Gutka, chewing tobacco with areca nut, slaked lime, and other ingredients, is a significant public health issue in India. With increasing awareness of its risks, its use still continues on a large scale, resulting in serious health outcomes. With stringent legislation and heightened public awareness, can India become gutka-free? Let’s understand the scenario now. The article talks about the health implications of tobacco use in India, and the country’s efforts to combat it.
How prevalent is gutka use in India?
Gutka is shockingly popular in India, especially among teenagers, manual labourers, and rural masses. The Global Adult Tobacco Survey 2 (GATS-2, 2016-17) reports that almost 26.7 crore Indians consume tobacco in any form. Around 19.9 crore people in rural areas and 6.8 crore people use tobacco in urban areas. Moreover, 19.9 crore people use smokeless tobacco products such as gutka and khaini.
In contrast to cigarettes, gutka is perceived to be socially acceptable, thus making it more challenging to counteract. Most consumers think gutka makes them stress-free or enhances concentration. However, it is very addictive because of nicotine and other toxic chemicals. Moreover, it is easily available in cheap, little sachets contributing to the issue, making them more accessible for people.
Dr Moujhuri Nandi, Consultant Radiation Oncologist, Karkinos Healthcare Pvt. Ltd, explains “Tobacco can be used in two forms – Smoking and smokeless. Tobacco products which are used in a way other than smoking are called smokeless tobacco. The most common smokeless products are chewing tobacco, naswar, snuff, snus, gutka, and topical tobacco paste. There are more than twenty-five compounds in smokeless tobacco that have cancer-causing properties. Tobacco-specific N-nitrosamines are the major cancer-causing agents in smokeless tobacco. Other cancer-causing agents that are present in smokeless tobacco include cadmium, polonium-210, formaldehyde, benzo(a)pyrene, and lead. Nicotine is an addictive agent. People repeatedly place it in the same area of the mouth, which increases the risk of changes in the inner lining or mucosal lining. People generally keep the juice either between their lower lip and gums, or their cheeks. The skin absorbs the carcinogens due to the close and prolonged contact of the tobacco with the mouth’s inner lining, or mucosa. This absorption leads to changes in the mucosa at those locations, as in other areas of the mouth, that later leads to cancer.”
What are the early warning signs of oral cancer?
Oral cancer, one of the most perilous side effects of gutka use, is one of the most prevalent cancers in India. Regrettably, most individuals do not heed the early warning signs until the condition reaches an advanced stage. Some of the earliest symptoms are:
- Chronic mouth ulcers that fail to heal
- Red or white patches in the mouth
- Trouble in chewing or swallowing
- Numbness or pain in the jaw and mouth
- Unintentional weight loss
- Continued bad breath and excessive saliva
Early identification of these signs and medical attention can lead to early diagnosis and treatment. Nevertheless, the best method of prevention of oral cancer is to give up gutka altogether.
Are flavoured tobacco products safer?
Numerous companies market flavoured gutka, paan masala, and tobacco products on the mistaken belief that they are safer. Nonetheless, these flavoured products contain almost the same amount of cancer chemicals including nicotine, areca nut, and toxic metals.
Flavored gutka is usually more attractive to younger consumers, and hence it leads to premature addiction. Research indicates that tobacco plus areca nut raises oral cancer risk greatly among non-users. Regardless of the flavour or company, there is nothing safe about any type of sugar-coated or flavoured gutka.
How strict laws can regulate tobacco consumption in India?
The Indian government has initiated various measures to discourage gutka consumption, but there are still issues. A few of the major steps are:
Prohibiting gutka in most states: Since 2012, numerous Indian states have prohibited gutka selling. Nonetheless, illicit selling persists, necessitating more stringent enforcement.
High taxing on tobacco products: Tolls cause gutka to become costly, reducing consumption.
Graphic warnings on health: Gutka packets contain ghastly pictures of oral cancer to alert consumers to its risks.
School awareness programs: Most schools make students aware of the hazards of tobacco, and avert premature addiction.
However, when we compare GATS 1 and 2, we see that there has been a reduction in the use of tobacco products by 2016-17 as compared to before. The number of tobacco consumers has reduced by 81 lakh, implying a tobacco free India could be possible.
Furthermore, the National Health Policy 2017 has set a target of “relative reduction in the tobacco users by 15% by 2020, and 30% by 2025” aiming to lead India to make gutka-free in the near future.
Nonetheless, loopholes in the system permit gutka to be easily accessible. Improving enforcement, higher penalties for vendors, and conducting vigorous anti-tobacco campaigns can bring India closer to being gutka-free.
Final Thoughts
A gutka-free India is an achievable goal, but it can only be achieved through a concerted effort by the government, health bodies, and the people. Tougher legislation, improved awareness, and access to quitting tobacco can free millions of Indians from this deadly habit.
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