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Youth Against Tobacco: Empowering Adolescents on Anti-Tobacco Day

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31-May-2024 | Akai Negi

Anti-Tobacco Day is celebrated on 31 May every year to educate the public about the dangers of tobacco use, the practices of tobacco companies, WHO's efforts to combat the tobacco epidemic, and how individuals worldwide can advocate for their right to health and healthy living to protect future generations.

India ranks as the world's third-largest tobacco producer and the second-largest consumer. Tobacco use in the country is estimated to cause over 1.3 million deaths annually.

As per the Global Adult Tobacco Survey (GATS) 2016– 2017, a total of 28.6% population in India consumes tobacco.

A striking aspect of tobacco use in India is the higher incidence of oral cancer compared to lung cancer. India alone accounts for nearly half of all oral cancer cases globally. Additionally, the connection between smoking and tuberculosis-related mortality is profound, with smoking increasing the risk of developing TB disease by more than two and a half times.

Types of Tobacco Consumption

In many countries worldwide, tobacco use is largely associated with cigarette smoking. However, in India, the landscape of tobacco consumption is diverse. It can be broadly categorised into two main types: smoking tobacco and smokeless tobacco.

Smoking tobacco encompasses various products like bidi, manufactured cigarettes, hand-rolled cigarettes, pipes, cigars, hookahs, water pipes, chuttas, dhumtis, and chillums.
On the other hand, smokeless tobacco comes in forms such as betel quid with tobacco, khaini, gutka, and tobacco-infused paan masala, typically consumed by chewing. Other forms of smokeless tobacco products like mishri, gul, bajjar, and gudakhu, which are applied to the teeth and gums, while snuff is inhaled.

The Impact of Tobacco on Youth

Smoking leads to cancer, heart disease, and other illnesses. Adolescents face immediate risks like addiction, reduced lung function, and decreased fitness. Starting tobacco use early heightens the risk of severe health issues later on.

Several factors contribute to youth tobacco product use

Social Environment:

Mass media portrayal of tobacco as normal.
Peer influence is a significant factor.
High school athletes more prone to smokeless tobacco.
Parental tobacco use influences youth.

Biological Factors:

Youth may be more sensitive to nicotine.
Genetic predisposition effects quitting challenges.
Prenatal exposure increases future smoking likelihood.

Mental Health:

Smoking linked to depression, anxiety, and stress in youth.

Personal Views:

Perceived benefits like stress relief drive smoking.

Additional Influences:

Socioeconomic status affects tobacco use.
Lack of refusal skills and parental support increase use.
Accessibility and price influence youth.
Poor academic performance and self-image contribute.
Exposure to tobacco advertising promotes use.

Tobacco Use in India

Tobacco Use in India: 28.6% of adults use tobacco in some form (smoking, chewing, applying to teeth/gums, or inhaling), with more using smokeless tobacco than smoking.
Starting Age: Average starting age is 18.7 years; 12.2% started before age 15, 23.6% at 15-17, and 19.4% at 18-19.
Gender Differences: Men use paan masala and areca nut more than women, but women use betel quid without tobacco more than men.
State Variations for Non-Tobacco Products: High use of paan masala without tobacco in Odisha, Arunachal Pradesh, Meghalaya, and Assam. Betel quid without tobacco is most prevalent in Meghalaya, Mizoram, and Assam. Areca nut is widely used in Tripura, Tamil Nadu, Maharashtra, and other states.
Smoking Products: Bidi is the most common smoking product in India, followed by cigarettes. Rural areas prefer bidi, while cigarettes are more popular in urban areas.
Daily Use: 84-88% of current users consume tobacco daily.
State-wise Tobacco Use: Highest prevalence in Tripura (64.5%) and lowest in Goa (9.7%). Tobacco use is higher in northeastern and eastern states, with Uttar Pradesh, West Bengal, and Maharashtra having the most users.
E-Cigarettes: Awareness of e-cigarettes is low (3%), with higher awareness among men, urban residents, and those with higher education. Current use is minimal (0.02%), with some states banning e-cigarette sales while traditional cigarettes remain legal.
Education and Tobacco Use: Tobacco use decreases with education. For instance, among those with no formal education, 66.1% of men and 25.9% of women use tobacco. But among those with secondary education or more, it's lower—24.4% of men and 2.5% of women.

Oral Cancer in India: A Critical Public Health Challenge

Globally, oral cancer ranks sixth among cancer types, with India contributing to almost one-third of cases and ranking second in total incidences.
Risk factors for oral cancer in India include tobacco consumption (smokeless and smoking), betel-quid chewing, excessive alcohol consumption, poor oral hygiene, and viral infections like human papillomavirus.
The increasing prevalence of oral cancer is a significant concern for public health in India, especially as about 70% of cases are detected in advanced stages, resulting in low five-year survival rates of around 20%.
Various forms of tobacco, including gutka, zarda, mawa, kharra, khaini, cigarettes, bidi, and hookah, are associated with oral cavity tumour development.
Regionally, Kerala has the lowest incidence of oral cancer in India, while West Bengal reports the highest.
India's position as the epicenter of oral cancer cases globally, with southern India experiencing the highest incidence rates among females both nationally and globally.

Reducing Youth Tobacco Product Use

Comprehensive national, state, and local programs have been effective in reducing and preventing youth tobacco product use. These programs include:

Increased Tobacco Prices: Raising the cost of tobacco products, such as through higher taxes.
Smoke-Free Policies: Banning smoking in indoor areas of workplaces and public spaces.
Age Restrictions: Increasing the minimum legal age for purchasing tobacco products to 21.
Counter-Media Campaigns: Utilising TV and radio commercials, posters, and other media messages to counteract tobacco product advertisements aimed at kids and teens.
Tobacco-Free Policies in Schools and Communities: Implementing policies in schools, colleges, and communities that promote tobacco-free environments and lifestyles.
Limiting Tobacco Accessibility and Advertising: Community programs aimed at reducing tobacco advertising and promotions, and making tobacco products less accessible.

Anti-Tobacco Day empowers adolescents against tobacco use through education and awareness events, policy advocacy for stricter regulations, community involvement with support groups and events, and impactful media campaigns leveraging social media influencers and creative content.

Success Stories and Case Studies

Salaam Bombay Foundation (SBF) runs tobacco control awareness campaigns through its leadership program, engaging school children.

Campaign Launches and Objectives:

Quit Tobacco Movement (2008): Annual school campaign promoting freedom from tobacco via street plays, rallies, and poster exhibitions.
Life Se Panga Mat Le Yaar (2011): Involved a celebrity to counter positive tobacco images with street plays, rallies, and media engagement.
Election Campaign (2014): Encouraged tobacco cessation during parliamentary elections with student-led campaigns and voting machine demos.
Tambakhu Ko Dhishum (2015): Ongoing online campaign collecting COTPA 2003 violations via social media, launched on World No Tobacco Day 2015.
Project MARG (2000): Empowers adolescents to advocate for tobacco control through peer education, media campaigns, and community engagement.

Global Action Against Tobacco: A Growing Movement

Tobacco control, embedded in the UN's SDG for health, aims to cut premature mortality from NCDs by a third through the WHO's Framework Convention on Tobacco Control and MPOWER strategy, with global monitoring via the Global Tobacco Surveillance System, encompassing efforts like GATS and GYTS, and including India's active participation.

India's Tobacco Control Initiatives

India's comprehensive tobacco control efforts include ratifying the WHO FCTC in 2004, enacting COTPA in 2003, launching the NTCP in 2007-08 with a three-tier structure, conducting extensive surveys like GYTS and GATS, implementing the Youth Against Tobacco Fellowship, banning e-cigarettes in 2019, expanding Tobacco Quitline Services, and aligning with the National Health Policy 2017 to reduce tobacco use by 30% by 2025.

Conclusion

On Anti-Tobacco Day, let's confront India's alarming status as a leading hub for tobacco-related diseases, particularly oral cancer. By prioritising youth education, advocating for stringent policies, and fostering community involvement, we can effectively combat the tobacco epidemic. Empowering adolescents to reject tobacco not only protects their health but also lays the foundation for a healthier, tobacco-free society for generations to come.

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