‘Tobacco addicts should have annual tests for cancer’
Huge tobacco use in India seen killing 1.5 million a year By Kate Kelland LONDON | Thu Sep 12, 2013 4:28am EDT (Reuters) – Tobacco inflicts huge damage on the health of India’s people and could be clocking up a death toll of 1.5 million a year by 2020 if more users are not persuaded to kick the habit, an international report said on Thursday. Despite having signed up to a global treaty on tobacco control and having numerous anti-tobacco and smoke-free laws, India is failing to implement them effectively, leaving its people vulnerable to addiction and ill health, according to the report by the International Tobacco Control Project (ITCP). “Compared with many countries around the world, India has been proactive in introducing tobacco control legislation since 2003,” said Geoffrey Fong, a professor of psychology at Canada’s University of Waterloo and a co-author of the report. “However … the legislation currently in place is not delivering the desired results – in terms of dissuading tobacco use and encouraging quitting.” As a result, India, with a population of 1.2 billion, currently has around 275 million tobacco users, the report said. Harm from tobacco accounts for nearly half of all cancers among males and a quarter of all cancers among females there, as well as being a major cause of heart and lung diseases. “The tobacco epidemic in India requires urgent attention,” the report said, adding that by 2020, tobacco consumption will account for more than 1.5 million Indian deaths a year. Worldwide, the number of deaths caused by tobacco is expected to rise from around 6 million a year now to more than 8 million by 2030, according to the World Health Organisation. The ITCP India Survey conducted face to face interviews with 8,000 tobacco users and 2,400 non-users across four Indian states – Bihar, Madhya Pradesh, Maharashtra and West Bengal. So-called smokeless tobacco – including chewing products such as gutkha, zarda, paan masal and khaini – is the most common form of tobacco use in India, with many poorer people and women preferring these over smoking cigarettes or bindis – small, cheap, locally-made cigarettes. According to the Global Adult Tobacco Survey, 26 percent of adults in India consume smokeless tobacco – 33 percent of men and 18.4 percent of women. Smokeless tobacco can cause oral and other cancers, as well as other mouth diseases and heart disease. Among several striking findings in the ITCP report was that, while many smokers and tobacco users said they knew of the health risks, only a small proportion said they would like to quit. Up to 94 percent of smokers and up to the same proportion of smokeless users in the survey said they had no plans to give up. more to follow…..
Set against this, the report also found that up to 81 percent of smokers and up to 87 percent of smokeless tobacco users expressed regret for taking up the habit, and more than 90 percent of tobacco users and non-users in all four states had negative views on smoking and tobacco. The report said that, while India has been a regional leader in enacting tobacco control legislation over the past 10 years, the laws are poorly enforced, regulations covering smoke-free zones are patchy, and tobacco remains relatively cheap. Fong said the low percentage of people wanting to quit meant deaths from tobacco use were destined to stay high. “If there is any single indicator of the urgent need for continued and strengthened efforts for strong, evidence-based tobacco control in India – this is it.” Cancer Statistics Smoking and Cancer – Statistics for the U.S. By Terry Martin, About.com Guide Learn About Pancreas Transplants. Advanced Options & Shorter Waitlist When people think of cancers caused by smoking, the first one that comes to mind is always lung cancer. Most cases of lung cancer death, close to 90% in men, and 80% in women are caused by cigarette smoking. There are several other forms of cancer attributed to smoking as well, and they include cancer of the oral cavity, pharynx, larynx, esophagus, bladder, stomach, cervix, kidney and pancreas, and acute myeloid leukemia. The list of additives allowed in the manufacture of cigarettes consists of 599 possible ingredients. When burned, cigarette smoke contains over 4000 chemicals, with over 40 of them being known carcinogens. Cancer is the second leading cause of death and was among the first diseases causally linked to smoking. Lung cancer is the leading cause of cancer death, and cigarette smoking causes most cases. Compared to nonsmokers, men who smoke are about 23 times more likely to develop lung cancer and women who smoke are about 13 times more likely. Smoking causes about 90% of lung cancer deaths in men and almost 80% in women. In 2003, an estimated 171,900 new cases of lung cancer occurred and approximately 157,200 people died from lung cancer. The 2004 Surgeon General’s report adds more evidence to previous conclusions that smoking causes cancers of the oral cavity, pharynx, larynx, esophagus, lung and bladder. Cancer-causing agents (carcinogens) in tobacco smoke damage important genes that control the growth of cells, causing them to grow abnormally or to reproduce too rapidly. Cigarette smoking is a major cause of esophageal cancer in the United States. Reductions in smoking and smokeless tobacco use could prevent many of the approximately 12,300 new cases and 12,100 deaths from esophgeal cancer that occur annually. The combination of smoking and alcohol consumption causes most laryngeal cancer cases. In 2003, an estimated 3800 deaths occurred from laryngeal cancer. more to follow….
In 2003, an estimated 57,400 new cases of bladder cancer were diagnosed and an estimated 12,500 died from the disease. For smoking-attributable cancers, the risk generally increases with the number of cigarettes smoked and the number of years of smoking, and generally decreases after quitting completely. Smoking cigarettes that have a lower yield of tar does not substantially reduce the risk for lung cancer. Cigarette smoking increases the risk of developing mouth cancers. This risk also increases among people who smoke pipes and cigars. Reductions in the number of people who smoke cigarettes, pipes, cigars, and other tobacco products or use smokeless tobacco could prevent most of the estimated 30,200 new cases and 7,800 deaths from oral cavity and pharynx cancers annually in the United States. New cancers confirmed by this report: The 2004 Surgeon General’s report newly identifies other cancers caused by smoking, including cancers of the stomach, cervix, kidney, and pancreas and acute myeloid leukemia. In 2003, an estimated 22,400 new cases of stomach cancer were diagnosed, and an estimated 12,100 deaths were expected to occur. Former smokers have lower rates of stomach cancer than those who continue to smoke. For women, the risk of cervical cancer increases with the duration of smoking. In 2003, an estimated 31,900 new cases of kidney cancer were diagnosed, and an estimated 11,900 people died from the disease. In 2003, an estimated 30,700 new cases of pancreatic cancer were diagnosed, attributing to 30,000 deaths. The median time from diagnosis to death from pancreatic cancer is about 3 months. In 2003, approximately 10,500 cases of acute myeloid leukemia were diagnosed in adults. Benzene is a known cause of acute myleoid leukemia, and cigarette smoke is a major source of benzene exposure. Among U.S. smokers, 90% of benzene exposures come from cigarettes. Smoking remains the leading cause of preventable death and has negative health impacts on people at all stages of life. It harms unborn babies, infants, children, adolescents, adults, and seniors. Cigarette Ingredients Ingredients in Cigarettes Hydrogen Cyanide in Cigarette Smoke Toxicology of Cigarette Smoke Help With Quitting Tobacco Quit Smoking 101 – A Free Email Course Developing the Will To Quit Smoking Preparing for Your Quit Date After You Quit Smoking How Your Body Heals 4 Steps to Defeating the Urge to Smoke 10 Things to Avoid when You Quit Smoking Related Articles Cigarette Smoking and Cancer – Questions and Answers – Smoking and Cancer 5 Reasons to Quit Smoking Cigarettes How Many People Die From Lung Cancer Each Year Smoking and Lung Cancer Carcinogens in Cigarettes: How They Cause Cancer Terry Martin Terry Martin Smoking Cessation Guide Â©2013 About.com. All rights reserved. …and I am Sid Harth
Tobacco Facts Tobacco is the leading cause of preventable illness and death in the United States. It causes many different cancers as well as chronic lung diseases, such as emphysema and bronchitis, and heart disease. Cigarette smoking causes an estimated 443,000 deaths each year, including approximately 49,000 deaths due to exposure to secondhand smoke.[2,3] Lung cancer is the leading cause of cancer death among both men and women in the United States, and 90 percent of lung cancer deaths among men and approximately 80 percent of lung cancer deaths among women are due to smoking.[4,5] Smoking causes many other types of cancer, including cancers of the throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, and cervix, and acute myeloid leukemia. People who smoke are up to six times more likely to suffer a heart attack than nonsmokers, and the risk increases with the number of cigarettes smoked. Smoking also causes most cases of chronic obstructive lung disease. In 2011, an estimated 19 percent of U.S. adults were cigarette smokers. Nearly 16 percent of high school students smoke cigarettes. An estimated 7.3 percent of high school students use smokeless tobacco. Cigarette Smoking: Health Risks and How to Quit (PDQÂ®) Current Cigarette Smoking Among Adults – United States, 2011. Morbidity and Mortality Weekly Report. 2012 NCI Fact Sheet: Secondhand Smoke and Cancer Lung Cancer Prevention (PDQÂ®) 2004 Surgeon General’s Report – The Health Consequences of Smoking National Heart, Lung, and Blood Institute: Your Guide to a Healthy Heart Current Tobacco Use Among Middle and High School Students – United States, 2011. Morbidity and Mortality Weekly Report. 2012
Tobacco and cancer risk statistics Summary Smoking is the single greatest avoidable risk factor for cancer; in the UK, it is the cause of more than a quarter (28%) of all deaths from cancer and has killed an estimated 6.5 million people over the last 50 years.2 A study published in December 2011 estimated that smoking causes nearly a fifth of all cancer cases in the UK.35 Worldwide, tobacco consumption caused an estimated 100 million deaths in the last century and if current trends continue it will kill 1,000 million in the 21st century.36 Around half of all regular smokers will die from the habit, half of these in middle age.1 One in five British adults currently smokes Smoking causes around 87% of lung cancer deaths in men and around 83% of lung cancer deaths in women in the UK Smoking prevalence (any tobacco product) in British men was 30% in 2002 compared with 82% in 1948 Table 1.1 shows the strength of evidence for an increased risk of cancer due to tobacco consumption. Table 1.1 Strength of evidence for an increased risk of cancer due to tobacco consumption Download this table (18.5KB) section reviewed 01/06/05 section updated 01/05/12 Back to top Lung cancer Smoking causes around 87% of male and around 83% of female deaths from lung cancer in the UK.2 The estimate of lung cancer cases due to smoking in the UK is almost identical (87% of cases in men and 84% in women). This figure includes around 1,000 lung cancer cases due to exposure to environmental tobacco smoke in lifelong non-smokers.35 The link between lung cancer and cigarette smoking was first established in 1950, with a study showing a 26-fold increased risk of lung cancer among smokers of 15-24 cigarettes a day, compared with non-smokers.3 Recently, a 50-year follow-up study of smoking and lung cancer in British doctors showed a similar 25-fold increase in lung cancer risk in men smoking 25 cigarettes a day or more, compared to lifelong non-smokers.27 Lung cancer risk increases with both duration and intensity of smoking.4 (Figure 1.15) Figure 1.1: Relative of risk of lung cancer according to duration and intensity of smoking, men Download this chart (16KB) The effect of stopping smoking at any age on the excess risk of lung cancer is striking. Figure 1.2 shows the cumulative risk of lung cancer among men in the UK at age 75 according to age at which they stopped smoking.6 Figure 1.2: Cumulative risk of lung cancer among men in the UK at age 75, according to age at which they stopped smoking Download this chart (14.5KB) The interaction between smoking and other harmful exposures can result in a much greater risk in people exposed to both. The risks of smoking and exposure to radon interact multiplicatively, and reanalysis of data from European case-control studies shows that most of the additional cases of lung cancer in people exposed to radon in the home are in smokers.7 more to follow….
Studies have shown that exposure to asbestos increases the risk of lung cancer by around ten-fold in non-smokers, while in smokers exposed to asbestos, there is a 100-fold increase in risk.8 Exposure to environmental tobacco smoke also causes lung cancer. The most recent meta-analyses show that exposure to ETS at work or in the home increases the risk of lung cancer among non-smokers by about a quarter, while heavy exposure at work doubles the risk.9,11 Exposure to ETS may also increase the risk of pharyngeal and laryngeal cancer.14 It has been estimated that exposure to ETS in the home causes around 11,000 deaths in the UK each year from lung cancer, stroke and heart disease combined.10 Male lung cancer incidence rates peaked in the early 1970s, reflecting the peak in smoking prevalence 20-30 years earlier. Rates in women have stabilised, after increasing throughout the 1970s and 1980s. Forecasting suggests that female lung cancer mortality rates will reach current male levels within the next ten years and then fall, while deaths will continue to fall in men.12 section reviewed 01/06/05 section updated 01/06/05 Back to top Types of tobacco Most UK evidence on tobacco and cancer risk is based on smokers of manufactured filtered cigarettes. Risk is generally higher among smokers of filter-less cigarettes, high tar cigarettes, and black tobacco. Hand-rolled cigarettes have a stronger effect than manufactured cigarettes on risk of cancer of the oral cavity and pharynx.17,18 The proportion of male British smokers consuming self-rolled cigarettes increased to 37% in 2009 from 25% in 1998, and among women it increased from 8% to 21% over the same period.19 Pipe and cigar smokers have an increased risk of lung and upper aerodigestive tract cancer compared with non-smokers.4 A cohort study reported a seven-fold increase in risk of liver cancer in current cigar smokers and another study reported a three-fold increase in risk for current cigar or pipe smokers.20,21 Heavy pipe or cigar smoking also increases risk of bladder, bowel, stomach and pancreas cancers.4 The proportion of all men in Britain smoking cigars in 2009 was 2%, compared with 16% in 1978. Less than 1% of men in Britain smoke a pipe.19 Long-term users of smokeless (chewing) tobacco have an increased risk for oral, pancreatic and oesophageal cancer. Much of the evidence for such an association comes from South East Asia, where betel quid is widely used. A recent review summarising the evidence about cancer and smokeless tobacco to date gave risk ratios for oral cancer in smokeless tobacco users in India and other Asian countries of about five, and in Sudan of about seven. The risk ratio for oral cancer in smokeless tobacco users in the USA and Canada was 2.6. more to follow….
Risk estimates of 1.6 and 1.8 were given for oesophageal and pancreatic cancer in Northern European smokeless tobacco users.22 In India, the risk of oral cancer is greatest in chewers of mixtures containing tobacco, but the risk in chewers of betel quid without tobacco is higher than non-users.23 While the use of smokeless tobacco is not widespread in the UK, it is relatively common among some South Asian communities (Figure 1.333). The prevalence of tobacco chewing increases with age, especially among Bangladeshi men and women. Betel quid (with and without tobacco) is the most commonly used product.25 Figure 1.3: Use of Smokeless Tobacco and Cigarette Smoking, UK South Asians, by Sex and Age, 2004 Figure 1.3: Use of smokeless tobacco and cigarette smoking in UK South Asians, by sex and age, 2004 Download this chart (33.5KB) section reviewed 01/06/05 section updated 01/02/09 Back to top Other smoking related cancers While deaths from lung cancer account for around a 66% of smoking related cancer deaths in the UK,2 smoking is also an established risk factor for cancers of the oesophagus, larynx, pharynx, oral cavity, pancreas, bladder, nasal cavity and sinuses, stomach, liver, kidney, cervix and myeloid leukaemia.4 The International Agency for Research on Cancer in 2009 stated there is now sufficient evidence that smoking is also a cause of bowel cancer and ovarian (mucinous) cancer.14 After lung cancer, the upper aerodigestive tract cancers (larynx, oral and pharynx and oesophagus) have the highest smoking population attributable fractions (PAFs), of around 65% or higher.35 Also, alcohol consumption in combination with smoking greatly increases the risk of upper aerodigestive tract cancers (see section on alcohol).13 Smoking cessation reduces the risk for most of these cancers. The risk for cancers of the upper aerodigestive tract in ex-smokers becomes lower than that of a current smoker within five years, although risk is still higher than someone who has never smoked 20 or more years after stopping, and the risk for bladder cancer is also higher than in never-smokers 20 years after giving up.15-16,28 section reviewed 01/06/05 section updated 01/04/12 More to follow…
Smoking prevalence One in five British adults currently smokes. In 2010, as in 2008, the difference in smoking prevalence between men (21%) and women (20%) was not significant.37 The average consumption of cigarettes per smoker per day is 14 in men and 13 in women.19 The peak smoking prevalence is in younger adults, after which prevalence falls. Only 14% of British people over 60 years old smoke cigarettes. Almost 40% of regular smokers began smoking regularly before the age of 16.19 Figure showing smoking prevalence in England by socioeconomic classification Download this chart As Figure 1.4 shows, smoking rates are higher in among manual workers compared with non-manual. Among managerial and professional workers in England, in 2009, smoking prevalence was 15%, compared with 28% of routine and manual workers.19 Geographical variations in smoking prevalence within the UK largely reflect these socioeconomic differences. Smoking rates in Scotland are higher than elsewhere in the UK with 25% of men and women smoking.19 The prevalence of smoking peaked in the late 1940s for British males at 82% and the 1970s for British females at 44%.26 The epidemic of smoking related cancers in the UK has peaked and recent years have seen record falls in death rates for smoking related diseases. (Figure 1.519) Figure 1.4: Prevalence of cigarette smoking in persons aged 16 or over, GB, 1974-2002 Download this chart (13.5KB) Currently in Britain, 28% of men and 22% of women are ex-smokers, and 63% of those who do smoke would like to quit.19 section reviewed 01/06/05 …and I am Sid Harth
References for tobacco and cancer risk Peto R. Smoking and death: the past 40 years and the next 40. BMJ 1994; 309(6959):937-9. Peto R, et al. Mortality from smoking in developed countries 1950-2005 (or later). March 2012. Doll R, Hill AB. Smoking and carcinoma of the lung. Preliminary report. British Medical Journal, 1950;739-48. International Agency for Research on Cancer, Tobacco smoking, in IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans. 1986, IARC: Lyon. p. 127-35. Rylander R, Axelsson G, Andersson L, et al. Lung cancer, smoking and diet among Swedish men. Lung Cancer 1996; 14 Suppl 1:S75-83. Crispo A, Brennan P, JÃ¶ckel KH, et al. The cumulative risk of lung cancer among current, ex- and never-smokers in European men. Br J Cancer 2004; 91(7):1280-6. Darby S, Hill D, Auvinen A, et al. Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies. BMJ 2005; 330(7485):223. Lee PN. Relation between exposure to asbestos and smoking jointly and the risk of lung cancer. Occup Environ Med 2001; 58(3):145-53. Taylor R, Najafi F, Dobson A, et al. Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent. Int J Epidemiol 2007; 36(5):1048-59. Jamrozik K. Estimate of deaths attributable to passive smoking among UK adults: database analysis. BMJ 2005; 330(7495):812. Stayner L, Bena J, Sasco AJ, et al. Lung cancer risk and workplace exposure to environmental tobacco smoke. Am J Public Health 2007; 97(3):545-51. Scottish Executive Health Department, Cancer Scenarios: An aid to planning cancer services in Scotland in the next decade. 2001. The Scottish Executive: Edinburgh. International Agency for Research on Cancer, IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Tobacco smoke and involuntary smoking. Volume83 ed. Vol. 83. 2004, Lyon: IARC Press. Secretan B, Straif K, Baan R, et al. A review of human carcinogens–Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol 2009; 10(11):1033-4. Brennan P, Bogillot O, Cordier S, et al. Cigarette smoking and bladder cancer in men: a pooled analysis of 11 case-control studies. Int J Cancer 2000; 86(2):289-94. Brennan P, Bogillot O, Greiser E, et al. The contribution of cigarette smoking to bladder cancer in women (pooled European data). Cancer Causes Control 2001; 12(5):411-7. De Stefani E, Boffetta P, Oreggia F, et al. Smoking patterns and cancer of the oral cavity and pharynx: a case-control study in Uruguay. Oral Oncol, 1998. 34(5): 340-6. De Stefani E, Oreggia F, Rivero S, et al. Hand-rolled cigarette smoking and risk of cancer of the mouth, pharynx, and larynx. Cancer 1992; 70(3):679-82. Office for National Statistics: General Lifestyle Survey: Smoking and drinking among adults, 2009. London: ONS; 2011. More to follow…
Cancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666) and the Isle of Man (1103). A company limited by guarantee. Registered company in England and Wales (4325234) and the Isle of Man (5713F). Registered address: Angel Building, 407 St John Street, London EC1V 4AD. …and I am Sid Harth Mr Modi, considering the evidence, Oops, make it a definitive scientific evidence, presented by me, what concrete plans do you have to eradicate tobacco consumption in India, Oops, Bharat, under your noble leadership, as a three terms chief minister of a progressive, Oops, ‘garvi gujarat,?’ I want to know. …and I am Sid Harth
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