies.
Can the government spare a thought on our lifestyles?
That’s why ban on tobacco advertising is simply not enough. Cigarettes still have a strong general appeal as a product, especially to young people, thanks to skillful marketing. The tobacco industry, for instance, had lobbied at the highest political level in Europe to try to prevent the EC passing a directive to ban tobacco advertising and sponsorship.
Tobacco kills — we all know that — but for the government tobacco is an extremely profitable means to kill. India produces about 0.64 million tonnes of tobacco per annum and is the second largest harvester of tobacco in the world after China. About 0.1013 million tonnes of tobacco are exported and the rest consumed within the country. India is the third largest consumer of tobacco in the world after China and the USA. Tobacco and tobacco products contribute over Rs 6,500 million in export earnings and over Rs 30,000 million to the excise of the country. But how to strike a balance between public welfare and revenue earning? According to an estimate, tobacco usage in India claims more than 8,00,000 lives annually.
Scholars on the subject argue that India is at the intersection of local and global forces fuelling a worldwide epidemic of smoking deaths.
Globally the number of smokers is expected to rise to 1.7 billion by 2020. The smoking epidemic that currently results in an estimated four million deaths annually is projected to rise to 10 million by 2030, 70 per cent of which will occur in developing countries. From the initial focus of men in high-income countries, the tobacco majors have turned to tap women both in developing and high-income countries, and more recently to men in low-income countries.
Ninety per cent of the smokers in the country start smoking before they are 24 years old, most of them experiencing their first puff before attaining the age of 18. Out of 1,000 teenagers who smoke, at least 500 have been found to die of tobacco-related diseases.
To go by a study of the Epidemiological Research Centre in Chennai, half the male tuberculosis deaths in India are caused by smoking. According to the World Health Organisation, if smoking is unchecked, by 2020, 1.5 million people in India will become regular smokers.
The rub is the volume of people making a living out the tobacco-related industries, which somehow feeds off the government policies and plays an important role in the Indian economy. The tobacco industry generates nearly five per cent of the budget revenue which is fairly substantial. About six million Indian farmers are engaged in growing tobacco. Another 20 million people work on tobacco farms, and a large percentage of the population is employed in the retail trade. Taking the employees’ families into account, the tobacco industry in India probably supports 100 million people.
Mind you, the worldwide trend is a downscale of smoking — even in high-smoking countries such as France, China and Japan. The 61st survey on household consumer expenditure by the National Sample Survey Organisation finds that smoking habit among Indians is on the decline as the percentage of rural and urban households having smokers has dropped sharply during the past 11 years.
But the freedom to slow-poison oneself without endangering others is also deemed a right in a fiercely independent country. So the best policy for the government is to sufficiently alarm people, to launch massive awareness campaigns, and to put a disincentive to the tobacco industry. In the USA, the drop in smoking has been attributed to a number of reasons — a growing awareness about the health-damaging effects of smoking, rising cigarette prices, rising cigarette taxes, aggressive anti-smoking campaigns and a decline in the social acceptability of smoking. India can take the cue.
Life after Quitting
* After two Weeks: Blood flow improves; nicotine has passed from the body
* Two weeks to three months: Circulation will improve, making walking and running easier; lung functioning increases up to 30 per cent
* After five Years : Risk of stroke will be substantially reduced; within five to 15 years after quitting, it becomes about the same as non-smokers
* After 10 years: Risk of dying from lung cancer will be about half of what it would have been if smoking is continued. Risk of cancer of the mouth, throat, Esophagus, bladder, kidney, and pancreas will also decrease
* After 15 years: Risk of dying from a heart attack is equal to a person who never smoked
Now A VACCINE
NicVAX is a vaccine against smoking which is presently under development. It produces antibodies against nicotine, the addictive substance in tobacco. If a vaccinated person smokes, the antibodies attach themselves to nicotine. The resultant nicotine-antibody complex is too large to cross the blood-brain barrier.
Consequently, the smoker does not experience the expected effect of smoking in his brain. Clinical trials on NicVAX have begun; the Food and Drug Administration in the USA has put this research on the fast track.
NicVAX could be useful for smokers who are trying to quit, and for abstinent smokers who wish to remain abstinent. NicVAX may also prevent smoking; for example, parents may vaccinate their children against the development of addiction. This then might be the first vaccine to prevent a behaviour rather than a disease!
Instead of smoking...
* Chew sugarless gum, cardamom, a toffee, etc
* Call a friend
* Go to a place where you can’t smoke
* Take a walk or work out
* Remind yourself why you want to quit
* Develop a healthy lifestyle
STEPS TO FOLLOW
* Stop on the stipulated date and time. lan little rewards for yourself for each tobacco-free day, week or month. Buy yourself a new shirt or ask a friend to see a movie with you.
* It is quite understandable if the person is not able to quit by himself, considering the addictive nature of tobacco. Help is available in the form of counselling and medication
* The Tobacco Cessation Clinic (TCC) a WHO and Ministry of Health, Government of India initiative, functions at the De-addiction Out Patient Department (OPD) of NIMHANS, Bangalore every Monday and Saturday from 9 am to 2 pm.
* You can call Sudha/Jerome at 080-26995311 (Tuesday-Friday, 9:30-4:40) or send a mail to tccbangalore@ gmail.com for further information.
By Prasenjit Chowdhury
Online at: http://www.deccanherald.com/Content/May312007/panorama200705304740.asp
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