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Health Matters newsletter: Smoke trail of India's tobacco burden

Health Matters newsletter: Smoke trail of India's tobacco burden

The Hindu2 days ago

On tobacco use in India fuelling a health and economic crisis, an update on the Covid-19 situation, what's killing Indians, the proposed mixing of various systems of medicine, and more
By now, everyone knows that tobacco is deeply unhealthy. You could be living under a rock on a remote mountain top, and you would still know that it is unhealthy. Tobacco, the World Health Organization says, is deadly in any form -- it kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke. And yet, over 260 million adults in India are users of tobacco, with the use of smokeless forms being about double that of smoked forms. Tobacco accounts for nearly 1.35 million deaths every year in India, even while the country is the second-largest consumer and producer of tobacco globally.
This World No Tobacco Day, marked on May 31, we had two experts writingas about what tobacco use does in our country: Dr. Vid Karmarkar writes on the health and economic costs of tobacco and calls for making tobacco products unaffordable, to discourage their use, while Dr. Kinshuk Gupta proposes the use of Artificial Intelligence (AI) as an adjunct to traditional strategies to help step up tobacco cessation efforts. The message is clear: if you are using tobacco, the best gift you can give yourself is to stop now.
Moving on to the issue that's been causing some concern across the country and one we discussed in last week's newsletter, the Covid-19 situation in India, Bindu Shajan Perappadan reports that as of June 2, active cases neared 4,000 with a total of 32 fatalities across the country; experts however have said that there is no reason to panic, but masking up when experiencing symptoms and ensuring high-risk individuals are protected are steps that should be taken. As Dr. Chandrakant Lahariya points out, if we treat every spike as an impending 'wave' and as a 'false alarm', it will strain the health system and workforce, resulting in response fatigue and undermining credibility. Do read The Hindu's edit on this subject too, offering a sober take on what needs to be done in this situation. Meanwhile, the United States Food and Drug Administration has approved drugmaker Moderna's next-generation COVID-19 vaccine for all individuals aged 65 and above, while however, it cancelled $766 million awarded to Moderna to develop a vaccine against potential pandemic influenza viruses, including the H5N1 bird flu. Go figure!
The other issue that is always slow roasting this time of the year, is of course the heat. Scientists say that 4 billion people, about half the world's population, experienced at least one extra month of extreme heat because of human-caused climate change from May 2024 to May 2025, while a study in the Middle East and North Africal found that global warming could be making cancer in women more common and deadly. If you to know why Indian summers are getting hotter, do read this piece by Ajay Singh Nagpure, and if you're wondering why we are talking about the heat during monsoon season, Nitya Mohan Khemka, Indu K. Murthytell you.
In other major news, the Indian Medical Association has condemned the proposed introduction of an integrated course combining MBBS and BAMS (Bachelor of Ayurvedic Medicine and Surgery) programmes at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. Calling the move 'unfortunate', it said this 'unscientific mixing of various systems of medicines will not benefit doctors or patients''. We'll keep track of this for you, going forward.
What else has happened this week? A quick round-up for you: Vignesh Radhakrishnanpresents data revealing that the number of Indians dying from cardiovascular diseases and diabetes has surged, while deaths from malaria, diarrhoea, tuberculosis, and perinatal conditions have declined -- as expected with the burden of non-communicable diseases in our country. And speaking of NCDs, do read Dr. Rajan Ravichandran's take on the cheapest way to combat NCDs, while Dr. Priya Chockalingam explains why hypertension and cardiovascular disease are silent killers in our midst. C. Maya, Dr. Chandiran Joseph, Athira Elssa Johnson, Maitri Porechi and I all write and podcast on another factor contributing to NCDs: our diets and nutrition -- the double burden of malnutrition in our country, urban India's rising problem of overnutrition, the importance of micronutrients in our diets and the urgent necessity for nutritional literacy among children to help keep sugar in check. Shonali Muthalay meanwhile, interviews Alexandra Sowa, the author of 'The Ozempic Revolution: A Doctor's Proven Plan for Success to Help You Reverse Obesity, End Yo-Yo Dieting, and Protect Yourself from Disease'.
For our tailpiece this week, we have Ramya Kannan's piece on the conjunction of good bugs and perfume: an infectious disease specialist's journey into looking at the skin microbiome to see what perfume is right for you.
And here is our list of explainers -- do give them a read to gain insights and have queries answered on a wide range of subjects related to health.
Dr. Dhavapalani Alagappan writes on how to be emergency ready in times of health crises
Rohini Karandikar and Sandhya P. Koushika explain how circadian rhythms regulate your health
Dr. Ennapadam S. Krishnamoorthy and Dr. Rema Raghu tackle the subject of integrating modern medicine with ancient wisdom
Dr. Alok Kulkarni writes both on all you need to know about drug addiction and treating it
Dr. S. Nagendra Boopathy demystifies calcified coronary artery disease
These pieces on menstrual hygiene and pregnancy deal with vital subjects: Drs. Sudha Kallakuri, Deepika Saluja and Josyula K. Lakshmi write on why menstruation is everyone's business; Karan Babbar calls for policy action on menstrual hygiene, Shrabana Chatterjee writes on lack of sanitation facilites keeping menstruating girls off school, Mrutyunjaya Bellad details the urgent need to tackle anaemia before pregnancy, and here is an explanation on preeclampsia, a potentially dangerous complication in pregnancy.
Dr. Puneet Kumar decodes a major study that says malaria reinfection creates special immune cells
And finally, Rashikkha Ra Iyer proposes that playing chess can galvanise a movement that promotes mental fitness, fosters social connections, and cultivates emotional resilience
Do not forget to watch our video, the Health Wrap that offers you a glimpse of everything important in the health sector over the past week, along with an expert's tips and tricks on how to take care of your skin this odd season, in many parts of India, that's all hot and rainy at the same time.
Still want something fun and health-related to dig into? Do take this quiz on movies that revolve around health.
For many more health stories, head to our health page and subscribe to the health newsletter here.

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EU redirects 335 billion Euros of Covid relief money to defence projects
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  • United News of India

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How will midcap and smallcaps perform vis-a-vis largecaps going ahead? Mahesh Patil explains
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  • Time of India

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How will midcap and smallcaps perform vis-a-vis largecaps going ahead? Mahesh Patil explains

Mahesh Patil of ABSL AMC suggests mid and small-cap companies may see renewed investment. Despite higher valuations, their long-term growth potential remains attractive. Rate cuts could boost urban consumption, particularly in mortgages and autos. Rural economy shows promise with better real wages and good monsoons. While auto sector outlook is weak, a post-festive season pick-up is possible. Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads , CIO,, says in the post-Covid period, mid and small-cap companies experienced higher earnings growth compared to large-caps, fueled by increased investment and sector re-evaluation. While earnings growth has converged and valuations have corrected, mid and small-caps still offer a better long-term growth outlook, potentially attracting renewed investment despite higher valuations and are two parts to it. One is urban and the other is rural. Urban is more dependent on to some extent also on interest rates because a lot of urban consumers have got mortgages and with interest rates coming down that should support over there. So, yes, clearly urban consumption can see improvement if we see more rate cuts, whether it is the mortgage sector, whether it is the auto sector. But the rural economy is also very important and there are some tailwinds there on the consumption has been trending down, so the real wages are now looking much better over there. Monsoons have been good. This year the crop output is supposed to be fairly good. All these factors one would expect the rural incomes to be better this fiscal year and that could drive rural good growth. We are also seeing commentary from a few companies coming in that direction. So, given that the outlook for some of these sectors if you talk about whether it is the auto sector, currently the outlook is still weak, we are not seeing any kind of pick up but one can really hope that in the second half after the festive season there could be a pick up over in some of the sectors are not necessarily cheap, but they are reasonable. We have seen this in some stocks in the sector underperforming. So there is nothing really cheap but rather reasonable valuations. It is more about the delta change. If we see the trend changing, then we could see upgrades in the earning cycle and this sector can start to outperform. But I would be more constructive on some of the sectors related to the rural economy rather than urban the post Covid period, the earnings growth of the midcap and smallcap companies was much higher than the largecap or the broader market and that was one of the we had seen a lot of money coming into the sector and we saw a rerating of that sector also. So, it is a combination of higher earnings growth and PE multiple expansion which led to the kind of outsized returns in the small and midcap sector. In the last nine months, we have seen that earnings growth has kind of converged a bit for the midcaps, especially if you look at it compared to the largecaps, it is more or less in line, and valuations have also corrected to some extent. But they are still expensive, especially in the midcap the question is whether the growth in this midcap and smallcap sectors, at least the outlook over there is better than the largecaps. Post the reset that we saw this year, at least on a bottom-up basis, we are seeing that in the midcap and smallcap universe, the earnings growth is slightly better than the largecap companies. If that is the case, then while the valuations are still higher, if they are able to exhibit better growth, then one can see people moving away from mid and smallcaps. That money will start to again come back into the sector and we have seen early trends of that I would say that while the risk-reward is better in the largecap stocks because in a market correction, any kind of a risk-off globally will provide that downside, but in a three-year, five-year view, midcap and smallcap bottom-ups will possibly still in the Indian market see a better growth outlook on domestic side and end up outperforming.

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