Amid concerns that the areca nut industry is blatantly roping in Bollywood celebrities to promote paan masala as a mouth freshener, a new Lancet study has highlighted that India has the highest number of oral cancer cases linked to smokeless tobacco (chewed, sucked on or sniffed) and areca nut (also called betel nut) use in South Asia.
In 2022, India accounted for 83,400 out of 120,200 global cases of oral cancer related to these substances, said the study led by the International Agency for Research on Cancer (IARC) and published in The Lancet Oncology journal.
The consumption of areca nut (30 per cent) and betel quid with tobacco (28 per cent) were responsible for the most oral cancer cases among women, followed by gutka (21 per cent) and khaini (21 per cent).
Among men, it was khaini (47 per cent), gutka (43 per cent), betel quid with tobacco (33 per cent), and areca nut (32 per cent). “Smokeless tobacco and areca nut products are available to consumers in many different forms across the world, but consuming smokeless tobacco and areca nut is linked to multiple diseases, including oral cancer,” said Dr Harriet Rumgay, a scientist in the Cancer Surveillance Branch at IARC.
“We found that more than 120,000 people across the world were diagnosed with oral cancer that could have been caused by using smokeless tobacco or areca nut. Our estimates highlight the burden these products pose on health care and the importance of prevention strategies to reduce consumption of smokeless tobacco and areca nuts,” he added.
The IARC study showed that 120,200 of the 389,800 oral cancer cases in 2022 could be caused by smokeless tobacco and areca nut use. The regions that contributed the largest numbers of oral cancers caused by smokeless tobacco and areca nut use were South-Central Asia (a total of 105,500 cases, with 83,400 in India, 9,700 in Bangladesh, 8,900 in Pakistan and 1,300 in Sri Lanka).
“Free accessibility with intense surrogate marketing of smokeless tobacco and areca nut has meant that India has one of the highest burdens of oral cancer in the world.
“While the revenue to the government is minimal, the health impact and associated healthcare losses are huge. The ban on gutkha was a courageous step that has been circumvented by the tobacco industry,” said Dr Pankaj Chaturvedi, Head and Neck Cancer surgeon and Director, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai. He is one of the co-authors of the study.
“Areca nuts cause a painful disease called submucous fibrosis apart from mouth cancer that is incurable. Unfortunately that is affecting our younger population and destroying families emotionally and financially. We need to implement the existing laws and regulations effectively for control of smokeless tobacco and areca nuts,” he said.
