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Tobacco kills more than 8 million people globally every year. More than 7 million of these deaths are from direct tobacco use and around 1.2 million are due to non-smokers being exposed to second-hand smoke. It is estimated that more than 1.3 million people in India, nearly as many people as the population of Nagaland die of health issues caused by tobacco use every year, according to the GATS survey. Of them, 1 million deaths can be attributed to smoking and the rest to the use of smokeless tobacco products.
Nearly 267 million or 29% Indians aged 15 and above currently use tobacco in some form as per GATS India 2016-17. Up to 199 million tobacco users in India either chew it or apply it on their gums and teeth in various forms and half that no. smoke as per available data. The level of addiction is high among tobacco users in India. 59% of those who consume it daily do so within 30 minutes of waking up and 78% within the first hour. About one in every 10 adults in India smoke, and 80% (80.1 million) of them smoke every day and 19.4 million occasionally.
Tobacco smoking/chewing is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with Covid-19, compared to non-smokers.
During this ongoing Covid-19 pandemic, a government directive on April 15 2020 asked for a strict ban on the sale of liquor, gutka and tobacco and spitting in all public places for health reasons. Two of these reasons are critical, experts say.
Covid-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other diseases. Since Covid-19 primarily affects lung functioning, patients who are smokers tend to need intensive care and ventilators more than non smokers as per the WHO. Tobacco is also a major risk factor for non communicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes which put people with these conditions at higher risk for developing severe illness when affected by Covid-19. Fatality rates were higher among patients with comorbidities such as cardiovascular disease, diabetes, hypertension, chronic respiratory disease or cancer, some of which are directly related to smoking. In India, of the 480 deceased on April 18, 83% had comorbidities.
The use of chewable tobacco leads to increased production of saliva and thus the urge to spit. Spitting in public places could enhance the spread of the Covid-19 virus. Spitting in public places has also been banned by the government and made a punishable offence under the Disaster Management Act.
Even while doing tests for Covid-19, the swab is collected from the throat which contains the virus in the saliva. So when the infected person spits, the entire virus is loaded into the saliva and the droplets are then thrown in the air. This risks the entire population in the sphere of influence or radius.
All forms of tobacco users are susceptible as fingers (and possibly contaminated cigarettes, khaini, gutka, paan, pan masala, etc) come in contact with lips which increases the possibility of transmission of virus from hand to mouth. Tobacco users have higher chances of getting Covid-19 infection because their defence in the respiratory system is low, being susceptible to pathogens, bacteria or any virus. Their immunity is suppressed because the mucosal barrier is damaged because of smoking/chewing tobacco.
About 55% of smokers and nearly 50% of smokeless tobacco users are interested in quitting the habit or plan to do so, as per the GATS report. The ban on the sale of tobacco products during the lockdown to curb the spread of Covid-19 is an opportunity to reduce tobacco consumption in India, the world’s second biggest consumer, experts say. Many times, the use of tobacco products, especially smoking, is a social activity among friends, colleagues and fellow tobacco users. Now that people are forced to go without tobacco for weeks and in isolation because of social distancing and from social circles where tobacco use is common, this could be a good opportunity to kick the habit. If people can manage 2-3 weeks without it, then why not forever?
Quitting tobacco use may be especially important at this time to reduce the harm caused by Covid-19. Within 20 minutes of quitting, elevated heart rate and blood pressure drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease. Tobacco users who manage to quit would almost immediately have improved lung and cardiovascular functioning and be better placed to manage comorbid conditions if infected.
Tobacco causes a loss of nearly INR 1 lakh crore ($13 billion) every year to the exchequer in terms of healthcare expenditure and is the number one preventable cause of death among youth. More awareness and better resolve is required to stop the use of tobacco products over the next two to three weeks because once people realise that they can avoid it and overcome the withdrawal symptoms, they will not let it come back into their life.
People suffer from addiction and it is important to have Tobacco Cessation Centres to support those who are willing to quit tobacco. Counselling will be given but in such a situation that will not be practical, so in that case they will need phone counselling through Quitline services (1800227787) of the government.
YOU ARE NOT LIVING IF YOU ARE USING TOBACCO. YOU ARE TAKING SMALL STEPS TOWARDS A DISASTROUS LIFE. SAY NO TO TOBACCO TO LIVE A HEALTHIER AND HAPPY LIFE.
Compiled by
District Tobacco Control Cell,
National Tobacco Control Programme Wokha
(Sources: WHO, ICMR, TATA Memorial Cancer Institute)
You Can Quit. We Will Help.
To quit tobacco call 8787869695/9366095060 or email us at ntcpwokha@gmail.com
Issued in Public Interest