*Smokeless tobacco is one of the major causes of cancer*

*It can also lead to heart diseases and other associated health issues over time*
*New Delhi, January 29, 2018:* According to the recent Global Adult Tobacco Survey India Report, 2017, one in every five Indian is hooked to smokeless tobacco (SLT). Among men, two most commonly used tobacco products are SLT, that is,*khaini* (8.5 crore) and *gutka* (5.1 crore). Amongst women, the three most commonly used are SLT, that is, betel quid (2 crore), oral
application (2 crore), and *khaini* (1.9 crore).

Use of SLT can cause oral precancerous lesions such as oral submucous fibrosis, which can put the user at risk of developing oral cancer. Apart from this it can predispose the user to other infections in the mouth and also heart disease. In India, the use of SLT remains the dominant cause of tobacco-attributable diseases, including cancer of the oral cavity (mouth), esophagus (food pipe) and pancreas. SLT not only causes adverse health effects but also accounts for a huge economic burden.

Speaking about this, *Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and **Immediate Past* *National President Indian Medical Association (IMA), *said “Any form of tobacco like snuff, chewing, and dipping varieties which are not burnt can be termed as smokeless. Sheesha is a form of fruit-flavored tobacco, which is roasted in a foil along with charcoal and passed into a small chamber of water through a glass-bottomed pipe. It is then inhaled slowly. Of late, there has been a drastic increase in the number of teenage sheesha users with the majority of them using it mainly as a form of recreation in groups. It is a common misconception that sheesha is less damaging to the body as compared to
cigarettes and hookahs since it is flavored and passed through water. However, the substance inhaled still contains nicotine and other carcinogens which can cause a lot of damage.”

SLT also contains sugar. Therefore, prolonged chewing of tobacco and inhalation of sheesha can adversely affect control of blood sugar levels in patients with diabetes. Adding further, *Dr Aggarwal, who is also the Vice President of Confederation of Medical Associations in Asia and Oceania*, said, “Use of SLT mixed with areca nut is a common practice in India and as stated in the beginning, betel quid and gutka, the two most commonly used forms of SLT have areca nut as a common ingredient. Areca nut itself is classified as a class one carcinogenic i.e. having cancer-causing properties, besides other
adverse health effects.”

Here are some ways in which one can quit this habit.
– Try short-acting nicotine replacement therapies such as nicotine gum,  lozenges, nasal sprays, or inhalers. These can help overcome intense cravings.

– Identify the trigger situation, which makes you smoke. Have a plan in place to avoid these or get through them alternatively.

– Chew on sugarless gum or hard candy, or munch raw carrots, celery, nuts or sunflower seeds instead of tobacco.

– Get physically active. Short bursts of physical activity such as running up and down the stairs a few times can make a tobacco craving go away.