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Say tata to tobacco

Mumbai’s premier cancer hospital, Tata Memorial Hospital, alongwith the Healis Sekhsaria Institute for Public Health and the Washington (US) based Campaign for Tobacco-Free Kids, is pushing their Voice of Tobacco Victims (VOTV) campaign with new vigour.

Punjab Dy. Chief Minister Sukhbir Singh Badal (r) and UP Chief Minister Akhilesh Yadav in New Delhi
Letter for you, Mr Yadav: Punjab Dy. Chief Minister Sukhbir Singh Badal (r) and UP Chief Minister Akhilesh Yadav in New Delhi 

  In a salvo aimed at policy makers, Tata Memorial’s Professor of Cancer Surgery, Dr Pankaj Chaturvedi has written what he calls as an “open” letter to Uttar Pradesh (UP) Chief Minister (CM) Akhilesh Yadav to move on banning tobacco in the state. By “open” letter, Dr Chaturvedi says this letter dated September 15 2012, is in the public domain and “we hope the news media, especially in UP publishes it, so that the Minister has a chance to see it.”

 An image hopes to say it better than words
 

The letter exhorts the State chief to follow other states in banning gutka and pan masala citing various examples of cancer patients at Tata Memorial.
 Excerpts from the letter read:

Dear Akhileshji,
“I humbly introduce myself as a Consultant Surgeon at Tata Memorial Hospital in Mumbai -- a hospital renowned for diagnosis and treatment of cancer. Every Tuesday and Thursday, I examine dozens of new patients waiting for admission. I am saddened to see among them a very large proportion of people who have contracted cancer of the mouth or throat because of their addiction to tobacco in its various forms.

School kids paint anti-tobacco messages on a BEST bus in the city, hoping to spread the word via a public medium
Awareness: School kids paint anti-tobacco messages on a BEST bus in the city, hoping to spread the word via a public medium 

These patients come from various states all over India. But I wish to tell you with great sadness that a very large proportion of them come from your state. In the last couple of weeks, about five out of 20 cancer patients were from the proud state of Uttar Pradesh’.

Ban it
The letter then goes on to give examples of various patients suffering from cancer, along with photographic evidence. The letter adds:

‘Dinesh Chand Sharma, aged 42, hails from Bawar, Mainpuri district in UP. He is a motorcycle mechanic and garage owner, and fond of eating khaini, a tobacco and lime mixture. He started eating this only two years ago, and that too only 2-3 times in the evening. Unfortunately, eight months after he started having khaini, a small tumour appeared on the inside of his cheek where he kept the tobacco quid. Now this cancer is fast spreading on his tongue, and he has great difficulty speaking clearly. Surgical removal of his tongue is a distinct possibility that looms before our team of doctors and surgeons’.

Like Chand, the letter describes at least four others all from UP, who have contracted cancer and are in various stages of treatment of the deadly disease at the Tata Memorial.

The anti-tobacco doc & Co. urge Yadav to jump on to the ban wagon (so to speak) of 13 states that have recently banned gutka and pan masala, which includes Maharashtra. 

The letter adds: 'The notification issued by Ministry of Health and Family Welfare (Food Safety and Standards Authority of India) on 1st August, 2011 is clear. It says, “Product not to contain any substance which may be injurious to health: Tobacco and nicotine shall not be used as ingredients in any food products." Hence all smokeless tobacco products such as gutka, khaini, etc stand banned. This is as per Food Safety and Standards Act, 2006, and under the authority of Food Safety and Standards Authority of India, Ministry of Health.

The report submitted by the National Institute of Health and Family Welfare (NIHFW) to the Supreme Court gives evidence of fatal diseases caused in millions of people in India by the deceptively named ‘smokeless tobacco’.”

The mandate
‘Sir, you have the undisputed power and the mandate to implement this ban in Uttar Pradesh. But I am saddened to see that your government is wasting time debating whether gutka and pan masala may be described as food. Akhileshji, while your FDA Commissioner and other bureaucrats engage in legal debates over imaginary issues, people in your state are dying. The tobacco industry is making lakhs of innocent people its addicts, leaving thousands of people crippled and disfigured after surgery, and killing hundreds. Every passing month, lives are lost and families are ruined.

Sir, please don’t delay. Ban gutka and pan masala now’.

The letter is signed by Dr Chaturvedi.

Get response
Says Dr Chaturvedi when asked whether they truly believed that this letter would get them some response, “Akhilesh Yadav is not one of your ‘regular breed’ of politicians. For one, he is a health freak, he is educated and is frequently seen using the I-Pad. He has been chosen by the masses and surely does realise that he could be de-throned by the same people. In the end, we are asking for a legal, pro-public action, so, we do not see what the problem could be with that.”

The doc also says that “practically every third or fourth person I see is from UP, battling cancer because of the tobacco habit. Yet, coming to Mumbai to get treatment is only part of the ordeal. Many of these patients are from poor or middle-class families. To compound their agony are the living conditions. They stay on the footpath opposite the hospital, or in dingy hotel rooms with very poor sanitation all through treatment of a disease in which one’s immunity is severely compromised.”

Like others though, Chaturvedi stresses that it is a fallacy to think that non-smoking tobacco addiction and consequent illnesses afflict only the poor. “Gutka and other forms of tobacco have infiltrated every strata of society. When you advertise, you appeal to the poor person because the product is relatively cheap. The well-heeled are attracted to it because film star endorsements give it a kind of legitimacy. It is also aimed at children,” he ends.

Rich pitch
Meanwhile, Dr. Prakash Gupta, Director, Healis Sekhsaria Institute of Public Health Navi Mumbai, adds that, “Advertising has a damaging effect. Youth is especially susceptible, a 40-year-old is not going to get swayed by a young man who eats some pan masala and jumps from a helicopter into a train to rescue a beautiful girl, but a youth probably would.”

This research scientist also adds that, “Even the educated, we have seen at least one leading politician from Maharashtra affected because of it, and even industrialists, do get addicted. Initially, people may be unaware of ramifications or start using it as a mouth freshener, as early as adolescence. Then, because it is easily available and gives them so much satisfaction, they are loath to kick the habit. By the time, they realise, it is too late.”

Dr Gupta too feels that a ban would be effective because accessibility to the products would be reduced to an extent. He adds though that even with so much suffering by the patient, there is little regret. He says, “it is quite amazing that even when doctors have literally pulled out patients from the jaws of death, the afflicted go back to their habit. But, that is the power of a very powerful addiction.”

Ban wagon
Several states have recently banned gutka and pan masala. These are: Madhya Pradesh, Kerala, Bihar, Maharashtra, Himachal Pradesh, Rajasthan, Haryana, Jharkhand, Chhattisgarh, Gujarat, Mizoram and Punjab and the union territory of Chandigarh.    

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