Day: June 8, 2025

“Tobacco and Health: Towards an Oral Cancer and Tobacco-Free Bharat, – at the “One Day International Seminar on Crop Protection Chemicals and Cancer” held on 5th June 2025 at AIIMS, New Delhi.

This abstract summarizes a presentation titled “Tobacco and Health: Towards an Oral Cancer and Tobacco-Free Bharat,” delivered at an International Seminar on Crop Protection Chemicals and Cancer on June 5, 2025, at AIIMS, New Delhi.

The presentation posits that tobacco is fundamentally a chemical issue, not just a health issue, as it is chemically engineered from cultivation to consumption. It is characterized as the only legal consumer product designed to kill when used as intended. Tobacco is an agrochemical-heavy crop, requiring substantial pesticides and fertilizers, many of which are carcinogenic or neurotoxic. These chemicals, though their half-life may be low in cultivation, accumulate in the leaf, and the final tobacco product itself contains numerous chemicals added during processing that cause toxicity.

The presentation highlights multi-faceted harms caused by tobacco:

• Health Impact:
  • On Farmers: Tobacco cultivators are routinely exposed to pesticides, nicotine-laden dust, and other chemicals, leading to “Green Tobacco Sickness” (acute nicotine poisoning absorbed through the skin). Studies indicate elevated rates of cancer, neurological issues, reproductive problems, and chronic fatigue among them.
  • On Users: Tobacco delivers over 7,000 chemicals, including 250 known harmful chemicals and over 70 known carcinogens such as formaldehyde, polonium-210, benzene, arsenic, cadmium, and lead. It causes approximately 200 different types of diseases, and is responsible for over 1.3 million deaths annually in India. Tobacco is a major contributor to 90% of oral cancers, 85% of lung cancers, and various other cancers (bladder, esophagus, pancreas, cervix, kidney), as well as heart disease, stroke, COPD, infertility, diabetes complications, and poor immunity. Chewing tobacco, specifically, contains slaked lime, which increases nicotine absorption but also causes oral submucous fibrosis (OSMF), a widespread precancerous condition in India. The brain experiences pleasure from dopamine secretion, leading to addiction and rewiring, but all other parts of the body are harmed.
  • Second and Third-Hand Exposure: Children exposed to secondhand smoke face increased risks of asthma, sudden infant death syndrome, and developmental delays. Third-hand smoking involves chemicals persisting on the body and surroundings, polluting those who come into contact.
• Environmental Impact: Tobacco is a severe environmental hazard at all stages of its production and distribution. This includes deforestation, soil degradation, loss of biodiversity, soil and water pollution from agrochemical runoff, and the generation of toxic wastes. Cigarette butts alone contribute 1.69 billion pounds of plastic pollution annually.
• Economic Consequences: India loses Rs. 177,000 crore annually to tobacco-related illness and productivity, with every ₹1 revenue generating a ₹16 loss. Farmers remain economically vulnerable.

The presentation emphasizes that tobacco addiction is a “chemically-driven, socially-engineered public health emergency,” not merely a behavioral issue. It attributes the persistence of this epidemic to the tobacco industry’s well-funded, strategic, and manipulative tactics, which include targeting youth with flavored products and influencers, lobbying against regulation, exploiting farmers, and avoiding full taxes.

The talk also detailed work in non-invasive optical diagnostic and treatment technologies for cancer, particularly for oral cancer screening and treatment, including AI-enabled technology. Pre-malignant lesions, like leukoplakia (stage zero cancer), are detectable and curable at this stage, which can last for 4-5 years before progressing to cancer. The aim is for an “oral cancer and tobacco-free Bharat”.

The proposed way forward includes:

• Regulating tobacco as a chemical hazard.
• Banning cultivation with viable alternatives and providing support to farmers.
• Protecting and screening farmers.
• Investing in cessation support, highlighting that medical treatment and standard protocols are available to help people quit. Only 4% of people can quit by themselves, but with help, the success rate can reach up to 42%.
• Building manpower through training programs like “Tobacco Marshal” and “Pink Angel” to motivate individuals, raise awareness, and provide intervention in communities and schools.

The core message of the talk is a call to action to treat tobacco like any other chemical hazard, emphasizing that prevention saves lives, money, and future generations through environmental control. It was suggested that framing tobacco as a “pesticide” could be an effective way to deter young people, as nicotine itself is a pesticide. The speaker concurred that while people know tobacco is bad, they need help to quit, and that the tobacco industry’s influence is a major barrier.

Call to Action:

• Join the ICanCaRe Quitline (9773856664)
  
• Promote tobacco-free environments at schools, workplaces, and public areas
  
• Encourage patients, peers, and policymakers to recognize tobacco as a chemical hazard
  
• Support farmer transitions away from tobacco cultivation
  

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PRof. Dr. Pawan Gupta M.Ch.
Senior Director, Surgical Oncology
Max Super Speciality Hospital, Vaishali
Founder – ICanCaRe | ICanWin
www.icancare.com | pawan@icancare.com

 

Prof. Dr. Pawan Gupta