Dr. S.L. Marbaniang
Some people become restless and uneasy when they have nothing to do. So they try to develop certain habits in order to divert their attention. One of these is smoking. Other justify that smoking helps in concentration, especially when they are alone with none around to share the problem. What may seem as a harmless exercise in the initial stage, continuous practice will lead to addiction.
A certain category of people smoke to exhibit their manly characteristics. Many of the younger group or even minors are in this category. Some just resort to smoking to imitate their parents and older relatives. Quite a few presume that smoking is a fashion. This usually is the case with smokers who came from different background. They do not mind spending a good amount of their pocket money because to them smoking is an outward form of manifestation of who they are and, therefore, count a lot in the society.
These are false pretensions but many fail to heed the premonition that smoking is a hazardous habit which, in the long run, is a very difficult one to do away with. The matter is not simple and does not end here only. The worse case is with respect to passive smokers, that is, people who are in the presence of active smokers but who themselves do not smoke at all. These categories of the population are known as second hand smokers (SHSs).
There are plenty of debates and discussions on the after effects of tobacco use. It has been proved that many of the diseases and deaths in the world could have been prevented if people stop smoking. Lung cancer, heart diseases and other illness are caused by tobacco use. Every year about 5.4 million people throughout the world are its victims. More than 80 percent of all these deaths take place in developing world. For every two users of tobacco, one will meet a fatal end.
In India, the figures are very discouraging. The number of fatalities due to tobacco related diseases every year stands at 8-9lakhs, which is more than 2,200 per day. The highest number of oral cancer cases in the world is in India, and about 90 percent of all these incidents is due to tobacco related use. Almost 50 percent of all cancers in India are due to tobacco use.
North East India offers a more grim picture. Out of an estimated 12.7 million who smoke and use smokeless tobacco products, 5.5 million are smokers and 7.2 million resort to all types of smokeless forms like gutkha, zarda, pann masala, paan with tobacco, khaini, and snuff. Every year, many people in Meghalaya succumb to cancer related to tobacco use. Lakhs of rupees are spent in treatment outside the State, the greatest number of them being at Christian Medical College(CMC), Vellore, Tamil Nadu. The commissioning of the North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences(NERIGHMS) at Mawdiangdiang, near Shillong city, since a few years back has been a great relief.
Tobacco kills slowly but surely. Smoking of tobacco can be in any form.
More than half of tobacco smokers in India use beeris. A beeris, a hand rolled unfiltered cigarette, is an indigenous cigarette in which tobacco is wrapped in a tendu or temburini leaf and tied with cotton thread at one end. Most of the employees in the beeri factories are women. Being exposed to tobacco dust and tobacco smoke, many to them suffer from breathing complications. Next is cigarette in which shredded or cut tobacco leaves are processed with hundred of chemicals. These are then wrapped in special paper in a cylinder form of tobacco use globally. Besides these, there are also other forms like cigars, cheroots, pipes, chillum, hookah, etc.
Unbelievably, a good number of people may not be aware of the fact that nearly 37 percent of children start smoking at quite a young age before 10, with boys at 55 percent and girls at 32 percent. The tragedy is with exposure to Second Hand Smoke (SHS) in public places which is very high, more than 40 percent. These data are taken from the Global Youth Tobacco Survey(GYTS), 2006, a school-based survey on adolescents in India.
Another school-based survey was conducted by the Global School Personnel Survey (GSPS), 2006 with school personnel (Teaching and non-teaching staff). The following are its findings. More than 29 percent of school personnel used tobacco in some form. About 38 percent of schools have an official policy declaring school to be tobacco free. Teaching materials on tobacco control are not available in majority of the schools. The sad part is that no instructions are stressed on the vices of tobacco to school personnel. Only about 34 percent or more of school personnel reported an access to teaching materials about tobacco.
The Indian Global Health Professional Students Survey (GHPSS), 2006 gave an interesting insight on the behaviour of medical students. The following data have been collected and compiled from a cohort of Third Year medical students from 15 medical colleges across India. Nearly 12 Percent of these students smoked cigarettes. Slightly more than 28 percent have ever smoked cigarette. Another 27percent have ever used tobacco products other than cigarettes. Nearly half of the medical colleges have an official policy which prohibits smoking in college buildings and clinics. About 77percent tried to stop smoking during the past year. Slightly lower than 74 percent believed that health professionals ought to serve as role models for other people. Over and above, more than 72percent agreed that smoking is bad for health and hence should be banned in all unclosed spaces.
More and more people are becoming aware of the health hazards due to smoking. Many non-smokers are the unwilling victims when they are in the company of smokers. Scientists have revealed that SHS is more dangerous and harmful. To have a balance for both smokers and non-smokers, the Government of India has initiated and introduced the Indian Tobacco Control Act, 2003. The World Health Organization (WHO), an international body on health care, has also addressed the issue in right perspective.
According to Indian Tobacco Control Act, 2003, no person is allowed to smoke in any public place. Public places are usually the areas and space where the public at large meet and congregate for their daily needs. These include auditorium, hospital buildings, railway waiting rooms, amusement Centres, restaurants and hotels, public offices, court buildings, educational institutions, workplaces, shopping malls, cinema halls, libraries, health institutions, public conveyance, stadiums, railway stations, bus stops and any open space visited by the public. For strict enforcement, warning through display of a board, measuring 60cm.x 30cm. Containing the words, “No Smoking Area- Smoking Here is an offence,” Law-breakers face a penalty of fine up to Rupees two hundred. The offence is compoundable and shall be tried summarily.
However, the Act provides for the need of the smokers too. Certain zones are specified whereby smoking is allowed with a sign that says, “Smoking Zone”. Restaurants and hotels, airports, railway designated are as for smoking, as per specification in the rules.
Due to these strict regulations, emission of the poisonous carbon Monoxide has greatly decreased. Such legislation has prompted a good number of people to quit smoking. Non-smokers who have all along suffered in silence ungrudgingly are heaving great sign of relief. In fact, the general health has improved much in those areas where the law has been enforced. Number of SHS has decreased much and consequently many of the workers in bars, restaurants and hotels have had great health improvement. Expenses on health issues have considerably declined. Because of clean environment and pure, fresh air, business has gone up in many affluent countries and employment opportunities have gone up.
Advertisements are being greatly restricted. Even if they do appear, they cannot be prominently featured. Over and above, they ought to contain health warnings, “Tobacco Kills or Tobacco Causes Cancer.” Boards displaying advertisements should not be illuminated or backlit.
Like all other hill States of the North Eastern Region; Meghalaya too is greatly affected by reckless smoking habits at every public place, unmindful of the passive smokers who have to inhale the carbon monoxide gas emitted by the smokers. The State, therefore, should enforce the Act stringently.
It is high time that a survey be made in the State to find out the full facts about health problems which are caused by tobacco users in any form, whatever. Any recognized and competent agency can be entrusted with the work.