Dr Gautam Sharma
Every year on 31st of May is observed as World No Tobacco Day. The theme of this year’s World no tobacco day is “grow food, not tobacco”.
World Health Organisation (WHO) has reiterated that the world is confronted with a global food crisis fueled by conflict, climate change and the COVID-19 pandemic. Meanwhile, tobacco is grown in over 124 countries, taking up millions of hectares of fertile land that could be used to grow food, address food security and nutrition challenges and help feed families. Tobacco growing also has serious health impacts on tobacco farmers due to heavy use of pesticides and high absorption of nicotine through the skin.
Furthermore, tobacco farmers often find themselves trapped in a vicious cycle of debt as a result of unfair contractual agreements with the tobacco industry and face difficulties in shifting away from tobacco. Fortunately, there are several examples of successful transitions where tobacco farmers have switched to growing high-iron beans, cashew, corn and green vegetables instead. In order to achieve this globally, it is important to adopt an ecosystem approach and identify economically sustainable alternatives to tobacco growing that will not only enable farmers to earn as much as, if not more than, what they earn from tobacco, and at the same time achieve better health and a better environment for themselves and their land and forests.
WHO has stressed that tobacco use is a well-documented threat to global health, and in the area of tobacco control, extensive work has been done to communicate the health risks of tobacco use and to reduce the demand for tobacco through effective policy interventions. What has been less discussed or documented are the environmental health risks of tobacco cultivation, production, distribution, consumption and waste. The harmful impact of the tobacco industry on the environment is vast and growing, and has thus far received relatively little attention from researchers and policy-makers.
The environmental consequences of tobacco use move it from being a human problem to a planetary problem. It is not just about the lives of tobacco users and those around them, or even those involved in tobacco production. Tobacco can no longer be categorized simply as a health threat – it is a threat to human development as a whole.
WHO maintains that World No Tobacco Day 2023 will serve as an opportunity to mobilize governments and policymakers to support farmers to switch to sustainable crops through creating market ecosystems for alternative crops. Scarce arable land and water are being used for tobacco cultivation with thousands of hectares of woods being destroyed to create space for tobacco production and to make fuel for curing tobacco leaves. Fertile land is thus being destroyed and cannot be used for growing much needed food crops. In many countries where tobacco production and growing are consequential, the issue of livelihoods often comes as an impediment for the implementation of strong tobacco control measures. “The tobacco industry is using the farmers livelihoods by creating front groups to lobby against policy changes aimed at reducing demand for tobacco,” said Dr Ruediger Krech, Director of Health Promotion, WHO, “We need to protect the health and well-being of farmers and their families, not only from the harms of tobacco growing but also from the exploitation of their livelihoods by the tobacco industry.”
Farmers are often under contractual arrangements with the tobacco industry and are trapped in a vicious circle of debt. In most countries, the tobacco industry provides farmers seeds and other materials needed to grow tobacco and then later removes the costs from the earnings, which makes moving away from tobacco very difficult from a farmer’s perspective. But the tobacco industry often fails to give farmers a fair price for their product and, farmers often fail to pay back the loan in full.
The global campaign will raise awareness about alternative crop production and marketing opportunities for tobacco farmers and encourage them to grow sustainable, nutritious crops. These crops will feed their families and millions more on a global scale, help them break free of the vicious debt-ridden cycle of tobacco growing, and support a healthier environment overall. The campaign will also support governments in developing suitable policies, strategies and enabling market conditions for the tobacco growing farmers to shift to growing food crops.
In India, tobacco is consumed in chewable and smoking forms. Both these forms are hazardous for human beings and causes multiple diseases. Smoking can cause cancer, cardiac diseases, lung diseases, diabetes, complicate periodontitis, teeth staining etc. Chewing tobacco can cause oral cancer, leukoplakia (White and grey patches in mouth), Oral Sub mucous fibrosis (difficulty in opening mouth), bad breath, gum diseases, teeth staining etc.
In J&K, an important public health issue has cropped up in the recent past and that is the increasing number of people who are indulging in the habit of chewing tobacco. I have seen a considerable increase in cases of tobacco pouch lesion on buccal mucosa as well as leukoplakia, which is a precancerous or premalignant condition. This is alarming for the health authorities of our state. The industrial workers as well as the labour class that has migrated to J&K from the states of Uttar Pradesh, Bihar, Orissa, Chhattisgarh etc in search of work are worst affected by these lesions due to heavy use of chewing tobacco. This is leading to some more complex public health issues as some of these people are already suffering from the diseases like Tuberculosis (TB), and frequent spitting during the use of chewable tobacco leads to the spreading of TB to general public. The government and health authorities are finding it difficult to tackle multi-drug resistant tuberculosis (MDR-TB) and Extensively drug-resistant tuberculosis (XDR-TB).
Jammu & Kashmir has bagged two cancer institute, one each at summer and winter capital of the state which is a welcome step but at the primary level strengthening of public health infrastructure is required so that the people do not indulge in the deleterious habit of consuming the tobacco.
(The writer is Dental Surgeon with the University of Jammu and former President of Indian Dental Association, Jammu).
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