Today, 30.2% Indian adults are exposed to passive smoking at their workplaces
By Prashant Mathur & Vishal Rao
The use of tobacco constitutes the single largest source of preventable deaths worldwide. Currently, in India, there are 266.8 million tobacco users aged 15 years and above, of which 99.9 million smoke tobacco (according to the Global Adult Tobacco Survey, India report 2016-17). Tobacco use is also a major cause of non-communicable diseases that account for about 62% of avoidable deaths in India. Widely prevalent smoking dates back to the 1930s, when there was a rise in the number of smokers globally, and was seen as in sync with the then modern lifestyle. There was absolutely no awareness about passive smoking (second-hand smoking) and it being injurious to health like first-hand tobacco smoking.
Passive smoking is the unintentional inhalation of smoke in the air or contact with its chemical constituents emerging from the burning end of a cigarette, bidi or any other means, and also the smoke breathed out by smokers. The Global Adult Tobacco Survey showed that all workplaces are not tobacco-smoke free yet. Today, 30.2% adults in India are exposed to passive smoking at their workplaces. Also, smoking is prevalent inside Indian houses—48.8% in all households and 45.5% in non-smoker households—with higher burden in rural India. A little more than one-third of non-smoking adults are exposed to passive smoking inside their homes. Prevalence of second-hand smoke inside homes is higher amongst females, due to obvious reasons. In addition, one in four of all adults are exposed to second-hand smoke in public places.
Even second-hand smoke can be lethal—it contains more than 7,000 chemicals, hundreds of which are toxic and over 70 of them can cause cancer. There is no risk-free level of exposure to passive smoke, and it is known to cause serious health problems among adults and children alike—in fact, there’s an increased risk of developing heart diseases by 25%, lung cancer by 20%, and stroke by 20% due to passive smoking. Pregnant women exposed to second-hand smoke have increased risk of congenital abnormalities, stillbirth, low-birth weight and respiratory illnesses in the baby.
Beyond the ‘smoking room’, tobacco smoke can permeate and settle into the hallways, stairways and the surrounding areas.
Children are likely to be affected as smoke infiltrates into parents’ hair, clothes, skin and in areas where children sleep or sit or play. If one can smell tobacco around, it implies that the chemicals present in tobacco are entering into your body and causing harm to you.
There is also the risk of third-hand smoke, i.e. harmful toxins of tobacco that remain behind on the walls, clothes, hair, toys and upholstery in public places, or in places where people have previously smoked and left. The dose and exposure to second-hand smoke is higher at public places such as hotels, clubs, bars or restaurants.
The law enforcing ban on smoking in public places was enacted in 2008 and was modified in 2009. Despite stringent efforts made by agencies across the country, an alarming 5,500 new users are added every day in our country. This brings in the question: Why should non-smokers suffer due to the deeds of smokers? The government of Karnataka, in a landmark decision towards making the state tobacco-free, has banned smoking in hotels, clubs, bars and restaurants. Accordingly, bars, pubs, restaurants and hotels should only have standing rooms for smoking, wherein no food and beverages can be served. Such steps can ensure safety of employees working in these establishments, guests who visit these places who are otherwise just mute spectators to the deprivation of their fundamental rights, and help in saving many lives and reducing healthcare costs. The victims of second-hand smoke have been empowered to seek justice. This could serve as a model for the rest of the country.
To make this and similar laws effective, citizens need to be part of full implementation, as we owe a brighter and safer place for our future generations.
-Mathur is director ICMR-National Center for Disease Informatics and Research, Bengaluru. Rao is oncologist, HCG Center & Member of High Power Committee on Tobacco Control, Karnataka government