During the early days of my training as a medical oncologist at AIIMS, New Delhi, I was alarmed to see patients as young as 20 years being diagnosed with advanced stages of oral cavity cancers and dying within one year of diagnosis despite treatment. Tobacco chewing is the single most important cause of these cancers and in certain parts of the country, it is so prevalent that it has become the most common cause of cancer.
Research points out that Tobacco abuse is the most common cause of cancer. It is responsible for 10 different types of cancers and collectively they are referred to as ‘Tobacco-related cancers’. They are head and neck cancers (mostly related to tobacco chewing), Lung cancer (primarily due to tobacco smoking), esophageal (food pipe) cancer, stomach cancer, pancreatic cancer, kidney cancer, bladder cancer, liver cancer, cervix cancer and acute myeloid leukemia (a type of blood cancer). Together, these account for almost 40% of the cancer burden worldwide, making tobacco the single most common cause of cancer.
Tobacco smoke has at least 70 chemicals that cause cancer, called as carcinogens. Tobacco chewing causes irritation of mucosa in the oral cavity which on long term exposure turns into cancer. An indirect exposure to tobacco smoke from people who smoke around you can place you at a higher risk of getting cancer. This is called ‘passive smoking’ and is especially important to pregnant women as it is shown to be one of the causes of childhood cancers.
If the current trend in smoking and population growth continue, the number of current smokers is expected to reach 2 billion worldwide by 2030. The WHO (World Health Organization) estimates that one out of two young people who start smoking and continue smoking throughout their lives will develop ‘Tobacco-Related Cancer’ (TRC). The numbers are alarming. According to the latest GLOBOCAN data (2018) for India, there were 1.1 million new cases of cancers occurring in a year and 2.2 million people living with cancer. Of these, at least 40% are tobacco-related. Even these reports are likely to be an under-representation due to lack of a good cancer registry covering an adequate population.
What these numbers would suggest is that cancer incidence is growing at an alarming rate and unfortunately a very significant proportion of it is due to a preventable cause, tobacco abuse. The need of the hour is a strong effort from Government and regulatory authorities to curb tobacco. Effective policies, public education through popular media and partnership of all stakeholders across multiple sectors are some of the ways. Every year on 31st May, the WHO and its global partners celebrate World No Tobacco Day (WNTD). The annual campaign is an opportunity to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form.
The focus of World No Tobacco Day 2019 is on “tobacco and lung health.” The campaign aims to increase awareness on the negative impact of tobacco on people’s lung health, from cancer to chronic respiratory disease.
The focus is not just on Government and such campaigns but on the public as well to understand the risks. Peers to peers, parents to children should talk about the negative impact of tobacco. Its time to ‘kick the butt’!