India is getting serious about helping smokers quit. The Union health ministry has put in place 19 tobacco cessation centres. Similar centres are expected to come up in 42 district hospitals in 21 states. The ministry has developed a training manual to train doctors on tobacco cessation, including nicotine replacement therapy (NRT).
India is yet to introduce NRT – chewing gums meant to help chain-smokers kick the butt – in these cessation centers.
India is home to nearly 12 crore smokers. Of these, experts say, only 2% manage to quit smoking L&M cigarette every year. However, the data from the tobacco cessation centres show that the quit rate is about 14%.
The ministry is also planning to write to the national pharmaceutical pricing authority to subsidize the price of nicotine chewing gums.
Once available in the government’s tobacco control programme, NRT will help a lot more Indian access “this life-saving therapy”. A pack of 10 gums cost between Rs 45 and Rs 90. A chain-smoker wanting to quit will need around two packs a day for a maximum of six months.
Union health minister Ghulam Nabi Azad said the World Health Organization (WHO) has included NRT in its list of essential medicines in 2008.
Azad said, “The ministry has developed tobacco dependence treatment guidelines recognizing the need for professional help to tobacco users to quit as well as to sensitize train and equip healthcare workers with the knowledge and skills providing treatment for tobacco dependence.”
Dr K Srinath Reddy, head of Public Health Foundation, said, “NRT acts as a bridge to cessation. It has to be doubled with counselling. Cost is a major factor why NRTs haven’t caught on in India. They have around 15% efficacy. Reducing their price will get more Indians trying to quit smoking to use NRT. But India has to increase its tobacco cessation centers.”
Globally, over 35 million smokers try to quit the habit each year, yet fewer than 5% reach their first anniversary. Nearly six million people die worldwide annually of tobacco use and exposure to second-hand smoke. This is expected to rise to eight million by 2030. It is also estimated that up to one billion could die of tobacco use in the world during the 21st century. In WHO’s South-East Asia Region, over 240 million adults smoke tobacco and nearly the same number of adults use smokeless forms of tobacco in various forms.
One of the world’s best known anti-tobacco scientist Dr Simon Chapman from the University of Sydney had earlier told TOI that cessation clinics for habitual smokers – a strategy used by India to help people kick the nicotine fix – is counterproductive.
Investments made to set up clinics don’t really help smokers to quit, and the funds could be better utilized in mass awareness campaigns, he had explained.
Dr Chapman had said only 3% smokers actually call helplines or attend cessation units. “While an overwhelming 97% actually quit on their own after learning of tobacco’s harmful effects on health. Mass media campaigns are a better intervention. Though cessation units lead to a decline in tobacco consumption, usually it happens over a very long period of time,” he had added.
The recently released Global Adult Tobacco Survey (GATS) revealed that one-third Indian adults consume tobacco of which 26% consume smokeless tobacco. India shares the highest burden of oral cancer in the world at 80%-90%. The health ministry believes that 40% of India’s health problems stem from tobacco use.