Tobacco has 40 chemicals that have been linked to cancer

Tobacco is one of the major contributors of cancer, leading to deaths globally. In India, the cases of cancer are annually increasing. In reports of 2023, there have been 1.46 million cases of cancer patients, estimated to increase 1.57 million by 2025 and a big percentage of this is caused due to tobacco use. Whereas many people are aware of its health hazards, Tobacco is still consumed by millions-257 million who often do not take seriously the profound health risks from its use.

The tobacco related cancer is highly caused disease in indie. Tobacco is not only contributing to the rise of cancer patients but also consumption of Tobacco increased by approximately 1.2 million annual deaths. According to these statistics, there is an urgent need to target interventions to control the deadly impact of tobacco use.

Tobacco has more than 4,000 chemicals, of which at least 40 have been reported to be carcinogens. Nicotine, therefore, gives Tobacco its addictiveness because it holds a person captive since quitting is not possible even though the health dangers are known. Whether smoked, chewed, or inhaled, it releases extremely toxic substances that disturb cellular structures and contribute to the formation of many types of cancers. Carcinogens in Tobacco, like hydrocarbons, amines, and aldehydes, generally facilitate the DNA methylation patterns and gene expression changes associated with tumorigenesis. Due to the habit of tobacco consumption in both smoking and smokeless forms, the prevalence rate of various cancers is very high in India.

Tobacco consumption, in a big way, is in the form of smoking either cigarettes or bidis, particularly by the younger sections of the population. Bidis are particularly common among lower-income groups. Smokeless varieties like khaini, gutka, and betel quid are also in current practice—the present trend of e-cigarettes, i.e. Vapes, particularly among the younger generation of metropolitan cities. Smoked and smokeless forms of Tobacco highly elevate the risk of cancers, particularly those of the mouth, oesophagus, and pancreas.




For successful interventions, the socioeconomic and psychological reasons for tobacco use have to be known. Besides, the use of Tobacco is normally much higher in poorer communities due to lack of education, cultural relevance, and a culture of affording products like bidis. There are some psychological factors which are contributing to this fact, which involves the incorrect belief that Tobacco relieves stress. Nicotine dependence worsens the situation due to addiction psychology.

To combat tobacco use in India, multiple initiatives are taken by government and non-profit organizations, such as increasing the price of Tobacco through taxation, implementing strict advertising bans, and public information, education, and communication. Anti-tobacco messages have also enlisted the services of influencers and celebrities. However, even after all these measures, there still needs to be a gap in raising awareness, which can eventually change the behaviour. The rapid rise in cancer incidents further demands more effort, which can change the scenario.

As identified, to establish a corresponding response to the increasing tobacco use epidemic and its impact on cancer, several approaches have to be taken. Increased information, education, and communication campaigns should be pursued. However, greater awareness of people regarding the risks of tobacco use and the benefits of quitting can be achieved through multimedia and community-based programs. These measures need to be developed for high-risk populations, the lower-income population and youth to meet their particular challenges in Tobacco quitting.

Addiction treatment support needs to be raised by providing more access to smoking cessation programs, counselling, and nicotine replacement therapies. Much stronger policy enforcement is needed to ensure strict adherence to the existing tobacco control laws and introduce even more stringent regulations when necessary. Finally, it shall ensure coordination among governmental bodies, NGOs and healthcare providers in researching and finding newer ways to counter tobacco use.

Tobacco consumption is not 'cool' for youngsters, nor is it 'stress-relieving' for the people; it does not constitute a good way of 'killing time'. It is a medium that severely affects health irrespective of geography and demography. As a society, we need collective efforts to curb the usage of Tobacco. We need further reinforcement if the disastrous health consequences of Tobacco are to be reduced and the burden of cancer in India decreased. You can join the fight against the use of Tobacco by supporting public awareness campaigns, advocating for stronger tobacco control laws, and encouraging people around you to quit. Together, we can make quite a difference in containing the tobacco epidemic and protecting public health.

(By Dr. A.K Dewan - Director of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre)