The weed that kills when used as directed

It works overtime disseminating information about the economic benefits this labour-intensive crop brings in. But all their arguments fall flat under scrutiny. True, tobacco contributes Rs 6,934 crore to the exchequer as revenue and Rs 1,059 as export earnings. But personal loss apart, the loss because of death and disability is much more.

An Indian Council Of Medical Research project that concluded earlier this month found that each person who suffers from a tobacco-related cancer costs the country over Rs 2.5 lakh (Rs 134,449 as direct cost to patient, and Rs 116,675 through absentism for treatment and loss of income due to premature death). These are the conservative figures for the years 1990-91. Naturally, the cost of dying is shooting up like everything else. To this add cost of premature death — one in two of all long-term smokers dies 20 to 25 years prematurely — and the cost of the many diseases which hamper productivity and puts a strain on economic resources but do not result in death.

There are 25 tobacco-related diseases known today, says World Health Organisation (WHO), of which cancers (lung, larynx, oral cavity, pharynx, oesophagus, pancreas, bladder, cervix and leukaemia) are just one kind. Nicotine increases blood pressure, exacerbates asthma, causes impotence, infertility, and increases serum carbon monoxide, which can lead to shortness of breath. Long-term use can lead to heart attack, stroke and cancer. World Bank estimates 500 million people alive today will eventually be killed by tobacco.

WHO statistics show that two-thirds of smokers begin the habit young so that by the time the health risks sink in, they have a addiction that is stronger than addiction to notorious drugs like heroin, marijuana and cocaine. Chronic exposure to nicotine through cigarettes causes structural damage to the brain as it increases the number of nicotine receptors. This is why smokers find it difficult to pyscologically and physically to quit the habit. The chances of succeeding in quiting unaidedly is no better than one in hundred. Attempts at cessation are usually cyclic, which is why most smokers who quit are at a risk of relapse.

Knowing this, cigarette companies do their best to “hook ’em young”, and use advertising to project images of rebellion, success, glamour and adventure. In India, 48.8 million USD are spent on advertising, with press (10 million) and television (9.8 million) getting the major chunk of advertising. Brand stretching exists: all the 11 players of the Indian cricket team — cricket is the most popular Indian sport which is telecast 125 days a year and is watched by 150 million Indians — sport a cigarette logo. Increasingly, the tobacco industry is promoting the term, `Courage of Choice’, using the yin & yang symbol of living in harmony.

The Ministry of Health has drafted a bill on tobacco control, but it is waiting Cabinet approval. “It’s going slow because we are trying to plug all the possible loopholes before the bill becomes a law because we have learnt from experience that the tobacco industry has a quicksilver ability to adapt to and sidestep restrictions,” says a Ministry of Health official.

As it sidestepped the ban on advertising on doordarshan by doing so through satellite channels and using brand-streching (Wills sprting apparel) and sponsoring popular sporting events (Wills World Cup). The industry wins this round, because cricket gets prime coverage 125 days a year!

Smoking is banned in hospitals, dispensaries and other healthcare extablishments, educational institutons, conference rooms, domestic air flights, airconditioned coaches in trains, suburban trains and air-conditioned buses run by thr Government. Three states — Delhi, Kerala and Goa — have a legislation in place which restricts smoking in publice areas (including beaches in Goa), selling tobacco to minors and advertising bans, but the laws are seldom enforced. This is where the judiciary could make a difference, as it did in the US, where big tobacco lost millions as compensation to three states who sued. But courtroom war is still in its infancy in India, with former four-time member of Parliament (South Mumbai) Murli Deora filing the first public interest litigation against the tobacco industry.

Realising the enormity of the problem, the WHO has used its constitutional mandate and initiated the Framewrk Convention on Tobacco Control to support and accelerate the work of member states to strengthen their tobacco-control programmes. “The good news is that there are real health gains to be made from stopping at any age,” says WHO Director-General Dr Gro Harlem Brundtland. “I invite all smokers to take a giant step towards better health.”

Marking the market: The market is one billion and growing and India is second as an emerging market. Only 19 per cent of tobacco users smoke cigarettes, but cigarette smoking is expected to touch 33 per cent by 2020. Bidis account for 54 per cent of tobacco use, while chewable tobacco makes up for the rest of the 27 per cent. Cigarettes, however, seem to be more popular among men, with 80 per cent of cigarettes smokers being men.

Price is a key influencing factor and the cigarette lobby targets on this upward mobility: upgrading people from chewing tobacco to bidis to cigarettes. The “premium brands” of cigarette cost about 7 cents per stick, while the more popular brands cost about 4 cents. Bidis, in comparison, cost about ) 0.5 cent per stick, so its no wonder that for every cigarette smoked, 8.5 bidis are consumed.

A farce of research: In an effort to reduce the tar and nicotine levels in cigarettes, the Indian Tobacco Research Institute is working in collaboration with the research and development wings of tobacco companies like ITC, Godfrey Philips and VST. But such researches are a complete sham, for the West found out long ago that there was no such thing as a safe cigarette. “Such researches are a complete sham because tobacco companies naturally ensure that smokers stay addicted to nicotine,” informed Jeffrey Wigand, the Brown & Williamson reasearch and development vice president who went public with tobacco lies. The newest Disney film, The Insider, tells his story. “Cigarettes are highly-engineered nicotine-delivery devices, and even the low tar-low nicotine cigarette are not any safer,” he revealed at a conference organised by the World Health Organisation in San Francisco, California. “Research has show that those who smoke low-nicotine cigarettes draw on the smoke deeper to ensure that theyget their nicotine hit,” informs Wigand.

Intimadation comes easy to Borwn a Williamson, with the company threatening to sue Disney for libel.

Last month, scientists linked smoking `Lights’ — by far more popular among women and teenagers because they are thought safer — with a rare kind of cancer.

Teens More Prone To Nicotine Addiction Than Adults: Adolescent smokers develop nicotine addiction faster than adults, and some can get addicted even if they smoke once a month, found Joseph R. DiFranza of the University of Massachusetts Medical Center in Worcester. Most adolescents, however, get addicted even before they begin smoking daily. Previous studies of adult smokers had indicated that nicotine dependence does not occur in adults until they smoke up to half a pack per day.

The researchers calculated symptoms of nicotine dependence — such as difficulty quitting, inability to quit — and feelings of addiction from the point when each adolescent reported smoking at a rate of at least once per month. Of the 95 adolescents who reported smoking at least once a month, DiFranza’s team found that 16 reported a symptom of nicotine dependence within two weeks and 21 reported symptoms within four weeks.

The overall analysis shows that at least one-half of those with symptoms showed those symptoms within 12 weeks of smoking at least once per month. “This study shows that dependence can occur before an adolescent smokes one cigarette per day,” DiFranza noted.