Adolescents
are the most vulnerable population to initiate tobacco use. It is now well
established that most of the adult users of tobacco start tobacco use in
childhood or adolescence. Tobacco use in children and adolescents is reaching
pandemic levels. The World Bank has reported that nearly 82,000–99,000 children
and adolescents all over the world begin smoking every day. About half of them
would continue to smoke to adulthood and half of the adult smokers are expected
to die prematurely due to smoking related diseases. If current smoking trends
continue, tobacco will kill nearly 250 million of today's children. The rise in
smoking and chewing habits among students are growing public health, education
and social concern Worldwide, especially in developing countries. Centre for
Disease Control and Prevention (CDC) in the United States (USA) has reported
that there is a significant increase in the percentage of high school students
that accounted prevalence of cigarette smoking raised from 27.5% in the year
1991 to 34.8% in 1999.
India is the second most populous
country in the world. It is a secular country but the Hindus form the majority.
Hinduism traditionally advocates abstinence from all intoxicants. Even then,
India is the third largest producer and consumer of tobacco in the world. The
country has a long history of tobacco use. Tobacco is used in a variety of ways
in India; its use has unfortunately been well recognized among the adolescents.
Tobacco addiction of a large number of adults has been initiated during the
adolescence. Recent studies in India demonstrated that use of tobacco among
school children is increasing distressingly. It is estimated that 5500
adolescents start using tobacco every day in India, about 4 million young
people under the age of 15 already are regularly using tobacco. Tobacco use is
the single avoidable cause of death and disability of the most important public
health issue in the present time. The World Health Organization (WHO) estimates
that in every 8 seconds somebody dies from a tobacco-related disease globally.
WHO described tobacco smoking as pandemic with an anticipated three million of
deaths per annum globally because of smoking. This figure is estimated to
ascend to 10 million by the year 2020 or early 2030, if the present trends of
smoking continue, seventy percent of these deaths will occur in the developing
countries. Tobacco use causes approximately one million deaths annually in
India, which is much than the collective mortality due to malaria, TB and
HIV/AIDS. The Tobacco Free Initiative of the World Health Organization (WHO) in
collaboration with Centers for Diseases Control, USA has undertaken the Global
Youth Tobacco Survey (GYTS). As per GYTS, 2009 in India, about 14.6% of 13-15
years school going children used tobacco. The habit usually starts in
adolescence and rapidly escalates thereafter. Due to high addiction potential
of nicotine, tobacco use leads to chronic dependence which requires treatment.
Only 5% of the world’s population is estimated to have access to treatment for
tobacco dependence. Existing tobacco cessation services in India, both in
public and private sector are grossly inadequate. Proper efforts to control the
addiction of smoking and chewing at early stage of life are lacking.
Considering
the enormous health complications associated with tobacco use, it is of utmost
importance to understand the factors leading to its use and to plan strategies
to reduce its intake. This is especially relevant for the developing countries
like India, where tobacco use continues to be common notwithstanding the
recognition of harmful consequences of its usage. This study reviews the
patterns of tobacco use in India, its prevalence in Indian adolescents, role of
psychosocial factors in initiation and prevention, and the steps taken by the
State to control its use.
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