World No Tobacco Day 2003

May 31st has been designated "World No Tobacco Day" by the World Health Organisation (WHO). This year's theme was the role of film, fashion and media in tobacco control. CPAA organised 11 ENT camps at various sites in Mumbai, screening individuals for early signs of oral cancer due to tobacco abuse. On May 31st a panel discussion and fashion show were held in which numerous celebrities participated. This report has been written by Sindhu Nair, CPAA volunteer.

Report on Camps: Oral cancer, the cancer of the mouth, lip, tongue and pharynx (the part of the throat at the back of the mouth, including the back of the tongue, the soft palate, tonsils and back of the throat), is the sixth most frequent cancer in the world. Other than age, the major risk factors for oral cancers are the use of tobacco products including cigarettes and chewing tobacco. Early detection of oral cancer is important because treatment is most effective before the disease has spread. Early warning signs include difficulty in chewing, swallowing, or moving the jaw or tongue, a sore that does not heal, a white or red patch (leukoplakia and erythroplakia), a lump or thickening in the cheek or a numbness of any area in the mouth, soreness or difficulty in swallowing. India has one of the highest rates of oral cancer in the world. Tobacco-related cancers account for about 50 per cent of all cancers among men and 25 per cent among women. Oral cancer accounts for one-third of the total cancer cases, with 90 per cent of the patients being tobacco-chewers.

India is one of the largest producers of tobacco in the world, which is one of the reasons for its widespread use, along with the centuries-old socially accepted customs of abuse in many forms-betel leaf (pan), tobacco (tambaku), betel nut (supari), gutkha, snuff (tapkeri), masheri and tobacco toothpaste as well as bidies and cigarettes. And many of the ingredients are carcinogenic. Chewing tobacco is more addictive than smoking cigarettes as it contains higher levels of nicotine.

Each year, tobacco causes 4.9 million deaths worldwide, or about 13,500 deaths per day. One million of these deaths occur in developing countries. By 2020, it is predicted that tobacco will become the leading cause of death and disability, killing more than 10 million people annually, thus causing more deaths worldwide than HIV, tuberculosis, maternal mortality, motor vehicle accidents, suicide, and homicide combined and the largest increase will be in developing countries. To counter this scourge, CPAA follows a three-pronged strategy of prevention and early detection, treatment and rehabilitation. As a part of WNTD 2003, cancer detection camps, consisting of a free check up with regular follow ups were held across the length and breath of Mumbai with a dedicated team from CPAA along with doctors and volunteers from the Rotaract Club of South Mumbai.

The signal's RED-Traffic Police Headquarters:

A monotonous, boring job, ongoing pollution, erratic meals, cars smoking fumes the whole day, night shifts, being alone in the midst of crowds makes the policemen reach for tobacco to keep their mind numb. Shockingly, awareness of dangers of oral cancer and its severity was found to be minimal.

On the right track-Dadar Railway Station:

'Its the way we all relax in between work and afterwards too.' A majority of the individuals from the National Railways Mazdoor Union (NRMU) caught on to tobacco at their work. They appeared to be enthusiastic about knocking off their habits, which included tobacco, masheri and bidis. 100 people underwent checkup and 70 were advised follow up.

Laying the foundation-Kalina school camp:

The camp had been organised for Indian Airlines employees. But people in the vicinity and even invitees at a wedding lunch made use of the opportunity to got themselves checked. Women were largely unaware that tobacco leads to oral cancer and were found to be addicted to masheri. Some actually thought that tobacco strengthens gums.72 people were screened, 29 required follow up.

Smoke no bar-behind the bars- Jail Camps:

They have access to tobacco, bidis and even charas. The younger prisoners (20 to 25 years) are aware of the ill effects of smoking and tobacco and that it causes cancer. They were anxious to check whether they had the dreaded disease. Older ones were not aware. The younger prisoners had caught the habit due to peer pressure, seeking an emotional support, a substitute for parental love. The older prisoners had been hooked on for a long time. 182 inmates were screened at Arthur Road Jail of whom 141 required follow up. A 51-year-old man was detected with cancer of the base of the tongue and is undergoing treatment at Tata Memorial Hospital.

A total of 1597 persons were screened and 799 were advised follow up during 11 camps held from 16th May to 29th May. One person was detected with cancer. A survey of tobacco habits showed that 24% each chew betal leaf and tobacco; 31% smoke cigarettes or bidis; 7% have pan masala or gutkha; 5% use masheri and 1% each use snuff and tobacco toothpaste.

Report on Activities on May 31st:

In India cancer registries have confirmed a high incidence of oral cancer due to widespread habits of tobacco chewing and smoking. There is intense promotion and marketing of these and newer forms of tobacco products. Currently, cigarettes, pan masala, zarda and gutkha account for about Rs. 170 crore of ad spend on TV and print, and Rs 70 crore on outdoor advertising for cigarettes alone. Recently, the Government of India has recently enacted the Tobacco Control Bill. Called the Cigarettes and Other Tobacco Products (Prohibition of Advertisement, Regulation of Trade and Commerce, Production, Supply and Distribution) Bill, 2003, it:
*Prohibits all forms of direct and indirect tobacco advertising
*Totally bans sponsorship of sport or cultural events by cigarette and other tobacco product companies
* Prohibits smoking in select public places and public conveyance
* Prohibits selling of tobacco products to persons below the age of 18

In a country where movies, cricket and music set trends and stars and sportsmen are role models, the Global Theme of 'Tobacco-free Films and Fashion' was especially relevant. CPAA took the first step-a commercial showcasing celebrities who have quit smoking-Shashi Kapoor, Urmila Matondkar and Vivek Oberoi. A series of press ads, hoardings simultaneously conveyed the same message.

On May 31st, the activities began with Union Minister for Health and family Welfare, Sushma Swaraj lighting the lamp with Director, WHO South East Asia Regional Office, Dr. Abdul Sattar Yoosuf; Maharashtra State Minister for Health, Digvijay Khanvilkar; film director, Mahesh Bhatt; film star, Shashi Kapoor; past Maharashtra Chief Secretary, B.G. Deshmukh; ex-Sheriff, Nana Chudasama and CPAA Chairman, Y. K. Sapru. Mrs. Swaraj gave a speech, which reflected her struggle against tobacco and liquor. She mentioned that while the Tobacco Control Bill would soon become a law, it could only actually be of use when people from all walks of life work in the same direction. She requested the support of media, film and film producers. She said that while, by banning tobacco, the government stands to lose Rs. 7,000 crores in revenue, it presently spends Rs. 13,000 crores every year on treatment of tobacco related cancers. She also said that this day should provide the focus to create a revolution.

Shashi Kapoor, Urmila Matondkar, Vivek Oberoi, Shaad Ali, Mahesh Mathai, Prasoon Joshi, Piyush Pandey and B. G. Deshmukh were felicitated followed by the screening of the new anti-tobacco films. The patients and staff of CPAA then presented a canvas to Mrs. Swaraj to convey their gratitude for the initiative she has taken in getting the anti-tobacco bill passed. This was followed by the release of 'Sahayata', a comprehensive directory of resources for the total management of cancer. The handbook is being printed in Marathi, English and Hindi and will provide information from accommodation to wigs relevant for cancer patients. Three cancer patients were presented with voice boxes.

The morning events went on to a panel discussion on the role of film, fashion, media and advertising in tobacco control moderated by Alka Kapadia and Shoba John of CPAA. Some of the points raised by various participants were:
Mahesh Bhatt was of the view that cinema was a reflection of society and changes must be made in the real world. Smoking is a personal choice and laws cannot force anybody to quit smoking. Vivek Oberoi was largely in agreement with him. He also felt that actors cannot take independent decisions not to smoke on screen. He personally supported the anti-tobacco movement by spreading the message 'I don't smoke in real life' and refusing to do cigarette and liquor ads. "Cigarettes give you a temporary high. What one should pursue are permanent highs such as love, passion and good deeds. I may be seen smoking on the screen, but I will never endorse smoking." Milind Soman, who is a smoker, has not only refused modeling roles for cigarette and liquor companies but also refuses to endorse the 'I am cool if I smoke' image in movies. He confessed, "Despite a strong will power and disciplined athletic background, cigarettes proved too addictive a drug for me." On being questioned on the role of TV in promoting tobacco, Peter Mukherjee was of the opinion that though TV showed only a fraction of what was being shown by films, they were blamed more. He mentioned that Star TV was currently airing the CPAA ads free. He suggested showing a message 'Supporting No Tobacco Usage' before movies having tobacco related scenes. Sushma Swaraj retorted that not just main line tobacco and liquor advertising but surrogate advertising, like Wills Lifestyle, must be stopped and a new wave of smoke and alcohol free films ushered in. Mahesh Bhatt then raised the point that there were other social evils also being depicted in movies, so where should one draw the line? Prasoon Joshi, who came up with the idea behind CPAA's current anti-tobacco films, said that as advertising has glorified tobacco and alcohol, it is also capable of deglamorising it and was already doing so. Dr. Abdul Sattar was of the opinion that demand must be reduced as one doesn't have much say in controlling supply in a democratic economy. Mr. Y.K. Sapru concluded the discussion by saying that while personal intentions are a beginning, what is needed is for these intentions to converge into a movement. The discussion ended with Vivek Oberoi announcing that he had agreed to be Brand Ambassador for CPAA.

In the evening, 60 eminent representatives of media, film, fashion, WHO, Ministry of Health and Family Welfare, CPAA and a large section of Mumbai glitterati assembled at the Taj President to watch a unique fashion show. They represented the soul of Aamchi Mumbai and they came together to Say No to Tobacco. The collections of Shaina NC, Neeta Lulla, Sabyasachi Mukherjee and Wendell Rodriques was choreographed by Hemant Trivedi and compered by Mandira Bedi.

The show commenced with a display of Indian wear by Queen of Drapes Shaina NC, followed by Wendell Rodriques' Goa collection. Sabyasachi's Indian bridal wear collection then rolled in and the show ended with Neeta Lullas' award winning creations. Mandira Bedi asked the celebrities that walked the ramp about their opinions on smoking. Riya Sen said, 'Don't smoke, if you have to-chew gum.' Pradeep Guha 'It is not easy to give up smoking for yourself, so give it up for someone you care.' Alyque Padamsee 'I gave up smoking 20 years ago. Now I visit my friends who didn't every Sunday-at the graveyard.' Bharat Dhabolkar 'Kiss a non smoker and enjoy the difference.' Jackie Shroff 'Sadke marna hain to piyo.' Anil Dharkar made a humorous comment on his refusal to model for cigarettes in the past when lots of money was offered. And here he was modeling for anti smoking for no money!

Amidst lights and laughter the evening ended with a round of applause for all the personalities who had given of their valuable time. Nana Chudasama gave the vote of thanks to Sushma Swaraj on behalf of CPAA Founder Chairman Y.K. Sapru, Rekha Sapru and Alka Kapadia. WHO and the Ministry of Health and Family Welfare supported the entire programme.