Tuesday, December 7, 2010

India’s Top Court Bans Sale of Tobacco Products in India

Dec. 7 (Bloomberg) -- India’s Supreme Court banned the sale
of tobacco products in plastic wrappers from March 1, citing
harm to public health and environmental damage from improper
disposal of the packets.
    The two-judge bench headed by Justice G.S. Singhvi also
directed the government to submit a report in eight weeks after
studying the harmful effects of gutka, a mixture of betel nuts,
tobacco and proprietary additives. The decision also applies to
pan masala, a non-tobacco product that has the same appearance,
taste and packaging.
    The court’s order may help discourage the use of gutka by
making it more expensive as manufacturers will be forced to seek
alternative ways of packaging, said Kaustav Ray, analyst at the
Hyderabad, India-based unit of Datamonitor Plc. The gukta is
mostly sold in the country in plastic packets and costs as
little as one rupee (2 cents) a sachet.
    Sales of chewing tobacco, valued at 210.3 billion rupees
($4.7 billion) in 2004, may double in India by 2014, according
to Datamonitor.
    Scientific studies have found that both gutka and pan
masala contain tumor-causing agents, said Pankaj Chaturvedi, a
surgeon at Tata Memorial Hospital, Asia’s largest cancer
treatment center. The products contribute to making India the
“mouth cancer capital” of the world, he said.
    “There is already so much evidence showing that a number
of cancers are caused by these products,” Chaturvedi said in an
interview today. “For the environment, the plastic is bad. But
for the individual, the immediate danger comes from the
    The Supreme Court’s interim order came after petitioners
challenged a 2007 decision by the Rajasthan High Court which
banned the use of plastics for making gutka packets. The next
date for the hearing is March 9.

SC bans sale of gutkha in plastic pouches from March

Dec. 7 (PTI) -- The Supreme Court today ordered a ban on
the sale of tobacco products like gutkha and pan masala in
plastic pouches from March 2011, while asking the government to
conduct a survey on the ill effects of these products within
eight weeks.
    A bench of justices G S Singhvi and A K Ganguly also asked
the manufacturers to explore and decide by March next year on
the alternative material for packaging them.
    The bench issued the directions while brushing aside the
pleas of some of the gutkha manufacturers who feared that such a
direction could lead to closure of thousands of gutkha and pan
masala manufacturing units.
    "Let it come," the bench quipped when counsel for one of
the manufacturers claimed that the whole industry would come to
a standstill.
    Cigarettes, which are generally sold in paper packs, are
out of the ambit of this ban.
    While asking the government to conduct a survey on the ill
effects of these tobacco products, the bench also asked it to
examine the effects of packaging these products in plastics
pouches over human health.
    The bench recorded an undertaking from Solicitor General
Gopal Subramanium that the government would get the required
survey done by the National Institute of Public Health on the
harmful effects of gutkha, pan masala and other tobacco products
and also the adverse effects, if any, of the plastic pouches
used for packaging the material.
    The bench also directed the Centre to finalise and enforce
withing eight weeks the Plastic Management and Disposal Rules
    It rued that despite the rules having been framed in 2009,
the authorities are yet to enforce them.
    The bench passed the direction while adjudicating a
petition by a civil society, which has approached the apex court
challenging the alleged unbridled sale of gutkha and pan masala
material in the country, seriously impinging upon public health.

Wednesday, October 20, 2010

The Cigarettes and Other Tobacco Products (Packaging & Labeling) (Amendment) Rules 2010

The Cigarettes and Other Tobacco Products (Packaging & Labeling) (Amendment) Rules 2010 or COTPA in short is an act passed by the Gonernment of India and please follow the link to read
The Cigarettes and Other Tobacco Products (Packaging & Labeling) (Amendment) Rules 2010

report of Global Adult Tobacco Survey India 2010

Following are the highlights of the GATS India findings:
· Current tobacco use in any form: 34.6% of adults; 47.9% of males and 20.3% of females
· Current tobacco smokers: 14.0% of adults: 24.3% of males and 2.9% of females
· Current cigarette smokers: 5.7% of adults: 10.3% of males and 0.8% of females.
· Current bidi smokers: 9.2% of adults: 16.0% of males and 1.9% of females.
· Current users of smokeless tobacco: 25.9% of adults: 32.9% of males and 18.4% of females.
· Among daily tobacco users, 60.2% consumed tobacco within half an hour of waking up
· Average age at initiation of tobacco use was 17.8 with 25.8% of females starting tobacco use before the age of 15
· Among minors (age 15-17), 9.6% consumed tobacco in some form and most of them were able to purchase tobacco products.
· Five in ten current smokers (46.6%) and users of smokeless tobacco (45.2%) planned to quit or at lease thought of quitting
· Among smokers and users of smokeless tobacco who visited a health care provider, 46.3% of smokers and 26.7% of users of smokeless tobacco were advised to quit by a health care provider
· About five in ten adults (52.3%) were exposed to second-hand smoke at home and 29.0% at public places(mainly in public transport and restaurants)
· About two in three adults (64.5%) noticed advertisement or promotion of tobacco products.
· Three in five current tobacco users (61.1%) noticed the health warning on tobacco packages and one in three current tobacco users (31.5%) thought of quitting tobacco because of the warning label.

Global Adult Tobacco Survey 2000

Global Adult Tobacco Survey of GATS published a result of the survey in 2000.
Follow the link to know more http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_Country_Profiles_india.pdf

Tuesday, October 5, 2010

Free health camp of tribals at Gholwad

Sangeeta Darvekar Charitable trust had arranged a free gynecology and pediatric camp for the tribals of gholwad region, Taluka Dahanu, Dist Thane, Maharashtra, India.
Following are the photos of the camp. Have a look

Tuesday, September 7, 2010

Do I have mouth cancer, wants to get checked up

Do I have mouth cancer, wants to get checked up

Dear Sir,

                   My name is Raghvendra Upadhyay, age 28, resident of Varanasi, Uttar Pradesh. I am writing you inquring about process and costing for a mouth cancer check up. I used to chew guthka, smoked cigarettes but don't do such things any more. Neither I have any problem eating spicy food nor have any problem in opening my mouth but I have lost two of my friends because of mouth cancer within past year which made me think about it. I read some books and your website about mouth cancer and they all said that primary indication of mouth cancer is having a lump in the mouth and it can be treated if diagnosed in early stage. I do not know if I have any lump in my mouth or not but I just want to get a checkup for mouth cancer at Tata Memorial Hospital, Mumbai. I do not want to go to BHU or any other hospital in my city because they do not care about the patients well and in fact I just don't believe them. Both of my friends who died of mouth cancer went to BHU first and they had really bad experience.
So please help me by giving some information about how my mouth can be diagnosed, how much would it cost and how long does it take to get the results?

Waiting for your reply,

Raghvendra Upadhyay
Uttar Pradesh

Dear Raghvendra,
I would like to answer your queries one by one
1.    Cost of mouth cancer check up should not be too much, but might depend upon place to place. What I would suggest is get your mouth checked up from a good dentist locally for a lesion in the mouth. The rule of thumb is a non healing ulcer for more than 15days should make you rush for the check up, even if it is not painful. The doctors might inspect your mouth for a suspicious lesion and if needed do some tests before arriving at a final diagnosis.
2.    Since you don’t have problem in eating spicy food and not problem in opening your mouth it seems you don’t have any problem of oral cancer, but friend I haven’t examined your mouth, so if in case you want to be sure, get yourself checked.
3.    Friend, if your friends had bad experience, doesn’t mean that the Hospital is bad. BHU is a hospital which is serving a large population and has a large OPD. The doctors are overworked and therefore they tend to be a little irritated but they are also equally good. Same is the condition in Tata Memorial Hospital. This tobacco habit is causing cancer in epidemic proportions in India, and the doctors and staff are really stretched to the limit. We need understanding individuals who spread the awareness about tobacco habit and mouth cancer so that this cancer can be prevented and the load on this hospital can be reduced.
4.    It is very unfortunate that your friends have died and you have suddenly realized the magnanimity of the problem. But unfortunately we don’t spread our knowledge and don’t speak against the habits. Are you ready to start a crusade in your town, your village where in every individual is counseled regarding the evil of this supposedly simple habit. Would you open your mouth or let many more deaths happen around you.
5.    Regarding results of tests done for checking for cancer don’t take too long; 4 to 5 days should be more than enough to get all the reports.
I have tried to explain almost all your queries, if anything more feel free to write to me.

Dr Suwas Darvekar
Write a review of our website on http://greatnonprofits.org/reviews/sangeeta-darvekar-charitable-trust1/

Thursday, July 15, 2010

Beware! Smoking can upset your genes

Washington, July 14 (IANS) Scientists have found that exposure to cigarette smoke not only upsets gene expression - the process by which genetic information is converted into the structures and functions of a cell - but their entire networks as well.

These alterations seem to have a wide-ranging negative influence on the immune system, including processes bearing on cancer, cell death and metabolism.

Scientists of Southwest Foundation for Biomedical Research at San Antonio in the US, identified 323 unique genes whose expression levels were significantly correlated with smoking behaviour in their study of 1,240 volunteers.

The changes were detected by studying the activity of genes within white blood cells of volunteers, the BMC Medical Genomics journal reports.

'Our results indicate that not only individual genes, but entire networks of gene interaction are influenced by cigarette smoking,' said Jac Charlesworth, who led the study, according to a university release.

Charlesworth, formerly at Southwest Foundation, is now a research fellow at the Menzies Research Institute at the University of Tasmania in Australia.

The study is part of Southwest Foundation's San Antonio Family Heart Study which includes 40 families in the Mexican-American community.

'Previous studies of gene expression as influenced by smoking have been seriously limited in size, with the largest of the studies including only 42 smokers and 43 non-smokers. We studied 1,240 individuals, including 297 current smokers,' Charlesworth said.

'The findings have a larger implications for human disease risk, especially in relation to the increased risk of a wide variety of cancers throughout the body as a result of cigarette smoke exposure,' Charlesworth said.

Tuesday, June 22, 2010

India ranks first in oral cancer cases: Study.

Itanagar, Jan. 11 -- India has the highest number of oral cancer cases in the world out of which 90 per cent were due to tobacco-related diseases, according to

a World Health
Organisation (WHO) survey report.

The report said more than 2,200 Indians die each day from a tobacco-related cases and in 2010, an estimated ten lakh

people will die due to the killer disease. Every day, 55,000
Indian youths start tobacco use, the report further said.

In view of the growing tobacco menace, a one-day Media Advocacy Workshop on Tobacco Control was jointly organised by Itanagar Press Club (IPC) and Voluntary Health Association
of India (VHAI) here recently.

In the meeting both the print and electronic media unanimously observed that strict enforcement of section 4four of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003, should be ensured.

Highlighting different aspects of tobacco in terms of health hazards and socio-economic impact, epidemiologist Dr L Jampa informed that India is the second largest consumer and is placed third in respect of tobacco production.

He informed that in 17 out of 29 states of India, tobacco use is more than 69 per cent. The Northeastern region exhibits highest rates of tobacco use - in Mizoram more than 80 per cent of men use some form of tobacco, followed by Tripura (76 per cent) and Assam (72). Arunachal Pradesh is the second largest state whose people chew tobacco products after

read more here http://www.thefreelibrary.com/India+ranks+first+in+oral+cancer+cases:+Study.-a0216451622

Tuesday, May 25, 2010

a few slogans on tobacco habit and oral cancer

तंबाखु का व्यसन ना सिर्फ आपके पैसे खाता है,
यह आपका जीवन भी खाता है .

तंबाखु का व्यसन छोडीए,
दर्दनाक मौत से बचिए.

जिस मुँह से प्रभु का नाम लेते हो ,
उसी को तंबखु से धोते हो.

गुटका तुमने खाया क्या,
मौत को जल्दी बुलाया क्या !!

गुटका खाओ ,
जल्द मर जाओ.

तंबाखु से आती है नपुंसकता और कमजोरी,
नहीं कर सकोगे अपने बीवी की इच्छा पूरी.

आपके तंबाखु के व्यसन के वजह से कितने घर चलते है,
नुक्कड़ के पानवाले का घर, तंबाखु के उत्पादक का घर, कई एजंटों का घर,
और तंबाखु के किसान का घर,
लेकिन आपका घर उजड जायेगा उसका क्या !!!!

तंबाखु की मज़ा
मौत की सज़ा........

ज़रा सोचो
कौन किसे खा रहा है,
आप तंबाखु को या तंबाखु आप को.......

Thursday, March 25, 2010

Head and Neck Radiation Treatment and Your Mouth

How Does Head and Neck Radiation Affect the Mouth?

Doctors use head and neck radiation to treat cancer because it kills cancer cells.  But radiation to the head and neck can harm normal cells, including cells in the mouth.  Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; glands that make saliva (spit); and jaw bones.
It's important to know that side effects in the mouth can be serious.
  • The side effects can hurt and make it hard to eat, talk, and swallow.
  • You are more likely to get an infection, which can be dangerous when you are receiving cancer treatment.
  • If the side effects are bad, you may not be able to keep up with your cancer treatment. Your doctor may need to cut back on your cancer treatment or may even stop it. 
Read more : Radiation complication and management in oral cancer

Know more about oral cancer treatment

Radiation Therapy
Targeted Therapy

People with early oral cancer may be treated with surgery or radiation therapy. People with advanced oral cancer may have a combination of treatments. For example, radiation therapy and chemotherapy are often given at the same time. Another treatment option is targeted therapy.
The choice of treatment depends mainly on your general health, where in your mouth or throat the cancer began, the size of the tumor, and whether the cancer has spread.
Many doctors encourage people with oral cancer to consider taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of oral cancer. See the Taking Part in Cancer Research section.
Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat oral cancer include:
Other health care professionals who work with the specialists as a team may include a dentist, plastic surgeon, reconstructive surgeon, speech pathologist, oncology nurse, registered dietitian, and mental health counselor.

Read more: http://www.cancer.gov/cancertopics/wyntk/oral/page8

All about of Oral Submucous Fibrosis

On the Indian subcontinent, the use of smokeless tobacco in various forms is very popular. This habit, which usually involves the chewing of a betel quid (combined areca nut, betel leaf, tobacco and slack lime), has led to the development, in a large proportion of users, of a unique generalized fibrosis of the oral soft tissues, called oral submucous fibrosis.  While not producing soft tissue masses in the usual sense, the fibrosis may be confused with generalized fibromatosis, hence, is included in this section of the present chapter.
The condition is found in 4/1,000 adults in rural India, and is caused by the areca nut in the quid. Additionally, it is estimated that as many as 5 million young Indians are suffering from this precancerous condition as a result of the increased popularity of the habit of chewing pan masala. It results in a marked rigidity with progressive inability to open the mouth.  There is a fibroelastic transformation of the juxta-epithelial connective tissues and an increased risk of oral carcinoma from the tobacco of the quid.

Clinical Features

Submucous fibrosis typically affects the buccal mucosa, lips, retromolar areas and the soft palate. Occasional involvement of the pharynx and esophagus is seen. Early lesions present as a blanching of the mucosa, imparting a mottled, marble-like appearance. Later lesions demonstrate palpable fibrous bands running vertically in the buccal mucosa and in a circular fashion around the mouth opening or lips.  As the disease progresses the mucosa becomes stiff, causing difficulty in eating and considerably restricting the patient's ability to open the mouth (trismus). If the tongue is involved, it becomes stiff and has a diminished size.
Mucosal petechiae are seen in more than 10% of cases and most patients complain of a burning sensation, often aggravated by spicy foods.  Salivary flow is diminished and blotchy melanotic mucosal pigmentation is often seen. More than a fourth of affected persons develop precancerous leukoplakia of one or more oral surfaces. Once present, oral submucous fibrosis does not regress, either spontaneously or with cessation of betel quid chewing.

Pathology and Differential Diagnosis

The early cases of oral submucous fibrosis present as chronic inflammatory cell infiltration of subepithelial connective tissues. This otherwise nonspecific infiltrate usually contains a number of eosinophils, cells seldom found in oral inflammation. Older lesions demonstrate a reduced vascularity, reduced numbers of inflammatory cells, and dense bundles and sheets of collagen immediately beneath the epithelium. The eventual thick band of hyalinized subepithelial collagen shows varying extension into submucosal tissues, typically replacing the fatty or fibrovascular tissues normal to the site.
Minor salivary glands in the area of habitual quid placement often demonstrate a chronic inflammatory infiltrate and replacement of acinar structures by the hyalinized fibrosis. The hyalinized stroma can be distinguished from the amyloid infiltration of amyloidosis through the use of Congo red staining and thioflavin-T staining under polarized and immunofluorescent light.
The epithelium is atrophic, with or without excess surface keratin, and demonstrates intercellular edema. A fourth of the biopsied cases will demonstrate epithelial dysplasia at the time of biopsy. When squamous cell carcinoma is seen, it has the same features of carcinoma as those seen in persons without the betel quid chewing habit.

Treatment and Prognosis
There is no effective treatment for oral submucous fibrosis and the condition is irreversible once formed.  Plastic surgery may be required to allow for improved opening of the mouth. Surface leukoplakias are handled by close follow-up and repeated biopsies of areas of severe involvement. All dysplasias and carcinomas are treated in the routine manner for those entities. Epidemiological studies have shown that as many as 10% of oral submucous fibrosis patients develop an oral carcinoma. Since the tobacco is the component of the quid most associated with cancer development, cessation of the quid chewing habit or eliminating the tobacco from the quid will reduce the risk of oral cancer. Likewise, a certain proportion of precancerous keratoses will diminish or disappear with habit cessation.

 To know more read the source article at: http://www.maxillofacialcenter.com/BondBook/softtissue/submucousfibrosis.html

Smokeless Tobacco and How to Quit

Many terms are used to describe smokeless tobacco products, such as oral, chewing, snuff, spit, and spitless tobacco. All forms of oral tobacco have chemicals known to cause cancer (carcinogens). These products can cause cancer of the mouth, pancreas, and esophagus (the tube that carries food from the mouth to the stomach). Oral and smokeless tobacco also cause many other health problems, such as gum disease, destruction of the bone sockets around the teeth, and tooth loss. They cause bad breath and stained teeth, too.
Smokeless tobacco is less lethal than cigarettes, but using any form of tobacco puts you at serious health risks. Smokeless tobacco is not a safe alternative to smoking. The bottom line: All forms of tobacco can be deadly.
Read more : http://www.cancer.org/docroot/PED/content/PED_10_13X_Quitting_Smokeless_Tobacco.asp

Smokeless tobacco and its harmful effects

Once considered a harmless pleasure, smokeless tobacco came to the forefrontof health news at the turn of the millennium due to increasing evidence thatit is just as dangerous as cigarette smoking. In fact, most medical professionals now agree that smokeless tobacco--also known as "chaw" or "chew"--is equally addictive and carcinogenic, and have come to consider the substance as contributing to the U.S. tobacco epidemic. Despite the medical community's efforts to warn people beginning in the mid-1980s, the use of smokeless tobaccowas on the rise as of the U.S. Surgeon General's report in 1997, which pinpointed young males as the largest growth area. Adolescent use of moist snuff, apowdered form of smokeless tobacco, has also skyrocketed, rising 1,500 percent between 1970 and 1991. As of 1995, 2.9 percent of Americans used some formof smokeless tobacco. From 1998 to 1999, the production of snuff rose eightpercent, even in the face of increased health warnings and tax hikes.

Oral Effects of Tobacco Abuse


Note: This information was first published in the Journal of the American Dental Institute for Continuing Education, 1992; 43:3-17. Authors: Drs. Jerry Bouquot & Kathy Schroeder, Department of Oral Pathology, West Virginia University, Morgantown, West Virginia.  It is updated periodically.
Tobacco has been variously hailed as a gift from the gods, a miraculous cure-all for life's physical ills, a solace to the lonely soldier or sailor, a filthy habit, a corrupting addiction, and the greatest disease-producing product known to man. This diversity of opinion has continued unchanged for centuries and has appeared until very recently to be little affected by research results from more than 900,000 papers thus far published on the topic. It is common knowledge that cigarette smoking is the single major cause of cancer and cardiovascular disease in the United States, contributing to hundreds of thousands of premature deaths each year, yet one-fourth to one-third of American adults continue to smoke.

For more on this article follow this link http://www.maxillofacialcenter.com/TobaccoEffects.html

Wednesday, March 24, 2010

Income from tobacco and expenditure on health issues from tobacco

Table 4.15: Trends in excise collection (Rs million per annum)
Other tobacco
Total excise revenue
Share (1)
Share (1)
Share (2)
(all tobacco)
Share (2)
1 930
2 780
20 610
6 840
1 500
74 210
24 500
27 490
245 140
27 680
31 050
281 100
27 400
3 870
311 460
4 090
35 000
373 470
34 270
4 880
40 360
401 870
39 827
9 667
46 494
450 080
44 924
7 225
52 149
477 000
51 118
8 322
59 440
559 100
Notes: (1) Percentage share in total tobacco excise. (2) Percentage share in total excise revenue.
Source: Government of India. Budget Documents.

Table 4. 16: Economic cost of major diseases attributed to tobacco use in India in 1999

Tobacco-related diseases
Coronary Artery Diseases
Chronic Obstructive Lung Disease
Number of cases attributable to tobacco use

154 300
4 200 000
3 700 000
163 500
4 450 000
3 920 000
Average cost per case in 1999 (1) (Rs)
350 000
29 000
23 300
Total cost for all India (1999) (Rs billion)
Total loss (1999)
Rs 277.611 billion (» US$6.5 billion)
Notes: (1) Percentage share in total tobacco excise. (2) Percentage share in total excise revenue.
Source: Government of India. Budget Documents.

Some scholarly articles

Some of the scholarly articles on revenue generation by the government and expenditure the government make on tobacco control.
Dr Suwas Darvekar

WHO Report on the Global Tobacco Epidemic, 2009: Implementing smoke-free environments

The report is the second in a series that tracks the status of the tobacco epidemic and the impact of the interventions that are being implemented to stop it.
- Download the full report - English  from official WHO site.

who report on Tpbacco and Tuberculosis

 It has been found that tobacco and Tuberculosis has intimate relation.
Read more on the official WHO website.
Follow the link below to know more.
Dr Suwas Darvekar

Wednesday, March 17, 2010

Betel quid without tobacco as a risk factor for oral precancers.

Oral Oncol. 2004 Aug;40(7):697-704.

Betel quid without tobacco as a risk factor for oral precancers.

Regional Cancer Centre, Trivandrum 695011, India.
The IARC monographs recently classified chewing betel quid without tobacco as a human carcinogen. Several studies in Taiwan have reported that betel quid without tobacco may increase the risk of oral precancers such as oral leukoplakia and oral submucous fibrosis. However in India, since most betel quid chewers prefer to add tobacco to the quid, the independent effect of betel quid on the risk of oral precancers is difficult to assess and has not yet been fully explored. We conducted a large case-control study in Kerala, India, including 927 oral leukoplakia cases, 170 oral submucous fibrosis cases, 100 erythroplakia cases, 115 multiple oral precancer cases and 47,773 controls. The focus of this reanalysis is on the minority of individuals who chewed betel quid without tobacco. Among nonsmokers and nondrinkers, chewing betel quid without tobacco conferred ORs of 22.2 (95%CI = 11.3, 43.7) for oral leukoplakia, 56.2 (95%CI = 21.8, 144.8) for oral submucous fibrosis, 29.0 (95%CI = 5.63, 149.5) for erythroplakia and 28.3 (95%CI = 6.88, 116.7) for multiple oral precancers, after adjustment for age, sex, education and BMI. Dose-response relationships were observed for both the frequency and duration of betel quid chewing without tobacco on the risk of oral precancers. In conclusion, our study supports the hypothesis that chewing betel quid without tobacco elevates the risks of various oral precancers.

A must read article for those interested in oral cancer prevention

An excellent must read article on oral cancer prevention.
The link is http://tinyurl.com/yhc7gac

Utilizing dental colleges for the eradication of oral cancer in India.

Indian J Dent Res. 2008 Oct-Dec;19(4):349-53.

Utilizing dental colleges for the eradication of oral cancer in India.

Department of Community Dentistry, Mar Baselios Dental College, Kothamangalam, Ernakulam District, Kerala, India. drjacobkuruvilla@gmail.com
Dental education in India has grown in such a way that it ranks first in the world in having the highest number of dental schools. There are 240 dental schools all over the country. Paradoxically, even with this large number of dentists and dental institutions, India contributes to the highest number of incident cases of oral cancer. In India, oral cancer burden approximates to 20-30% of all cancers. The plausible reason for this high incidence of oral cancer could be expounded on the fact that there exists a high usage of tobacco within the country. The evidence for the high prevalence of using chewable tobacco products, especially in the youth, was recently reported in the Global Youth Tobacco Survey. This increasing usage of chewing tobacco and related products will further accrue to the mortality and morbidity figures in the near future. To effectuate a breakthrough in the existing situation, the work force of dental schools could be capitalized on. The aim of this article is to present the burden of oral cancer in the country and identify trends in the prevalence of tobacco usage, which if continues could alert an epidemic of oral cancer in the near future; and how dental schools in the country can be utilized for preventing this upcoming epidemic.

Tobacco chewing and female oral cavity cancer

Br J Cancer. 2009 Mar 10;100(5):848-52.

Tobacco chewing and female oral cavity cancer risk in Karunagappally cohort, India.

Regional Cancer Center, Trivandrum, Kerala, India. nbrrkply@gmail.com
This study examined oral cancer in a cohort of 78 140 women aged 30-84 years in Karunagappally, Kerala, India, on whom baseline information was collected on lifestyle, including tobacco chewing, and sociodemographic factors during the period 1990-1997. By the end of 2005, 92 oral cancer cases were identified by the Karunagappally Cancer Registry. Poisson regression analysis of grouped data, taking into account age and income, showed that oral cancer incidence was strongly related to daily frequency of tobacco chewing (P<0.001) and was increased 9.2-fold among women chewing tobacco 10 times or more a day. The risk increased with the duration of tobacco chewing during the first 20 years of tobacco chewing. Age at starting tobacco chewing was not significantly related to oral cancer risk. This is the first cohort study of oral cancer in relation to tobacco chewing among women.

Smokeless tobacco use among adult patients

J Oral Pathol Med. 2009 May;38(5):416-21.

Smokeless tobacco use among adult patients who visited family practice clinics in Karachi, Pakistan.

Department of Family Medicine, Aga Khan University, Karachi, Pakistan.
BACKGROUND: Use of smokeless tobacco (SLT) is significantly associated with poor oral health and cancers. The objectives of this study were to estimate the proportion of use and the knowledge about SLT in relation to oral cancer and its differentials by socio-demographic and patient's diagnostic categories. This study also aimed to assess the SLT user's attitude and practices for its use. METHODS: In a cross-sectional study, 502 adult patients (> or =15 years) were randomly interviewed in family practice clinics in Karachi, Pakistan. SLT use was considered as usage of any of the following: betel quid (paan) with tobacco, betel nuts with tobacco (gutkha), and snuff (naswar). RESULTS: Overall, 52.4% subjects had used SLT at least in one form. More males were using SLT than females (P = 0.03). Similarly, higher proportion of patients with gastro-intestinal diseases were using SLT compared with other diagnostic categories (P = 0.004). Knowledge about the oral carcinogenic effect of SLT was higher among men and those who had schooling of >10 years (P < 0.001). This knowledge was also higher in patients with non-communicable and infectious diseases. Among SLT users, 31.3% tried to quit this habit but failed. The majority of users started using SLT before the age of 15 years; 40.2% and 30.8% started after being inspired by media advertisements and friends/peer pressure, respectively. CONCLUSIONS: In this study, over half of the patients were using SLT in various forms and had poor knowledge about its hazards. We suggest that there is a need for socially and culturally acceptable educational and behavioral interventions for control of SLT usage.

Khaini damages chromosomes

Asian Pac J Cancer Prev. 2009 Oct-Dec;10(4):715-6.

Khaini chewing damages chromosomes 2q, 3p and 21q: occurrence in a South Asian population.

International Centre for Tropical Oral Health, Poole Hospital NHS and Bournemouth University, England.
Chewing Khaini damages chromosomes, in the form of loss of heterozygosity (LOH), identified on the long arm of chromosome 2 (2q), the short arm of chromosome 3 (3p) and the long arm of chromosome 21 (21q) of oral cancer cases who had quid chewing habit of more than 10 years duration, and chewed 10-15 times a day.

Oral Cancer presentation at Borivali

Welcome to my presentation

I have a presentation at Borivali Medical Brother hood, Doctor house, TPS III, Borival West, Mumbai 400093.
The presentation is on oral cancer prevention and awareness, on 17th April 2010, from 3.00 pm to 5 pm.
All are welcome.
You can have a glimpse of this presentation at http://www.freewebs.com/oralcancer/
Dr Suwas Darvekar

Mental Function May Be Impaired By Smoking

Men and women with a history of alcohol abuse may not see long-term negative effects on their memory and thinking, but female smokers do, a new study suggests.

In a study of 287 men and women ages 31 to 60, researchers found that those with past alcohol-use disorders performed similarly on standard tests of cognitive function as those with no past drinking problems.

The findings were not as positive when it came to tobacco, however.

In general, women who had ever been addicted to smoking had lower scores on certain cognitive tests than their nonsmoking counterparts. The same pattern was not true of men, however, the researchers report in the March issue of the Journal of Studies on Alcohol and Drugs.

The reasons for the disparate findings on alcohol and smoking are not fully clear. Nor do they necessarily mean that serious alcohol problems would not affect long-term memory and other cognitive abilities; most study participants who had ever had drinking problems met the criteria for alcohol abuse rather than the more serious diagnosis of dependence.

Alcohol abuse was diagnosed when people reported one symptom of problem drinking -- drinking and driving, for instance, or failing to meet work or school obligations as a result of drinking. Dependence, on the other hand, required people to have at least three symptoms -- such as needing to drink more and more to achieve the same effects and experiencing physical withdrawal symptoms when they did not drink.

If more study participants had been alcohol dependent, the findings on cognition might have been different, says lead researcher Dr. Kristin Caspers, an assistant research scientist in the department of psychiatry at the University of Iowa in Iowa City.

But the bottom line, she says, is that people with a history of alcohol abuse appear not to be "doomed" to suffer cognitive effects when current levels of drinking are in the light to moderate range.

The findings are based on assessments of 115 men and 169 women with an average age of 43. Overall, 45 percent of men and 37 percent of women met the criteria for lifetime alcohol abuse, and 13 percent and nearly 4 percent, respectively, had a lifetime history of alcohol dependence. One quarter of women and 18 percent of men had a history of tobacco dependence.

Overall, women who reported having ever smoked 20 or more cigarettes a day scored lower than nonsmokers on tests of executive function -- that is, "higher-order" brain functions that include the ability to reason, plan and organize. The scores were, however, all within normal range.

As for why smoking was related to cognitive scores only among women, it's possible that there is a role for estrogen, according to Caspers.

Animal research suggests that nicotine lowers blood estrogen levels and may inhibit the positive effects of the hormone on brain cells. Sixty percent of the women in the current study were between the ages of 40 and 54, when menopause usually occurs. In theory, nicotine may exacerbate any brain-cell effects of fluctuating estrogen levels in women as they age, the researchers speculate.

Caspers, K., Arndt, S. Yucuis, R., McKirgan, L., & Spinks, R. (March 2010). Effects of alcohol- and cigarette-use disorders on global and specific measures of cognition in middle-age adults. Journal of Studies on Alcohol and Drugs, 71 (2), 192-200.

Kristin Caspers, Ph.D.
Journal of Studies on Alcohol and Drugs

Thursday, March 11, 2010

Your Top 10 Tips for Quitting Smoking

Need Help Kicking the Habit? Beliefnet Members Share Advice

Your Top 10 Tips for Quitting Smoking
Smoking may be one of the most common bad habits, but it's also one of the hardest addictions to crack. You probably want to quit smoking, but there are a ton of obstacles in your way. Mommy2Christopher best sums up what has become your ultimate challenge: “I need to get my WANT bigger than my addiction.” But don’t fear; in this struggle, you are not alone. Whether you want new tricks to try or you're completely revamping your mindset, the members of Beliefnet’s
Fresh Air support group offer up their best methods for kicking the habit.

Look Yourself in the Eye

Your Top 10 Tips for Quitting Smoking
“Look in the mirror and say out loud, ‘I CAN be a nonsmoker!’ ‘I AM a nonsmoker!’ or, even better, ‘I LOVE being FREE of nicotine!’ Verbal and mental affirmations like these are most effective if you state them in the present tense and use strong, positive words…. While it won't give us long-term protection, this do-it-yourself technique can make the difference in a pinch.”

Recognize Your Role

Tips for Quitting Smoking
"Overcoming any addiction is a matter of taking full responsibility... Daily confronting, penetrating, understanding; and by that, resolving the attachment to the negative energy that is the affliction."

Stay in Control

Your Top 10 Tips for Quitting Smoking
"You have to be in a strong frame of mind...is this the best time to quit? Not that there's ever a best time, but some are better than others. If you want to anyway, you could keep reminding yourself that some things are out of your control right now, but smoking isn't. You can control it, it just takes practice."

Make a List

Your Top 10 Tips for Quitting Smoking
"Make a list of reasons to quit, and reasons to smoke. Do this over the course of a day or two, and meanwhile try to wait as long as possible between cigs, just so you get a good idea of why you smoke. Put this list away for a week or two, then look at it as if someone you love wrote it. Perhaps looking at the addiction from outside will help you understand that this is an addiction, and not just something fun to do."

Seek Help from Above

Your Top 10 Tips for Quitting Smoking
"Each time I wanted to smoke again, I turned to chewing gum and hard candies, keeping in mind possible weight gain. I also requested that Almighty God would remove this nasty habit."

Resist the Triggers

Your Top 10 Tips for Quitting Smoking
"Certain situations trigger an intense desire for just 'one more.' Visualizing myself in that situation, using a better way to cope, is helpful in preparing myself to face it the next time, without lighting up."

Swap Nicotine for Potassium

Your Top 10 Tips for Quitting Smoking
"Bananas can help people trying to give up smoking. The B6 and B12 they contain, as well as the potassium and magnesium, help the body recover from the effects of nicotine withdrawal. Stressed from trying to quit? Eat a banana! When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack."

Change Your Schedule

Your Top 10 Tips for Quitting Smoking
"I created blocks of time to not smoke... like, one upon awakening, one at work, one at lunch, one at day's end, etc. I began increasing the time between cigarettes. I finally got twenty-four hours without one and threw out all my cigarettes. I stayed away from smokers, and I told myself that no matter what, I would just not smoke for that day -- 'one day at a time.' One day became two days, and two days a week, etc."

Treat Yourself

Your Top 10 Tips for Quitting Smoking
"Any money I used for cigarettes I put in a jar marked 'Special Money Only for Mommy.' Now I get my feet done, and massages!"

Focus on the Big Picture

Your Top 10 Tips for Quitting Smoking
"When you have a cig crave, think of how much better you will be able to breathe. And how much better you smell. And how good food will taste when your taste buds start to work again.

Look at the 'when' and 'why' of your soon-to-be ex-smoking habit. Change your patterns."

Find More Support

Fresh Air Support Group Want to find more tips and share the strategies that worked for you? Join the
Fresh Air smoking support group on Beliefnet Community to trade stories and meet others who have struggled with similar issues.


10 Reasons I Quit Smoking

You're almost there. You want to quit. In fact, 80 percent of your brain is sure you can. But 20 percent insists that you can't. How do you make it over to the other side without falling SPLAT on your face?
Do this. Make a list. Of ten reasons you should quit.
Here's mine.
1. Smoking Made Me Sick
For real. Within a few minutes of inhaling a few cigarettes, my throat would start to tickle and my head would begin hurt. The day after a binge, I'd wake up with a nasty cold that kept me in bed when I had a million things to do.
Smoking shrinks your blood vessels, clogs up your lungs, and wears down your immune system. Your body is less able to fight off bacteria and viruses, so, yes, you get sick. And there's of course the lung cancer and increased chances of heart attack, stroke, and other serious health conditions.
2. My Husband Told Me I Smelled
He didn't issue an ultimatum: "It's either me or the lung rockets."
But he did, one night right after we had sex, say, "You smell like smoke. And it's not sexy." I could have, theoretically, told him to visit a place where there are no lemonade stands. But I knew he was just being honest with me, and that I needed to file that information in the "reasons I should quit" box.
3. I Wanted to Set a Good Example for My Kids
I got tired of hiding it from them. It was getting complicated. I rationalized that smoking in front of 11-month-old Katherine was okay because she would never remember it and she would be unable to tell on me. But three-year-old David could very well process it and file the picture (and definitely debrief the rest of the house on the white candy sticks). It was too much of a risk. One day I finally said to myself, "Self, if it's so important to hide this habit from my kids, shouldn't I quit?" And there was silence.
4. I Looked Stupid Lighting Up After a Run
You can picture it, right? Here I was working so hard on my wellness
program: eating lots of greens, loading up on Omega-3 fatty acids, trying to get adequate sleep, meditating, and of course exercising five times a week. So when I'd light up after a good run, you can imagine the stares. The snapshot was like a Sesame Street episode where you have to pick out one thing that doesn't belong in the picture. That one thing was the white stick.
5. It Sent the Wrong Message
A few months after college graduation, when I was working at my first job, my mom told me to dress for the position that I wanted... to send the subtle but effective messages whenever possible. Her wisdom translated to smoking breaks. By going out of the building for a few puffs with some co-workers, I was sending a very direct message, and not the right one. So much for the nice suit.
6. I Ran Out of Money
You've probably tallied it up, and it kills you, doesn't it? Knowing how much cash you are squandering for your fix? An average pack of cigs costs about $4.50 today. Let's say you smoke a pack a day. You're throwing out $135 a month, and $1620 a year. It's a bloody expensive habit. I started to see it as babysitting money. And then it hit me. I'd much rather get a sitter and go out to a nice dinner than to be a slave to the white sticks.
7. It Made Me Depressed
Given my delicate biochemistry, I need to avoid all foods, drinks, or chemicals that make me depressed. That's essentially why I eliminated booze from my life. It's a depressant: my hangovers involved more than a headache. Smoking cigarettes can also increase the chance of developing depression. By a whopping 41 percent, according to a new study from the University of Navarra in Spain and the Harvard School of Public Health. Researchers discovered there was a direct correlation between smoking and depression among the 8,556 participants.
8. It Was Bad for My Image
I realize I'm not the perfect poster girl for mental health, but I do like to practice what I preach. So if I'm writing about my addictions with a cigarette in one hand and a brandy in the other--all while dispensing smart advice on how you all can break free of your habits--I'm going to feel like a mongo hypocrite. And that creates stress, which is bad for my mental health. So, for as long as I'm in the business of writing mental health material, I need to keep a sort-of clean image.
9. It Looks Ugly
I will always remember the sight at this elegant wedding I attended of a gorgeous bride with a cigarette in her mouth. Take away the white stick, and she could have posed for the magazine of her choice. She was petite and exquisite. Add the lung rocket, and she looked, well, like she had just been dropped off on a motorcycle to her nuptial vows. It was just not a good look at all. Not in anyway. And I started to think to myself, "Yipes. Is that what I look like when I'm smoking?"
10. I Wanted to Be Free
All addictions enslave you. They place you on their schedule, and you have no say in the matter. If you miss your afternoon smoke break, you are a wreck by the evening. There is not much you can do. You grow irritable. You need your fix. NOW.
I don't like belonging to anyone. I like to make my own rules. When I want. How I want. So because of that, I had to bid adios to my inflexible friend, to the addiction that wouldn't let me determine what I did with my afternoon.
Originally published on Beyond Blue at Beliefnet.com. To read more of Therese, visit her blog, Beyond Blue at Beliefnet.com, or subscribe here. You may also find her at www.thereseborchard.com.

New Anti-Tobacco Ads Remind Smokers That They Can Heal

While most anti-smoking ads use graphic images to show the long-term effects of tobacco, few serve to remind people just how quickly the human body heals once it's weaned off cigarettes.
The Bloomberg administration just released a new set of ads aimed at doing just this.
Check out the ads below to see the city's latest attempt to stamp out smoking.
(WARNING: Some graphic images).
For detail follow this link http://www.huffingtonpost.com/2010/03/10/new-anti-tobacco-ads-remi_n_494076.html

From June 1, tobacco packs to carry scarier pictures

NEW DELHI: It's a picture that 98% people polled in seven states of India said will repulse tobacco users, in turn helping them to quit smoking or chewing tobacco.

A new pictorial warning will appear on every tobacco pack sold in India from June 1 and it sure isn't pretty.

The health ministry's latest notification, made on March 5, has chosen a gory picture of a rotting cancer-stricken mouth to appear on tobacco packs. In field tests in Orissa, Bihar, Arunachal Pradesh, Sikkim, Madhya Pradesh, Kerala and Andhra Pradesh by the Voluntary Health Association of India, 98% of the 734 people polled found the picture repulsive and perfect to help smokers quit.

The warning will cover 40% of the tobacco pack in all local languages with the message 'Tobacco Kills' and 'Tobacco Causes Cancer'.

Pictorial warning was enforced on May 31, 2009 after the intervention of the Supreme Court. However, the pictorial warnings notified then were very mild and therefore found ineffective. The rules mandate that the pictorial warnings should be rotated every 12 months.

"Pictures with shock value will make smokers quit. Earlier, warnings were feelgood. While one depicted a scorpion, the other two was an X-ray plate of a TB patient's chest and a photograph of a cigarette stub with a cross sign over it," a ministry official said.

Experts say mild pictorial warnings would defeat its purpose — to scare away smokers.

"The warnings can't be soft. It has to convey the ills of tobacco smoking and chewing," the official said.

According to researchers, smoking in India is more common among illiterate men than those who had at least completed primary education. Over 50% of tobacco deaths occur in illiterate men or women, with 80% of them residing in rural India. "Pictorial warning labels, that can convey risks of smoking to the large number of illiterate adults in India who smoke, might be a particularly effective strategy," the official said.

"International experience has taught us that warnings need to be big and scary and colourful. Only then do they catch the eye and deter people. In India, only 2% smokers quit," he added.

Presently, 9 lakh people, nearly 2,200 per day, die every year in India due to tobacco related diseases. About 250 million people in India use tobacco products like gutka, cigarettes and bidis. Over 16% are cigarette smokers and 44% smoke bidis. The health ministry estimates that 40% of India's health problems stem from tobacco use.

You can quit, at will

Will the Centre’s decision to make pictorial warning mandatory on cigarette packets have the desired impact on smokers? Probably not. Doctors say will power and motivation are the two pivotal requirements to quit smoking.

A smoker has to first make up his or her mind. Once this is done, there are many methods to help one kick the habit, including nicotine replacement therapy (NRT).

NRT involves use of a nicotine inhaler, nicotine gum, nicotine nasal spray or skin patches. These products are available over-the-counter. The therapy is known to reduce withdrawal symptoms like restlessness, craving and tension.


Psychiatry professor at Nimhans, Dr Pratima Murthy, says tobacco users who fail to give up the habit should seek medical consultation. The institute's Tobacco Association Clinic helps those addicted to cigarettes or other forms of tobacco. "It is not easy to quit because of the powerful nature of nicotine addiction. A combination of counselling, NRT and medication is necessary in most cases. It is recommended for three months," she said. The centre receives 350-400 persons every year. Of these, only 18-20% are able to quit. Many leave with reduced nicotine use, but most drop out early.


* Nicotine, in lesser doses, is given in different forms like gum or patches

* This gives the addict a kick similar to the one got from smoking

* It's a short-term solution and can be used for a couple of months; has side-effects

* Nicotine patches: Stuck to the skin and slowly release constant amount of nicotine into the blood

* Nicotine gum: Releases nicotine slowly into the mouth

* Nicotine nasal spray: Used like any other nasal spray

* Nicotine inhaler: It has a holder that contains nicotine; inhaler delivers a puff of nicotine vapour into mouth and throat


* "The therapy helps lessen nicotine withdrawal and the urge to smoke. When one inhales tobacco smoke, the nicotine moves quickly from the lungs to the bloodstream. Replacement products take longer"

-- Respiratory medicine consultant Dr Isaac Mathew

* "One can use NRT therapy products available in stores. Preferably, it should be taken under the supervison of a qualified doctor for controlled dosage and period of use. However, there is only 10-15% success rate"

-- Cardio-vascular surgeon Dr Ganesh Iyer


* Cold Turkey: one decides to stop smoking abruptly

* Gradual reduction in number of cigarettes


* Tobacco is the second major cause of death across the world

* One in ten tobacco deaths is due to brain death

* Five million people die due to tobacco-related diseases every year

* Smokers are thrre times more prone to lung cancer than non-smokers

* Smokers are three times prone to heart diseases than non-smokers

* Women smokers are five times more susceptible to lung cancer than men

Wednesday, March 10, 2010

Garbage disaster in Mira Bhayandar

The garbage menace of Mira Bhayandar has reached a menacing proportions and I am sure we are waiting for a major health disaster to happen for the same. The garbage is being burnt at every nook and corner and since most of the garbage contains plastic bags, it liberates a poisonous gas called as dioxin when burnt. Actually the residents of Mira Bhayandar are being poisoned by the very authorities who are supposed to take care of them.
It is high time that the Mira Bhayandar Municipal Corporations wakes up to this mammoth problem brewing in its own backyard

A permanent medical centre at Gholwad

While working on the camp, and getting feedback from the local people, I felt that the local tribal people would be benefited with something of a permanent nature there at Gholwad. We have the place, but lack finances to build one more structure. If this finances can be managed, we might have a permanent structure there and not only a dental clinic, a medical center, a free computer education center, and free education center for English and Mathematics for the tribal’s around. I have spoken with the sarpanch of 5 tribal villages and they feel it would be of immense help to all the tribals.

Monday, March 8, 2010

Camp on 7th March

A Camp was organized by Sangeeta Darvekar Charitable Trust and IDA Mumbai West Suburban Branch, at Gholwad on 7th of March 2010 from 10am to 1pm and following activities were conducted.
1.     A dental Awareness camp was conducted. Dr Shailendra Pathak President IDA Mumbai West suburban branch( IDA MWSB), Dr Durgesh Aroor Past Secretary IDAMWSB , Dr Suwas Darvekar Past President IDAMWSB, Dr Salgoankar, Dr Saumit Sampat, Dr Tejank Shinde, Dr Raman Gohil, Dr Yuvraj Shinde volunterred for Dental check up and awareness regarding brushing habits. Dr Yohanna and Dr Amarjit singh Marwah from Dahanu consented to do dental treatment almost free for the tribals. Almost 400 tribals were checked for dental problem and free sample tooth paste and tooth brush were distributed. The toothpaste and toothbrush were provided by Colgate.
2.     Dr Beena Tendulkar, an eminent advocate, spoke about problems of women and their solutions.
3.     Ms Manasi Chaudhari spoke with the women of the village and created awareness on Breast cancer and cervical cancer.
4.     Dr Suwas Darvekar conducted the oral cancer awareness part.
At the closing ceremony 5 sarpanch’s of the adjoining villages spoke and consented for further help for ongoing health check up program. Dr Suwas Darvekar thanked all the dignitaries from that area and concluded the function.
Dr Suwas Darvekar
P.S View the photos of the camp at http://picasaweb.google.co.in/sndarvekar/7thMarchCamp?authkey=Gv1sRgCKafydv06ayBUA&feat=directlink