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Time of India
18 hours ago
- Health
- Time of India
Why smokeless tobacco shouldn't be ignored in India's fight against TB
According to the Global Adult Tobacco Survey India, 2016-17, close to 267 million adults (15 years and above) in India (29% of all adults) consume tobacco. Unlike most of the developed world, smokeless tobacco (SLT) is the predominant mode in which tobacco is consumed, in products such as khaini, gutkha, betel quid with tobacco and zarda. India also has a significant burden of tuberculosis, with 195 incident patients per 100,000 population. Is it a coincidence that the country that has the highest number of patients with tuberculosis is also the second highest consumer of tobacco? While common risk factors are low socioeconomic status, malnutrition and educational status, there are clear indicators that tobacco and tuberculosis are causally associated. Those who smoke are twice as likely to get TB, and over thrice as likely to die of the disease. In addition, recent studies suggest that smoking also negatively influences treatment success and risk of relapse. In 2011, we argued strongly in favor of addressing smoking cessation as a key pillar of eradicating TB in an article 'Why 'STOP TB' is incomplete without 'QUIT SMOKING'. What about SLT? While the observed association of smoking with an airborne pathogen seems obvious, several studies have reported a higher prevalence of SLT use among those diagnosed with TB when compared to the general population. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Walmart Photos Which Are Not For Everyone Old Money Style Undo There are several postulated mechanisms. Damage to the lining of the mouth, and a chronic inflammatory state caused by SLT impair the body's defences against TB bacteria. Nicotine and nitrosamines in SLT have been shown, in animal models, to impair cellular immunity (such as macrophage function), increasing susceptibility to infection and disease. What has been observed is that people often use SLT to suppress appetite among impoverished populations, often leading to malnutrition. The link between nutrition and TB has been established, and the malnutrition associated with SLT use could predispose to the disease. There may also be other confounders such as increased susceptibility to oral cancers/pre-cancerous conditions, overcrowding and alcohol use, which are prevalent in SLT users and could predispose to TB. Spitting behaviors associated with SLT also facilitate spread of TB from those with the disease. Smokeless tobacco cannot be ignored in India's fight against TB. Firstly, because use of SLT is widely prevalent. This is a public health concern in itself, for multiple reasons such as the development of cancer and cardiovascular disease. Secondly, SLT use may be responsible for the development of TB, through immunosuppressive mechanisms. Thirdly, even if the association isn't causal, SLT use is associated with TB, and identifying SLT users and helping them quit is an opportunity to screen for asymptomatic (subclinical) TB, identify and offer support for risk factors such as malnutrition, diabetes and alcohol use, and thereby prevent the development of the disease. Support for tobacco addiction needs to move beyond the display of graphic imagery in advertisements to offering psychosocial, behavioural and pharmacologic support to those who wish to quit. Just as TB and HIV were considered a syndemic in parts of the world, tobacco and tuberculosis need to be accorded the same status, and joint efforts are the way forward. Authored by: Dr. Lancelot Pinto, Consultant, Pulmonologist and Epidemiologist, P. D. Hinduja Hospital & Medical Research Centre, Mahim World Tuberculosis Day: How to tell a TB cough from regular cough One step to a healthier you—join Times Health+ Yoga and feel the change
Time of India
5 days ago
- Health
- Time of India
Surrogate ads fuel tobacco use: Docs
Ranchi: On the occasion of World No Tobacco Day on Friday, health experts in Jharkhand, expressed their concern over the role of celebrity-endorsed surrogate advertisements of tobacco products in fuelling the rise of tobacco consumption in the state, particularly among the youth. Tired of too many ads? go ad free now The experts identified celebrity advertisements as a significant factor contributing to the trend, posing a major challenge to tobacco-control efforts. According to the latest Global Adult Tobacco Survey India report, a staggering 47.9% of individuals initiate consumption of tobacco products between the ages of 20 and 34 years in Jharkhand, surpassing the national rate of 44.7% in this category. While 26.2% start to use in the age group of 18-19 years, against the national rate of 19.4%, and 19.2% start in the 15-17 years age group. In the state, 38.9% of adults use tobacco products of any form, out of which 59.7% are men, and women users amount to 17%. Dr Ajit Kumar Kushwaha, associate professor and head of the surgical oncology department at Rims, said that the young generation, especially from rural areas, is getting addicted to tobacco consumption, both smokeless and smoked. "Around 70-80% of patients who come to oncology department of Rims are below the age of 35 years. Youths from rural areas, who mostly use smokeless tobacco products such as pan masala, gutkha, and khaini, make up a huge chunk of the segment. One of the major reasons behind the increase is that the surrogate advertisements are displayed on various platforms, where celebrity players and film stars, who have a huge influence among the youth, endorse the products. Although they advertise the products as mouth fresheners, on the ground, the consumers are consuming tobacco with that, which is fuelling the ailments among youths," Kushwaha added.
