World No Tobacco Day: Battle against tobacco far from over

DIMAPUR — The battle against tobacco is far from over, demanding immediate and collective action even as cardiologists sound the alarm on the risks associated with smoking and consuming other tobacco products.

World No Tobacco Day is celebrated every year on May 31 with an aim to raise awareness about the danger of tobacco and its silent impact on health. However, the demand for such products seems to be still high in Nagaland.

A major distributor of tobacco products in Dimapur disclosed to Eastern Mirror that cigarettes and other tobacco items worth INR 40 to INR 50 lakh are sold to retailers every month.

He said that the cigarettes are transported to Dimapur from Guwahati, via a supplier based in Kolkata, West Bengal. In Dimapur, bidis are sold more than cigarettes, he added.

While maintaining that it is difficult to determine whether cigarette sales are increasing or decreasing due to the fluctuating nature of the market, the distributor said he sells various cigarette brands, with the most expensive being India King, priced at INR 330 per packet.

Another cigarette supplier at the Naga Shopping Arcade (Super Market) said that he supplies 50 packets of various cigarettes to five shops daily.

A small pan shop owner also disclosed that he sells about seven packets of cigarettes per day, and among them, the Gold Flake brand, priced at INR 100 per packet, is the most popular one among consumers.

He went on to say that the majority of his customers are youths.

Health risk

Speaking to Eastern Mirror, Dr. Siddarth Varshney from Medanta Hospital, Gurugram, warned that smoking drastically increases the risks of heart attacks, strokes and aortic aneurysms, while Dr. Nepuni Athikho of Eden Medical Centre, Dimapur, highlighted its devastating impact on the lung, contributing to chronic diseases and rising non-communicable deaths in Nagaland.

Dr. Varshney, a senior cardiologist at Medanta, said that cigarette smoking is a major factor in a variety of cardiovascular diseases, including coronary artery disease (CAD), as it accelerates the development of atherosclerosis, leading to blockages in the coronary arteries. It is also a major contributor of peripheral artery disease (PAD), heart attack, stroke and hypertension.

Another serious effect of smoking is that it weakens the aorta, leading to aortic aneurysm, which is potentially life-threatening if the aorta ruptures, he said.

The doctor also mentioned that some of the lesser-known cardiovascular effects of smoking that patients might not be aware of include increased heart rate, reduced exercise tolerance and abdominal aortic aneurysm disease.

Dr. Nepuni Athikho, consultant, family medicine, pain and palliative/ elderly care (geriatrics) at Eden Medical Centre, Dimapur, said that smoking is one of the leading contributory factors to cardiovascular deaths in Nagaland.

He said that chronic obstructive pulmonary disease of the lung, cancer of the lung, chronic bronchitis, emphysema and aggravation of asthma are long-term consequences of cigarette smoking.

Besides these, smoking also increases the risks of oral cancer or gum problems like gingivitis and diabetes, affects the fertility of both sexes and poses greater risk of cataract and macular degeneration.

Secondhand smoke

On the risk posed by exposure to secondhand smoke, Dr. Varshney said that it carries significant cardiovascular risks, though the risk is somewhat lower compared to firsthand smoking.

He informed that non-smokers exposed to secondhand smoke have 25%-30% increased risk of developing heart diseases and 20%-30% increased risk of getting a stroke.

Also, children and adolescents exposed to secondhand smoke are at higher risk of developing cardiovascular issues later in life, including early onset of atherosclerosis, he added

On kicking the butt

Dr. Varshney shared that some strategies and interventions employed for patients struggling to quit smoking are behavioural therapy, pharmacotherapy, educating patients, usage of various mobile apps and digital tools, online resources and motivational content.

He underscored that healthy lifestyle changes, regular follow-up appointments to monitor progress and continuous encouragement are critical for long-term success.

Dr. Nepuni also said that while smoking is addictive and quitting is not easy, one can develop the willpower to stop smoking.

The two common methods applied to quit smoking are cold turkey and gradual cutting down, he said, adding that while the former method is more successful and commonly used, the latter requires a lot of effort and will power.

COTPA enforcement in Dimapur

Commissioner of Police, Dimapur, Kevithuto Sophie, said that all police stations are regularly conducting enforcement drives around schools and colleges in their respective jurisdictions as per the mandate under Section 6(a) of the Cigarettes and Other Tobacco Products Act (COTPA) 2003 and Amendment Rules, 2011, which prohibit the sale of tobacco products to and by people under 18 years of age.

Also under Section 6(b) of COTPA, there is a prohibition on the sale of tobacco products in an area within a radius of 100 yards of any educational institution.

Sophie informed that the police anti-tobacco squad is also a part of the District Tobacco Control Cell, which along with other stakeholders, regularly conducts anti-tobacco advocacy campaigns and carry out enforcement drives near educational institutions.

He said that one of the challenges they encounter while conducting such enforcement drives is the presence of many shop owners operating near educational institutions who are ignorant of the existing laws and regulations.

Moreover, there is a constraint in allocating adequate manpower to maintain consistent checks around the educational institutions due to the need to maintain law and order, VIP duties and the investigation of cases taking precedence, he said.

Complacent attitude

District NODAL OFFICER of the National Tobacco Control Programme (NTCP), Moa Jamir, said that there has been a gradual positive change in Nagaland since the implementation of National Tobacco Control Programme (NTCP) a decade ago but the state still has a long way to go in effectively curbing the menace of tobacco use.

While pointing out that one key challenge in implementing tobacco control measures in Nagaland is the “complacent attitude” of the people, he said shortage of manpower is also hindering the implementation of the programme.