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Mouth cancer among youths alarming in Assam

GUWAHATI, May 30: With rising consumption of chewable tobacco by the younger generation, there is an alarming trend of mouth cancer in relatively young patients below 40 years, said a team of doctors from the Dr Bhubaneswar Barooah Cancer Institute, Guwahati. Addressing the media on the eve of the World No Tobacco Day, 2018 on Wednesday in Guwahati, the team said that tobacco use is a leading cause of cancer and of death from cancer. Tobacco use causes many types of cancer, including cancer of the lung, larynx (voice box), mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon, rectum, and cervix as well as leukemia.

The team, led by Associate Prof. (Dr) Ashok Kumar Das, Dr SM Bhagabaty, Dr M Krishnatreya and Dr Kaberi Kakati Das revealed that more than 6,000 patients (60% of all cancer patients) with tobacco related cancer were registered at Dr BB Cancer Institute, Guwahati last year alone.

According to the team, the statistical rise of mouth cancers among the younger patients were 33 in 2011, 35 in 2012, 47 2013, 73 in 2014 and 80 in 2015.

There is a common perception among 80 percent of smokers that e-cigarettes could help them to quit, while more than 97 percent believe that the battery-powered device can help to reduce the use of conventional tobacco and thus reduce the risk of cancer. However, researchers at the New York University School of Medicine in New York City found that the e-cigarette vapor damages DNA in the lungs, bladder, and heart, which could increase the risk of cancer. A team of researchers recently reported their findings in the proceedings of the National Academy of Sciences, said the team.

Dwelling in length, the team exposed that e-cigarettes are not approved by the Food and Drug Administration (FDA) of the US as a quit-smoking aid, after the US Preventive Service Task Force concluded that there is “insufficient evidence to recommend for or against (their) use for smoking cessation.”

Referring the data prepared by the Global Adult Tobacco Survey (GATS) 2016-17, Ministry of Health & family Welfare (MoHFW), Government of India the team highlighted that the estimated deaths in Assam are as high as 34,000 per annum. According to GATS, 2016-17 report, children initiating tobacco (in any form) use every day was recorded at 140 while adult prevalence (15+ years), overall 48.2%, cigarette 6.1%, Bidi 8.6% and Smokeless 41.7%. The numbers of adult tobacco users were recorded as overall 105 lakh, cigarette 13.3 lakh, bidi 18.7 Lakh and Smokeless 91 lakh.

The Global Adult Tobacco Survey (GATS) is a global standard for systematically monitoring adult tobacco use (smoking and smokeless) and tracking key tobacco control indicators. GATS is a household survey of persons 15 years of age and older conducted in all 30 states of India and two Union Territories. The first round of GATS was conducted between June 2009 and January 2010. The second round of GATS was conducted between August 2016 to February 2017 by Tata Institute of Social Sciences (TISS), Mumbai for Ministry of health and Family Welfare (MoHFW), Government of India.

The GATS 2016-17, Assam highlighted that 25.3% of men, 0.8% of women and 13.3% of all adults currently smoke tobacco. 50.5% of men and 32.5% of women and 41.7% of all adults currently use smokeless tobacco. 62.9% among men and 32.9% of women and 48.2% of all adults either smoke tobacco and/or use smokeless tobacco. From GATS 1 to GATS 2, the prevalence of smoking has decreased by 1.1 percentage points; however the decrease is not significant. The prevalence of smokeless tobacco use has increased significantly from GATS 1 to GATS 2 by 9.0 percentage points. The prevalence of any tobacco use has significantly increased from 39.3% in GATS 1 to 48.2% in GATS 2.
Khaini and Betel quid with tobacco are the most commonly used tobacco products. 23.1% of the adults use khaini and 19.0% use betel quid with tobacco. The prevalence of tobacco use among persons aged 15-17 has decreased from 19.6 in GATS 1 to 9.1% in GATS 2.

The mean age at initiation of tobacco use has increased from 18.1 years in GATS 1 to 18.5 years in GATS 2. 26.1% of smokers were advised by a health care provider to quit smoking and 30.2% of smokeless tobacco users were advised by a health care provider to quit use of smokeless tobacco. 30.8% of all adults who worked indoors were exposed to second-hand smoke at their workplace. 15.0% of all adults were exposed to second-hand smoke at any public place. 68.9% of cigarette smokers and 58.6% of bidi smokers thought of quitting smoking because of warning label.

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Ankur Kalita