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‘Ignorance is not always a bliss!’

The recent utterances of few of our parliamentarians for not proceeding with increment of warning picture from 45% to 85% on tobacco products from April 1, 2015, isn’t strange when we learn that the people who are tycoons of bidi industry are part of the said parliamentary committee to advise for anti-tobacco measures. What a travesty, they talk so loudly about ethics and morality in public but throw all the norms to wind and get involved knee deep into conflict of interest.

It smacks of not simply ignorance, but deeper conspiracy to promote business of tobacco industry rather than public health. It is a sad commentary that they are feigning ignorance about the ill effects of bidi smoking on human health. Though they are elected representatives of the people, for the people and by the people they behave just the opposite. Is it not known to every man in the street and corridors of health ministry that the bidi smoking causes many types of cancers, mainly lungs and/or oral cancer, produces heart disease, blood pressure, diabetes, tuberculosis and debilitating lung problems?

The statement made by these so-called caretakers of democracy is not only unfortunate but also shocking and absurd. To say that there is no Indian study to prove the detrimental effects of smoking is simply hogwash. There is not only few, but many Indian studies which have conclusively proved the causal relationship of smoking and cancer.

To support the use of tobacco based on a fraction of population (4 crore) earning their livelihood is a myopic view of the entire picture. We know for definite that our country is facing tremendous financial loss and healthcare burden due to tobacco related health problems mentioned above.

According to the Indian Council of Medical Research (ICMR), the total losses in 1999 due to tobacco-related diseases were about Rs 277.6 billion, equivalent to $6.5 billion. And still our honourable MPs claiming that there is no scientific evidence to support ban on smoking and smoking products is beyond reasons.

Smoking and/or tobacco products are particularly devastating for low socio-economic people because the poor think that bidi is safer than cigarette. The fact of the matter is — bidi is more deadly than cigarette. Let us present four illustrative examples to support our contention that bidi is as dangerous as cigarette if not more:

Illustration 1: A-26-year-old peon in police department, heavy bidi smoker, lean and thin individual, without evidence of hypertension or diabetes, presented to hospital as acute coronary syndrome (heart attack). There was no other plausible reason for this extremely poor young boy to suffer from heart attack other than bidi smoking.
Illustration 1: A-26-year-old peon in police department, heavy bidi smoker, lean and thin individual, without evidence of hypertension or diabetes, presented to hospital as acute coronary syndrome (heart attack). There was no other plausible reason for this extremely poor young boy to suffer from heart attack other than bidi smoking.
Illustration 2: A-55-year-old male, guard in office, chronic bidi smoker was found to be having diabetes, after he developed gangrene in left foot. He continued to smoke. The poor man had to undergo below knee amputation of one leg and suffered septicaemia -- thanks to persistent smoking and diabetes.
Illustration 2: A-55-year-old male, guard in office, chronic bidi smoker was found to be having diabetes, after he developed gangrene in left foot. He continued to smoke. The poor man had to undergo below knee amputation of one leg and suffered septicaemia — thanks to persistent smoking and diabetes.
Illustration 3: A-56-year-old lady with lipid deposits over eye lids, chronic smoker, suffered stroke, had chronic lung disease, heart attack, carotid and aortic arterial disease and extensive dental lesions.
Illustration 3: A-56-year-old lady with lipid deposits over eye lids, chronic smoker, suffered stroke, had chronic lung disease, heart attack, carotid and aortic arterial disease and extensive dental lesions.
Illustration 4: An-85-year-old male, chronic smoker who started smoking at age 7, presented with loss of appetite, inanition, was dehydrated, confused, had severe tenderness in right lumbar region. Ultrasound revealed heterogeneous mass lesion in mid and lower pole of left kidney with extension into left renal vein, suggesting renal cell carcinoma.
Illustration 4: An-85-year-old male, chronic smoker who started smoking at age 7, presented with loss of appetite, inanition, was dehydrated, confused, had severe tenderness in right lumbar region. Ultrasound revealed heterogeneous mass lesion in mid and lower pole of left kidney with extension into left renal vein, suggesting renal cell carcinoma.

It is thus amply clear that ignorance is not always a bliss and when feigned in matters of public health it is a curse which can’t be simply ignored. It is a disgrace and crime against the mankind.

Dr S Dwivedi, Dean/Principal;
Dr Praveen K Malik, Assistant Professor of Medicine;
Dr Mushtaque Ahmed, Lecturer in Medicine;
Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi

7 Comments

  1. Dr.Mamta Dr.Mamta Thursday, April 9, 2015

    The ubiquity of tobacco consumption and its related complications can be gauged from the fact that it has been documented in different cultures and societies all over India. Dr. S. Dwivedi has wonderfully pointed out the problem. Unfortunately, it has caught fantasy of all –Students, auto rickshaw drivers, old, young, professionals, men and women alike. Most tormenting aspect is the general social acceptance and even approval of it in India. Unlike any other disease, Smoking not only affects the individual but at the same time due to Second and Third hand smoke increases risk of tobacco-related health problem in nonsmokers also. Total social costs of tobacco products exceed the direct outlay on them, owing to morbidity, mortality and negative externalities associated with the consumption of tobacco products. It is very heartbreaking that just for their self interests and money, recognition of the costs of tobacco has been obfuscated and obscured by the unethical tactics and practices of the tobacco lobbies. Huge social, economic and environmental costs that are attributable to tobacco consumption make it an important area of public health concern requiring urgent attention. Dr. S Dwivedi has truly written that tobacco consumption is a disgrace and crime against mankind. Policy-makers and researchers have to consider the matter seriously. Policies and initiatives are, therefore, required on priority to encourage cessation of all kinds of tobacco products and Governments need to take strong measures to prevent the menace from spreading. Let us all join hands in an effort to fight for tobacco free world in India.

  2. Dr. (Prof.) Anupam Prakash Dr. (Prof.) Anupam Prakash Tuesday, April 7, 2015

    Tobacco chewing/smoking can not be justified. It does not give you nutrition, just paves way for addiction and a whole of lot of diseases, disability and death. Tobacco cultivation is a good crop to grow, but the result of this cultivation contributes to significant morbidity and mortality.
    Prof. Dwivedi has rightly showed that nobody benefits from tobacco. It is an addiction wherein the cigarette/beedi burns outside, and the smoker burns his life into ashes.
    Foul breath, poor oral hygiene, stained teeth, pigmented oral mucosa do not need evidence, they are self-evident.
    Ask a smoker who develops chronic bronchitis, what his sufferring is! Ask a patient who in middle-age develops Buerger’s disease and has to undergo lower limb amputation! Ask a smoker’s family, when the smoker member does of cancer of lung or for that matter other smoking-related cancers (oral cancer, gut cancer, genitourinary tract cancers). Heart attacks, paralysis, high blood pressure, elevated cholesterol, the tobacco casts its evil shadow on all parts of the body.
    SMOKING KILLS is an apt slogan and all smokers are aware of the same. Those who are not able to quit the habit, are either slave of its addiction potential or alternatively are deriving benefits from the tobacco industry.
    Nobody can justify tobacco use, and any attempt at defending the tobacco industry is going to be suicidal.
    We should all discourage tobacco use and show thumbs down to those who support it.
    Let us strive for a tobacco-free world.

  3. shridhar Dwivedi shridhar Dwivedi Tuesday, April 7, 2015

    Wonderul exposition Prof. Manoj Sharma . Kudos to you

  4. Prof. Manoj Sharma Prof. Manoj Sharma Tuesday, April 7, 2015

    The Irony is that it was in India that it was discovered that oral cancers are caused in Vadakkan ( A type of Tobacco quid) eaters Shrilankan tobacco farm workers in Kanya Kumari District. It was then he suggested to grow more fruits and vegetables that can give protection from these cancers
    It was at Neyyoor Missionary hospital that a Missionary doctor Dr. Ian Morrison Orr discovered the carcinogenic effect of tobacco Please see LANCET of 1933 where this article is published . Later ….my God what a plethora of research, Suryabai, Khanolkar one more punjabi gentleman in Lahore Subba Rao in Hyderbad and Wahi and Luthra in Agra have given enough of research work on Maenpuri tobacco .. Dr.Prem Nath Wahi son of Dr. Parmeshwar Nath Wahi. At one point of Time Chief Minister Mulayam Singh Wanted to start a Cancer Hospital in Maenpuri
    Much later Prof S. Krishnamurthy Father of Oncological Sciences and Prof. V. Shanta Mother of Oncological Sciences have continued this work the the world famous Centre of Excellence at Adyar Chennai, the Cancer Institute of Adyar under the auspecies of Womens IndianAssociation as founded by Dr. Muthulakshmi Reddy , the first lady FRCS of India.
    The very first systemic population based screening carried out in 1956 in the Chinglepet Taluka of Madras Presidency revealed the evidence of tobacco related cancers .

    Dr. BM Nene in Barshi di the similar survey to collect similar evidence in mid seventies or so

    Prof Attar Dev Singh of CMC Vellore/ BHU VARANASI and PMCH Patna has also lectured aroudn with those ghastly photographs of what he called KHAINEE CANCER!!!

    What about the world over research and the fight against tobacco in developing countries? it will take their life time to study those details . But they do not read all this and can afford to blabber or blurt out because they have an unquestionable MAJORITY!!!
    That is why they say Absolute Power Corrupts and this Govt. is no exception , their MPS are talking what ever they want where ever they want .

    Prof. Usha Luthra and Prof. V. Shanta are still there serving the humanity in their great capacities.
    They are not the mebers of this partialmentary committee but some ignorant illiterate in terms of medical sciences education are the members . This is the irony , this is the BAD NASEEB of this country. Who is NASEEB WALA then? the tobacco magnets, the Lalas( the businessmen) and the Biri industry.

    In the end I have to say भैंस के आगे बीन बजाए , और भैंस खड़ी बौराए।

  5. subhadra Jalali subhadra Jalali Monday, April 6, 2015

    Profound harmful effects of tobacco on the eye have been shown in experimental studies in animals, extrapolated to humans and also shown in large scale epidemiological studies of populations who smoke versus those who do not smoke.
    1. Early onset cataracts, especially Niger cataracts (or black cataracts) are seen in smokers. These are hard and difficult to remove cataracts. Tobacco feed to rodents have shown same type of cataracts developing.
    2. Age related macular dehgeneration occurs more often in smokers than in non-smokers and causes legal blindness after 60 years or so of age due to bleeding in choroid-retina at macular area.
    3.Chronic use of Gutka/Bidi/ chewing tobacco, with or without alcohol causes Optic atrophy very well documented from more than 100 years as ‘Tobacco-alcohol amblyopia’. Youngest patient of this entity was a twenty year old boy. I saw who became nearly blind as he would eat 20 packs of Gutka daily. After counselling and stopping Gutka, partial vision could be restored only.

    Tobacco not only causes lungs and heart and vascular diseases but also blindness and vision loss!

  6. A. Indrayan A. Indrayan Sunday, April 5, 2015

    Well said, Prof Dwivedi and others.

  7. Dr. Firdous Wani Dr. Firdous Wani Sunday, April 5, 2015

    An impartial observations of Prof. Dewvidi and his colleagues is reality. But who care? India is living in status quo. We all know how to generate comforts for us and our family. How many citizens predominantly the medical fraternity, to mobilise mass movement to protect against those who deliberately tried to misled the nation.

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