uncontrolled and abnormal cell growth due to intake of carcinogenic substances like tabaco, gutka etc leads to which kind of disease
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This is a review paper comprehensively encompassing the different aspects of tobacco control with particular reference to the Indian scenario. The information on prevalent tobacco habits in India, health hazards and environmental hazards due to tobacco use, passive smoking and its impact, economics of tobacco, legislation to control tobacco in India, the tobacco cessation services and the way ahead for effective tobacco control are discussed. Tobacco is a leading preventable cause of death, killing nearly six million people worldwide each year. Reversing this entirely preventable manmade epidemic should be our top priority. This global tobacco epidemic kills more people than tuberculosis, HIV/AIDS and malaria combined. This epidemic can be resolved by becoming aware of the devastating effects of tobacco, learning about the proven effective tobacco control measures, national programmes and legislation prevailing in the home country and then engaging completely to halt the epidemic to move toward a tobacco-free world. India is the second largest consumer of tobacco globally, and accounts for approximately one-sixth of the world's tobacco-related deaths. The tobacco problem in India is peculiar, with consumption of variety of smokeless and smoking forms. Understanding the tobacco problem in India, focusing more efforts on what works and investigating the impact of sociocultural diversity and cost-effectiveness of various modalities of tobacco control should be our priority.
Keywords: Cigarettes and other tobacco products act, framework convention on tobacco control, hazards of tobacco, tobacco control, national tobacco control program
INTRODUCTION
Tobacco use kills nearly six million people worldwide each year. According to the World Health Organization (WHO) estimates, globally, there were 100 million premature deaths due to tobacco in the 20th century, and if the current trends of tobacco use continue, this number is expected to rise to 1 billion in the 21st century.[1]
Jha et al. have estimated that around 1 million deaths a year in India will be attributable to smoking by the early 2010s.[2] Gupta et al. have estimated the tobacco-attributable mortality among Indian men and women from their Mumbai cohort study. Based on these estimates, nearly 23.7% of the deaths among men (527,500) and 5.7% of the deaths among women (83,000) aged 35–69 years are due to tobacco-attributable illnesses.[3] Another cohort study from southern India reported mortality risks of 0.98 (0.86–0.94) and 1.22 (1.04–1.44) for all-cause and tobacco-related cancer mortality, respectively, for tobacco chewing, while with smoking, the respective mortality risks were 1.31 (1.24–1.39) and 1.68 (1.36–2.08).[4]
According to the National Family Health Survey (NFHS)-3 survey, conducted in 2005–06, tobacco use is more prevalent among men, rural population, illiterates, poor and vulnerable section of the society.[5] The estimates of the Global Adult Tobacco Survey (GATS) conducted among persons 15 years of age or older during 2009–10 indicate that 34.6% of the adults (47.9% males and 20.3% females) are current tobacco users. Fourteen percent of the adults smoke (24.3% males and 2.9% females) and 25.9% use smokeless tobacco (32.9% males and 18.4% females).[6] According to the Global Youth Tobacco Survey (GYTS) conducted among 24,000 students aged 13–15 years in 2009, 14.6% students were tobacco users.[7]
India's tobacco problem is very complex, with a large use of a variety of smoking forms and an array of smokeless tobacco products. Many of these products are manufactured as cottage and small-scale industries using varying mixtures and widely differing processes of manufacturing.[8] Bidis are mostly manufactured in the unorganized sector while cigarettes are mainly manufactured in large-scale industries.