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Toss away the tobacco

Tobacco Breaks Hearts is the theme of this year’s World No Tobacco Day. Tobacco products may be heavily taxed, but it doesn’t deter users from purchasing the products. As the use of tobacco is on a rise, especially among children, and quit rate figures are negligible, NT BUZZ highlights how this addiction needs to be curbed through a collective effort

Danuska Da Gama I NT BUZZ

Haven’t we heard, read or watched similar disclaimers about smoking and the use of tobacco umpteen times? Time and again we see boards put up in public places like restaurants, etc. The Public Social Announcement in the multiplex with testimonials of cancer patients and gory visuals made us sigh in the beginning, but with several views it has made us immune or rather thick skinned to them.

For many these warning messages are a waste – waste of time, waste of advertising space or even a waste of money by the government, but it is because of these warning and efforts by people, organisations, government departments that there is controlled usage of tobacco.

Tobacco Breaks Hearts

Today, May 31 is observed as World Tobacco Day by United Nations. This year the theme, ‘Tobacco Breaks Hearts’ focuses on the impact of tobacco on cardiovascular health. It is well known that chewing or smoking tobacco is a key risk factor for heart disease, stroke and other vascular diseases.

World Health Organisation’s campaign seeks to promote awareness on the link between tobacco and heart diseases and other cardiovascular diseases (CVD), including stroke which when combined are the world’s leading causes of death; encourage feasible actions and measures that key audiences, including governments and the public, can take to reduce the risks posed by tobacco to heart health.

District nodal officer for tobacco control, North District, Shaheen Saiyed tells us that every year about 20 lakh people die of cardio vascular diseases, which is mainly due to the addictive substance nicotine that not just leads to blockage of arteries but also high blood pressure, gangrene and impotency.

Tobacco has nicotine with other chemicals which are cancer causing. Nicotine is not cancer causing, but affects the arteries and brains and is highly addictive. Cancer is caused by the chemicals used in tobacco like lead, tar, ammonia and others.

Efforts in Goa are aimed at targeting school children who are potential tobacco users. A lot of their activity throughout the year is targeted at creating awareness and sensitising schools in the state with the aid of the Directorate of Education.

Need to protect children

She says: “Everyday about 5,500 children start using tobacco. It is considered a gateway drug which then leads to the consumption of alcohol and other form of drugs.” The sensitisation programme also includes creating awareness about the Cigarettes and Other Tobacco Products Act, 2003 (COTPA), wherein each state must implement measures to provide non-smokers protection from involuntary exposure to tobacco smoke. Saiyed tells us that the common reasons why youngsters start using tobacco are because of role modelling. “So here the young users have seen their father or mother smoke and thus think it is okay for them to also smoke. The media too has created this notion of smoking being a status symbol especially when a celebrity is seen smoking. Though these messages and visuals are controlled today, the impression still remains.”

She also states that today children are stressed due to several reasons and thus think that using tobacco can relieve them of their stress, which only goes on to become a strong addiction. “Besides, there is tremendous peer pressure among the youth who take up smoking tobacco so they can fit into a circle of friends and not be outcast,” she explains.

“My father was a heavy smoker but quit when I was born. However, I grew up seeing my uncle smoke cigarettes non-stop. Three to four packets was his daily intake. I always liked how people would hold a cigarette and take a puff, and then blow the smoke creatively. It was fascinating. Somehow, I also like the earthy smell around smokers. It was when I was in college that I began openly talking about cigarettes since male classmates would smoke. So, our group of girls decided to try it and we went to a shop near the college and bought three to try. We were left coughing and scared. I am not a daily smoker, but do smoke one or two occasionally. I know it’s harmful and am happy that the addiction hasn’t got the better of me,” narrates a working professional who doesn’t wished to be named.

Talking about the COTPA Act Saiyed states that emphasis is mainly on Sections 4 and 6. Section 4 that states ‘No person shall smoke in any public place’ is to protect non smokers so that they have a clean environment. “Passive smokers’ health is at stake. A no smoking signage of the specific size with the warning ‘No Smoking Area. Smoking here is an offence’ is to be put up. Violators are fined up to `200,” she explains.

Section 6 states that no person shall sell, offer for sale or permit sale of cigarettes or any other tobacco products to a minor and no person shall sell, offer for sale or permit sale of, cigarettes or any other tobacco product in an area with a radius of one hundred yards (approximately 91 metres) of any educational institution. “In Goa there are enforcement squads formed which perform regular checks. Here the shop owner as well as the school is fined `200. Of course the amount is too less, and there is a struggle to bring about amendments in the act but it will take some time for the changes to be implemented,” says Saiyed. The District Task Force Committee’s have various stake holders like panchayat, Food and Drugs Administration, police and the education department that trying to curb the use of tobacco.

However, it isn’t a hidden fact that shop vendors blatantly violate these rules when it comes to selling tobacco products to children. For them it is a means of earning their daily bread and they are unperturbed about the lives of vulnerable children. “People are losing social values in today’s society. People are selling tobacco products openly to children, there is peer pressure and parents too are busy with their lives and aren’t inculcating good habits in children. It is a lifestyle problem,” she says. She goes on to inform us that the NCERT syllabus will include a chapter on tobacco for standard three so that children are made aware of the ill effects of tobacco and will acquire right knowledge.

Tobacco use on the rise, low quit rate

The Global Adult Tobacco Survey 2016-17 states that an average of 9.7 per cent of all adults in the state use tobacco. Also, the overall use of tobacco has gone up among adults in Goa from 8.8 per cent in 2009-2010 to 9.7 per cent. Use of smokeless tobacco has increased from 4.6 per cent to 6.5 per cent.

Data also revealed that a higher percentage of smokers and tobacco chewers want to quit compared to the previous survey conducted. However, smoking has decreased among adults from 4.8 per cent to 4.2 per cent during this time period. This shows us two trends – one, that there are people who are getting into the habit of using tobacco, while there is self realisation among users who want to quit or those who have attempted to quit.

Saiyed tells us that at the District Hospital in Mapusa the quit rate is hardly between 3 per cent and 4 per cent despite therapy, counselling and pharmacotherapy. The brighter side indicates that the reduced rate of tobacco use is about 35 per cent. She says: “There is self realisation among tobacco users who know that is harmful. Over 90 per cent have seen such health messages or advertisements, but the addiction is so strong that the quit rate isn’t high, though multiple attempts have been made.”

While the Goa Public Health Act 2005 has banned ghutka products, it is readily available in the state, more in rural areas, and in fact it is being consumed more than the smoking form of tobacco – Khaini being the most common form. Large illegal consignments of ghutka come from Belgaum and other nearby areas.

“Never ever start tobacco, because it is very difficult to quit tobacco use. Why stop tobacco after getting cancer which develops over years and go through the pain. Coming back is possible, it’s not impossible, but with a lot of pain,” Saiyed says.

“I started smoking at the age of 19 as our gang guys would be smoking too, while we would have our drinks and parties. It slowly became an addiction and I would smoke all the time due to nicotine addiction. I had no motivation to give up cigarettes. It was only in when I was about 36 or so and realised that my young son was choking on the smoke that I gave it up. He wouldn’t be able to even bear my breath. At that time I was smoking about 60 cigarettes a day. I gave up one fine day due to people’s persuasion, prayers and a retreat,” says a businessman who hasn’t touched a cigarette since 2002.

Saiyed tells us that when it comes to quitting tobacco, people put in great efforts but fail on several occasions due to the nicotine addiction. “Tobacco is very potent compared to alcohol or other forms of drugs. We don’t tell patients or users to directly stop tobacco but we give them some replacement and substitute through NRT (Nicotine Replacement Therapy). It cannot be bought over the counter or where it is available illegally. It should be taken under a doctor’s guidance or be administered by psychiatrists. It is meant to be taken in systematic doses which are reduced gradually. These doses are based on the frequency of tobacco consumption,” explains Saiyed.

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