Starting Tobacco use at an earlier age can increase the risk of lung cancer. - Seeker's Thoughts

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Tuesday, 23 July 2019

Starting Tobacco use at an earlier age can increase the risk of lung cancer.

Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke.

Around 80% of the world's 1.1 billion smokers live in low- and middle-income countries. – WHO

India has stringent laws to deter tobacco use, which the government says kills more than 900,000 people every year.

E-Cigarettes do not have nicotine- this is a common misconception among students, teachers, and parents.”

There are misconceptions about e-cigarettes and due to these misconceptions, people started buying more e-cigarettes. E-cigarettes were introduced in the world during 2003, and soon enough in other parts of the world.

Tobacco companies promote e-cigarette as a lesser risky smoking option, or as an alternative of quitting.

Research suggests that many youngsters, who would otherwise have never started using nicotine, took up conventional smoking after being introduced to e-cigarettes.

The reality is that the tobacco industry, hit by the success of the state’s efforts to reduce tobacco use, had developed such products to hold on to customers who would have otherwise quit."

As per the World Health Organization report on the Global Tobacco Epidemic 2017, governments of 30 countries which includes, Mauritius, Australia, Singapore, South Korea, Sri Lanka, Thailand, Brazil, Mexico, Uruguay, Bahrain, Iran Saudi Arabia, and UAE, have already banned the electronic cigarettes.

Electronic cigarette or e-cigarette is a handheld electronic device that simulates the feeling of tobacco smoking.

It works by heating a liquid to generate an aerosol, commonly called a “vapor” that the user inhales. Using e-cigarettes is commonly referred to as vaping.

The liquid in the e-cigarette, called e-liquid, or e-juice, is usually made of nicotine, propylene glycol, glycerine, and flavourings. Not all e-liquids contain nicotine.

Most e-cigarette has:
·       A mouthpiece or cartridge
·       A healing element
·       A rechargeable battery
·       Electronic circuits

As the user sucks on the mouthpiece, a sensor activates a heating element that vaporizes a flavoured, liquid solution held in the mouthpiece. The person then “vapes,” or inhale, the aerosol solution.

The mouthpiece is a cartridge that is fixed to the end of tube. The cartridge can either be refilled or replaced with another pre-filled cartridge when necessary. The atomizer is a heating element that heats the liquid, causing it to vaporize.

The solution can then be breathed in or inhaled. The battery powers the heating element. This is normally a rechargeable lithium-ion battery. The sensor activates the heater when the user sucks on the device. A LED may show when it is activated.

Use of Tobacco or cigarette among youth

Tobacco use among youth rapidly increasing in many countries; in some, tobacco is now more commonly used by the young than adults.
Globally the estimated number of boys and girls (13-15 years old) who smoke a cigarette or use smokeless tobacco products are approximately 25 million and 13 million, respectively. 

From the beginning of the Global Youth Tobacco survey in 1999 and through 2016, 108 completed at least two surveys at some point.  43 countries saw no statistically significant change in tobacco use prevalence among boys and girls aged 13-15 years as per the survey.

Tobacco use prevalence among both boys and girls decreased in 20 countries, but has increased in 18 other countries. In 27 countries, the trends for boys and girls were mixed.

Other Tobacco Products

Although cigarette smoking is the most common type of tobacco use among youth worldwide, the use of other tobacco products is very common in some populations. 

For example, smokeless tobacco was the most common tobacco product used by boys and girls aged 13-15 in Nepal in 2011, with the prevalence of 19.7% and 12.9%, respectively, while the prevalence of any tobacco product use was 45.6 among boys and 16.4% among girls.

Waterpipe or e-cigarette has historically been more common in some parts of Asia and North Africa, but it has become popular among young adults, particularly college students, in some other countries.

Prevalence of the use of more novel nicotine-containing products including e-cigarettes among youth has substantially increased in some very high HDI countries.

Duration of tobacco use is more likely to be longer among those who start tobacco use at earlier ages than those who start it later in life. It has been shown that the duration of smoking is a particularly important factor in increasing lung cancer risk.

This further underscores the need for implementation of effective tobacco control policies to prevent initiation of tobacco use – and provide help with cessation for those who already use tobacco – among youth. Tobacco taxation is a major important intervention because youth are more sensitive to increases in tobacco price.

Health Effect by Smoking E-cigarettes

The report found conclusive evidence that the clear majority of e-cigarettes contain a wide variety of substances that are potentially toxic. There is also substantial evidence that “heart rate increases after nicotine intake from e-cigarettes” and that “some chemical present in e-cigarette aerosols (e.g., formaldehyde, acrolein) are capable of causing DNA damages and mutagenesis. 

What steps India has taken to curb E-cigarette?

On the Occasion of World Tobacco Day, which was observed on 31 May 2019. Rajasthan government announced to ban production, distribution, advertisement and sale of e-cigarette in the state.

Government has banned both online and offline sale, storage production. Moreover, the state government had constituted a committee to do a detailed study on rising use of e-cigarettes as a better alternative to tobacco cigarettes.

Earlier Ministry of commerce and industries urged the health ministry to frame law banning manufacture and sale of e-cigarettes in the country as in the absence of the domestic legislation, it would not be possible to put a blanket ban on its imports.

The ministry of commerce and industries has stated that without banning domestic sale and manufacturing of electronic nicotine delivery system (ENDS) through the law, it will be an infringement of global trade norms to put an import ban.

Union health ministry considering stopping the sale or import of electronic cigarettes and heat-not-burn tobacco devices that companies like Philip Morris International were planning to launch in the country. Philip Morris is an international leading tobacco company which develops a less harmful alternative to cigarette, according to the claim. 

 In a move to protect health risks to children, adolescents, and women of reproductive age, health ministry also has asked states to ban electronic nicotine delivery system (ENDS) including E-cigarettes, vape, E-sheesha, e- hookah, etc.

In an advisory to state governments, the health ministry said such devices were a “great health risk” and it was possible that children and non- smokers using such products could switch to cigarettes once they get addicted to nicotine.

The government took a strong position on such products with tobacco even against a giant organization like Philip Morris as the company has been planning to launch its iQOS smoking device in India.  Philip Morris was working towards achieving iQOS’s acceptability as a reduced risk product in the country.

Government “sending a strong message” about how many such products are harmful to the public especially for the youth of the country.

In recent years, the Indian government has emphasized its tobacco- control efforts by raising cigarette taxes, ordering companies to print bigger health warning on packs and introducing a quit-smoking helpline and opened many rehabilitation Centres in the country.

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