[Intl-tobacco] Tobacco on Trial: India: Mouth cancer epidemic on the way (fwd)

[Robert Weissman]

Tobacco on Trial: India: Mouth  cancer epidemic on the way
Source: BBC Online, Wednesday, 8/2/00

Indian doctors are worried about the surging popularity of chewable or
smokeless tobacco, particularly among the young. They are already
reporting a rise in pre-cancerous lesions in the mouth. But what's the
reason for this?
                           Colourful packets of Guthka - targetting
children?

Tobacco's been chewed for centuries in India - wrapped inside a betel leaf
and placed in the side of the mouth - but it's only in the last decade
that the tobacco companies have started selling tobacco ready-packaged in
small sachets.

Street vendor in Mumbai

Known as "gutkha", they're very cheap costing from half a rupee - which
means you could buy 90 sachets for the price of US$1.

In Mumbai they are sold by street vendors virtually everywhere.

They're popular with street children. We spoke to teenagers who were going
through 15 packets a day. They like gutkha because it's an appetite
suppressant.  It stops them feeling hungry.

Doctors at the Tata Memorial Hospital report a rise in pre-cancerous
lesions in the mouth - little white patches - which they're absolutely
convinced are caused by chewing tobacco.

Mouth cancer has a ten-year incubation period. Children started using
gutkha six or seven years ago.

Patient with Sub- mucous fibrosis

So they fear a huge bout of oral cancer will hit India in a few years
time.

Another illness is sub-mucous fibrosis - brought on by Areca nut - another
substance mixed with the tobacco.

People suffering from this disease find it progressively more difficult to
open their mouth. In the worst cases patients can no longer eat normal
food -they can only drink through a small opening in their mouths.

If you want to see some particularly nasty pictures of the effects of
chewing tobacco click here.

ACTION NOW

Voluntary health warnings have started appearing on some packets of gutkha
but anti-tobacco campaigners want tougher Government action to control
their sale - especially to the young. Already phenomenally popular in the
north western states of Maharashta and Gujarat, doctors fear gutkha will
penetrate all over the country.

This advert for Guthka appeared on Independence Day
        

Health campaigners are appalled that some big names in sport and cinema
have promoted these products in TV adverts and that Mumbai's annual film
awards (the "Bollywood Oscars") are sponsored by one of the main producers
of gutkha.
  

The problem, say campaigners, is that chewing tobacco has always been seen
as socially acceptable in India.

Whole families - generally unaware of the dangers - will share these
products at the end of a meal - regarding them as little more than mouth
refreshers.

SMOKING

Smoking of cigarettes or beedies - the traditional Indian smoked tobacco -
is less socially acceptable and women almost never smoke.

Men and boys will often tend not to in front of their elders.

Eight year old rolling beedies

Women might never smoke beedies - the traditional method of smoking
tobacco in India - but it's a woman's job to roll them.

And there have been confirmed reports that some beedie manufacturers use
child labour.

Cigarettes - promoting the Western lifestyle

Whereas beedies cost about 5 Rupees (11 US cents) for a packet of twenty,
cigarettes are much more expensive. A western style brand will cost 65
rupees per packet.

On the streets of Mumbai billboards advertising cigarettes jostle for
space with those promoting mobile phones and internet start-ups.

It's clear that the tobacco companies would like us to believe cigarette
smoking is the sophisticated pass-time for the dot.com generation.

THE TOUGHEST ANTI-TOBACCO LAWS IN THE WORLD

Tobacco was first brought to India by Portuguese merchants 400 years ago.  
Although there were already some strains of locally-grown tobacco in India
these were outclassed by the new imported varieties from Brazil.

The trade boomed and tobacco quickly established itself as the most
important commodity passing through Goa in the seventeenth century.

Virtually every household in the Portuguese colony took up the new fashion
of smoking or chewing tobacco.

Later on the British introduced modern commercially-produced cigarettes.
    Tobacco entered India through Goa and it will leave through Goa
    Dr Sharad Vaidya

"Tobacco entered India through Goa and it will leave through Goa,"
proclaims Dr Sharad Vaidya, a cancer surgeon in Panjim, the capital of Goa
state.

"It took us 100 years to free ourselves from British colonialism. It has
taken us 400 years already to free ourselves from the colonialism that is
tobacco".
          

Dr Vaidya has already been remarkably successful.

He has persuaded the Goan legislature to pass the toughest anti-tobacco
laws in the world. The Goa Prohibition of Smoking and Spitting Act
prohibits smoking in public places (including bus stands and beaches).

It bans all tobacco advertising in the state and the sale of tobacco
products within 100m of a school.

After a long-term public education campaign involving the state's school
children, the law has generally been well-received although local tourism
officials are worried about the impact of the ban on smoking on beaches.

They also fear that European tourists who arrive wearing a T-shirt or cap
with "Marlboro" written on it could be making themselves liable for
arrest.