.

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World No Tobacco day

Dr.Lalit Mohan SharmaSenior Cancer Specialist

MGUMST, Jaipur

Key facts- tobacco users

▪ Tobacco kills up to half of its users.

▪ Tobacco kills more than 8 million people each year. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.

▪ Over 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries.

▪ Safe Limit of Tobacco??

Global Burden

▪ Over 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries

▪ Burden of tobacco-related illness and death is heaviest

▪ Tobacco use contributes to poverty by diverting household spending from basic needs such as food and shelter to tobacco.

What are the ways to improve awareness in youth ▪ Individual

▪ Family

▪ Organization

▪ Government

▪ Social Media

Restriction of Tobacco use

▪ Family

▪ Environment

▪ Government

▪ Media

▪ Religious platforms

▪ Tobacco Addiction is Simply an addiction?

WHO 2020

▪ Stop tobacco industry exploitation of children and young people

▪ Every year the tobacco industry invests more than USD 9 billion to advertise its products. Increasingly, it is targeting young people with nicotine and tobacco products in a bid to replace the 8 million people that its products kill every year.

▪ This year’s WHO’s World No Tobacco Day campaign focuses on protecting children and young people from exploitation by the tobacco and related industry.

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Tobacco- Introduction

• About 25% of adults in most western societies

smoke.

• The prevalence rates in developing countries

are higher than this and are increasing.

• The prevalence of smoking varies according to

sex, social class, and ethnicity.

Introduction

• Tobacco use is the leading preventable cause of death

worldwide

• Approximately 6 million deaths related to tobacco use

occur each year, including 600,000 from second-hand

smoke

• By 2030, approximately 8 million persons will die each

year from tobacco use, and 80% of those persons will

reside in low- and middle-income countries

Tobacco Toll in India

❖ 700, 000 deaths per year due to

smoking

❖ 800, 000 to 900, 000 per year due

to all forms of tobacco use/

exposure

❖ Fastest trajectory of rise in tobacco

related deaths forecast for the next

20 years

❖ Many of the deaths (>50%) occur

below 50 years of age

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Death due to smoking

⚫50% of smokers will die of diseases related to smoking.

⚫25% of all death due to heart disease

⚫30% of all death due to cancer

⚫25% of all death due to stroke

⚫90% of all death due to lung cancer

⚫85% of all death due to COPD

1. RESPIRATORY AIRWAY DISEASES 10 - 20 X

2. LUNG CANCER 5 –30 X

3. THROAT CANCER 5 - 30 X

4. ORAL CANCER 3 - 15 X

5. ESOPHAGUS CANCER 4 - 5 X

6. CANCER OF PANCREAS 2 X

7. URINARY BLADDERCANCER 2 - 3 X

8. HEART DISEASE 2 - 3 X

9. KIDNEY CANCERS 1.5 X

Mortality risk among smoker Tobacco- Facts

• Fewer than 10% of lung cancer patients survive 5 yrs after diagnosis.

• Smokers (between 1 -14 cigarettes/day) have 8 times risk of dying

from lung cancer compared to non-smokers.

• Smokers (>25 cigarettes/day) have 25 times this risk compared to

non-smokers.

• Increased sperm abnormalities & impotence

• Smoking leads to an earlier menopause

• Average women smokers – early menopause

• Increased risk of osteoporosis, heart attacks

FactsIt has been estimated that an average of 14 minutes of

life is lost for each cigarette smoked

Tobacco users loose an average of 20-25 years of non-

tobacco life expectancy

In india one people die every 40 seconds because of

tobacco related problems

One third of all cancers in india are tobacco related

90% of oral cancers are due to tobacco use

50% of all cancers in man are due to tobacco use

25% of all cancers in woman are due to tobacco use

90% of lung cancer deaths are caused due to smoking

R.J. REYNOLDS:Lived and died from tobacco

“Founded the tobacco company in 1875, began manufacturing Camel cigarettes in 1913. He died in 1918, of cancer of the pancreas, after a lifetime of chewing tobacco -- ironically, the same product which established his fortune, and earlier, his father's, in the tobacco business. Studies have linked cancer of the pancreas to chewing tobacco. He married at age 53, and died at age 67, when his eldest son, R.J. Reynolds, Jr., was just 12. As a result, R.J. Jr. would never spend much time working in the tobacco business, nor would any of R.J. Jr.'s 6 sons.”

Source:

info@adbusters.org

SIGN OF THE TIMES: Patrick Reynolds, grandson of R.J. Reynolds, leading anti-smoking campaigner

Photo: Hara Photo.

Top Leading sites of Cancer – Mumbai 2001-2003

Males

Females

Forms of Tobacco Usage In IndiaTobacco is smoked – in Bidis, Cigarettes, Cigars, Cheroots,

Chuttas, Dhumti, Pipe, Hooklis, Chillum, Hookah

Tobacco is chewed – in Paan (betel quid) with

tobacco, Paan masala with tobacco

Tobacco is used – as snuff, ghutkas & Pan masala

20%

55%

25%

CIGARETTE

BIDI

CHEWING

TOBACCO,

PANMASALA

Effects of Smoking on the Body & Health

Copyright © 2010 Pearson Education, Inc.

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Bronchitis

1. Chronic bronchitis is a chronic inflammatory

condition in the lungs that causes the

respiratory passages to be swollen and

irritated, increases the mucus production

and may damage the lungs. The symptoms

are coughing and breathlessness, which will

get worse over the years.

2. The definition of chronic bronchitis is chronic

cough or mucus reproduction for at least

three months in two successive years when

other causes have been excluded

Emphysema

• Effects the alveoli (smallest structures of the

lung)

• The smokers cough weeken the walls of the

alveoli, therefore the lungs can not take in

enough oxygen which leads to breathlessness.

Cancer

• Increased risk of developing lung cancer

• Number of cigarettes smoked per day Annual

death rate per 100,000 men

• 10-14 (8 times that of non-smokers)

• 15-25 (13 times that of non-smokers)

• 25 or more25 (25 times that of non-smokers)

Lung Cancer: Smoking Facts

• Tobacco use is the leading cause of lung cancer

• 87% of lung cancers are related to smoking

• Risk related to:

– amount smoked (pack years- # cigs/day x # yrs)

– age of smoking onset

– product smoked (tar/nicotine content, filters)

– depth of inhalation

– gender

Lung Cancer

• Lung cancer kills more people than any other type of cancer and at least

80% of these deaths are caused by smoking. In 1999, 29,406 people in

England and Wales died of lung cancer.

• It is the tar in the `cigarettes which contain the carcinogenic “cancer causing” substances

• Not only are you susceptible to lung cancer, but also: mouth, throat,

stomach cancer. Cigarette tars contain some of the most carcinogenic

chemicals known to man. Consider this when watching people smoking

and exhaling only 10% of the tars they actually take in. Not only are these chemicals being painted into the lung, but smoker are also constantly

painting them up on their lips, tongue, larynx, swallowing some and thus

painting it in the esophagus and throughout the digestive tract. Smokers

have increased incidents of cancer in all of these exposed sites.

Heart Disease

• The role of smoking in Coronary Heart Disease

• Inhaling tobacco smoke causes several immediate responses within the heart and its blood vessels. Within one minute of starting to smoke, the heart rate begins to rise: it may increase by as much as 30 percent during the first 10 minutes of smoking.

• Nicotine raises blood pressure: blood vessels constrict which forces the heart to work harder to deliver oxygen to the rest of the body. Meanwhile,

• carbon monoxide in tobacco smoke exerts a negative effect on the heart by reducing the blood’s ability to carry oxygen.

Heart Disease

• Smoking tends to increase blood cholesterol

levels.

• Carbon monoxide attaches itself to haemoglobin (the oxygen-carrying pigment in red blood cells) much more easily than oxygen

does. This reduces the amount of oxygen available to the tissues. This again will put pressure on the heart!

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How Cigarette Smoking Damages Lungs ?

Copyright © 2010 Pearson Education, Inc.

Healthy Lungs

• You can see how the lung looks without the effects of inhalation of smoke.

• Note black specks throughout indicative of carbon deposits from pollution.

Lung after smoking

• Smokers lung with cancer. White area on top is the cancer, this is what killed the person. The blackened area is just the deposit of tars that all smokers paint into their lungs with every puff they take.

Smokeless tobaccoGutka chewing leading to oral cancer Gutka chewing leading to oral cancer

Tobacco chewing leading to oral cancer Tobacco chewing leading to oral cancer Tobacco chewing leading to oral cancer

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20 minutes:Blood pressure and pulse rate drops to normal;

8 hours:Oxygen level increases to normal & carbon monoxide

level drops in blood.

24 hours:Chance for a heart attack goes down.

48 hours:Ability to smell and taste improves; walking is becoming

easier.

2 weeks to 3 months:Blood circulation improves. No more cold hands and

cold feet. Lung function increased up to 30%.

Benefits Of Quitting Tobacco

1 month to 9 months:Coughing, sinus congestion and shortness of breath

have decreased dramatically. 1 year:

Risk of coronary heart disease is cut in half.5 years:

Risk of stroke reduced to that of a nonsmoker. Risk of cancers of the mouth, throat and esophagus cut in

half. Risk of lung cancer reduced in half.10 years:

Risk of dying from lung cancer is cut in half15 years:

Risk for coronary heart disease and stroke is the same as for a lifelong nonsmoker.

Benefits Of Quitting Tobacco

Tobacco Cessation

Resource Development Centre

Steps to quit-tobacco1. Deep Breathing

2. Drink lots of water and fluids

3. Stay away from alcohol, sugar and coffee and avoid fatty foods

4. After dinner, instead of a cigarette, treat yourself to a cup of mint tea or a peppermint

candy5. Go to a gym and jog around the block or park for to change your normal

routine.

6. Ask friends and family members not to smoke in your presence

7. On your quit day, hide all ashtrays and destroy all your cigarettes.

8. Write down ten good and bad things about being a nonsmoker and smoker.

WHO Framework Convention on Tobacco Control

• Industry's attempts to undermine the treaty continue on other fronts,

particularly with regard to countries' attempts to ban smoking in enclosed

public places and to ban tobacco advertising, promotion and sponsorship.

• Educate policy-makers and the general public about the tobacco industry's

nefarious and harmful tactics

• “The need to be alert to any efforts by the tobacco industry to undermine or

subvert tobacco control efforts and the need to be informed of activities of the

tobacco industry that have a negative impact on tobacco control efforts".

• Article 5.3 of the treaty states that "in setting and implementing their public

health policies with respect to tobacco control, Parties shall act to protect these

policies from commercial and other vested interests of the tobacco industry in

accordance with national law".

• Article 5.3 state that Parties are recommended to "raise awareness

about…tobacco industry interference with Parties' tobacco control policies".

Battle for Tobacco Control in India

- Activism and advocacy efforts by

civil society organization in India

- Strong role played by Indian

judiciary

- Role of media in building positive

public opinion on tobacco control

- Commitment by the Government

of India (Ministry of Health and

Family Welfare) towards effective

tobacco control efforts

- Support of well informed

Parliamentarians and Policy-

makers

- Tobacco industry’s continuous resistance to strong tobacco control laws or regulations

- Violation of regulations by the industry (e.g. ad ban)

- Economic issues related to tobacco production and tobacco control, distorted by the industry.

- Over emphasizing employment issues in connection with tobacco control

- Industry’s efforts to create fears of adverse impact of tobacco control on poor

Anti-Tobacco Influences Pro-Tobacco Influences

Land Mark Events – I

1970s to 2005

1975: Cigarettes (Regulation of Production, Supply and

Distribution) Act

1980: Central and State Governments imposed restrictions on

tobacco trade and initiated efforts for comprehensive

legislation for tobacco control

1990: Central Government issued directive for prohibiting smoking

in public places, banned tobacco advertisements on

National Radio and T.V. channels, advised State

Governments to discourage sale of tobacco around

educational institutions and mandated display of statutory

health warning on chewing tobacco products.

1991: Regional and National Consultations on “Tobacco or Health”

1991: Central Government directed the Central Board of Film

Certification to comply with the Cinematograph Act of 1952

Land Mark Events – II

1970s to 2005

1995: The Parliamentary Committee on Subordinate legislation of the Tenth

Lok Sabha examined the rules framed under Cigarette (Regulation of

Production, Supply and Distribution) Act, 1975 and made specific

suggestions for stronger provisions to achieve better results in tobacco

control

1995: Expert Committee on the economics of tobacco use constituted by the

Central Ministry of Health.

1999: High Court of Kerala announced ban on smoking in public places

1999: Ministry of Railways banned sale of cigarettes and beedis on railway

platforms and in trains

2000: Central Government banned tobacco advertisements on cable television

2001: Supreme Court of India mandated a ban on smoking in public places.

Land Mark Events – III

1970s to 2005

2001: Ministry of Railways imposed ban on sale of gutkha on railway station,

concourses, reservation centres and in trains

2001: The National Human Rights Commission of India (NHRC) convened a South-

East Asia Regional consultation on ‘Public Health and Human Rights”, and

advocated tobacco control as an essential measure to protect human rights.

2001-2003: Ban on Gutkha production and sale of gutkha and paan masala containing

tobacco or not containing tobacco in states of Tamil Nadu, Andhra Pradesh,

Maharashtra, Madhya Pradesh, Bihar and Goa using the provision of the

Prevention of Food Adulteration Act.

2003: The Cigarettes and other Tobacco Products (Prohibition of Advertisement and

Regulation of Trade and Commerce, Production, Supply and Distribution) Act,

2003

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Indian Law- At a Glance

Key Provision of cigarettes and other tobacco product Act,

2003

❖ Ban on smoking in public places (including indoor workplaces)

❖ Ban on direct and indirect advertising of tobacco products

- Point-of-sale advertising is permitted

❖ Ban on sales to minors

- Tobacco products cannot be sold to children <18 years

- Tobacco products cannot be sold within a radius of 100 yards of

educational institutions

❖ Pictorial health warnings

❖ English and one or more Indian languages to be used for

health warnings on tobacco packs

❖ Testing and Regulation: Ingredients to be declared on tobacco

product packages (Tar and Nicotine)

Implementation of Indian Law - I

❖ Prohibition of smoking in public places- mandates display of board containing the warning ”No Smoking Area-

Smoking Here is an Offence”

- Hotels & Restaurants should ensure:• physical segregation of smoking and non-smoking areas

• these areas should be labeled as ”Smoking Area/Non-smoking Area”

• proper location of smoking and non-smoking areas

❖ Prohibition of advertisement of cigarettes and other tobacco products- Point of sale advertisement not to exceed two boards

- This board should contain health warnings “Tobacco Kills or Tobacco Causes Cancer”

❖ Prohibition of Sale to Minors- Display board containing the warning “Sale of tobacco products to a

person under the age of 18 yrs is a punishable offence” to be put at point of sale

Rules Notified and Enforced from May 1, 2004

Implementation of Indian Law-II

Rules notified and enforced from December 1, 2004

❖ Prohibition on Sale of Cigarettes and other Tobacco

Products around Educational Institutions

• Board outside the premises to be displayed stating that sale of

cigarettes and other tobacco products in an area within a radius

of 100 yards of educational institution is strictly prohibited

• Distance of 100 yards shall be measured radically starting from

the outer limit of boundary wall or fence of the institution.

Proposed Indian Health Warning on Gutkha Pack Proposed Indian Health Warning on Cigarette Pack

Implementation challenges being faced

❖ Violation of Ad ban through:

- Surrogate methods (Red & White Bravery Awards-GPI)- Brand stretching (Wills Life Style Apparel-ITC)- Sponsorship of events (Formula 1 news in print media-

Marlboro)

❖ Violation of ban on smoking in public places due to:

- Lack of awareness among stakeholders (managers of restaurants, hotels etc.)

- Low compliance levels among the management of public places

- Low motivation at Health Ministries at State Level

❖ Violation of provision allowing point-of-sale advertisement

- Display board specifications being violated- Health warning area specified on this board has been

reduced by the industry

Other measures that need to be taken to

strengthen tobacco control

❖ Tax Net to be Uniform

- Current financial budget (2005-06) increased specific (excise) rate on cigarettes by about 10% and a surcharge of 10% ad valorem duties on other tobacco products (gutkha, chewing tobacco, snuff and pan masala)

- Bidis to be brought under similar tax regime to avoid cost influenced product choice by youth and poor

❖ Ban on Gutkha by Centre

- State governments to request the Centre to impose such a ban (as per Supreme Court judgment)

FCTC Implementation in India

❖ The Indian Act enactment preceded the adoption and enforcement of the

FCTC

❖ Indian Legislation needs to be upscale to comply with the provisions of

FCTC

- Tax and price measures to be implemented to reduce tobacco consumption

- Duty free sales to be tackled by Ministry of Finance

- Prohibiting use of misleading terms to label tobacco products

- Mobilize stakeholders, engage civil society to promote and strengthen

education, communication, training and public awareness on tobacco control

issues

- Promote effective measure for tobacco use cessation

- Elimination of all forms of illicit trade in tobacco products including smuggling,

illicit manufacturing and counterfeiting

- Sale to and by minors

- Curb cross-border advertising

- Promote economically viable alternatives for tobacco workers, growers and

individual sellers (as appropriate)

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Mouth cancer

Lung

Cancer

SVC Obstruction

Buerger’s

Disease

Peripheral

Vascular

Disease

May Cause Erectile dysfunction

abortion

Deformed fetus

Women who smoke has a 3

times probability of getting

spontaneous abortion and fetal anomalies

Premature delivery

Low birth weight

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Emphysema

Images of

Chronic Obstructive Airways Disease

Emphysema

Bronchiectasis

Normal Lung

Smoker’s lung specimen ANTI-TOBACCO PROGRAMMES

Steps to quit-tobacco

1. Deep Breathing

2. Drink lots of water and fluids

3. Stay away from alcohol, sugar and coffee and

avoid fatty foods

4. After dinner, instead of a cigarette, treat

yourself to a cup of mint tea or a peppermintcandy

Resource Development Centre

5. Go to a gym and jog around the block or park

for to change your normal routine.

6. Ask friends and family members not to smoke

in your presence.

7. On your quit day, hide all ashtrays and destroy

all your cigarettes.

8. Write down ten good and bad things about being

a nonsmoker and smoker.

Resource Development Centre

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If you won’t

give up smoking

for your lungs, heart or throat,

maybe you’ll

do it for

your penis.

Smoking is addictive, so once you start it can be very difficult to give up.

Click on the icons to find out some of the consequences.

Smoking may cause your arteries to clog up which stops the oxygen in your blood reaching your heart properly.

This can seriously damage your heart or may even cause a heart attack.

Smoking makes your breath smelly.

Smoking turns your teeth yellow by leaving sticky tar deposits which can also cause brown stains.

Just look at what could happen to your teeth!

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Smoking makes your heart beat faster and makes you short of breath – If you enjoy sports then smoking will spoil your chances of performing well.

Smoking may cause lung diseases which can have a serious effect on your health.

End

Ramgopal- 46 yrs heavy

smoker x 25 yrs

Government Initiatives towards Tobacco Control Laws

• Cigarette Act 1975 – statutory health warning, – “Cigarette smoking is injurious to health”

• No Tobacco Day (31st May) since 1988

• Prevention of Food Adulteration Rules (1955) in 1990 - every package and advertisement of smokeless tobacco product should have a warning stating that “chewing of tobacco is injurious to health”.

• Prevention and Control of Pollution Act - included smoking in the definition of air pollution

• Motor Vehicles Act of 1988 - illegal to smoke in a public vehicle

• Cables Television Network Amendment Act of 2000- prohibited the transmission of tobacco commercials on cable TV across the country.

Tobacco Control Policy

• Smoke-free environments: India has a national ban on smoking in indoor workplaces and public places. Hotels with more than 30 rooms, and restaurants and bars with a seating capacity of over 30 people are allowed to have designated smoking rooms. Enforcement and compliance levels vary by state and city.

• Advertising, promotion and sponsorship: India bans tobacco promotion, sponsorship and most forms of advertising.

• Warning labels: In March 2010, the government approved a new pictorial warning label.

• Tobacco taxes

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THANK YOU

• GIANTS

• COMRADES

• HEROES

• FRIENDS

IT IS A PREVENTABLE TRAGEDY

Changing Life Style Rs.10,000 Question

True or false: Tobacco is good for health….

True False

Different forms of tobacco

Smoking cigarettes/cigars cannot cause:

Lung

Cancer

Low

birth

weight

babies

Stroke Diabetes

Rs.20,000 Question

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Most people start Habit of Smoking at what age?

15-20

Years

20-30

Years

30-40

Years

10-15

Years

Rs.50,000 Question Age of Start of Tobacco Habit in India

Age in yrs No. (%)

< 5 16 (7)

6 – 7 20 (9)

8 – 9 15 (7)

10 – 11 51 (23)

12 – 13 51 (23)

14 – 15 49 (22)

16 – 17 17 (8)

18 – 19 1 (1)

20 – 21 1 (1)

Who is responsible???;s viuk eqUuk rks ugha \ eqUuk rks vHkh NksVk gS !

1 Lac Question

A single cigar may contain as much tobacco as

1 Cigarette

½ Pack of Cigarettes

1 Pack of Cigarettes

10 Packs of Cigarettes

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2 LacsQuestion

Tobacco consumption has relation to educational status?

True False

Smoking is more common among the less educated

Source: Gajalakshmi and others, background paper

6 4 %

5 8 %

4 2 %

2 1 %

0 %

2 0 %

4 0 %

6 0 %

Il l i t e ra t e < 6 y e a rs 6 -1 2

y e a rs

> 1 2

y e a rs

L e n g th o f sc h o o l i n g

Sm

ok

ing p

revale

nc

e

5 lacsQuestion

Tobacco can lead to which of the following diseases?

Cancer

Heart Attack

Paralysis

All of the above

Smoking & Heart Disease

• 30% of all heart disease is caused by Smoking,

• Smoking is the single largest cause of

preventable heart disease

• Smokers have 70% greater chance of dying

from coronary artery disease than nonsmokersEmphysema

Chronic Obstructive Airways Disease

Peripheral Vascular

Disease

Decreased Blood Flow

10 LacsQuestion

True or false: Biri is less dangerous than cigarettes

True False

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• One will be murdered

• Six will die in road accident

• 250 will die in middle age from

tobacco related causes

For every 1000, 20 years old

smokers it is estimated that

12.5 lacsQuestion

Tobacco contains all of the following except:

Rat poison

Pesticides

Embalming fluid

Asbestos

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jsfM;ks,fDVo dEikmaMl ¼ijek.kq gfFk;kj½

25 LacsQuestion

True or False:

Children who live with smokers are more likely to develop asthma.

True False

Cigarette and cigar smoke is a trigger for asthma attacks in smokers and non-smokers who breathe in secondhand smoke.

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eas vkus ij Hkh chekfj;k¡ gks

ldrh gSA

▪ QsQMksa dk dSalj

▪ vLFkek

▪ cPpks esa xys] dku o ’okl ls

lEcfU/kr jksx

▪ cPps esa QsQM+s dh chekjh gksrh gSA

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Globally, it is estimated that about one third of adults are regularly exposed to second-hand

tobacco smoke

Smoking and Heart Disease

• Smoking ban in the work places & public places has

reduced the heart attack rates

• In the USA the number of heart attack admissions fell

by 40% during ban

• Stopping smoking reduces the risk of smoking related

cardiovascular disease by 50%within one year

Smoking decreases circulation

Smoking & Heart Attack Risk of Second Hand Smoke

• If a person spends 2 hrs with smoker, the non

smoker inhales equivalent of 4 cigarettes

• Nonsmoking women living with a smoker have

91% risk of heart disease & double the risk of

lung cancer

• For every eighth smoker who dies from smoking one

innocent bystander dies from secondhand smoke

50 LacsQuestion

How much time does it take for your blood pressure and pulse rate to decrease after smoking?

10 minutes

1 hour

20 minutes

Never

1 CroreQuestion

Which of the following animals can smoke cigarette?

Camel

Donkey

Dog

Snake

.

17

2 CroreQuestion

When you quit smoking, all of the following happen except:

Your sense of taste and

smell improve.

You lower your risk of cancers of the bladder,

kidney, pancreas and larynx.

You reduce your risk of gum disease

You can win the lottery

Why Do People Smoke?

❖Social pressure

❖Peer pressure

❖Significant other smokes

❖Susceptibility to advertising

❖90% of smokers knew that it was harmful

❖Underestimated risk of premature death

❖Men who smoked 25 cigarettes a day thought they had a 50% chance of

reaching 75 yrs but only have a 26% chance

❖Physical Dependence

❖Become dependent on nicotine❖Stimulates the brain so that eventually must have nicotine or it is a state of hypo

arousal

❖Smoking releases endorphins (opiate like chemical)

❖Women use it as an appetite suppressant

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detksj dkuwu O;oLFkk

tkx:drk dh deh ds dkj.k ;qok o efgyk,sa

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Hkkjr ds vkWadMs+

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feyh-xkze Vkj gksrk gSA

.

18

rEckdw dk ’kkSd + + +fdLrkas esa ekSr . . .

.

19

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gksrh gSA bu dfBukbZ;ksa dks nokb;ksa

vkSj euksfpfdRlk ¼lkbdksFkSjkih½ }kjk

de ;k lekIr fd;k tk ldrk gSA

D;k vki rEckdw NksMus ls Mjrs gS

◼ viuh rEckdw ds iz;ksx dh ek=k dk fjdkMZ j[ksa

◼ eq¶r dh rEckdw@flxjsV fn;s tkus ij uk djuk lh[ksa

◼ rEckdw o flxjsV dk lsou djus okyksa ds lEidZ ls cps

◼ vxj ryc yxs rks byk;ph] lkSaQ] VkWQh] pwbaxe] ihijehaV

;k ,d fxykl BaMk is; ysa ;k yEch YkEch lkal ysaA

D;k vki rEckdw NksMus ls Mjrs gS

End

Let us

break this

death

chain

QUIT SMOKING ONCE FOR ALL

❖ REDUCING TO 4 PER DAY

❖ OR

❖ EVEN ONE PER DAY WILL NOT HELP

❖ QUIT SMOKING FORTH WITH

.

20

◼ ,d xaHkhjrkiwoZd

iz;kl ls u'kk

NwV ldrk gSA

t:jr gS vkids ladYi dhDO NOT START

◼ Cigarettes, Beedi, Snuffing & Gutkha

◼ They are highly addictive

◼ Very difficult to stop

◼ SO PLEASE DO NOT START

◼ Please discourage your friends & family from

tobacco use

India – Mizoram

Global Youth Tobacco Survey (GYTS)

• The India – Mizoram GYTS was a school-based survey of students in standards 8-10, conducted in 2001. 2295 students participated

• 54% - Use any form of tobacco

• 23% - Smoke Cigarettes

• 32% - Use some other form of tobacco