Lung cancer is increasing at an alarming rate in Kashmir with experts linking 90 per cent of the cases to tobacco usage. Aliya Bashir reports.
Despite the gory pictorial warnings on cigarette packets, the cigarette industry generates Rs 400 crore in sales in Jammu and Kashmir. And it is taking a toll. Both on Kashmir’s economy and the health of its people.
Health experts opine that if people don’t rise against the menace of smoking, lung cancer would create havoc in the valley in near future.
Dr Muhammad Maqbool Lone, head of the department, Radiation Oncology, SKIMS, said most of the lung cancer cases in Kashmir are caused by smoking. “90 per cent of the lung cancers can be attributed to cigarette smoking. Rest of the cases usually have no history of smoking,” he said.
Lung cancer constitutes 12 per cent of all cancer cases in Valley, says Dr Lone, “Out of 2968 patients registered in the hospital in 2009, 363 were having lung cancer. The number of such patients was 265 in 2008”. The new study on the disease is still in process and may be released next year.
The Regional Cancer Centre (RCC) of SKIMS maintains the record of cancer patients in the hospital. The data at the centre reveals that food pipe, stomach and large intestines cancers are the most prevalent in Kashmir. “Lung cancer is following the list as it is increasing with a great speed. Within a decade, lung cancer would be the most common cancer in males in Kashmir,” Dr Lone claimed.
More than 7,000 cancer patients were registered at SKIMS in last three years. “1000 patients had developed lung cancer with nearly 900 patients among them having a history of smoking,” he added.
In general, the doctor said, 40 per cent of cancers can also be caused due to dietary habits and changing lifestyle. Oncologists say the risks of food pipe cancers can be reduced up to a large extent if the people change their dietary habits and start consuming fresh vegetables, less oily food, avoid hot tea (nun-chai) and go for regular exercise. Adopting proper methods of preservation of sun-dried vegetables and pickles can also help in reducing the prevalence of some cancers, they added.
According to a report released by The Global Adult Tobacco Survey (GATS) this year in New Delhi, exposure to second hand smoking at work place was the highest (68 per cent) in Jammu and Kashmir and the lowest in Chandigarh (15 per cent). Exposure to passive smoking at workplaces was as high as 30 per cent.
The report suggested that there is a need to prevent any further increase in the prevalence of tobacco use at national level, especially among the vulnerable groups. Different programmes should also be targeted to address the problems of different tobacco users, it suggested.
The GATS India survey has revealed that more than one-third (35 per cent) of adults in India use tobacco directly or indirectly. Among them 21 per cent adults use only smokeless tobacco, nine per cent only smoke and five per cent do both. The overall prevalence of smoking among men is 48 per cent and in women it is 20 per cent. The prevalence of tobacco use also ranges from the highest of 67 per cent in Mizoram to the lowest of nine per cent in Goa.
Dr Lone says that the risks of cancer for smokers is directly related to the number of cigarettes one smokes in a day.
“It causes loss of appetite, weakness and heart diseases. It attacks males across all age groups. Though the elderly are more vulnerable and in youngsters there can also be small lung cancers which are equally dreadful,” he said.
He said the problem is also of wrong diagnosis. “A person having bleeding problem and after X-ray and other tests, is sometimes wrongly diagnosed as having T.B, which later proves disastrous. If there is some severe infection, they should keep cancers in mind,” Lone stressed.
He said most of the cases come to them in advance stages like “stage three or four”. “In such circumstances, we try to improve the quality of life. There are very little survival chances then,”
Dr. Javaid Malik, a pulmonologist in SKIMS said that on an average they see 40 cancer cases a month. “Majority of them are male and most of these cases can be attributed to smoking,” he said. “The ratio of lung cancers is 14:1; out of which one is non-smoker, rest are the cases of aggressive smoking with more bleeding histories. Smoking is one of the highest risk factors which lead to cancer.”
As per Human Development Report, J&K, 2008, in 53 per cent of the households one or more members are smoking. The least smoking districts are Leh, Kargil and Srinagar. The incidence of families having at least one member smoking is highest in Kashmir. Islamabad tops the chart with 73.9 per cent, followed by Kupwara (73.8 per cent), Pulwama (73.6 per cent), Budgam (71.5 per cent), Baramulla (68.2 per cent), Srinagar (53.8 per cent), Doda (49.9 per cent), Kathua (48.8 per cent), Udhampur (48.1 per cent), Rajouri (42.2 per cent), Poonch (37.5 per cent), Jammu (32.3 per cent), Kargil (27.9 per cent) and Leh (20.7 per cent). The incidence is more in rural (56.2 per cent) than urban (46.1 per cent) areas and the trend exhibits a persistent decline with the educational score and the per capita income of the family but showed an increase with the increase in the size of the family. The 55-64 age group tops the chart with 31.9 per cent.
Cancer Society of Kashmir provides cancer patients with counseling and free chemotherapy on weekends. Its general secretary, Masood Ahmed Mir, says, “The cigarette has around 3000 chemicals and there is almost 300 degree temperature which means temperature in the mouth must be around 50 degree which is also one of the alarming thing associated with smoking.”
Terming passive smoking as more dangerous Mir says that people around smokers also suffer badly. “If an expecting woman inhales cigarette smoke, she can develop severe complications.”
The CSIK, was established in 1999, to spread awareness about cancer. The society mostly targets the college going youth and students of higher secondary schools where from the habit of smoking kicks in. “We have held around 40-50 camps and other awareness programmes in both villages and Srinagar to make people aware about cancer risk and how it can be prevented,” Mir said.
In a major drive against smoking in Kashmir, Divisional Commissioner, Kashmir Asgar Samoon ordered raids on various outlets selling tobacco products outside schools and a crackdown on smoking in public places.
The drive has been launched to ensure that smoking does not take place at public places and the selling of cigarettes in violation of Section 6 (b) of Cigarettes and Other Tobacco Products Act 2003 (COTPA) which puts a ban on sale of tobacco products within 100 yards of educational institutions, an official not authorized to talk to media said.
Any violation of this act is punishable with a fine.
The Section 4 of COTPA prohibits smoking in public places and authorities have fined quite a few people for smoking in public places.
President Federation Chambers and Industries Kashmir, Shakeel Qalander said as per the industrial policy of India, cigarette and tobacco industry is one among few industries which comes under the restriction and it needs special permission for its registration, the procedure of which is very difficult.
“We don’t have a cigarette industry in Kashmir. But annually, the state imports cigarette worth Rs 400 crore and the taxes are also very high,” he said.
“There is no specific mechanism to stop the industries from tobacco production. But the government has set some precautionary guidelines to curtail its use,” Qalander said.
