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Health Campaign in India Uses “Too Graphic for TV” to Highlight Risks of Chewing Tobacco

Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”

(Delhi, India and New York, United States) – A group of health organizations including government, local, national and international NGOs such as Tata Memorial Hospital, World Lung Foundation, Indian Dental Association, Art of Living Foundation and Doctors For You today launched, a web site that graphically depicts the terrible consequences of chewing tobacco forms the centerpiece of a new public health campaign that will SMS more than 2 million Indians and use picture ads on social networking sites to drive them to a two-minute web video with images that were considered too graphic for TV.

Smokeless tobacco products such as Khaini, Pan, Gutkha and Pan Masala remain the main form of tobacco use and a leading cause of tobacco attributable disease in India.(1) As a result, India has the highest incidence of oral cancers in the world, accounting for one third of the global oral cancer burden. (2) builds on a successful anti-chewing TV and radio campaign in India from the Ministry of Health and Family Welfare’s (MOHFW) National Tobacco Control Program supported by World Lung Foundation and other partners. The campaign features patients at Tata Memorial Hospital in Mumbai, including a 24 year-old smokeless tobacco user, ‘Mukesh’, who died as a result of throat cancer caused by chewing tobacco. The year-long mass media campaign shows the physical harms of smokeless tobacco and urges chewers to quit. Many of the images captured at Tata Memorial Hospital that were too shocking to be included in the TV campaign are now being used on exposes the images the tobacco industry doesn’t want Indians to see,” said Sandra Mullin, Senior Vice President, Policy and Communications, World Lung Foundation. “Sometimes reality is too graphic for TV but new media allows us to appeal and interface directly with citizens. The campaign shows how young men and women suffer with gruesome oral cancers, some with windpipes or tongues removed.”

Mr. B.K. Prasad, Joint Secretary in the Ministry of Health and Family Welfare, Government of India said; “Chewing tobacco is a major health challenge to the country as it causes 80-90% of the oral cancers. We are more concerned because India shares the highest burden of oral cancer in the world. We have already launched an intensive prevention campaign against the use of tobacco especially chewing tobacco.”

Dr P.C. Gupta of Healis—Sekhsaria Institute for Public Health, in Mumbai added, “Every person who chews tobacco, as well as those considering smokeless tobacco use, must see this website to get a true picture of what they face in years to come. The shocking reality is that smokeless tobacco is highly addictive and contains many cancer- causing agents. Its effect on the soft tissue in the mouth and throat is so virulent that people can suffer cancerous lesions after only one or two years of chewing.”

The campaign is being promoted via social networking and through a number of eminent medical and advocacy organizations. Groups such as the Indian Dental Association, the Voluntary Health Association of India, Tata Memorial Hospital, the Art of Living Foundation, Doctors For You and Mouth Cancer Foundation are circulating details of the website to their own stakeholders. Advocates have also worked with World Lung Foundation on outdoor billboards in New Delhi to call attention to the health consequences of smokeless tobacco and to support important legislation to ban smokeless tobacco.

The total economic cost of tobacco use in India has been estimated at $1.7 billion. Of this, the direct medical costs of treating tobacco related diseases amounted to $907 million for smoked tobacco and $285 million for smokeless tobacco. The indirect morbidity costs, including the cost of caregivers and the value of work lost due to illness, were estimated at US$398 million and US$104 million respectively for smoked and smokeless tobacco products.(3) Tobacco related treatment alone and associated costs have pushed 15 million people in India below the poverty line.(4)

Research has shown that mass media campaigns are one of the most effective means to encourage people to stop smoking. It is one of the World Health Organization’s M-P-O-W-E-R (W=Warn) strategies to reduce tobacco consumption. MPOWER strategies are endorsed and promoted by the Bloomberg Initiative to Reduce Tobacco Use, of which World Lung Foundation is a principal partner and CHD-MM is a grantee.

1. Parkin, D.M. et al. Global Cancer Statistics, 2002. CA: Cancer Journal for Clinicians, 2005, 55(2): 74-108. Retrieved from relevance&author1=parkin&fulltext=global+cancer+statistics&pubdate_year=2005&volume=&firstpage=
2. Gupta, P.C. et al. Oral Submucous fibrosis in India: A new epidemic? National Medical Journal of Cancer, 2001; 85(5):658-660.
3. John, R. Economic cost of tobacco Control in India, 2004. Tobacco Control. 2009: 18, 138-143.
4. John, R. et al. Counting 15 million more poor in India, thanks to tobacco. Tobacco Control. 2011. Feb 3. [Epub ahead of print]