Understanding tobacco – going beyond cancer…

We call it one of the biggest enemies of mankind, because

  • Tobacco is the largest cause of preventable premature deaths across the world!
  •  10% of premature male deaths in age bracket of 30-44 yrs and 19% of premature male deaths in age bracket of 45-59 yrs are attributable to tobacco use!   (WHO Global Report, mortality attributable to tobacco, 2012)
  • On an average, tobacco smokers end up dying around 10 years earlier than non-smokers!

These premature deaths are very painful for the family members to accept; because a lot of active life years are lost and because these death were avoidable. Also, the person has to undergo pain and disability for a lot of months before death finally arrives…


Sounds impossible! But these statistics have been derived from large, authentic studies. Have a look at some of them:

  1. In a 20 yrs prospective study of over 1 million people, conducted by the American Cancer Society, in 1960s, tobacco alone was found responsible for:

30% of Cancer deaths

22% of deaths due to heart attacks

27% of deaths due to strokes and

72% of deaths due to COPDs (Chronic obstructive lung diseases).

Just imagine, the prevalence of cancers can decrease by 30% in 1 shot; if only mankind gave up its habit of using tobacco !

  1. After 1965, with increasing awareness about its dangers, its use has decreased significantly. But still as per 2004 statistics: In men,

    most oral cancers

    78% lung cancers

    16% heart attacks

    10% deaths due to brain strokes

    9% of TB deaths and

    49% of deaths due to COPDs (chronic obstructive pulmonary diseases – diseases resulting from damage to the internal structure of lungs)

    are attributable to tobacco! Infact 50% of premature heart attacks in males (age group 30-44yrs) are attributable to tobacco!

    -          WHO global report: mortality attributable to tobacoo. WHO, 2012.


  2.  According to a 50 year follow up study on British doctors, more than half of the long term tobacco smoking doctors (>50%) died earlier than their expected life span! On an average they lost 10 years compared to non-smokers. Those who died in middle life lost around 20 years.

  1. According to a huge study, which included 11 lakh homes from different parts of India,

  • Smoking is responsible for 20% male deaths and for 5% female deaths which occur prematurely between the ages of 30 and 69 years.
  • For men, the rate of premature deaths in smokers was 1.7 times that in nonsmokers of similar age, educational level and alcohol status. For women who smoked, the chances of a premature death got doubled
  • With increasing severity of smoking, the risk of premature death also increases. This dose response relationship is a strong proof of the causative association between smoking & deaths.

    Dose per day

    Relative risk of premature death

    1-7 bidis /day

    ≥ 8 bidis /day


  1. Dose per day

    Relative risk

    of premature death

    1-7cigarettes /day


     ≥8 cigarettes /day


    Oral Cancer: It is a rare cancer in western countries.However in India, because of our favourite habit of chewing tobacco & supari, it has become the most common cancer! India has become the oral cancer capital of the world; with 86% of the world’s cases recorded in our country! (Remember supari is also carcinogenic, not just tobacco.) Tobacco damages the genes. This leads to uncontrolled cell division, giving rise to various cancers.

  1. Besides oral and lung cancers, tobacco is responsible for a large proportion of cancers of upper respiratory tract, oesophagus, urinary bladder, kidney, pancreas, blood cells & stomach also.

  1. 50% of the heart attacks occurring in young males in the age group of 30-44years are just because of tobacco!

Alcohol and tobacco damage the inner lining of arteries, making them more prone for deposition of cholesterol, hardening and narrowing – a process called atherosclerosis. This ultimately results in the arteries getting blocked completely. When the artery to the heart is blocked and the heart muscle dies out, we call it a heart attack.

  1. Smoking damages the lungs badly. And then the damaged lungs easily catch various infections. Hence deaths from tuberculosis, pneumonia, etc. are common in smokers.

  1. Tobacco alone causes more than 10,00,000 deaths/ year in India! What is more disturbing is that 10% of these, i.e. 1,00,000 deaths are amongst innocent near & dear ones of smokers due to passive smoking!

You might be getting a question which I had got – If tobacco and alcohol are such big killers, how come we don’t know about it? This is because:

1. Our awareness about tobacco is limited to oral & lung cancer and our awareness about alcohol is limited to liver cirrhosis: Besides cancer, tobacco kills through many other diseases also; like COPDs (emphysema, bronchitis, etc.), heart attacks, brain strokes, TB, pneumonia, etc. It causes cancers of many organs like lung, mouth, oesophagus, stomach, kidney, liver, urinary bladder, cervix, blood, etc. What the mind doesn’t know, the eyes don’t see! Because we are not aware about all these causes, we dont realise the magnitude of deaths tobacco is causing. 

2. Because there is a lag period between the onset of regular smoking and the resulting death.Yes, It doesn’t kill immediately; but studies have proven beyond doubt that it kills for sure. And be it cancer, heart disease, stroke, or respiratory disease – its a slow painful death involving a lot of pain, disability and dependency.

3. Dead bodies cant speak: People who take alcohol & tobacco keep claiming for many years that they have not had any health consequences because of their addiction. However, after they get struck by a disease they don’t keep publicising their pain with equal enthusiasm and after they die their souls are not able to communicate with us what happened! Consequently, the damage done by these addictive poisons doesn’t come to our attention; unless we are working in a hospital.

Another interesting paradox about tobacco is that though it is regarded to be a minor addiction by most Indians, it is the most addictive and all other drugs!

According to values given in Stephen Stahl’s Textbook of Psychopharmacology, one of the most authoritative textbooks in Psychiatry, Out of every 100 people who touch addictive substances, percentage of people who get trapped in the addiction is as follows:


Percentage of people who get addicted on using it









Inspite of tobacco being the most addictive substance known to mankind and inspite of it killing so many people 47% adult males in our country take it!! Are they fools? I don’t think so. Its sheer lack of ignorance about what this addictive poison actually is; because of which people themselves give tobacco to their near & dear ones.

Is it not the duty of the educated class to take these facts to our less privileged brothers & sisters in India; and protect them from this addictive poison?

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