As tobacco-induced cancer is emerging as a major public health threat in the country, top medical experts have suggested a three-pronged tobacco control strategy— public awareness, strengthening legislation and hiking taxes -- to make the cancerous item out of reach of the common man, especially kids.India reports at least 14 lakh new cancer cases and 8 lakh mortalities due to cancer every year. With at least 27 per cent cancer cases due to use of tobacco-related products like cigarettes, gutka and khaini, the oncologists felt that passage of the proposed amendments for a stricter tobacco-control law, COTPA, will help reduce the menace.

 “Tobacco products are major reason for various cancers and other diseases. In India, tobacco-related cancers (TRCs) contribute nearly half of the total cancers in males and one-fifth in females. This is scary,” Dr GK Rath, former Head, National Cancer Institute, said at a webinar organised on the World Cancer Day on February 4.

Equating tobacco with poison, he said that it kills slowly given that tobacco consumption causes 17 types of cancers of which many are preventable.  He also criticized tobacco firms for targeting children as young as ten years old by adopting various marketing strategies.

Dr Rath was equally dismayed at some Bollywood celebrities engaged in surrogate advertisements of health hazardous items like gutka, luring impressionable minds to adopt the suicidal addiction.

“This is very unfortunate. We have been writing to them that how their action is harming the children and youth who take them as a role model,” he said at the event.

Dr Alok Thakar, Professor of head-neck surgery and otorhinolaryngology at AIIMS, New Delhi, flagged the concern of rising oral cancer cases due to unabated sale and consumption of tobacco products like cigarette, beedi, khaini, tambaku, gutka and zarda.

“Since these are yet to be regulated in true sense and not many people are aware about its ill-effects, it will increase the country's health burden dramatically,” he said.

Dr Rahul Bhargava, leading hemato-oncologist from Gurugram-based Fortis Hospital, echoed similar views and asserted that as long as tobacco products were easily available and affordable for poor and children, achieving ‘Tobacco Free India’ mission will remain a dream.

While stressing on strengthening the population-based cancer screening under the NPCDCS programme, Dr Bhargava pointed out that the burden from tobacco use amounted to Rs. 177,341 crores in 2017-18 which is 1 percent of India’s GDP.  He also suggested that reforming tobacco taxes provides an easy way for the government to raise much needed revenue.

According to an ICMR report, tobacco contains at least 69 cancer-causing agents. Yet another report by the National Cancer Registry Programme (NCRP), the number of new cancer cases in India is likely to increase from 13.9 lakh in 2020 to 15.7 lakh by 2025, a rise of nearly 20 per cent.

Dr Rambha Pandey, Additional Professor, radiation oncologist, AIIMS, New Delhi lamented that women too are increasingly taking up tobacco consumption, viewing it as a ‘fashion symbol’. “This is a very disturbing trend. The habit of smoking and chewing start at the age of 10-12 years among kids and once they get into the habit it is difficult to shun.”

Dr Pandey hoped that the stringent COTPA amendments having provisions such as ban on designated smoking zones (DSA) will help in cutting down tobacco consumption and thus cancer cases. People must be told that tobacco has no single benefit, she said.

“The link between tobacco consumption and cancer is very clear. There is a need to look into the financial toxicity caused by tobacco consumption resulting in cancer. A multi-pronged strategy focussing on awareness, higher taxes and stringent laws is needed to make these killer products unaffordable and inaccessible to make India healthy,” emphasized Dr Rakesh Garg, Additional Professor of Anaesthesiology, Critical Care, Pain and Palliative Medicine, AIIMS, New Delhi.

According to the health experts, tobacco-induced cancers impact lungs, mouth, pharynx (upper throat), nose and sinuses, larynx (voice box), oesophagus (food pipe), liver, pancreas, stomach, kidney, ovary, bladder, cervix, and some types of leukaemia. Smoking causes other diseases too, such as heart disease and various lung diseases.