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Shocking New Ad Featuring Oral Cancer Victim, Sunita, Creating Powerful Responses

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

(New Delhi, India and New York, United States ) – The powerful anti-tobacco mass media campaign entitled Sunita, which was launched in August by the Honorable Union Minister of Health, Dr. Harsh Vardhan, is now being broadcast to people across India. The 30-second Public Service Announcement (PSA) has been translated into 17 languages and will run for five weeks nationally on all government and private TV and radio channels through the National Tobacco Control Program (NTCP). The PSA commenced broadcast on radio and TV on 21st October. Viewers who watch the new ad say they experience fear, shock and concern at seeing the harm inflicted on Sunita and her family by smokeless tobacco (also referred to as “chewing tobacco”). Men and women who currently use smokeless tobacco express their intention to quit. World Lung Foundation (WLF) hopes that the ad campaign will reduce the prevalence of chewing (smokeless) tobacco, change the social acceptability of smokeless tobacco, and create greater public support for government regulation of chewing tobacco.

The campaign shows the personal testimony of Sunita Tomar, a 27-year old wife and mother who developed oral cancer after using smokeless tobacco. Sunita lives in a small town in Madhya Pradesh with her husband, a truck driver, her 12- and 13-year old sons, and her parents-in-law. The ad shows Sunita before and after an operation to remove a cancerous growth and part of her mouth. She describes how happy she was before tobacco took its terrible toll on her health and her appearance and how she never expected to develop oral cancer. The ad closes with a warning against using smokeless tobacco in various forms. This PSA was developed by the Ministry of Health and Family Welfare with technical assistance from WLF.

Reaction to the ad

Qualitative research to evaluate the impact of the campaign among the intended audience of smokeless tobacco users found that the overwhelming majority rated Sunita as highly effective as a tobacco control ad. Most viewers experienced concern and discomfort after viewing the PSA. While respondents feel emotionally connected with the family scene, the real life situation, grave hospital setting and jaw removal scenes reinforce the credibility and urgency of the PSA’s messages. Respondents also say the ad increases their intention to “quit tobacco” and “initiate discussion with others”.

Dr. Nandita Murukutla, Country Director, WLF says: “Based on the research, we are confident that people across India will relate to Sunita’s story and realise it could happen to them or to someone they love. The high impact scenes in the PSA can encourage smokeless tobacco users to quit and act as a deterrent to tobacco usage among non–users too. This is what we hope the campaign will achieve.”

The Ministry of Health and Family Welfare believes Sunita will be highly effective in warning children, youth and women about the health and economic impact of smokeless tobacco and in reducing the use of these deadly products. To reduce the deadly toll of smokeless tobacco use in India, Dr. Harsh Vardhan has urged the Chief Ministers of various states to pass the necessary order/notification under Regulation 2.3.4 of the Food Safety and Standards Act, 2006 to implement a ban on all forms of processed/flavoured/scented chewing tobacco, whether going by the name or in the form of gutka, zarda etc.

Smokeless Tobacco Prevalence in India

According to The Tobacco Atlas, 33 percent of men and 18 percent of women use smokeless tobacco in India – one of the highest levels of prevalence in the word. The Global Adult Tobacco Survey (GATS-India) identifies that 27.5 crore people use any form of tobacco in India. The use of smokeless tobacco is on the rise especially among women since it does not have the stigma of smoking attached to it. As more and more women take to chewing Gutkha, Khaini, Zarda & Mishri, serious health problems like cancer of the mouth & neck and still births are increasing at a rapid pace.

A 2004 study found that many students in India use tobacco products as dentifrice, in spite of a 1992 law banning the use of tobacco in toothpaste or tooth powder. This reflects a widespread misconception in India that tobacco is good for teeth and some manufacturers package and market their smokeless tobacco products as dental care products. Female tobacco users can be particularly susceptible to these messages; one study in an area of Kerala found that over 90 percent of female tobacco users started using tobacco because of tooth-related problems.

Dr. Pankaj Chaturvedi, a senior cancer surgeon from Tata Memorial Hospital, where Sunita was treated, added, “It is extremely disturbing to note that people have been misled by the tobacco industry to believe that smokeless tobacco can play a role in dental health. Sunita thought she was looking after her teeth, not harming her health, but there is no safe level of tobacco use. We are confident that this campaign will be instrumental in increasing awareness of the real harms of smokeless tobacco use and help to build support for a much-needed ban on smokeless tobacco products.”

Research has shown that mass media campaigns are one of the most effective means to encourage people to stop using tobacco. Hard-hitting campaigns can compel tobacco users to quit, increase knowledge of the health risks of tobacco use, and promote behavior change in both smokers and non-smokers. 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.