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Gutka,  Paanwallahs and a Tory candidate


If Tory leadership candidate Kenneth Clarke is selected his to replace Michael Howard his stated plan is to resign from the board of British American Tobacco (he is deputy chairman).

Along with his recent reversal of opinion on the EURO Clarke is undergoing a metamorphosis aimed to influence grassroots voters who regard him as a classic 'wet' liberal.

The MP for Rushcliffe might also miss out on a growing business opportunity in the Indian sub-continent where nicotine addicts will require to find alternative ways to get their fix.

Yesterday (August 7th) the Sindh High Court upheld a ban on Gutka, a sweet, flavorful tobacco product manufactured in India and exported to a few other countries. Used by millions of adults it is also marketed to children. It is used in the same way as American chewing tobacco and, like American chewing tobacco, is considered responsible for oral cancer and other severe negative health effects.

Gutka use often begins at a very young age. The product contains large amounts of sweeteners to conceal the bitterness of the tobacco, and children often consider it as a type of candy. Symptoms of cancer often appear by high school or college age. Social custom does not permit children in India to smoke cigarettes, so gutka use, being all but invisible to others, is the method of choice.

Maharashtra State has placed a five year ban on all use of gutka (as a potentially hazardous foodstuff), but an active black market persists.

Pan masala is a sort of mouth freshener of Indian origin. The basic ingredients of pan masala are betelnuts, catechu, cardamom, lime and a number of fine natural perfuming materials. Gutkha is a variant of Pan Masala made by adding chewing tobacco in flavored pan masala. Pan (betel leaf) was originally chewed after meals as the betel leaf is considered to have digestive properties. However with changing life style, the Pan has been to some extent been replaced by its counterpart Pan masala, which is more convenient to carry. These products are generally habit forming and addictive in nature.

Pan masala and gutkha products are popular in both the urban and the rural areas of the country. Pan masala has a higher penetration of 8.6% in the urban areas as compared to 6.6% in the rural areas. The industry has a strong presence in the western and northern states of India.  According to India online  banning is not enough to prevent the menace.

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Need for a healthy and safe alternative.

Thousands of Gutka chewers went without their favorite pouches on Thursday August 1st as Maharashtra began implementing its blanket ban on chewing and sale of Gutka in Maharashtra. Paanwallahs, shops and stalls selling tobacco products preferred not to sell gutka mostly fearing imprisonment for six months to three years and a fine of Rs 1,000.

To top this the anti tobacco activists and concerned citizens are asking why other tobacco products like zarda, bidis and cigarettes are still being ignored as health hazards.

But the big question is would a ban on all tobacco products be able to prevent this national menace? Will this not induce the users to find other ways and means to procure and satisfy their craving?

Banning addictive substances does not stop people from using them. Rather, it leads to illegal, parallel markets. Solution lies not just with the ban but also in providing safe and healthy alternatives. Nicotine Replacement Therapies, which are aimed at ending tobacco dependence, should be made easily available simultaneously in the country. Unlike the western forms of NRTs like transdermal patches, India should have its own version of NRTs, developed keeping in mind the lifestyle, habits, tastes and attitudes of the Indian population. It should be made affordable and accessible to everyone.

Toll of Tobacco Hazards in India:
A survey done by the Indian Dental Association found that 10%-40% of school students and 70% of students in colleges in Mumbai chew gutka and paan masala. Gutka, a cocktail of carcinogens contains many unhealthy addictives like magnesium carbonate, Phenyl Ethyl Alcohol along with harmful perfumery compounds like Musk Ketones and other injurious fragrance compounds, which are not safe even in toiletries and is one of the major causes of Oral cancer in the country. India has 75,000 to 80,000 new cases of oral cancer a year - the world's highest incidence, and an estimated 2,200 deaths a day are tobacco related.

According to WHO findings, Tobacco is responsible for a significant amount of morbidity and mortality among middle-aged adults. India has one of the highest rates of oral cancer in the world, and the rates are still increasing. Tobacco-related cancers account for about half of all cancers among men and one-fourth among women.

In 1992, 6.1% of world total unmanufactured tobacco and 1.5 % of world total manufactured cigarettes were consumed in India. Only about 20% of the total tobacco consumed in India (by weight) is in the form of cigarettes. Bidis account for about 40% of tobacco consumption (about 675,000 million bidis), with the rest divided among Gutka, pan masala, snuff, hookah, hookli, chutta dhumti, and other tobacco mixtures featuring ingredients such as areca nut. Chuttas and dhumtis are also smoked in reverse fashion, with the lighted end inside the mouth.

How harmful is Nicotine per se:

According to research findings nicotine in itself is not the primary cause of tobacco related disease. The main disease causing elements are the other carcinogens present in all tobacco products like cigarettes, gutka, etc.

‘Tar’, a dark, viscous fluid formed from tobacco smoke contains at least 4,000 different chemicals, including over 50 known carcinogens and metabolic poisons. Other carcinogens include carbon monoxide, oxides of nitrogen and hydrogen cyanide. Similarly in Gutka, along with tobacco other ingredients include … gutka also contains betel nuts, tobacco, lime and catechu. These substances damage the sensitive oral mucosa, causing constant irritation and micro trauma to the mucosa.

Chemicals present act as toxin. This can lead to sub mucous fibrosis (a state when the sufferer can’t open the mouth and had to live on liquids only), cancer of mouth and pharynx, leukoplakia (white sores in the mouth that can lead to cancer), gum recession or peeling back of gums, bone loss around teeth, abrasion of teeth and bad breath.Thus it is the delivery system, not the drug, which is responsible for the vast majority of tobacco-caused disease.


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