India’s fatality rates owing to smokeless tobacco rise: Study

LONDON: The number of deaths due to smokeless tobacco in India is on the rise, say researchers, adding that deaths due to it globally has also gone up by a third in seven years to an estimated 350,000 people.

According to the study, South and SouthEast Asia continue to be a hotspot with India accounting for 70 per cent, Pakistan for seven per cent and Bangladesh for five per cent of the global disease burden due to smokeless tobacco.

The research, published in the journal BMC Medicine, comes at a time when there are concerns that spiting — a behaviour common among those who chew tobacco — is likely to transmit the Covid-19 virus.

“The study has come at a time when Covid-19 is affecting almost all aspects of our lives. Chewing tobacco increases saliva production and leads to compulsive spiting,” said study researcher Kamran Siddiqi from the University of York in the UK.

There are concerns that spiting — a behaviour common among those who chew tobacco- is likely to transmit the virus to others.

“In acknowledgement of this, India, for example, has already taken a positive step by banning spiting in public places to reduce the transmission of COVID-19,” Siddiqi added.

The study estimated that in 2017 alone smokeless tobacco resulted in more than 90,000 deaths due to cancers of the mouth, pharynx and oesophagus and accounted for more than 258,000 deaths from heart disease.

Millions more have their lives shortened by ill-health due to the effects of chewing tobaccobased products, the study reveals.

Researchers compiled the figures using data from 127 countries and extracted from the 2017 Global Burden of Disease Study and surveys such as the Global Adult Tobacco Survey.

“Smokeless tobacco is used by almost a quarter of tobacco users and most of them live in India, Pakistan and Bangladesh,” Siddiqi said.

In the UK, South Asian communities also consume smokeless tobacco products which too needs to be regulated just like cigarettes, according to the researchers.

“We have an international policy in the form of the World Health Organisation’s Framework Convention for Tobacco Control, to regulate the supply and demand for tobacco products,” the study authors wrote.

“We need to apply this framework to smokeless tobacco with the same rigour as it is applied to cigarettes,” they noted.

On the other hand, each cigarette smoked a day by heavy smokers increases the risk of contracting several diseases by more than 30 per cent, warn researchers.

The study, which links heavy smoking with 28 separate health conditions, revealed a 17-fold increase in emphysema (chronic obstructive pulmonary disease), an 8-fold increase in atherosclerosis (clogged arteries) and a 6.5-fold higher incidence of lung cancer.

“Tobacco smoking is the leading preventable cause of death worldwide and smokers typically die 10 years earlier than non-smokers,” said study researcher Elina Hypponen from the University of South Australia. “Despite a global decline in smoking over the last 20 years, an estimated 20 per cent of the world’s population aged over 15 years are still smoking tobacco,” Hypponen added.

In the US alone, smokers number 40 million, with 16 million of those living with a disease caused by smoking. This costs their economy more than $300 billion per annum.

According to the researchers, the most recent statistics from Australia show that about 13.8 per cent of its adult population (2.6 million people) are daily smokers. Despite a 10 per cent reduction since 1995, smoking is estimated to kill 19,000 Australians a year, accounting for nine per cent of the total burden of disease and $137 billion in annual medical costs.

For the findings, published in EclinicalMedicine, the research team analysed hospital data and mortality statistics from more than 152,483 smokers in the UK Biobank to look at how heavy smoking affects disease risks.

The researchers found the risk of suffering respiratory diseases, cancer sand cardiovascular diseases increased with each cigarette smoked per day.

The link between heavy smoking and emphysema, heart disease, pneumonia and respiratory cancers was particularly high. The study also found associations with many other respiratory diseases, renal failure, septicaemia, eye disorders and complications of surgery or medical procedures.

Several known smoking outcomes, including stroke, were not identified in the study. “We only looked at how heavy smoking further affects disease risk in a group of people who are all at least past smokers, so compared to never smokers the health effects are going to be even more notable,” Hypponen said.

Other factors, including when people start smoking or how long they have smoked, may also affect the health consequences arising from smoking. “Our study shows that each additional cigarette smoked maters, notably increasing the risks of cancer, respiratory, circulatory and many other diseases,” the study author wrote.