Indias socially acceptable addiction: Tobacco. Advantages more or disadvantages?

At the outset let us get it clear that cigarette, bidi, chewable tobacco, gutkha, jarda, misri,
snuff, etc. all contain tobacco. First, lets have a look at the disadvantages of using tobacco.

I) Tobacco use has been found to be the single largest cause of preventable premature death,
throughout the world! In USA, about 25% of male deaths are due to smoking! Sounds
impossible; but these statistics have been derived from large, authentic studies:
1) According to a prospective study of over 1 million people, conducted by the American
Cancer Society, tobacco is responsible for:
30% of Cancers (This includes 87% of lung cancers), 22% of heart attacks,27% of paralytic
strokes and 72% of COPDs (Chronic obstructive pulmonary diseases).

2) Oral Cancer, is a rare cancer throughout the world. However in India, because chewing
tobacco, betel nut (supari) gutkha and misri is loved by a large number of people, it has
become the most common cancer! Tobacco damages the chromosomes. This leads to
uncontrolled cell division, giving rise to various cancers.

3) One fourth of the heart attacks and strokes happening around us are because of tobacco!
Like cholesterol, tobacco also causes premature hardening and narrowing of arteries. When
the artery to the heart or brain gets blocked completely, one gets a heart attack or a
paralytic stroke.

4) Smoking damages the lungs badly. 72% of the COPDs i.e. diseases with severe breathing
difficulties, are caused by smoking. And then the damaged lungs easily catch various
infections. Hence deaths from tuberculosis, pneumonia, etc. are common in smokers.

5) According to an Indian study by V.Gajalakshmi, et.al published in The Lancet, (Lancet is the
no.1 medical Journal in the world)
Smoking is the cause of half the male tuberculosis deaths in India, and of 25% of all
male deaths in middle age.
Out of those who smoke, 1 in 4 gets killed by tobacco at ages 2569 years; those
killed at these ages losing about 20 years of life expectancy.

6) According to a huge study, which included 11 lakh homes from different parts of India,
Smoking is responsible for 20% male deaths and for 5% female deaths which occur
prematurely between the ages of 30 and 69 years. When a person dies prematurely it is
very painful for the family members to accept it. Because a lot of active life years are
lost and because that death was avoidable.
For men, the rate of premature deaths in smokers was 1.7 times that in non smokers of
similar age, educational level and alcohol status. For women who smoked, the chances
of a premature death got doubled.
With increasing severity of smoking, the risk of premature death also increases. This
dose response relationship is a proof of the causative association between smoking &
deaths.
 Dose per day Relative risk of
Dose per day Relative risk of
premature death
premature
1-7 cigarettes 1.8
death
/day
1-7 bidis /day 1.3
8 or more 2.9
8 or more bidis 2.2
cigarettes
/day
/day

Tobacco consumption Proportion of deaths in that

of a group group attributable to
smoking
1-7 bidis/day 25%
1-7 cigarettes/day, Almost 50%

Smoking only few cigarettes/day also kills: Among those who smoked 1-7 bidis/day,
smoking associated excess deaths accounted for one fourth of all the deaths occurring from
any medical cause. And among those who smoked 1-7 cigarettes/day, smoking accounted
for almost half of all medical deaths occurring in that group.

Annually, smoking alone causes about 9,30,000 deaths in India! The deaths caused by orally
consumed tobacco are extra!

If tobacco is such a big killer, how come we dont know about it?

1) Lack of awareness about how tobacco kills: Out of all the smoking related deaths, 20% are
caused by TB, 19% are caused by other respiratory diseases, 19% are caused by heart
disease, 6% are caused by strokes and only around 10% deaths are caused by cancers. But
the only cause we generally talk of is cancer!
2) Because there is a lag period of 20 to 40 years, between the onset of regular smoking and
the resulting death. Yes, It doesnt kill immediately; but studies have proven beyond doubt
that it kills for sure. And be it cancer, heart disease, stroke, or respiratory disease its a
slow painful death involving many years of pain, disability and dependency.

There is a common misconception that though tobacco and alcohol kill a person early, till he
lives he lives a great and happy life! Utter nonsense. Even before it finally kills, tobacco
harms the quality of life in multiple ways!