Sorry For Smoking.

Smoking in India has risen tremendously over the past few years. There has been a marked rise in tobacco consumption amongst the illetrate classes thanks largely to the poverty and lack of awareness that is aiding them in starting to smoke. Developed countries are now visibly showing signs of a decline in the consumption of tobacco(mainly parts of western europe, The United Kingdom, United States, Canada and Australia). They lie in the 4th stage of tobacco consumption as elaborated below. India on the other hand inspite of the various measures taken in by the government has shown a marked increase in the consumption. 

Studies conclude that the trends in Tobocca consumption can be broadly classified into 4 stages. India being in the 2nd one. Below is entailed the socio-economic aspects of tobacco epidemic in the world.

Socio-economic aspects of the tobacco epidemic described in four stages (Source)

The socio-economic pattern of the tobacco epidemic can be divided into the following four stages Stage 1: smoking is uncommon and mainly a habit of the higher socio-economic groups;(Africa)

• Stage 2: smoking becomes increasingly common. Rates among men peak at 50%-80% and are either the same for the different socio-economic groups or higher among higher socio-economic groups. This pattern is, however, delayed by 10-20 years for women. Smoking is first adopted by women from higher socio-economic groups;(India, China, Brazil)
• Stage 3: prevalence rates among men decrease to about 40% as many men stop smoking, especially those with a higher educational level. Women reach their peak rate (35%-45%) during this stage, and at the end of this stage their rates also start to decline;(Central and Eastern Europe mainly)
• Stage 4: prevalence rates keep declining slowly for both men and women, and smoking progressively becomes more a habit of the lower socio-economic groups.(Western Europe, UK, US, Canada, Australia)

During the smoking epidemic there is a reversal from a positive to a negative association between socio-economic status and smoking.

The government on its part has taken a slew of measures to curb the rising menace of a smoking epidemic. Some of them include:

• The 2003 Tobacco Control Act
• Ban on Public Smoking (2008): This entails among others: 1) A fine of Rs. 200 for smoking in public places, 2) No death/smoking chambers on any companies' premises (companies would be held liable for their employee's smoking habits) 3) No smoking allowed at all indoor places.

• Pictorial warnings to appear on packs in May 2009, subject to the government winning the court cases against this. The grotesque depiction of skulls and affected smokers will do a world of good to drive away the youths in India from taking up smoking as a cool pass time. 
• A five year plan in place for massive awareness campaigns. How successful the 5 year plan is can be anybody's guess. 

Who is Smoking?

The un-educated Indians are fast taking up the habit of smoking which is visible from the rise in the number of bidi smokers in India. 

• Bidi smokers: 50%
• Tobacco chewers: 38%
• Cigarette smokers: 14%

Even educated Indians knowing the harm a fag can do are fast taking up the addiction thanks largely to a heavy overdose of westernized media, aggressive marketing by tobacco giants. The idea of masculinity that Cigarette has come to be associated with has propelled the youth here to consider this as a fashion statement. Sad but True.

The consistent growth of the bidi segment in the smoking market has been partly due to taxation being lower then cigarettes, which has given bidis a considerable price advantage. Other factors supporting rapid growth in demand for bidis include the traditional habit of bidi smoking in the family, which is passed on to the children; the relatively low income level of a large part of the population, especially among the rural masses; and increased use of bidis by women in rural areas in certain states, as there is no inhibition to their smoking. By contrast, the government taxation policy seems to have restricted growth of the cigarette market. From 1970/7l to 1997/98, cigarette taxes increased almost 15-fold (from Rs 31 to Rs 439 per 1 000 cigarettes). This resulted in smokers using more bidis. The Indian tobacco market is highly price sensitive. The price elasticity for cigarette consumption was estimated at -0.66 between 1967/68 and 1992/93, i.e. a 10 percent increase in price would result in a reduction in consumption of 6.6 percent. While increased prices have a constraining affect, the wide use of sponsorship of sport events, publicity and advertisement by the cigarette companies have helped introduce large numbers of young people to cigarette smoking. 

Interesting facts regarding tobacco consumption/production/supply chain in India is detailed here here and here. 

Smoking was popular in the west during the early nineties when the harmful effects of the fatal leaves was not known to the mankind. As evidence poured in of the dangerous effects of smoking educated people grew aware and gave up smoking. What surprises me in the case of India is the absence of this awareness inspite of the knowledge becoming known to one and all. One-Fifth of Indians are now consuming tobacco one way or the other. 

A study undertaken by New England Journal of Medicine says that by 2010 one in every 10 deaths in India would be smoking-related.

A task force of the Indian Council of Medical Research conducted a research study from 1990 to 1996 on the Cost of Tobacco-Related Diseases in India. The average economic cost of major diseases due to tobacco use in India in 1999 was estimated at Rs 350 000 for cancer, Rs 29 000 for Coronary Artery Disease (CAD) and over Rs. 23 000 for Chronic Obstructive Lung Disease (COLD). Total losses from these tobacco-related diseases in 1999 was about Rs 277.6 billion, equivalent to US$6.5 billion (Table 4.16). The medical experts, however, consider the estimated total loss to be an underestimate as it is derived from only a small sample.

Smoking Effects on the Human Body (Source)

• Toxic ingredients in cigarette smoke travel throughout the body, causing damage in several different ways.
• Nicotine reaches the brain within 10 seconds after smoke is inhaled. It has been found in every part of the body and in breast milk.
• Carbon Monoxide binds to hemoglobin in red blood cells, preventing affected cells from carrying a full load of oxygen.
• Cancer-causing agents in tobacco smoke damage important genes that control the growth of cells, causing them to grow abnormally or to reproduce too rapidly.
• The carcinogen benzo(a)pyrene binds to cells in the airways and major organs of smokers.
• Smoking affects the function of the immune system and may increase the risk for respiratory and other infections.
• There are several likely ways that cigarette smoke does its damage. One is oxidative stress that mutates DNA, promotes artherosclerosis, and leads to chronic lung injury. Oxidative stress is thought to be the general mechanism behind the aging process, contributing to the development of cancer, cardiovascular disease, and COPD. 
• The body produces antioxidants to help repair damaged cells. Smokers have lower levels of antioxidants in their blood than do nonsmokers.
• Smoking is associated with higher levels of chronic inflammation, another damaging process that may result in oxidative stress.

It is high time to let the masses know of the danger that this epidemic poses on a population that is the youngest in the whole world. To think that 50% of the youth in India can take up Smoking at any given time is alarming while at the same time frightening. Alongwith the degeneration it inflicts on the smoker, passive smoking by the family, friends and by-standers paints a very dismal picture. Mass awareness campaigns, stricter regulations, ecplicit banning and rehabiliation programmes can go a long way in tackling this menace that is all set to embrace the population here with its lethal tentacles.