Wednesday, July 06, 2011

23 Cancer Specialists team up across 17 States against Tobacco

6th July, 2011:

I am a cancer surgeon. In order to save the lives of the victims of tobacco, I have to cut away their cheeks, jaws, tongues, voice boxes, foodpipes and glands, leaving them permanently disfigured and handicapped,” says Dr U S Vishal Rao, a Consultant Oncologist and Surgeon at Fortis Hospital, Bangalore. His blood boils because he sees these people as the victims of their own stupidity, and of the government’s refusal to ban tobacco.

Every week, Dr Vishal and his friend Dr Vikash Agarwal (currently at Kolkata’s Apollo cancer Institute) each examine 25-30 patients and perform 4-5 surgeries. Till date, they have each performed 200-250 surgeries. Another close friend, Dr Pankaj Chaturvedi who works at Mumbai’s Tata Memorial Hospital, handles 150-200 patients and does 10-15 surgeries per week, and has performed over 2000 surgeries over his career. If there is one thing that this trio of friends (see photos) agrees on, it is that over 50% of the cases of cancer that they treat are tobacco-related. And of all the tobacco-related cases, half are related to chewing tobacco i.e. gutka and its variants.

“The most disfiguring tumours of mouth, throat and chest are caused by chewing gutka. When Vikash and I were together at Tata Memorial Hospital in Mumbai, we would see hundreds of patients, waiting in long queues for a consultation, some lying on the streets with no accommodation after having travelled thousands of miles by train. And we would wonder why so much money was being spend on sophisticated cancer hospitals? Why didn’t the government just ban tobacco instead?” he asks angrily.

Cancer specialists throughout the country share their sentiment, and asking the same question. Nearly two dozen cancer specialists across 17 states have teamed up to change their state governments’ policies on tobacco. The cancer specialists who are part of this campaign are:

Outraged by what they have to deal with every day – the ravages of cancer caused by chewing gutka — prominent surgeons are now focusing on curing cancer before it strikes i.e. banning tobacco products.

POWERPOINT PRESENTATION – Tobacco through the eyes of Cancer Surgeons:

HIGH-RESOLUTION PHOTOS of Cancer patients:


1. Gutka i.e. chewable tobacco annually causes 2.5 lakh cases of cancer -- about half of all the tobacco-related cancer cases in the country, and about 25% of all cancer cases in the country.

2. Even after incurring treatment costs (including surgery) averaging Rs 3.5 lakh per head, many patients are left horribly disfigured for life.

3. Annual cost of treatment of 2.5 lakh gutka patients is approximately Rs 87.5 billion or Rs 8,750 crore. (Just for comparision, this is roughly three times the annual plan outlay of a state like Meghalaya.)

4. One third of India’s population -- about 27 crore persons of all ages -- are addicted to some form of tobacco consumption.

5. Cigarettes account for 13 percent, bidis account for about 37 percent and gutka accounts for 50 percent.

6. Over 21 percent of boys in the 10-14 age group smoke beedis or consume gutka.

7. Over 14 percent of girls in the 10-14 age group smoke beedis or consume gutka.

8. India has the highest incidence of mouth-cancer in the world – a clear correlation to the unique popularity of gutka in this country.

9. Of the 27 crore tobacco addicts in India, 9 crore suffer premature deaths due to various ailments, including cancer.

10. Even the lives of the 7 crore people whose livelihoods depend on the tobacco farming are affected by disease. Even those farmers and workers who abstain from consuming tobacco suffer Green Tobacco Sickness by continually inhaling dust and fumes from the leaves.

In the face of such clear statistics, why does the government allow the tobacco industry to do business and continue to spread poison in society? Isn’t it cynical to enable the private sector – tobacco sector and the medical sector -- to profit by inflicting addiction and chronic disease of the people of India?


The tobacco industry has a large number of supporters within the government. Three of them – Pranab Mukherjee, Jaipal Reddy and Kamal Nath – are on the Group of Ministers (GOM), which is supposed to implement steps to reduce tobacco consumption by issuing pictorial warnings on the packaging of cigarettes, gutkas etc. Naturally, they have been repeatedly diluting, delaying and sabotaging the implementation of the measures. Look at their credentials:

· PRANAB MUKHERJEE comes from Jangipur constituency in Murshidabad district, where almost every rural household is the occupation of bidi rolling.

· JAIPAL REDDY has been a lobbyist of tobacco farmers of Andhra Pradesh for about two decades.

· KAMAL NATH comes from Chhindwara constituency, where tendu leaves gathering is a big business.

Others outside the GOM are also distorting the government’s tobacco policy:

· ABHISHEK MANU SINGHVI, a Congress Rajya Sabha member, is known to be on the payroll of Gutka/Pan Masala industry.

· PRAFUL PATEL, who is not a part of the GOM, has nonetheless been influencing it from outside. He is known as ‘bidi king’ in Vidarbha, as his Rs 800 crore empire stands on tendu leaves and tobacco.

· ARUN JAITLY (BJP leader of opposition in Rajya sabha) frequently represents Indian Tobacco Company (ITC) in court as a lawyer. He is the lobby’s man in the opposition, and exercises considerable clout.


The 23 cancer specialists who are now part of this movement work in major cancer hospitals in 17 states of India. They, along with about 200 cancer patients afflicted by tobacco consumption, are part of the Voice Of Victims project, which aims to reach out to policy makers and the general public. See their website:

These surgeons are asking their state government: Why is this nation continuing to serve poison to millions of people, including school children, and then struggling to cure them? What is the point in our continuing to do these surgeries, if the government will not ban tobacco?

The surgeons consider their campaign as “preventive oncology”, as against curative oncology. So far, the results are promising. In the past two months, the Chief Ministers of eight states (Arunachal Pradesh, Chhattisgarh, Goa, Karnataka, Kerala, Madhya Pradesh, Rajasthan and Uttrakhand, Maharastra) have responded. Governors of three states (Karnataka, Bihar, Madhya Pradesh) have signed the pledge to take a strong action against tobacco.


Kerala: the Chief Minister has agreed to file an intervener in the gutka case in the Supreme Court asking for a ban on gutka. Kerala CM in his first Cabinet Meeting restricted the sale of tobacco products to 400 yards of educational institutes.

Karnataka: the Chief Minister and his Cabinet signed the Pledge to ban gutka. Note: the same Chief Minister had a few weeks back made widely quoted public statements about asking the Supreme Court to relax the ban on plastic gutka sachets as it was impacting areca nut and tobacco farmers!

Goa: In addition to signing the Pledge the CM is ready to help the group of cancer specialists with the Supreme Court case.

Chhattisgarh: the CM wrote asking for a ban and that his statement should be presented in Court.

Arunachal Pradesh: CM has asked for tax rates to be raised further.

Maharashtra: CM is going to give time in the Maharashtra Assembly for a talk on tobacco control.


Krishnaraj Rao

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