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A whopping 70 million Indian women above age 15 use smokeless tobacco (SLT), which alone constitutes 63 per cent of the world's SLT consumption, according to a Union Health Ministry report on SLT.
The first-ever comprehensive report by the ministry, launched at the ongoing World Health Organization's (WHO) Framework Convention on Tobacco Control (FCTC) here, also stated that one factor influencing SLT use among disadvantaged women is the desire to suppress hunger while performing difficult and laborious tasks.
"Easy availability and low cost of the SLT were other key factors promoting SLT use by women. The SLT use raises women's risk of adverse reproductive outcomes. The prevalence of SLT use when pregnant or breastfeeding was similar to prevalence of use among all women of reproductive age in India," said the report.
According to the Health Ministry, over 3,500,000 people are dying due to exclusive use of tobacco, of which over 100,000 are dying due to cancer.
According to the report, the consumption of SLT stood at 9.5 per cent for the school-going children, with 10.7 per cent of the boys and 7.5 per cent of the girls being its regular users.
"India is the first country to prohibit the sale, storage and manufacturing of smokeless tobacco product like gutkha across all states. However, stronger measures are required for effective implementation of the law," said Amal Pusp, Director at Ministry of Health and Family Welfare.
The report outlines all the facets of smokeless tobacco use, including their determinants, economic costs and health consequences, along with advocacy, policy and judicial measures that can be utilised to curb its impact, Pusp added.
The report also says that the prevalence rate of use of dual tobacco use -- both smoking and smokeless tobacco -- was 5.3 per cent of the total population, amounting to 42.3 million adults.
"The Northeast region had the highest prevalence with 9.8 per cent of the population affected by dual tobacco use. The interval between starting the use of the two forms of tobacco was two years or less for over half of all dual users," said the report.
The report, which will act as the source of data for every health department of India, also stated that the incidence of cancer of oral cavity and pharynx are an important public health problem in India, with nearly 85,000 new cases among men and 34,000 among women in India each year.
"At least 90 per cent of these cancer cases were caused by tobacco use in some form, and more than half by SLT use. Using SLT during pregnancy also caused 70 per cent higher risk of anaemia in pregnant women, 2-3 times higher rate of low birth weight and 2-3 times higher rate of still births," said the report.
The report was compiled by the Health Ministry in collaboration with the WHO, Public Health Foundation of India, Healis-Sekhsarisa Institute of Public Health Centers for Disease Control & Prevention and National Cancer Institute, US.
"The author of the report undertook a review of all existing scientific evidence and socio-political developments in India, in order to produce an evidence-based and peer-reviewed compendium of information on smokeless tobacco use in the country. All the chapters were edited by technical editors from partnering institutes in India and the USA," said Prakash C. Gupta, Director, Healis-Sekhsaria Institute of Public Health.