The Lancet study has hit the nail on its head. It has demonstrated that a vast proportion of cancers is propelled by the tobacco industry for making vulgar profits. While the Government seems to be busy collecting the revenue, innocent citizens are dying miserably.
Cancer is an ever-increasing public health challenge in India. It is not a health issue alone among three million cancer patients to which nearly one million is added every year. It is indeed linked to significant causes of poverty, violation of human dignity, insecurity of young kids and social ostracisation at times. Cancer kills around five lakh Indians annually and many more have to live with permanent physical and mental scars not only among the patients but their relatives. The UN resolution 2011 declared four key strategies to curb the rising burden of cancer mainly by control of tobacco, alcohol and obesity. This is in sync with the National Health Policy unveiled by the Government of India. Are we serious about it?
India is home to nearly 28 crores tobacco users and it is estimated that nearly one third of them will die prematurely due to serious illnesses such as cancers, heart diseases and so on. Almost two in five deaths among adults aged 30 years and above are caused due to smokeless tobacco. Nearly 22 crores Indians are using smokeless tobacco. This is responsible for an epidemic proportion of oral cancer, especially among youth.
Though gutka is banned, it can be easily accessed anywhere with little restriction. India has a unique problem of paan masala use that is also an established cause of mouth cancer. Unfortunately, the Government has failed to regulate the use of paan masala. The Cigarette and Tobacco Products Act 2003 needs amendment to plug the loopholes in the law. As expected, this has received tremendous pushback from the industry and is still languishing.
Alcohol is causally related to various cancers. It has a great social acceptability because of shrewd marketing. It is associated with many negative consequences, both for the drinker’s family and the community, especially among the impoverished sections of society. Unfortunately, alcohol is being heavily advertised in all forms of media. The positive portrayal of alcohol in cinemas has dramatically increased. Newspapers, television and hoardings carry surrogate advertisements of alcohol and the Advertising Standard Council of India seems to have done nothing about that. The government has failed to make a national policy for alcohol control.
The proportion of cancer attributed to obesity varied widely, but was as high as 40 per cent for some cancers. The fast food industry has mushroomed all over India and its powerful advertising has influenced the eating habits of most urban kids. The advertisement of burger, pizza, chocolates, soft drinks, noodles and biscuits have misled the vulnerable young to accept them as safe food. There is a need to regulate glamourisation of unhealthy food.
It is a mammoth task to improve the nutritional status of a huge nation like ours. However, control on tobacco, areca nut, alcohol and junk food are well within the reach of our policy makers. This article is a wakeup call for all of us.
(Dr Pankaj Chaturvedi is Deputy Director, Centre for Cancer Epidemiology, Tata Memorial Centre, Professor and Surgeon, Department of Head Neck Surgery, Tata Memorial Centre, Secretary-General, International Federation of Head and Neck Oncologic Societies)