(GATS) India 2009 – 10

2. (GATS) India 2009 – 10 • 26.6% population of Jammu & Kashmir is using tobacco product in one or the other of its form • J&K’s cigarette use prevalence (12%) is almost double the nationwide prevalence of 5.7%. • It has come to light that the highest proportion of adults (67.9%) exposed to tobacco smoke in offices are in J&K and the lowest (15.4%) are in Chandigarh. http://freepresskashmir.com/kashmir-tops-states-in-highest-number-of-smokers/

3. a survey • a survey on more than 1300 college-going students across the Valley at SKIMS few years ago • Nearly one third of college goers in Kashmir are tobacco users. • Thirty (30) percent of college students were found to have been consuming tobacco in its various forms forms like cigarettes, hookah, chewing tobacco, gutka and bidi.

5. Kashmiris have been living under constant stress since several years • as such, the probability of drug abuse and addiction are high.

6. Consequently, health hazards due to passive smoking are also more in J&K than elsewhere in the North.

7. Medical experts are worried • Medical experts are worried at the rate people are taking to smoking across Kashmir and subsequently the increase in number of cancer patients. • every month people puff cigarettes worth Rs 10 crore across Kashmir • .

8. Every cancer is related to smoking in one way or the other • It is surprising that like in developing countries, the trend to smoke is increasing day by day in Kashmir. In America it is decreasing,” • In Kashmir, on top of the chart, are esophagus and lung cancers which are mostly caused by smoking

9. kids as young as eight can be seen smoking on way to school or coaching centers • Smoking is a gateway to harder drugs.

10. Statistics by Regional Cancer Centre of SKIMS indicate • Around 27.4 per cent men studied in the survey are smokers. And 10.3 of the women were found addicted to smoking • that over 3000 women have registered in the institute with cancer in the past three years.

11. Although the survey shows men as the majority smokers, the percentage of women smokers is also quite high in the conservative Kashmir society. http://freepresskashmir.com/alongside-conflict-kashmiris-battle-smoking-cancer/

12. Teenage girls who smoke carry a higher risk of developing osteoporosis later in life, according to new research. • childhood passive smoke exposure may be a more significant cardiovascular risk factor for women than men -

13. reasons for the trend • easy availability of the tobacco products • peer pressure • percolation of media • and the use of cigarettes by role models like actors and actresses

14. The theme for World No Tobacco Day 2013 is • Ban tobacco advertising • promotion • and sponsorship

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17. safety and efficacy of e-cigarettes • consumers of e-cigarette products currently have no way of knowing whether e-cigarettes are safe for their intended use • how much nicotine or other potentially harmful chemicals are being inhaled during use • it is not known if e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death.

18. Hookah smoking is common in kashmir • in a 45-minute smoking session a typical smoker would inhale 1.7 times the nicotine of a single cigarette. • is generally believed to be innocuous because of the passage of the smoke through water before inhalation

19. Hookah in Kashmir has some peculiar features in having a direct contact of the live embers with the burning tobacco thus resulting in high temperatures that augments the production of carcinogenic products from tobacco burning.

20. water in the hookah base is not changed • Additionally water in the hookah base is not changed after every session that renders the water contaminated to a greater degree and thus a possible source of dissolved carcinogens.

21. second hand smoke • Children exposed to second hand smoke in early childhood are more likely to become physically aggressive and antisocial as adults, according to a new study.

24. Objective: • To determine the relationship of hookah smoking to lung cancer in Kashmir.

25. Background • : The literature about the causal relationship between lung cancer and tobacco smoking mostly concerns cigarettes.

26. Materials and Methods • : In a case control design, 251 cases of lung cancer and 500 age-matched controls were studied. • A predefined questionnaire was administered through a personal interview regarding various smoking and dietary patterns and the results compared through statistical analyses.

27. results • . Smokers had a 4.2 times risk of lung cancer compared to non smokers (p<0.0001). • There were 120 hookah smokers amongst the cases and 100 amongst the controls and hookah smokers were nearly six times at risk for lung cancer as compared to nonsmokers p< 0.0001). Cigarette smokers were commoner amongst cases (p=0.000). The severity of smoking was associated with a higher risk of lung cancer (Chi-square 72.09, p 0.000). • The practice of changing water of the hookah after each session proved non-existent.

28. all of our female smokers had a history of hookah smoking. • Hookah smoking has since the olden times been themajorform of smoking in Kashmir and is nearly the exclusive form of smoking in women

29. Conclusion: • Hookah smoking is associated with a significantly higher risk for lung cancer in Kashmiri population, with about 6 fold elevated risk as compared to non-smoking controls.

30. What can be done? • Higher tobacco taxes are the single most effective intervention to reduce smoking and smoking deaths worldwide • Prominent warning labels, advertising restrictions and cessation support also raise cessation rates

31. Whether it’s No Tobacco Day or not • any day is a good day to quit smoking • anything more serious than tobacco, such as drugs.

33. Thank you