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Tobacco and effects

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Tobacco is killing human being.

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Tobacco and effects

  1. 1. World No Tobacco Day- 31-05-2015 Chikkodi: “STOP ILLICIT TRADE OF TOBACCO” Dr.Jagadish Nuchin .MD, MBA. District Surveillance Officer, Belagavi 1 SHIVA
  2. 2. World No Tobacco Day is observed annually on 31 May to raise awareness around the world about the dangers of tobacco products, the single largest preventable cause of disability and death. 2
  3. 3. Introduction Tobacco plant is native to North and South American continents and they knew its cultivation 8000 years ago. It was Christopher Columbus who landed in America in the year 1492 who brought this plant to European countries. . Portuguese traders brought tobacco plants to India during 1600 through Goa and Indians started cultivating it. 3 Deadly Plant
  4. 4. Thus, the tobacco use spread from Americas to rest of the world. In India, earlier it was restricted to Royal people but later in 17th century even common people started using it. Gradually tobacco got assimilated into the cultural rituals and social fabric due to presumed medicinal and actually addictive properties attributed to it. 4
  5. 5. Tobacco in India • British East India company grew tobacco in India as cash crop and its use became widespread wherever British ruled. Cultivated tobacco in India Exported to Britain Re-imported cigarettes to India to earn revenue 5
  6. 6. Tobacco can be consumed in the forms of smoking, chewing, dipping or sniffing.
  7. 7. Smoking tobacco and Smokeless tobacco 7
  8. 8. Smoking tobacco -- use in India  Smoked forms of tobacco use - Bidis - Cigarette - Cigars - Cheroots - Chuttas - Dhumti - Pipe - Hooklis - Chillum - Hookah. 8
  9. 9. Smokeless tobacco • Known as spit tobacco, chew, snuff, and dip, is a form of tobacco that has become popular, especially with athletes . • Chewing on an average-size piece of chewing tobacco for 30 minutes can deliver as much nicotine as smoking three cigarettes. 9
  10. 10. Smokeless forms of tobacco use- in India - Pan (betel quid) with tobacco, Pan Masala with tobacco - Tobacco, areca nut and slaked lime preparations, Manipuri tobacco, Mawa, Khaini, chewing tobacco, snus, gutkha 10
  11. 11. Smokeless forms of tobacco use • Tobacco products for application: Nicotine patch, Mishri, Gul, Bajjar, Lal dantmanjan, Gudhaku, Creamy snuff, Tobacco water, Nicotine chewing gum. 11
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  13. 13. World Tobacco Facts 130 Crore people worldwide smoke. 6,00,000 Crore cigarette sticks are smoked worldwide every year. Tobacco kills up to half of its users. Half the people that smoke today – that is about 65 Crore people will eventually be killed by tobacco. Tobacco kills nearly 60 Lakh people each year. More than 54 lakh of those deaths are the result of direct tobacco use, while more than 6 lakh are the result of non-smokers being exposed to second- hand smoke. 13
  14. 14. • Unless urgent action is taken, the annual death toll could rise to more than one Crore by 2020 and 1.6 Crore by 2025. • Nearly 80% of the world's 130 Crore smokers live in low- and middle-income countries. • Tobacco is the second major cause of death in the world. • Approximately one person dies every six seconds and 10 per minute due to tobacco, accounting for one in 10 adult deaths. 14
  15. 15. • Children who are engaged in tobacco related works are especially vulnerable to "green tobacco sickness", which is caused by the continuous absorption of nicotine through the skin from the handling of wet tobacco leaves. 15
  16. 16. • Tobacco caused 10 Crore deaths in the 20th century. If current trends continue, it may cause 100 Crore deaths in the 21st century. • Tobacco use is linked to a large number of diseases and is the single most preventable cause of death in the world, according to the World Health Organization. • Smoking kills more people each year than AIDS, fires, car accidents, murders, suicides, alcohol and other drugs combined. 16
  17. 17. • Tobacco is responsible for one in four deaths in the United States. • In some countries, it is even more — in Turkey, nearly 40% of deaths among males are related to tobacco. • The prevalence is decreasing in developed countries but increasing in developing countries. • Developed countries have reduced smoking by 10% while developing countries have increased by 60% after 1970. 17
  18. 18. Smoking is increasing in the developing world Male adult prevalence, 1995 US 28 % (was 61% in 1939) East Asia 61 % Europe, Central Asia 57 % Latin America, Caribb 40 % South Asia 41 % (cigs + bidis) Sub-Saharan Africa29 %
  19. 19. USA 18 and over UK 16 and over Japan 15 and over 81% 1960 78% 1970 70% 0198 61% 1990 54% 2000 61% 1960 55% 1970 42% 1980 31% 1990 28% 1998 52% 1965 44% 1970 38% 1979 28% 1990 26% 1999 Physicians who smoke Smoking prevalence among physicians 2000or latest available data selected countries percentages women 1 3 men Australi a Banglades h Bosniaand Herzegovina Chil e Chin a Colombi a Denmar k Icelan d Indi a Morocc o Republicof Korea Russian Federation Saudi Arabia Spai n Swede n SyrianArab Republic U K 50 55 24 40 12 61 22 21 20 29 0 3 2 4 1 8 0 18 Indonesi a 14 1 LaoPeople’sDemocratic Republic 1 43 5 30 41 16 38 32 37 6 6 2 4 6 8 0 28 Smoking trends percentage of male smokers 1960–2000 selected countries Smoking among males aged 15 and over latest available data 40% – 49% Top tenhighest overall smoking ratesof men and women combined 60% and above 30% – 39% 50% – 59% 20% – 29% below 20% no data Smoking prevalence for men 50 % 49 % 47 % 44 % 48 % 54 % 47 % 52% GUINEA 45 % 44 % SAN CROATIA B-H YUGOSLAVIA ITALY SLOVENIA REP. MOLDOVA UKRAIN E ESTONI A LATVIA LITHUANIA ALBANIA AUSTRIA FYR MACEDONIA HUNGAR Y BULGARIA ROMANI A GREEC E POLAN D BELARU S RUSSIA N FED.UNITED KINGDOM TUNISI A TUNISI A LIBYANARAB JAMAHIRIYA IRELAN D DENMAR K FRANC E SPAI NPORTUGAL GERMANY CZECH SWITZ . NET H. BELGIUM LUX . MOROCC O ALGERI A ICELAN D NORWA Y FINLAN D SWEDE N REPUBLIC SLOVAKIA MALTA MARINO ANDORR A A U S T R A L I A REP. KORE A BARBADOS TRINIDAD & TOBAGO PALAU NAURU TUVALU TONGA STVINCENT& GRENADINES NICARAGUA BAHAMA S ZIMBABW E UGAND A TURKME N UZBEKISTA N KYRGYZST ANGE O AZE R Hong KongSA R SRILANKA CUBA DOMINICA NREPUBLIC PUERTORICO BRUNEI DAR. M A L A Y S I A SAUDI ARABIA C H I N A MONGOLI A PDR VIETNAM CAMBODI A LAO THAILAN D I N D I A BANGLADE SH ISL. REP. IRAN PAKISTA N TURKEY SYRIAN ARAB REPUBLIC IRA Q CYPRUS LEBAN ON ISRAELWEST BANK & GAZA JO R BAHRAI N QATA R UA E OMA N KUWAI T YEME N NEPA L K A Z A K H S T A N U N I T E D ST ATES OF A M E R I C A C A N A D A ALGERI A CHA D S U D A N NIGERI A DEM. REP. CONGO E GY P T MOROCC O SENEGA L GAMBI A CÔTE D’IVOIR E GHAN A NAMIBI A SOUT H AFRIC A MALA WIZAMBI A UNITED REP. TANZANIA KENY A DJIBOU TI S L GUATEMALA ELSALVADOR MEXIC O HAITI BOLIVI A B R A Z I L VENEZUEL A COLOMBI A HONDURAS COSTA RICA PANAMA ECUADOR PER U ARGENTIN A URUGUA Y CHIL E PHILIPPINE S NE WZEALAN D PAPU A NEW GUIN EA I N D O N E S I A JAPA N R U S S I A N F E DE R A T I ON GREENLAN D MAURITIUS SEYCHELLES SINGAPO RE MYANMA R KIRIBATI TOKELAU SAMOA NIUE COOK FIJI VANUATU RWAND A MALDIVES SAOTOME & PRINCIPE 2524 feature on the landscape.” Male Smoking global scenario 19
  20. 20. Ranking Country No. of Cigarettes per adult per year 1 Greece 2,924 2 Serbia 2,822 3 Bulgaria 2,786 4 Russia 2,479 5 Moldova 2,401 6 Ukraine 2,360 7 Slovenia 2,278 8 Bosnia 2,266 9 Belarus 2,157 10 Montenegro 2,139 11 Lebanon 2,125 12 Czech 2,125 13 South Korea 1,958 14 Kazakhstan 1,934 15 Japan 1,934 16 Kuwait 1800 17 Spain 1752 18 Switzerland 1743 19 China 1712 20 Austria 1650 51 USA 1028 99 Pakistan 468 158 India 98 164 Sudan 75 165 Somalia 67 170 Afghanistan 69 174 Ghana 44 178 Ethiopia 42 180 Uganda 24 184 Solomon Islands 18 185 Guinea 9 20
  21. 21. Indian Scenario  700, 000 deaths per year due to smoking accounting for nearly 2200 deaths every day and 3 people every 2 minutes.  800, 000 to 900, 000 deaths per year due to all forms of tobacco use/exposure 4 lakh cases of cancer, 13 lakh cases of heart ailments, 80 to 90% of lung cancer cases due to smoking. Single most preventable cause of premature death 21
  22. 22.  Tobacco is used by the youth all over India with a wide range of variation among states.  Two in every ten boys and one in every ten girls use a tobacco product.  Initiation to tobacco products before the age of 15 years is increasing. Tobacco Use Among Youth in India 22
  23. 23. There are currently about 24 Crore tobacco users aged 15 years and above (19.5 Crore male users and 4.5 Crore female users) in India.  India is the world’s third largest producer of tobacco (Next to China and Brazil) and also the second largest consumer of unmanufactured tobacco. It is a second largest exporter of unmanufactured tobacco. 23
  24. 24. Tobacco deaths are on the increase in India 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1985 1990 1995 2000 2005 2010 2015 2020 Year Tobaccodeaths(inmillion) Estimates by WHO 1996, 1999 Estimates by Gupta 1989 Estimates by ICMR 1985 24
  25. 25. Tobacco in India • In late Nineteenth century Beedi industry grew in India • Oldest Beedi manufacturing firm established in 1887 • Introduction of Gutkha aggravated the problem • Bihar, Jharkhand, Chhattisgarh, Nagaland, Orissa, Tripura and Mizoram show more than 40% of the prevalence where as Karnataka 19%. 25
  26. 26. Pattern of Consumption in India • 54% Bidis, 19% Cigarette and 27% Pan Masala, Snuff, Chewing tobacco • 55,000 children start smoking in an year. • Indians smoke 9000 Crore cigarettes an year. • At an average Rs. 12 a cigarette, Rs. 1,08000 Crores goes up in smoke. 26
  27. 27. According to Indian Council of Medical Research the cost of treating tobacco related diseases and cancers was Rs. 27760 Crores. Whereas the value of tobacco products sold nation wide is about 24,400 Crores. If this trend goes unchecked 13% of all deaths in India would be solely due to tobacco. 27
  28. 28. Nicotine is highly addictive • Nicotine --> release of serotonin, dopamine, norepinephrine • Neuro-adaptation  Each year, nearly 3.5 Crore people make a concerted effort to quit smoking.  < 7% stay smoke- free for a year; most start smoking again within days.
  29. 29. Smoke-A DEADLY MIXTURE  Cigarettes burn at 900 0 C – 10000 C  Cigarette smoke contains over 4000 chemicals and 69 of these are known to cause cancer.  Even if you don't smoke you can still get sick from these poisonous chemicals just by breathing in other people's smoke. The smoke contains:  Tar, a black, sticky substance that contains many poisonous chemical such as: ammonia (found in floor and window cleaner), toluene (found in industrial solvents) and acetone (found in paint stripper and nail polish remover)  Nicotine, the addictive drug in tobacco 29
  30. 30.  carbon monoxide, a poisonous gas that reduces the amount of oxygen taken up by a person's red blood cells  hydrogen cyanide, the poison used in gas chambers during World War ll  metals, including lead, nickel, arsenic ( white ant poison) and cadmium (used in car batteries)  pesticides such as Methoprene (found in flea powder). Other chemicals such as Benzene (found in petrol) and Naphthalene (found in mothballs) are also in tobacco smoke. 30
  31. 31. • And even including radioactive polonium 210. • These chemicals are absorbed into the blood, reaches every organ system in the body and are cancer causing, mutagenic and tumor causing. 31
  32. 32. Are some cigarettes better? • No such thing as a safe cigarette • “light”, “low tar” cigarettes are deceptive – - Manipulation by maker - Compensation by smokers so actual yields not = FTC (machine) yield
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  34. 34. • A cigarette contains 8 or 9 milligrams of Nicotine • A cigar contains 100-200mg of Nicotine • There is enough nicotine in 4 or 5 cigarettes to kill an average adult if ingested whole 34
  35. 35. Illicit trade of tobacco products must be stopped  The illicit cigarette trade is defined as “the production, import, export, purchase, sale, or possession of tobacco goods which fail to comply with legislation” (FATF 2012). Illicit cigarette trade activities fall under 3 categories:  Contraband: Cigarettes smuggled from abroad without domestic duty paid  Counterfeit: Cigarettes manufactured without authorization of the rightful owners, with intent to deceive consumers and to avoid paying duty  Illicit whites: Brands manufactured legitimately in one country, but smuggled and sold in another without duties being paid. 35
  36. 36. Illicit trade of tobacco products must be stopped  It is estimated that one in every 10 cigarettes and tobacco products consumed globally are illicit.  Illicit tobacco products are typically sold at lower prices, thereby increasing consumption. 36
  37. 37. The illicit trade of tobacco products poses major health, economic and security concerns around the world. Eliminating illicit trade in tobacco will reduce the harmful consumption of tobacco by restricting availability of cheap, unregulated alternatives and increasing overall tobacco prices. Critically, this will reduce premature deaths from tobacco use and raise tax revenue for governments 37
  38. 38. Raise the tax Ban the advertisements Put the pictorial health warnings on the packets Strict implementation of COTPA-2003 38
  39. 39. Takes 10-25 years to be discomposed into the land 39
  40. 40. Health effects of tobacco 40
  41. 41. Diseases caused by tobacco use  Cancer- mouth, lips, tongue, gums, palate , larynx, the lung, pancreas, kidney, Cervix  COPD (emphysema, bronchitis, etc)  Stroke (bleeding in the brain)  Heart attack and heart disease  Narrowing and clogging of arteries  Peptic ulcers (stomach bleeding)  Respiratory infections and compromise (cough, wheezing etc)  Gum disease and tooth loss  Low birth weight and SIDS  Asthma  Ear infections  Compromised sexual performance  Greater susceptibility to TB?  Cataracts  Age-related macular degeneration, a leading cause of blindness in older people  Hearing loss  Incontinence 41
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  45. 45. Smoking decreases the blood supply to your brain, constricts the blood vessels and causes ‘atherosclerosis’. 45
  46. 46. Smoking & chewing tobacco are the main cause of cancers of the tongue, salivary gland, mouth, pharynx and for brown teeth. 46
  47. 47. Cancer of the cheek with erosion of tissue 47
  48. 48. Smokers are ten times as likely to get lung cancer and emphysema as non-smokers. 48
  49. 49. Nicotine causes the blood clots & development of plaque which leads to Risk of heart attack. 49
  50. 50. Esophageal cancer in esophagus happens due to smoking. 50
  51. 51. Tobacco smoking or chewing accelerate the process of Stomach cancer. 51
  52. 52. Kidney cancer is more common and aggressive among tobacco users. 52
  53. 53. Poor blood circulation damages the blood vessel lead to death of body tissue which increases risk of ‘Gangrene’. 53
  54. 54. Tobacco smokers suffer more fractures due to higher rate of Osteoporosis (Decreased bone density). 54
  55. 55. Effects on Male Fertility and Erectile Dysfunction • Smoking can harm a man's sexuality and fertility. • erectile dysfunction because it decreases the amount of blood flowing into the penis • impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. 55
  56. 56. Women who smoke during pregnancy are more likely to have: – LBW/Premature baby – An ectopic pregnancy – Spontaneous abortion/miscarriage – Vaginal bleeding – Placental abruption )placenta peels away, partially or almost completely, from the uterine wall before delivery) – A stillbirth 56
  58. 58. Second-hand smoke kills • Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water pipes. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. • There is no safe level of exposure to second-hand tobacco smoke. • In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight. • Almost half of children regularly breathe air polluted by tobacco smoke in public places. • Over 40% of children have at least one smoking parent. • Second-hand smoke causes more than 600 000 premature deaths per year. • In 2004, children accounted for 28% of the deaths attributable to second-hand smoke. • Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers, are popular, do not harm business and encourage smokers to quit. • Over 1 billion people, or 16% of the world's population, are protected by comprehensive national smoke-free laws. 58
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  60. 60. Strict warning for tobacco misuse was also issued in ancients times. 60
  61. 61. • 1604 (England) – King James I pronounced in his “counter blast to tobacco” that smoking was “Loathsome to eyes, hateful to nose, harmful to the brain and dangerous to the Lungs” • 1633 (Turkey) – Death penalty for smoking 61
  62. 62. COTPA-2003 • The Government of India has passed an anti- tobacco legislation. • “The Cigarettes and Other Tobacco (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Products Act 2003”, which came into force on May 1, 2004. This replaces the Cigarette Act 1975. • If this act is enforced fully, there can be a tobacco- free India. 62
  63. 63. TOBACCO CONTROL ACT, 2003 Cigarettes and Other tobacco products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003
  64. 64. SCOPE OF THE ACT • The Act is applicable to all products containing tobacco in any form i.e. cigarettes, cigars, cheroots, bidis, gutka, pan masala (containing tobacco) khaini, mawa, mishri, snuff etc. as detailed in the schedule to the Act. • The Act extends to whole of India.
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