Of the 180 parties to the WHO Framework Convention on Tobacco Control, 138 countries define smokeless tobacco in their statutes while only 34 have so far reported levying a tax on such products, according to a recent study. According to the study published in the Lancet Oncology journal on Thursday, just six countries check and regulate the content of smokeless tobacco products while only 41 countries mandate pictorial health warnings on them.
Describing the extent of the policy implementation gap in smokeless tobacco (SLT) control, researchers stated that there are only a handful of public awareness campaigns on the harms associated with tobacco so far and only 16 countries have implemented a comprehensive ban on smokeless tobacco advertisement, promotion and sponsorships.
Globally, fewer smokeless tobacco users are advised to quit vis-à-vis smokers. Professor Ravi Mehrotra, Director of the National Institute of Cancer Prevention and Research (ICMR-NICPR) and the lead author of the paper, said that smokeless tobacco use as a public health concern requires a comprehensive approach to deal with the challenges identified in the paper.
In this regard, the WHO Framework Convention on Tobacco Control Global Knowledge Hub on Smokeless Tobacco at ICMR-NICPR is committed to assisting all countries in implementing the key recommendations from the paper, he said. Co-author of the study Dhirendra Sinha from the School of Preventive Oncology highlighted the global burden of SLT use and said “smokeless tobacco kills over half a million adults worldwide”.
Dr Prakash Gupta, Director, Healis Sekhsaria Institute for Public Health, Navi Mumbai and the senior author of the paper, said, as per the WHO-FCTC, control policies need to be enforced for all types of tobacco including smokeless. Within the area of tobacco control, smokeless tobacco gets less attention from policy makers. The need of our times is to formulate and enforce strong control policies to curb it.
Director General of ICMR Balram Bhargava said, “Given the extent and multiple faces of SLT in India (almost 65 pc of the world SLT users are in India), the need of the hour is to undertake a national mission to fight SLT use by bringing together all stakeholders under one umbrella. In this regard, ICMR envisages a comprehensive and scientific approach to reduce the SLT burden of the country.”
There are approximately 110 crore tobacco users in the world and almost a third of them (35.6 crore) use tobacco in the form of smokeless tobacco products. Smokeless tobacco refers to tobacco products that are consumed without smoking usually through mouth and nose.
Head and neck cancers are very common in those who consume such smokeless tobacco products. In India, where smokeless tobacco products are common, socially acceptable and part of cultural use, mouth cancer is the leading cause of cancer-related deaths.
Almost 90 per cent of the oral cancers in India are due to the use of smokeless tobacco. Smokeless tobacco use is also very common among females and is more socially acceptable than the use of cigarettes in the country.
The paper concludes that use of smokeless tobacco is becoming a global cause of concern requiring a greater commitment for full implementation of the evidence-based policy measures.