World No Tobacco Day

The Tobacco epidemic kills more than 7 million people each year in the world, out of
which nearly 900 000 are non-smokers dying from breathing second-hand smoke.
In India, tobacco kills nearly 1.3 million persons every year besides leading to a lot of
morbidity due to various diseases and also leading to a heavy burden on national
economy. Tobacco is the most easily preventable cause of death & disease.
It is the leading cause of 13 different types of cancer, including Head & Neck Cancer,
which amongst all countries in the world has, its highest incidence in India. Tobacco
use is the second leading cause of CVD, after high blood pressure.
Tobacco not only affects the health of pregnant ladies but also has very bad effect on
the health of foetus in the womb. Smoking during pregnancy increases the risk of
health problems for developing babies, including preterm birth, low birth weight, and
birth defects of the mouth and lip. Nicotine is dangerous for pregnant women and
developing babies and can damage a developing baby's brain and lungs
As per Global Adult Tobacco Survey (GATS 2016-17) 55% of smokers & 50% of
Smokeless Tobacco users in India, are planning or thinking of quitting and we know,
they are likely to seek help of doctors for the same.
India is a signatory to WHO-FCTC and our COTPA law is also in force but
unfortunately the implementation of law is not upto the mark. A lot needs to be done
to prevent youth from starting tobacco, which is easily accessible to them, inspite of
stringent Juvenile Justice act which has a provision of fine upto Rs.1 lakh and upto 7
years imprisonment also, if tobacco is sold to a child below 18 years of age.
Started in 1987, WHO theme for 2019 World No Tobacco Day is “TOBACCO & LUNG
Tobacco smoke can cause:
Lung cancer. Tobacco smoking and its association with lung cancer was first
highlighted in 1964 surgeon general report. It is the primary cause for lung
cancer, responsible for over two thirds of all lung cancer deaths globally.
Exposure to Second-hand smoke also increases risk of lung cancer.

Chronic respiratory disease. Tobacco smoking is the leading cause of COPD. The risk is
particularly high among individuals who start smoking at a young age, as tobacco smoke
significantly slows lung development. Tobacco also exacerbates asthma.
Pregnant Mothers smoking or exposed to second hand smoke, exposes foetus to in-utero tobacco
smoke toxins, who also frequently experiences reduced lung growth and function. Young children
exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia
and bronchitis, and frequent lower respiratory infections.
Tuberculosis. India still has a high incidence of TB and the TB damages the lungs and reduces lung
function, which is further exacerbated by tobacco smoking. The chemical components of tobacco
smoke can trigger latent infections of TB.
Air pollution. Tobacco smoke contains over 7 000 chemicals, 69 of which are known carcinogens. It
is a very dangerous form of indoor air pollution. The invisible, odourless smoke can linger in the air
for up to five hours.
We all know, tobacco use is an important risk factor for the development of coronary heart
disease, stroke, many Cancers and peripheral vascular disease.
IMA Doctors should proactively work as tobacco control advocates, must reach out to
communities and communicate health hazards of tobacco-both smoking & smokeless tobacco.
They themselves should be well versed with tobacco control counseling & pharmacotherapy.
On WNTD, IMA branches have been communicated to organise awareness rally, arrange
workshops/ symposium/ lectures for media/public/social groups/police, give talk show on
Radio/TV, Distribute pamphlets, stickers, arrange oral lesion/Cancer detection camps etc.
To empower all IMA members in tobacco control, prevention, early detection of cancer IMA has
decided to organize/advise:-
Anti Tobacco Slogan Contest-All states to conduct online slogan contest
(English/Hindi/regional language – max.15 words) amongst IMA members,
from WNTD (31st May) to International Day Against Drug Abuse & Illicit Trafficking (26th June) and
choose their best 10 slogans in each language & inform to HSG. One member-one entry only. A
committee formed by National President, will declare best 10 slogans in English & Hindi and 5 best in
regional languages on World Head & Neck Cancer Day (27th July) and all winning slogans with
winners names will be published in our e newsletter and felicitated.
Essay Competition-IMA student wing to organize essay competition amongst its members. Topic-
“NCD & Tobacco”, maximum 1500 words, submitted online in MS word. Best essay will be published
in our e newsletter & winner will be felicitated during National Conference.

IMA in its Central Working Committee meeting in Puri in April 2019 has decided to oppose use of
e cigarettes/ENDS.
Regional Workshops-(Five) :Workshop for the Training of the Trainers- IMA leaders/members (TOT)
of the Five regions of the country-North, East, West, South & central India.
The aim of the workshop would be to sensitize IMA leaders, members and inform them about the
epidemiology, the impact, the need for and the methodology for Tobacco control. The participants
will be informed about the health hazards & quitting methods. WHO –FCTC, MPOWER,COTPA & its
implementation will also be discussed.
All state branches to have a session on CANCER PREVENTION, EARLY DETECTION AND
TOBACCO CONTROL in their state conferences.
All branches to organize a lecture on Tobacco-health hazards, quitting methods & Tobacco laws-
COTPA etc. in next six months and to felicitate IMA members who have quit.
All members to be requested, to be a non smoker & non tobacco user.
All hospitals, nursing homes, clinics should be not only Smoking free but also Tobacco free.
IMA is involving RWA’s and market associations to spread awareness through public in parks, religious
places and community centres.
 All IMA members shall be motivated to follow “5A” in their clinical practice.
1. Ask about tobacco use
2. Advise to quit
3. Assess willingness to attempt
4. Assist in quit attempt
5. Arrange follow up
 IMA members are advised to keep tobacco health hazards pamphlets/leaflets/posters
in the waiting area of their clinics/hospitals.
As informed earlier, IMA meetings are to be Tobacco free.
Dr. Shantanu Sen- National President IMA
Dr. R.V. Asokan- Hony. Secretary General ,IMA
Dr. Dilip Kumar Acharya- Chairman IMA Tobacco Control Committee
Dr. V.K. Monga : Chairman WNTD
Dr. Anil Goyal: Coordinator WNTD